EVALUATION OF ACUTE PAIN SYNDROME IN PATIENTS AFTER SEPTOPLASTY AND VARIOUS ANESTHETIC STRATEGIES

2021 ◽  
pp. 97-110
Author(s):  
I.K. Kalmykov ◽  
V.I. Torshin ◽  
N.V. Ermakova ◽  
A.N. Sinel'nikova ◽  
I.V. Kastyro
Keyword(s):  
Tranexamic Acid ◽  
General Anesthesia ◽  
Acute Pain ◽  
Rating Scale ◽  
Pain Syndrome ◽  
Numeric Rating Scale ◽  
Local Infiltration Anesthesia ◽  
Group 3 ◽  
Group 2 ◽  
Nasal Tamponade

The aim of the study was to evaluate acute pain syndrome in patients after septoplasty and various strategies of general anesthesia. Materials and Methods. All patients received local infiltration anesthesia with 2 % procaine solution. In group 1 (n=105), a 2 % solution of promedol and 60 mg of ketorolac were used as evening premedication; in group 2 (n=108), fentanyl, propofol, cisatracuria besylate, tranexamic acid, atropine and metoclopramide were used; in group 3 (n=78), atracuria besylate, sodium thiopental, nitrous oxide and halothane were used. In groups 2 and 3, 100 mg of ketoprofen was injected intramuscularly in the evening of the postsurgical day. Anterior tamponade was carried out with foam tampons. The tamponade was removed on the 2nd day in the groups 1 and 2, and in group 3 it was removed one day after the surgery. Pain syndrome was assessed in 1, 3, and 6 hours, 1 and 2 days after surgery using a visual analogue scale (VAS), a verbal “lightning” scale (VLS), and a numeric rating scale (NRS). Pain was also assessed 1 hour after tamponade removal. Results. At all stages of the examination (except Day 2), the pain syndrome was less pronounced in group 2. A day after surgery, the patients of group 3 had more severe pain if compared with those of other groups. Conclusion. During septoplasty, the least painful reaction is provoked by the general anesthesia scheme as used in group 3: fentanyl, propofol, cisatracuria besylate, tranexamic acid, atropine and metoclopramide. In case of nasal tamponade after septoplasty, the tampons should be removed on the 2nd day after surgery. Key words: septoplasty, anesthesia, analogue scales, pain. Цель исследования заключалась в оценке острого болевого синдрома у пациентов после септопластики при применении различных тактик общей анестезии. Материалы и методы. Ко всем пациентам применяли местную инфильтрационную анестезию 2 % раствором прокаина. В 1-й группе (105 чел.) использовали премедикацию 2 % раствором промедола и 60 мг кеторолака вечером, во 2-й группе (108 чел.) – фентанил, пропофол, цисатракурия безилат, транексамовую кислоту, атропин и метоклопрамид, в 3-й группе (78 чел.) – атракурия безилат, тиопентал натрия, закись азота и галотан. Во 2-й и 3-й группах вечером в день операции внутримышечно вводили 100 мг кетопрофена. Переднюю тампонаду осуществляли поролоновыми тампонами в резиновой перчатке. В 1-й и 2-й группах тампонаду удаляли на 2-й день, а в 3-й группе – через сутки после операции. Болевой синдром оценивали через 1, 3 и 6 ч, 1 и 2 сут после операции с помощью визуально-аналоговой шкалы, вербальной шкалы-«молнии», цифровой рейтинговой шкалы. После удаления тампонов боль оценивали через 1 ч. Результаты. На всех этапах обследования, кроме 2-го дня, болевой синдром был менее выражен во 2-й группе. Через сутки у пациентов 3-й группы боль была выше, чем в остальных. Выводы. При проведении септопластики наименьшую болевую реакцию провоцирует схема общей анестезии, примененная в 3-й группе: фентанил, пропофол, цисатракурия безилат, транексамовая кислота, атропин и метоклопрамид. В условиях тампонады носа после септопластики тампоны необходимо удалять на 2-й день после операции. Ключевые слова: септопластика, анестезия, аналоговые шкалы, боль.

Use of Tumescent Anesthesia in Surgical Excision of Gynecomastia

2021 ◽  
pp. 155335062110080
Author(s):  
Amitabh Mohan ◽  
Murtuza Rangwala ◽  
Nagamahendran Rajendran
Keyword(s):  
Tranexamic Acid ◽  
General Anesthesia ◽  
Rating Scale ◽  
Surgical Excision ◽  
Numeric Rating Scale ◽  
Tumescent Anesthesia ◽  
Stromal Tissue ◽  
Intraoperative Pain ◽  
Time Required ◽  
High Level

Background. Gynecomastia, benign enlargement of the male breast is the most common breast pathology amongst males. The most widely used modality of treatment is liposuction under general anesthesia. To date however there is no published study that specifically addresses to use tumescent anesthesia & use of tranexamic acid in it for excision of gynecomastia. Objective. To evaluate the efficacy of tumescent anesthesia in surgical excision of gynecomastia. Methods. A 4-year study with 100 patients of gynecomastia aged 14 to 47 years were enrolled with follow up for 3 months. All patients were given tumescence anesthesia in each breast comprising subcutaneous infiltration of 500 ml RL, 20 ml 0.5% bupivacaine, 30 ml 2% lignocaine, 1 mg adrenaline & 1 gm tranexamic acid. Breast tissue was excised in each breast by a single infraareolar incision & patients were assessed for intra-op pain and post-op pain by using numeric rating scale (NRS). Results. Bilateral presentation was there in 69 patients and 31 unilateral with 4 recurrent cases. Size of gland excised were 12-14 cms in 53 cases, 15-18 cms in 38 & 19-20 cms in 9 patients. Average surgical time required for each breast was 30 minutes. Intraoperative pain NRS-0 for 66, NRS-1 for 31 & NRS-5 for 03 patients. Postoperative pain for first eight hours was NRS-0 for 69 and NRS-1 for 31 patients. Conclusion. Tumescent anaesthesia for surgical excision of gynecomastia using a periareolar incision is a minimally invasive bloodless and painless technique in which ductal and stromal tissue can be removed resulting in a high level of patient satisfaction. In todays covid era it avoids the use of general anesthesia and electrocautery.

scholarly journals P030: Acute pain resolution after an emergency department visit: a 14-day trajectory analysis

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S73-S74
Author(s):  
R. Daoust ◽  
J. Paquet ◽  
A. Cournoyer ◽  
E. Piette ◽  
J. Morris ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Acute Pain ◽  
Linear Models ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
The Other ◽  
Future Research ◽  
Intensity Level ◽  
Opioid Prescription ◽  
Mild Pain

Introduction: The objective of the study was to evaluate the acute pain intensity evolution in ED discharged patients using Group-based trajectory modeling (GBTM). This method identified patient groups with similar profiles of change over time without assuming the existence of a particular pattern or number of groups. Methods: This was a prospective cohort study of ED patients aged ≥18 years with an acute pain condition (≤ 2 weeks) and discharged with an opioid prescription. Patients completed a 14-day diary assessing daily pain intensity level (0-10 numeric rating scale) and pain medication use. Results: Among the 372 included patients, six distinct post-ED pain intensity trajectories were identified: two started with severe levels of pain, one remained with severe pain intensity (12.6% of the sample) and the other ended with moderate pain intensity level (26.3%). Two other trajectories had severe initial pain, one decreased to mild pain (21.7%) and the other to no-pain (13.8%). Another trajectory had moderate initial pain which decreased to a mild level (15.9%) and the last one started with mild pain intensity and had no pain at the end of the 14-day (9.7%). The pain trajectory patterns were significantly associated with age, type of painful conditions, pain intensity at ED discharge, and with opioid consumption. Conclusion: Acute pain resolution following an ED visit seems to progress through six different trajectory patterns that are more informative than simple linear models and could be useful to adapt acute pain management in future research.

The Outcome of Pulsed Radiofrequency Treatment According to Electodiagnosis in Patients with Intractable Lumbosacral Radicular Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (9) ◽  
pp. 1697-1701
Author(s):  
Chan Hong Park ◽  
Sang Ho Lee
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Failed Back Surgery Syndrome ◽  
Radicular Pain ◽  
Spinal Nerve ◽  
Pulsed Radiofrequency ◽  
Pulsed Radiofrequency Treatment ◽  
Significant Difference ◽  
Failed Back Surgery ◽  
Group 2

AbstractBackgroundRadicular pain is related to lesions that either directly compromise the dorsal root ganglion (DRG) or indirectly compromise the spinal nerve and its roots by causing ischemia or inflammation of the axons.ObjectiveOur study aimed to assess the outcomes of pulsed readiofrequency treatment (PRF) according to electrodiagnosis results in patients with chronic intractable lumbosacral radicular pain.MethodsA total of 82 failed back surgery syndrome (FBSS) patients were included in this study. All of them underwent electromyography/nerve conduction studies before pulsed radiofrequency (PRF) treatment at the DRG, and they were classified according to the electrodiagnostic results as: group 1, no definite finding (normal); group 2, radiculopathy; and group 3, neuropathy. Pain intensity was assessed according to a numeric rating scale score and the Oswestry Disability Index (ODI) before treatment and at one, three, six, and 12 months after treatment, and successful treatment was defined as a pain score reduction of ≥50% at 12 months, as compared with the pretreatment score.ResultsPretreatment electrodiagnosis identified 28 patients with no definite findings, 31 patients with radiculopathy, and 23 patients with neuropathy. The patients with neuropathy had less pain relief after treatment than those with no definite findings and those with radiculopathy. The prevalence of pain reduction of at least 50% was lower in the neuropathy group than in the other groups. There was no statistically significant difference in ODI between group.ConclusionOutcomes after PRF at the DRG did not show strong differences according to electrodiagnostic findings in FBSS patients with chronic intractable lumbosacral radicular pain.

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

scholarly journals Efficacy of Analgesic Therapy after Hip and Knee Arthroplasty

2014 ◽  
Vol 21 (1) ◽  
pp. 57-60
Author(s):  
P. V Markov ◽  
G. A Pal’shin ◽  
A. N Komissarov
Keyword(s):  
Soft Tissue ◽  
Combined Therapy ◽  
Pain Syndrome ◽  
Tissue Edema ◽  
Complete Restoration ◽  
Hip And Knee Arthroplasty ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Knee And Hip Arthroplasty

Efficacy of pain syndrome drug therapy using aceclofenac in combination with tolperisone after total knee and hip arthroplasty was studied. Study included 100 patients. Patients from group 1 ( n =30) received ketorolac, from group 2 (n=35) - aceclofenac, from group 3 (n=35) - aceclofenac in combination with tolperisone, for 3 postoperative days in recommended doses. Severity of pain syndrome by VAS, range of motion, and dynamics of soft tissue edema was assessed. It was shown that combined therapy with aceclofenac and tolperisone was more effective in pain syndrome reduction, contributed to more marked regress of soft tissue edema and more complete restoration of movements as compared to monotherapy with nonsteroid anti- inflammatory drugs.

scholarly journals Impact of low-opioid anesthesia on the incidence of postoperative nausea and vomiting during laparoscopic kidney surgery

2021 ◽  
Vol 17 (2) ◽  
pp. 42-48
Author(s):  
T.V. Ovsiienko ◽  
M.V. Bondar ◽  
O.A. Loskutov
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Average Dose ◽  
Kidney Surgery ◽  
Entire Time ◽  
Group 3 ◽  
Group 2 ◽  
Total Average

Background. The problem of postoperative nausea and vomiting has attracted the attention of specialists in various fields of surgery and anesthesiology for a long time and has not lost its relevance today, being the subject of active discussion in domestic and foreign literature. It can become an independent cause of other quite serious postoperative complications. The article presents the results of our own study of the use of multimodal low-opioid general anesthesia as one of the methods for the prevention of postoperative nausea and vomiting during anesthetic provision of laparoscopic kidney surgery. Materials and methods. The study involved 50 patients who underwent laparoscopic kidney surgery. To compare the incidence of postoperative nausea and vomiting, patients were randomly divided into three groups. Group 1 (control group) used multimodal general anesthesia with standard doses of opioids; group 2 used multimodal low-opioid general anesthesia with lidocaine, and group 3 used multimodal low-opioid anesthesia with dexmedetomidine. Results. The total average dose of fentanyl used during the entire time of anesthesia in the control group was 373.3 ± 50.8 μg (4.34 μg/kg/h). The total average dose of fentanyl used during the entire time of anesthesia in group 2 was 217.39 ± ± 49.1 μg (1.76 μg/kg/h). The total average dose of fentanyl used during the entire time of anesthesia in group 3 was 308.33 ± ± 51.49 µg (2.44 µg/kg/h). In group 1, vomiting in the postoperative period occurred in 4 patients out of 15 (26.7 % of cases), in group 2 — in 4 patients out of 23 operated (17.4 % of cases), in group 3 — in 1 patient out of 12 (8.3 % of cases). Conclusions. As a result of comparing the incidence of postoperative nausea and vomiting in the patients of the studied groups, it was found that a decrease in the dose of perioperative use of opioids helps to reduce the incidence of this complication, increases the safety of anesthesia, significantly facilitates and accelerates the rehabilitation of patients after laparoscopic surgery on the kidneys.

scholarly journals Efficacy of Analgesic Therapy after Hip and Knee Arthroplasty

2014 ◽  
pp. 57-60
Author(s):  
P. V. Markov ◽  
G. A. Pal’Shin ◽  
A. N. Komissarov
Keyword(s):  
Soft Tissue ◽  
Combined Therapy ◽  
Pain Syndrome ◽  
Tissue Edema ◽  
Complete Restoration ◽  
Hip And Knee Arthroplasty ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Knee And Hip Arthroplasty

Efficacy of pain syndrome drug therapy using aceclofenac in combination with tolperisone after total knee and hip arthroplasty was studied. Study included 100 patients. Patients from group 1 ( n =30) received ketorolac, from group 2 (n=35) - aceclofenac, from group 3 (n=35) - aceclofenac in combination with tolperisone, for 3 postoperative days in recommended doses. Severity of pain syndrome by VAS, range of motion, and dynamics of soft tissue edema was assessed. It was shown that combined therapy with aceclofenac and tolperisone was more effective in pain syndrome reduction, contributed to more marked regress of soft tissue edema and more complete restoration of movements as compared to monotherapy with nonsteroid anti- inflammatory drugs.

scholarly journals Choice of surgical treatment for chronic composite hemorrhoid

2020 ◽  
Vol 39 (3) ◽  
pp. 27-31
Author(s):  
Oleg A. Litvinov ◽  
Evgeniy V. Zhitikhin ◽  
Igor G. Ignatovich ◽  
Hovannes A. Arutyunyan ◽  
Artur G. Arustamov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Rating Scale ◽  
Stage Iv ◽  
Pain Syndrome ◽  
Numeric Rating Scale ◽  
Early Postoperative Period ◽  
Control Group ◽  
Scientific Center ◽  
Cavernous Tissue ◽  
Numeric Rating

A comparative analysis of the treatment of 142 patients operated on chronic hemorrhoid stage IIIIV has been passed by way of assess the results of using new version of hemorrhoidectomy. The age of patients ranged from 27 to 80 (mean age was 50.46.7). 86 (60.6%) patients were diagnosed with stage III chronic hemorrhoid, at 56 (39.4%) patients the stage IV. For this study patients were divided into basic and controlled groups. The basic group consisted of 73 (51.4%) patients that have had hemorrhoidectomy using our modification. There were 69 (48.6%) patients in control group that have been operated by MilliganMorgan method in second modify of State Scientific Center of Proctology using bipolar coagulator LigaSure. The level of pain was assessed in the early postoperative period by numeric rating scale. The patients had been operated by our method mentioned that the pain syndrome was less pronounced (3.2 against 4.9 balls), that required less painkillers in the early postoperative period. In the case of doing semicircle cuts on the border of anocutaneous crinkle and bringing down mucous membrane, the significant excision of the cavernous tissue doesnt lead to contraction of the anal canal by that reduces the number of functional disorders after hemorrhoidectomy (4 figs, 1 table, bibliography: 7 refs).

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