PREOPERATIVE USE OF MICRO-FLAVONOID FRACTION (MMF) AS PART OF A MULTIMODAL ANALGESIA IN ANORECTAL SURGERY: PROSPECTIVE, RANDOMIZED, PLACEBO-CONTROLLED, DOUBLE-BLIND STUDY PROTOCOL

Aim: To assess the efficiency of the micro-flavonoid fraction (MMF) administration prior to anorectal surgery with spinal anesthesia on postoperative pain severity reduction.Methods: Patients of our clinic who meet the following inclusion criteria are included: they must be diagnosed with surgical treatment of anorectal diseases. All participants are randomly divided into 2 groups: the first one gets a tablet with 1000 mg MFF (Detralex®), the second one gets a tablet containing starch per os 14 days before surgery (72 participants per arm). Then patients of each group will continue MFF administration for 30 days after surgery. Patients of both arms receive spinal anesthesia and undergo surgery. Following the procedure the primary and secondary outcomes are evaluated: frequency of the opioid drugs intake, the severity of the postoperative pain syndrome, duration and frequency of other drugs intake, readmission rate, overall quality of life, time from the procedure to returning to work and the complications rate, C-reactive protein level.Discussion: the MFF intake allows reducing the severity of the hemorrhoidal disease symptoms during conservative treatment. In addition, the Detralex® efficacy has been proven in postoperative pain reduction for patients diagnosed with varicose veins of the lower extremities. We intend to evaluate the feasibility of the preoperative MFF administration for the postoperative pain reduction and the decrease of the postoperative complications in patients with hemorrhoidal disease.

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Preemptive Gabapentin vs Pregabalin for Acute Postoperative Pain in Women Undergoing Cesarean Section Under Spinal Anesthesia: A Prospective Randomized Double-blind Study

Indian Journal of Anaesthesia and Analgesia ◽

10.21088/ijaa.2349.8471.6519.52 ◽

2019 ◽

Vol 6 (5 (P-2)) ◽

pp. 1852-1856

Author(s):

Savita Gupta ◽

◽

Ankita Aggarwal ◽

Rashmi Sharma ◽

◽

...

Keyword(s):

Postoperative Pain ◽

Cesarean Section ◽

Spinal Anesthesia ◽

Blind Study ◽

Double Blind Study ◽

Acute Postoperative Pain ◽

Double Blind

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Combined pre-incisional oral dextromethorphan and epidural lidocaine for postoperative pain reduction and morphine sparing: a randomised double-blind study on day-surgery patients

Anaesthesia ◽

10.1046/j.1365-2044.2001.02088.x ◽

2001 ◽

Vol 56 (7) ◽

pp. 616-622 ◽

Cited By ~ 24

Author(s):

A. A. Weinbroum ◽

G. Lalayev ◽

T. Yashar ◽

R. Ben-Abraham ◽

D. Niv ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Reduction ◽

Day Surgery ◽

Blind Study ◽

Double Blind Study ◽

Double Blind

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PREEMPTIVE ANALGESIA IN ANORECTAL SURGERY: STUDY PROTOCOL FOR A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND TRIAL

Surgical Practice ◽

10.38181/2223-2427-2021-1-5-12 ◽

2021 ◽

pp. 5-12

Author(s):

T. N. Garmanova ◽

D. R. Markaryan ◽

E. A. Kazachenko ◽

A. M. Lukianov ◽

M. A. Agapov

Keyword(s):

Postoperative Pain ◽

Spinal Anesthesia ◽

Pain Control ◽

Opioid Analgesics ◽

Life Time ◽

Multimodal Analgesia ◽

Preemptive Analgesia ◽

Anorectal Surgery ◽

Double Blind ◽

Opioid Administration

Aim: To assess the efficiency of preemptive analgesia with Ketoprofen 10 mg 2 hours before procedure per os with spinal anesthesia to decrease postoperative pain and the amount of used analgesics.Methods: Patients of our clinic who meet the following inclusion criteria are included: they must be diagnosed with anorectal disease and planned anorectal procedure. After signing the consent all participants are randomly divided into 2 groups: the first one gets a tablet with 10 mg Ketoprofen, the second one gets a tablet containing starch per os 2 hours before surgery (72 participants per arm). Patients of both arms receive spinal anesthesia and undergo open hemorrhoidectomy. Following the procedure the primary and secondary outcomes are evaluated: opioid administration intake, the pain at rest and during defecation, duration and frequency of other analgesics intake, readmission rate, overall quality of life, time from the procedure to returning to work and the complications rate.Discussion: Multimodality pain management has been shown to improve pain control and decrease opioid intake in patients after anorectal surgery in several studies. Gabapentin can be considered as an alternative approach to pain control as NSAIDs have limitative adverse effects. Systemic admission of ketorolac with local anesthetics also showed significant efficacy in patients undergoing anorectal surgery. We hope to prove the efficacy of multimodal analgesia including preemptive one for patients undergoing anorectal procedure that will help to hold postoperative pain level no more than 3-4 points on VAS with minimal consumption of opioid analgesics.

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Comparison of the Effectiveness of Unimodal Opioid Analgesia with Multimodal Analgesia in the Management of Postoperative Pain in Patients Undergoing Surgery under Spinal Anesthesia-Double Blind Study

Journal of Anesthesia & Clinical Research ◽

10.4172/2155-6148.1000673 ◽

2016 ◽

Vol 7 (10) ◽

Cited By ~ 2

Author(s):

Madhu Mala ◽

Prabha Parthasarathy ◽

Raghavendra Rao

Keyword(s):

Postoperative Pain ◽

Spinal Anesthesia ◽

Multimodal Analgesia ◽

Blind Study ◽

Opioid Analgesia ◽

Double Blind Study ◽

Double Blind

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The effect of various occlusal reduction levels on postoperative pain in teeth with symptomatic apical periodontitis using computerized analysis: a prospective, randomized, double-blind study

Clinical Oral Investigations ◽

10.1007/s00784-016-1835-y ◽

2016 ◽

Vol 21 (3) ◽

pp. 857-863 ◽

Cited By ~ 9

Author(s):

Hakan Arslan ◽

Fatih Seckin ◽

Duygu Kurklu ◽

Ertugrul Karatas ◽

Nuran Yanikoglu ◽

...

Keyword(s):

Postoperative Pain ◽

Apical Periodontitis ◽

Blind Study ◽

Double Blind Study ◽

Double Blind ◽

Computerized Analysis

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A Comparison of Oral Gabapentin and Oral Pregabalin as Preemptive Analgesia for Orthopedic Surgery Under Spinal Anaesthesia

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0901.15 ◽

2021 ◽

Vol 9 (1) ◽

pp. 74-78

Author(s):

Neena Jain ◽

Rahul Bankapur ◽

Preeti Lamba ◽

saurav Singh

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Spinal Anesthesia ◽

Spinal Anaesthesia ◽

Orthopedic Surgery ◽

Lower Limb ◽

Analgesic Efficacy ◽

Double Blind Study ◽

Group A ◽

Group B

Background and Aims: Gabapentin and pregabalin, by decreasing noxious stimulus induced excitatory neurotransmitter release at central nervous system, may attenuate central sensitization and eventually decrease development of postoperative pain. We evaluated preemptive analgesic efficacy of single dose of oral gabapentin 600 mg and pregabalin 75mg for postoperative pain in patients undergoing lower limb orthopedic surgery under spinal anesthesia. Material and methods: A prospective, randomized, double blind study was conducted on 70 patients aged between 18 to 60 years with ASA grade 1 and 2 posted for lower limb surgeries under spinal anaesthesia. Patients were allocated into Group A and Group B receiving oral gabapentin(600mg) and oral pregabalin (75mg) respectively 1.5 hours before surgery. Primary objective was assessing duration and quality of analgesia by Visual Analogue Scale (VAS) score at 2,4,6,8,10,12,16,20 and 24 hours.Secondary objective was to assess total dose of rescue analgesic in first 24 hours, perioperative hemodynamic change and various side effects. Statistical Analysis used: Categorical data was compared using Chi- square test. Quantitative parametric data was analysed using unpaired student t-test. P value < 0.05 was considered statistically significant. Results: Mean duration of analgesia in Group A (10.53 ± 2.686 hours) was longer than Group B (7.943±3.199hr) (P = 0.0006).Mean number of analgesic dosesrequired in first 24 hourswere less in Group A (1.429 ± 0.5021) ascompared to Group B (1.771±0.6897) (P = 0.0202).All patients remained hemodynamically stable with no significant side effects noted in either group. Conclusion: We conclude that preemptive analgesic efficacy of oral gabapentin 600mg is better in comparison to oral pregabalin 75 mg for patients posted for lower limb orthopedic surgeries under spinal anesthesia.

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