scholarly journals Analgesic Efficacy of Nefopam as an Adjuvant in Patient-Controlled Analgesia for Acute Postoperative Pain After Laparoscopic Colorectal Cancer Surgery

2021 ◽  
Vol 10 (2) ◽  
pp. 270
Author(s):  
Eun Jung Oh ◽  
Woo Seog Sim ◽  
Won Gook Wi ◽  
Jeayoun Kim ◽  
Woo Jin Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Pain ◽  
Surgical Techniques ◽  
Analgesic Efficacy ◽  
Cancer Surgery ◽  
Patient Controlled Analgesia ◽  
Acute Postoperative Pain ◽  
Colorectal Cancer Surgery ◽  
Clinical Issue ◽  
Opioid Administration

Despite rapid advancements in laparoscopic surgical techniques and perioperative management, postoperative pain remains a significant clinical issue. We examined the analgesic efficacy of nefopam as an adjuvant in patient-controlled analgesia (PCA) for acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery. We retrospectively analyzed the medical records of 120 patients who did or did not receive 80 mg of nefopam as an adjuvant in fentanyl PCA; they were allocated to the nefopam (n = 60) or non-nefopam group (n = 60). The demographic, clinical, and anesthetic data, with data on pain severity and opioid administration at the postoperative anesthesia care unit (PACU) on postoperative days (PODs) 1, 3, and 5, were compared between the groups. The pain score and opioid administration did not differ at the PACU or on PODs 1, 3, or 5. The day of PCA discontinuation, time to pass flatus, length of the hospital stay, and incidence of nausea/vomiting, dizziness, and headache also did not differ between the groups. Fentanyl PCA with 80 mg of nefopam as an adjuvant did not have a superior analgesic effect after laparoscopic colorectal cancer surgery.

scholarly journals Evaluation of the Intraoperative Perfusion Index for Correlation with Acute Postoperative Pain in Patients Undergoing Laparoscopic Colorectal Cancer Surgery

2019 ◽  
Vol 8 (9) ◽  
pp. 1299
Author(s):  
Ji Hye Kwon ◽  
Hue Jung Park ◽  
Woo Seog Sim ◽  
Joo Hyun Park ◽  
Kang Ha Jung ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Pain ◽  
Diagnostic Value ◽  
Cancer Surgery ◽  
Perfusion Index ◽  
Acute Postoperative Pain ◽  
Colorectal Cancer Surgery ◽  
Clinical Issue ◽  
Index Change ◽  
Pain Scores

Despite technical advancements in the perioperative management of cancer surgery, postoperative pain remains a significant clinical issue. We examined the diagnostic value of the intraoperative perfusion index for predicting acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery. We retrospectively analyzed data for 105 patients who had undergone laparoscopic colorectal cancer surgery. Patients with pain scores <7 and ≥7 on a 10-point scale upon arrival in the postoperative anesthesia care unit (PACU) were categorized into the N and P groups, respectively. The perfusion index value was extracted prior to intubation, at the start and end of surgery, and after extubation. To minimize individual variance in the absolute value of the perfusion index, we calculated the perfusion index change ratio. A total of 98 patients were examined. Among them, 50 (51.0%) and 48 (49.0%) patients reported pain scores of <7 and ≥7 upon arrival at the PACU, respectively. Fentanyl consumption during the intraoperative and PACU periods was significantly higher in Group P than in Group N (p < 0.001). The perfusion index change ratios did not significantly differ between the groups. The intraoperative perfusion index change ratios do not correlate with acute postoperative pain following laparoscopic colorectal cancer surgery.

A patient-activated iontophoretic transdermal system for acute pain management with fentanyl hydrochloride: Overview and applications

2006 ◽  
Vol 2 (6) ◽  
pp. 314 ◽  
Author(s):  
Kevin T. Bain, PharmD, BCPS, CGP, FASCP
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Acute Pain ◽  
Medication Administration ◽  
Patient Controlled Analgesia ◽  
Acute Postoperative Pain ◽  
Acute Pain Management ◽  
Free System ◽  
Opioid Administration ◽  
Iontophoretic Transdermal System

Opioid administration by patient-controlled analgesia (PCA) is the standard therapy for acute postoperative pain. Despite its utility in this setting, limitations of this modality do exist. Consequently, noninvasive PCA systems, including an iontophoretic transdermal system (ITS) with fentanyl hydrochloride, are under development to circumvent many of these limitations. This preprogram med, self-contained, compact, needle-free system provides pain con trol superior to that of placebo and comparable to morphine PCA in the first 24 hours after major surgical procedures. The objectives of this article are to describe the method of transdermal iontophoretic medication administration and to review the literature pertaining to the fentanyl ITS.

Intrathecal Morphine in Postoperative Analgesia for Colorectal Cancer Surgery: A Retrospective Study

Pain Medicine ◽  
2020 ◽  
Author(s):  
Jamie Young ◽  
Alistair Macpherson ◽  
Arti Thakerar ◽  
Marliese Alexander
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Study ◽  
Intrathecal Morphine ◽  
Oral Morphine ◽  
Postoperative Pain Management ◽  
Cancer Surgery ◽  
Opioid Consumption ◽  
Nausea And Vomiting ◽  
Patient Controlled Analgesia ◽  
Colorectal Cancer Surgery

Abstract Background Colorectal cancer surgery is commonly performed with adequate analgesia essential for patient recovery. This study assessed the effectiveness of intrathecal morphine and patient-controlled analgesia (ITM + PCA) vs patient-controlled analgesia alone (PCA) for postoperative pain management in colorectal cancer surgery. Methods This retrospective study extracted and analyzed data covering a 4-year period (2014–2018) from a clinical database with 24- and 48-hour postsurgery follow-up. Primary outcomes included pain scores, median opioid consumption (oral morphine equivalence dose), sedation, nausea and vomiting, and length of admission. Outcomes were analyzed for ITM + PCA vs PCA alone, overall and stratified by laparotomy or laparoscopy procedures. Results In total, 283 patients were included: ITM + PCA (163) and PCA alone (120). Median opioid consumption in the first 24 hours for ITM + PCA vs PCA alone was lower for laparotomy (–32.7 mg, P&lt;0.001) and laparoscopy (–14.3 mg, P&lt;0.001). Median pain score (worst pain) within the first 24 hours for ITM + PCA vs PCA alone was similar for laparotomy (P&gt;0.05) and lower for laparoscopy (–1 unit, P=0.031). Sedation occurred less frequently for ITM + PCA vs PCA at 24 hours (3.5% vs 11.4%, P=0.031), with nonsignificant reduction at 48 hours (4.8% vs 18.8%, P=0.090) for laparotomy, but with no difference for laparoscopy (P&gt;0.05). Incidence of nausea and vomiting and length of admission were similar for ITM + PCA vs PCA alone for laparotomy or laparoscopy (P&gt;0.05). Conclusion This retrospective study demonstrated that ITM + PCA can achieve similar analgesic effects after laparotomy and laparoscopy colorectal cancer surgery compared with PCA alone while resulting in a reduction of oral opioid consumption and lower incidence of sedation.

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