scholarly journals Postoperative pain management in patients undergoing thoracoscopic repair of pectus excavatum: A retrospective analysis of opioid consumption and adverse effects in adolescents

2017 ◽  
Vol 11 (4) ◽  
pp. 427 ◽  
Author(s):  
JosephD Tobias ◽  
Ralph Beltran ◽  
Giorgio Veneziano ◽  
Tarun Bhalla ◽  
Brian Kenney ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Retrospective Analysis ◽  
Pectus Excavatum ◽  
Postoperative Pain Management ◽  
Opioid Consumption ◽  
Thoracoscopic Repair

scholarly journals Safety and Tolerability of Lidocaine Infusions as a Component of Multimodal Postoperative Analgesia in Children

2019 ◽  
Vol 24 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Katherine Lemming ◽  
Gary Fang ◽  
Marcia L. Buck
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Dose Reduction ◽  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Postoperative Pain Management ◽  
Nuss Procedure ◽  
The Mean

OBJECTIVES Use of lidocaine as part of a multimodal approach to postoperative pain management has increased in adults; however, limited information is available regarding safety and tolerability in pediatrics. This study's primary objective was to evaluate the incidence of adverse effects related to lidocaine infusions in a sample of pediatric patients. METHODS A retrospective analysis was conducted in pediatric patients receiving lidocaine infusion for the management of postoperative analgesia at the University of Virginia Health System. RESULTS A total of 50 patients with 51 infusions were included in the final analysis. The median patient age was 14 years (range, 2–17 years). The most frequent surgeries were spinal fusion (30%), Nuss procedure for pectus excavatum (16%), and nephrectomy (6%). The mean ± SD starting rate was 13.6 ± 6.5 mcg/kg/min. The mean infusion rate during administration was 15.2 ± 6.3 mcg/kg/min, with 14.4 ± 6.2 mcg/kg/min at discontinuation. The mean length of therapy was 30.6 ± 22 hours. A total of 12 infusions (24%) were associated with adverse effects, primarily neurologic ones, including paresthesias in the upper extremities (10%) and visual disturbances (4%). The average time to onset was 16.2 ± 15.2 hours. Seven infusions were discontinued, whereas the remaining infusions resulted in either dose reduction or continuation without further incident. No patients experienced toxicity requiring treatment with lipid emulsion. CONCLUSIONS In this sample, lidocaine was a well-tolerated addition to multimodal postoperative pain management in the pediatric population. Although adverse effects were common, they were mild and resolved with either dose reduction or discontinuation.

Postoperative pain management in pediatric patients undergoing minimally invasive repair of pectus excavatum: The role of intercostal block

2013 ◽  
Vol 48 (12) ◽  
pp. 2425-2430 ◽  
Author(s):  
Laura Lukosiene ◽  
Danguole Ceslava Rugyte ◽  
Andrius Macas ◽  
Lina Kalibatiene ◽  
Dalius Malcius ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Pediatric Patients ◽  
Postoperative Pain Management ◽  
Intercostal Block

Regional anaesthesia for postoperative pain management after liver resection

2012 ◽  
Vol 19 (3) ◽  
pp. 126-129
Author(s):  
Darius Trepenaitis ◽  
Tadas Česnaitis ◽  
Andrius Macas
Keyword(s):  
Pain Management ◽  
Liver Resection ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Wound Infiltration ◽  
Adequate Treatment

Background. Pain is the most common complication in the postoperative period. If adequate treatment is not taken, it can transform to chronic pain. Postoperative pain brings a lot of social, psychological and financial problems for patients and their families. Materials and methods. This prospective study included 30 patients after laparatomic liver resection operation. Patients were randomly assign­ ed to Infiltrated or Control groups. An infiltration of 40 ml levobupivacaine 0.25% solution to the operation cut edges was performed to the Infiltrated group. The pain was evaluated using the numerical rating scale after 2, 5, 12, 24, 48 hours and 1 month after the operation. Our aim was to determine the effect of local anesthesia in the operation wound. The total usage of morphine and any side effects were registered. Results. A statistically significant reduction in pain was observed in the Infiltrated group in all evaluation periods. Opioids usage was higher in the Control group almost by 4 times and adverse effects were 9 to 1 compared to the Infiltrated group. Conclusions. Surgical wound infiltration with local anesthetic for postoperative pain management after liver resection operations has a positive effect on postoperative pain reduction and leads to lesser usage of opioid analgetics. As a result, there is a less chance of opioids induced adverse effects.

scholarly journals Expanding the Perisurgical Home to Improve Postoperative Pain Management and Reduce Opioid Consumption

2019 ◽  
Vol 19 (2) ◽  
pp. 68-69
Author(s):  
Ivan Urits ◽  
Omar Viswanath ◽  
Vwaire Orhurhu ◽  
Viet Cai ◽  
Musa Aner
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Opioid Consumption

scholarly journals Current Trends in Pediatric Spine Deformity Surgery: Multimodal Pain Management and Rapid Recovery

2019 ◽  
Vol 10 (3) ◽  
pp. 346-352
Author(s):  
Sagar A. Shah ◽  
Richard Guidry ◽  
Abhishek Kumar ◽  
Tyler White ◽  
Andrew King ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Recovery Time ◽  
Postoperative Pain Management ◽  
Opioid Consumption ◽  
Rapid Recovery ◽  
Spine Deformity ◽  
Pediatric Spine ◽  
Pubmed Database ◽  
Scoliosis Correction

Study Design: Narrative review. Objectives: The purpose of this article is to perform a review of the literature assessing the efficacy of opioid alternatives, multimodal pain regimens, and rapid recovery in pediatric spine surgery. Methods: A literature search utilizing PubMed database was performed. Relevant studies from all the evidence levels have been included. Recommendations to decrease postoperative pain and expedite recovery after posterior spinal fusion in adolescent idiopathic scoliosis patients have been provided based on results of studies with the highest level of evidence. Results: Refining perioperative pain management to lessen opioid consumption with multimodal regimens may be useful to decrease recovery time, pain, and complications. Nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentin, neuraxial blockades, and local anesthesia alone offer benefits for postoperative pain management, but their combination in multimodal regimens and rapid recovery pathways may contribute to faster recovery time, improved pain levels, and lower reduction in total opioid consumption. Conclusion: A rapid recovery pathway using the multimodal approach for pediatric scoliosis correction may offer superior postoperative pain management and faster recovery than traditional opioid only pain protocols.

scholarly journals Intravenous Acetaminophen use in Postoperative Pain Management

2014 ◽  
Author(s):  
Selvi Kumar
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Adverse Effects ◽  
Acute Pain ◽  
Postoperative Pain Management ◽  
Multimodal Approach ◽  
Intravenous Acetaminophen ◽  
Group 2 ◽  
Group 1

<p>Surgery is a most common source of acute pain and effective postoperative pain management is crucial for wound healing and recovery. Opiods are the mainstay for acute pain management but have various adverse effects including death. The multimodal approach involves the use of multiple drugs with varying mechanism of action to achieve optimal pain relief with less adverse effects. Intravenous acetaminophen (IVAPAP) is a new addition to the multimodal approach that appears to afford effective pain relief with a low risk profile. The purpose of this research study was to examine the impact of IVAPAP use in multimodal pain management on decreased opioid consumption and decreased average length of hospital stay in the post colectomy population. A comparative two group retrospective chart review was conducted, with a total of 72 charts meeting the inclusion criteria. Group 1(n=36) study subjects who received IVAPAP for pain management were compared to Group 2(n=36) subjects who had not received IVAPAP after colectomy. Results demonstrated that Group 1, those who had received IVAPAP, used less opioids during the postoperative period as compared to those in Group 2 who had not received IVAPAP; there was no difference in length of stay between the groups. Further research related to the use of multimodal pain management strategies in general, and related to IVAPAP in particular, is indicated. Recommendations and implications for advanced practice nursing are presented and discussed.</p>

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