scholarly journals Effect of topical bupivacaine on post-tonsillectomy pain relief in children

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Musa Kallamu Suleiman ◽  
Abdulkarim Aitek Abdullahi ◽  
Alhassan Datti Mohammed ◽  
Kufre Robert Iseh ◽  
Abdulrahman Aliyu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Intensity ◽  
Normal Saline ◽  
Pain Scale ◽  
Inclusion Criteria ◽  
Tonsillar Fossa ◽  
The Difference ◽  
Group B

Tonsillectomy is a common surgery performed in paediatric otorhinolaryngology and is usually accompanied by considerable postoperative pain. Earlier literature has shown the use of topical bupivacaine for post-tonsillectomy pain relief to be promising. This study was conducted to evaluate the efficacy of topical bupivacaine application on post-tonsillectomy pain relief. Fifty consenting patients scheduled for tonsillectomy that met the inclusion criteria were enrolled in the study and assigned into two groups of 25 patients each. Group B had their tonsillar fossa packed with 0.5% bupivacaine soaked gauze for 5 minutes while Group S had normal saline. Pain intensity was measured at 1, 2, 4, 12 and 24 hours postoperatively, using the Faces Pain Scale- Revised (FPS-R). Mean scores for groups B and S at 1, 2, 4, 8, 12, 24 hours were 1.96±1.17, 2.40±0.82, 2.8±1.0, 2.88±1.17, 3.08±0.99, and 3.04±1.02 and 3.36±1.38, 4.72±1.62, 3.92±1.35, 3.76±1.45, 4.00±1.41, 3.38±0.98 respectively. The difference was significant at 1 and 2 hours only (P≤0.05). Post-tonsillectomy pain was reduced in the first two hours by application of bupivacaine soaked gauze.

scholarly journals Comparison of two analgesic block techniques for circumcision: dorsal penile nerve block and caudal block

2020 ◽  
Vol 7 (2) ◽  
pp. 360
Author(s):  
Fatih Gokalp ◽  
Onur Karsli
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Scale ◽  
Caudal Block ◽  
Anesthetic Care ◽  
Dorsal Penile Nerve Block ◽  
Significant Difference ◽  
The Difference ◽  
Dorsal Penile Nerve ◽  
Analgesic Block

Background: Circumcision is most common and oldest surgery but also could be frightening for children because of postoperative pain. Authors aim to evaluate postoperative pain conditions of patients by using the visual pain scale (VPS).Methods: Between 2016 and 2018, 168 children undergone circumcision. The patients were splitted into three groups depend on their anesthetic care; the dorsal penile block (DPNB), caudal block (CB) and combine block.Results: The mean age were 95.3±20.9 (65-186) months. There was no significant difference between the CB and combine block in VPS at 1st, 3rd hours and second days (p=0.19, p=0.39 and p=0.9 respectively). The VPS significantly higher in the DPNB arm when compared with caudal and combine block arm at 1st and 3rd hours (p<0.01 and p<0.01 respectively) but there was no significant difference between the DPNB and caudal block at second days (p=0.9). There was no significant difference between groups for analgesic requirements (p=0.07). Incidences of nausea and vomiting were seen rarely especially in the DPNB arm and the difference was not statistically significant among the groups (p=0.9).Conclusions: CB and DPNB are effective techniques for pain relief following penile surgery. CB has superior to DPNB at 1st and 3rd hours but no difference at follow up. Both techniques are appropriate methods for postoperative pain relief. 

scholarly journals Effect of Nebulized Morphine vs. Intravenous Morphine in Decreased Pain in Renal Colic Patient

2020 ◽  
Author(s):  
Mehrnaz Nikouyeh ◽  
Mohammad ali Jafari nedoushan ◽  
Mahmood Vakili ◽  
Majid Hajimaghsoudi ◽  
Mehdi Bagherabadi ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Normal Saline ◽  
Renal Colic ◽  
Chi Square ◽  
Mean Intensity ◽  
Significant Difference ◽  
Intravenous Morphine ◽  
The Mean ◽  
The Difference

Introduction: Renal colic refers to one or more acute and painful short-term attacks due to the movement and excretion of kidney stones. The aim of this study was to determine the effect of intravenous morphine and inhaled morphine on pain relief in renal colic patients. Methods: This clinical trial study was performed on 50 patients of Shahid Sadoghi Hospital and Shahid Rahnemoon Hospital with renal colic symptoms who were randomly divided into two groups. The first group received 5 mg intravenous morphine and 5 cc normal saline (placebo) and the second group received 10 mg inhaled morphine and 5 cc normal saline. Severity of pain was assessed at the time of emergency and onset of Visual Analog Scale and then questionnaires were completed at 10, 20 and 30 minutes intervals.  The data through SPSS Inc., Chicago, IL; Version 16 and the Friedman, Mann-Whitney, and Chi-square tests were analyzed. Results: Our study showed the mean intensity of pain was 9.52±1.12 (nebulized) and 9.24±1.51 (intravenous) on admission without significant difference (p=0.46). After 10 minutes, mean pain intensity in both nebulized and intravenous groups was 7.76±1.3 and 6.68±2.03, respectively. There was a significant difference between the two groups (p=0.03). After 20 minutes, the mean pain intensity was 5.68±1.72 and 4.32±2.17, respectively, and the difference between the two groups was significant. After 30 minutes, the mean intensity of pain in two groups of nebulized and intravenous was 3.88±3.14 and 3.36±3.34, respectively. The difference between the two groups was not significant (p = 0.57).The mean pain intensity in the intravenous method was lower than the nebulized, but in the nebulized method it was showed a decreasing trend. Conclusion: Nebulized morphine relieves pain in the patients with renal colic, but pain relief is faster by intravenous morphine. Accordingly, this method is more preferred in renal colic patients.

scholarly journals A comparative study to assess the effect of intrathecal bupivacaine with morphine or butorphanol on post-operative pain relief following abdominal and vaginal hysterectomy

2014 ◽  
Vol 11 (3) ◽  
pp. 246-249
Author(s):  
SN Singh ◽  
A Subedi ◽  
JN Prasad ◽  
MC Regmi
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Urinary Retention ◽  
Normal Saline ◽  
Vaginal Hysterectomy ◽  
Intrathecal Morphine ◽  
Postoperative Pain Relief ◽  
Sensory Level ◽  
Post Operative Pain ◽  
Group B

Background: Post-operative pain management can be challenging. Objectives: To compare the efficiency of morphine with that of butorphanol in controlling the postoperative pain relief. Methods: This double-blind randomized clinical trial was performed on 75 consecutive patients. Intrathecal 3ml hyperbaric bupivacaine mixed with morphine (200 microgm-0.25ml); or mixed with butorphanol (200 microgm-0.25ml); or mixed with normal saline 0.25ml was administered to alternate groups (25 patients in each group), for postoperative pain relief after abdominal and vaginal hysterectomy. They were monitored for pain relief in the recovery and gynaecological ward for 24 hours. If the patient had any complications like nausea, vomiting, itching and urinary retention were recorded. Results: Time for two segment regression of sensory level in patients receiving intrathecal morphine (Group-M), was 114.0±12.2 min., intrathecal butorphanol (Group- B) was 96.0+24.4 min and normal saline (Group- N) was 104.4 ± 18.5min. Duration of pain relief after subarachonoid block In Group-M was 492.0 ± 153.2min, in Group- B 311.20 ±58.7min and in Group-N it was 299.4 ± 72.7min. Two patients (8%) in Group-M had nausea, vomiting and itching but none in other groups. Urinary retention occurred in 3 patients (12%), in Group- M, whereas the same was found in 2 patients (8%) and 1 patient (4%) of Group-B and N respectively. Conclusion: Intrathecal morphine provided prolonged and better analgesic effect after abdominal and vaginal hysterectomy than butorphanol, though there were some side effects like nausea, vomiting, itching and urinary retention which were graded by the patients as clinically not significant. DOI: http://dx.doi.org/10.3126/hren.v11i3.9640 Health Renaissance 2013;11(3):246-249

Using an App to monitor postoperative pain at home in pediatric patients

2021 ◽  
pp. 136749352091931
Author(s):  
Emanuela Tiozzo ◽  
Valentina Biagioli ◽  
Matilde Brancaccio ◽  
Riccardo Ricci ◽  
Anna Marchetti ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Health Professionals ◽  
Pediatric Patients ◽  
Pain Scale ◽  
Factors Associated ◽  
Prospective Comparative Study ◽  
Paper And Pencil ◽  
The Impact ◽  
At Home

A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud
Keyword(s):  
Postoperative Pain ◽  
Postoperative Bleeding ◽  
Throat Pain ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Case Surgery ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

scholarly journals Comparison between intravenous injectable diclofenac and per rectal diclofenac suppository as analgesics in operated per anal and perianal benign pathologies

2019 ◽  
Vol 7 (1) ◽  
pp. 263
Author(s):  
Juthikaa Abhijit Deherkar
Keyword(s):  
Pain Relief ◽  
Hospital Stay ◽  
Pain Score ◽  
Pain Scale ◽  
Group A ◽  
Group B ◽  
At Home

Background: Per anal and perianal surgeries are one of the bread and butter surgeries in a surgeons life, and satisfaction of patient matters a lot. Early miraculous recovery has always been patient’s expectations hence we decided to study standard IV method of diclofenac as analgesic with diclofenac suppository and compared their effects on patients with the help of pain scale of 0 to 10.Methods: 200 common per anal surgeries were considered in the study, and were divided in two groups group A post operatively IV diclofenac was given 12 hourly and in group B cases diclofenac suppository 100 mg was started daily twice and the pain score was noted for a week.Results: Diclofenac suppositories resulted in early pain relief and thus early discharges of these patients. The pain score had decreased to a larger extent by day 3 and was almost negligible by day 5 and a few cases to day 7. The hospital stay reduced as patient could manage suppository at home by themselves. IV site complications like thrombophlebitis leading to pain and fever could be easily avoided.Conclusions: Thus diclofenac suppositories proved to be an effective way to give a pain free satisfaction compared to intravenous painful analgesics, thus decreased their hospital stay and also it was a patient friendly.

Immediate-release tapentadol or oxycodone for treatment of acute postoperative pain after elective arthroscopic shoulder surgery: A randomized, phase IIIb study

2013 ◽  
Vol 9 (4) ◽  
pp. 281-290 ◽  
Author(s):  
Gary J. Vorsanger, PhD, MD ◽  
Angela M. Klopfer, BS ◽  
Jim Xiang, PhD ◽  
Carmela J. Benson, MS ◽  
Bruce L. Moskovitz, MD ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Intensity ◽  
Immediate Release ◽  
Similar Efficacy ◽  
Shoulder Surgery ◽  
Included Patient ◽  
Phase Iiib ◽  
Arthroscopic Shoulder Surgery ◽  
Global Impression Of Change

Objective: Arthroscopic shoulder surgery can result in substantial postoperative pain. This study evaluated the efficacy and safety of tapentadol immediate release (IR) or oxycodone IR in this setting for the treatment of acute pain.Design: Subjects received tapentadol IR 50 or 100 mg or oxycodone IR 5 or 10 mg every 4-6 hours as needed for pain up to 7 days after arthroscopic shoulder surgery. Twice daily, subjects recorded pain intensity from 0 (no pain) to 10 (pain as bad as you can imagine) and pain relief from 0 (none) to 5 (complete). Final assessments included patient and clinician global impression of change and subject satisfaction with treatment. The primary efficacy endpoint was the sum of pain intensity differences (SPID) over 3 days.Results: Of 378 subjects (192 tapentadol IR, 186 oxycodone IR) who took study medication, 312 (158 tapentadol IR, 154 oxycodone IR) had pain intensity ≥4 before the first dose and were evaluated for efficacy. Mean SPID scores over 3 days were 32.1 and 41.1 in the tapentadol IR and oxycodone IR groups, respectively (least-squares mean difference [95% confidence interval], 9.0 [-18.9, 36.9]; p = 0.527). Secondary analyses of pain intensity, pain relief, and subject satisfaction were similar between groups. Subjects and clinicians reported significantly better global impression of change for tapentadol IR. Adverse events were consistent with established safety profiles for IR opioids.Conclusions: Tapentadol IR and oxycodone IR had similar efficacy for pain after arthroscopic shoulder surgery, but subjects and clinicians reported greater overall improvement with tapentadol IR.

scholarly journals Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

2016 ◽  
Vol 3 (2) ◽  
pp. 41 ◽  
Author(s):  
Mahesh Sharma ◽  
Kalpana Kharbuja ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Normal Saline ◽  
Randomized Study ◽  
Saline Group ◽  
Normal Saline Group ◽  
Analgesic Requirement ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy.  Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy.   Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19.   Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable.   Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

scholarly journals THE DIFFERENCE OF PAIN SCALE USING NUMERIC RATING SCALE AND VISUAL ANALOG SCALE IN POST-OPERATIVE PATIENTS

2019 ◽  
Vol 7 (1) ◽  
pp. 52
Author(s):  
Natya Ayu Paluwih ◽  
Riama Marlyn Sihombing ◽  
Kinanthi Lebdawicaksaputri
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Comparative Approach ◽  
Mild Pain ◽  
Post Operative Pain ◽  
Perceived Pain ◽  
The Difference ◽  
Numeric Rating

Post-operative pain is acute and subjective therefore the perceived pain intensity will be different. In one of the western Indonesia Hospitals in measuring the pain threshold using 2 tools namely Numeric Rating Scale and Wong Baker Face. Measurement of the pain intensity can be done with NRS and VAS scale. The objective of this research was to identify the difference of pain scale using the NRS and VAS scale in post-operative patients. The research method was descriptive quantitative using comparative approach. The study was conducted on 1 November 2017 – 12 December 2017.The population of the study are the post-operative patients at the In-Patient wards in a private hospital in Western Part of Indonesia. The samples were obtained using purposive sampling with n = 41. Research instrument consists of observation sheet using NRS and VAS scale. The results showed most respondents during the first eight hours using NRS scale had mild pain (80.5%); first 16 hours had light pain (63.4%); and had mild pain in the first 24 hours (85.4%). Using VAS scale, most of the respondents on the first eight hours has mild pain (87.8%); first 16 hours has mild pain (68.3%); and has mild pain in the first 24 hours (87.8%). The conclusion of this study is there is no difference in pain scale of post-operative patients using VAS scale and NRS scale. So, hospitals can also use the VAS scale to assess pain scale in post-operative patients.

scholarly journals Intraperitoneal analgesia for postoperative pain relief after laparoscopic gynecological surgeries

2017 ◽  
Vol 6 (11) ◽  
pp. 5099 ◽  
Author(s):  
Basant Kumar Pati
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Visual Analogue Score ◽  
Local Anaesthetics ◽  
Safe Method ◽  
Analgesic Consumption ◽  
Post Operative Pain ◽  
Intraperitoneal Instillation ◽  
Group B

Background: Though laparoscopic gynaecological surgeries are less invasive and produces less post-operative pain, post-laparoscopy pain is still a concern. Intraperitoneal (IP) instillation of local anaesthetics has been shown to minimize the postoperative pain after laparoscopic surgeries. This study was conducted to compare the efficacy of intraperitoneal instillation of dexmedetomidine with bupivacaine and bupivacaine alone in reducing postoperative pain.Methods: 60 patients, enrolled for gynaecological laparoscopic surgeries were divided randomly into two groups of 30 each. Group B: Bupivacaine (30 ml, 0.25%) with 2 ml normal saline was instilled prior to removal of trocars, and Group BD: Bupivacaine (30 ml, 0.25%) with dexmedetomidine (1 mcg/kg, diluted to 2 ml) was instilled prior to removal of trocars. In postoperative period, Visual Analogue Score (VAS) was recorded up to 24 hours. Postoperative analgesic requirements, and side effects were recorded.Results: The Visual Analogue Score (VAS) during the first postoperative 24 hours was significantly lower in group BD compared to group B. Time to first analgesia required was delayed and total analgesic consumption was lower in group BD compared to group B which was statistically significant.Conclusions: Intraperitoneal instillation of dexmedetomidine with bupivacaine is an effective and safe method for reducing pain after laparoscopic gynaecological surgeries.

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