scholarly journals Comparison of analgesic efficacy of shoulder block versus interscalene block for postoperative analgesia in arthroscopic shoulder surgeries: A randomised trial

2021 ◽  
Vol 65 (6) ◽  
pp. 451
Author(s):  
Anju Gupta ◽  
Suman Saini ◽  
ShrutiMahesh Rao ◽  
Nidhi Agrawal
Keyword(s):  
Postoperative Analgesia ◽  
Randomised Trial ◽  
Analgesic Efficacy ◽  
Interscalene Block

scholarly journals Comparison of intramuscular diclofenac sodium, diclofenac sodium suppository and intravenous tramadol for postoperative analgesia in gynaecological surgeries done under spinal anaesthesia

2018 ◽  
Vol 6 (9) ◽  
pp. 3034
Author(s):  
Sonali Mahendra Khobragade
Keyword(s):  
Blood Pressure ◽  
Postoperative Pain ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Diclofenac Sodium ◽  
Tertiary Care ◽  
Analgesic Efficacy ◽  
Care Hospital ◽  
Tramadol Hydrochloride ◽  
Sodium Diclofenac

Background: Postoperative pain management is a vital factor contributing towards speedy recovery of the patient in the perioperative period without significant morbidity. The purpose of this study was to compare the analgesic efficacy and safety of three most frequently used analgesic drugs-intramuscular diclofenac sodium, diclofenac suppository and intravenous tramadol hydrochloride in patients undergoing gynaecological surgeries.Methods: A hospital based, prospective, randomized, comparative study was undertaken in tertiary care hospital for a period of two years. The study included 90 adult patients undergoing gynaecological surgeries in spinal anaesthesia. Postoperative pain intensity was assessed by visual analogue scale. Level of sedation was assessed by four point scale along with haemodynamics.Results: There were no significant changes in the pulse rate, systolic blood pressure and diastolic blood pressure after giving I.M. diclofenac, diclofenac suppository and I.V. tramadol. The mean VAS scores were comparable in all three groups (p>0.05). The level of sedation was more in tramadol group than in diclofenac intramuscular and rectal group which was statistically significant (p=0.001).Conclusions: Diclofenac suppository provides effective postoperative analgesia when compared with Inj. Diclofenac I.M. and Inj. tramadol I.V. in patients undergoing infraumbilical gynaecological surgeries with stable vitals and no side effects.

Interscalene block for postoperative analgesia using only ultrasound guidance: the outcome in 200 patients

2009 ◽  
Vol 21 (4) ◽  
pp. 272-277 ◽  
Author(s):  
Jennifer J. Davis ◽  
Jeffrey D. Swenson ◽  
Patrick E. Greis ◽  
Robert T. Burks ◽  
Robert Z. Tashjian
Keyword(s):  
Postoperative Analgesia ◽  
Ultrasound Guidance ◽  
Interscalene Block

Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review

2020 ◽  
Vol 45 (8) ◽  
pp. 645-655
Author(s):  
Johnny Wei Bai ◽  
Dong An ◽  
Anahi Perlas ◽  
Vincent Chan
Keyword(s):  
Systematic Review ◽  
Postoperative Analgesia ◽  
Full Text ◽  
Subcutaneous Tissue ◽  
Analgesic Efficacy ◽  
Wound Infiltration ◽  
Surgical Wounds ◽  
Full Text Review ◽  
Protocol Registration ◽  
Abstract Screening

Local anesthetics (LAs) are commonly infiltrated into surgical wounds for postsurgical analgesia. While many adjuncts to LA agents have been studied, it is unclear which adjuncts are most effective for co-infiltration to improve and prolong analgesia. We performed a systematic review on adjuncts (excluding epinephrine) to local infiltrative anesthesia to determine their analgesic efficacy and opioid-sparing properties. Multiple databases were searched up to December 2019 for randomized controlled trials (RCTs) and two reviewers independently performed title/abstract screening and full-text review. Inclusion criteria were (1) adult surgical patients and (2) adjunct and LA agents infiltration into the surgical wound or subcutaneous tissue for postoperative analgesia. To focus on wound infiltration, studies on intra-articular, peri-tonsillar, or fascial plane infiltration were excluded. The primary outcome was reduction in postoperative opioid requirement. Secondary outcomes were time-to-first analgesic use, postoperative pain score, and any reported adverse effects. We screened 6670 citations, reviewed 126 full-text articles, and included 89 RCTs. Adjuncts included opioids, non-steroidal anti-inflammatory drugs, steroids, alpha-2 agonists, ketamine, magnesium, neosaxitoxin, and methylene blue. Alpha-2 agonists have the most evidence to support their use as adjuncts to LA infiltration. Fentanyl, ketorolac, dexamethasone, magnesium and several other agents show potential as adjuncts but require more evidence. Most studies support the safety of these agents. Our findings suggest benefits of several adjuncts to local infiltrative anesthesia for postoperative analgesia. Further well-powered RCTs are needed to compare various infiltration regimens and agents.Protocol registrationPROSPERO (CRD42018103851) (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103851)

Superior Trunk Block Provides Noninferior Analgesia Compared with Interscalene Brachial Plexus Block in Arthroscopic Shoulder Surgery

2019 ◽  
Vol 131 (6) ◽  
pp. 1316-1326 ◽  
Author(s):  
RyungA Kang ◽  
Ji Seon Jeong ◽  
Ki Jinn Chin ◽  
Jae Chul Yoo ◽  
Jong Hwan Lee ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Brachial Plexus Block ◽  
Group Versus ◽  
Shoulder Surgery ◽  
Interscalene Block ◽  
Block Group ◽  
Interscalene Brachial Plexus Block ◽  
Arthroscopic Shoulder Surgery ◽  
Plexus Block

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Interscalene brachial plexus block of the C5–C6 roots provides highly effective postoperative analgesia after shoulder surgery but usually results in hemidiaphragmatic paresis. Injection around the superior trunk of the brachial plexus is an alternative technique that may reduce this risk. The authors hypothesized that the superior trunk block would provide noninferior postoperative analgesia compared with the interscalene block and reduce hemidiaphragmatic paresis. Methods Eighty patients undergoing arthroscopic shoulder surgery were randomized to receive a preoperative injection of 15 ml of 0.5% ropivacaine and 5 μg · ml−1 epinephrine around either (1) the C5–C6 nerve roots (interscalene block group) or (2) the superior trunk (superior trunk block group). The primary outcome was pain intensity 24 h after surgery measured on an 11-point numerical rating score; the prespecified noninferiority limit was 1. Diaphragmatic function was assessed using both ultrasonographic measurement of excursion and incentive spirometry by a blinded investigator before and 30 min after block completion. Results Seventy-eight patients completed the study. The pain score 24 h postoperatively (means ± SDs) was 1.4 ± 1.0 versus 1.2 ± 1.0 in the superior trunk block (n = 38) and interscalene block (n = 40) groups, respectively. The mean difference in pain scores was 0.1 (95% CI, −0.3 to 0.6), and the upper limit of the 95% CI was lower than the prespecified noninferiority limit. Analgesic requirements and all other pain measurements were similar between groups. Hemidiaphragmatic paresis was observed in 97.5% of the interscalene block group versus 76.3% of the superior trunk block group (P = 0.006); paresis was complete in 72.5% versus 5.3% of the patients, respectively. The decrease in spirometry values from baseline was significantly greater in the interscalene block group. Conclusions The superior trunk block provided noninferior analgesia compared with interscalene brachial plexus block for up to 24 h after arthroscopic shoulder surgery and resulted in significantly less hemidiaphragmatic paresis.

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