scholarly journals Morphine versus fentanyl patient-controlled analgesia for postoperative pain control in major hepatic resection surgeries including living liver donors: A retrospective study

2018 ◽  
Vol 12 (2) ◽  
pp. 250 ◽  
Author(s):  
EmanM Nada ◽  
Abdulmajeed Alabdulkareem
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Hepatic Resection ◽  
Pain Control ◽  
Patient Controlled Analgesia ◽  
Postoperative Pain Control ◽  
Major Hepatic Resection ◽  
Living Liver Donors ◽  
Liver Donors

Preemptive analgesia for endoscopic sinus surgery: a retrospective study

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
D. Nakashima ◽  
E. Mori ◽  
T. Takeda ◽  
Y. Hosokawa ◽  
S. Takaishi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Endoscopic Sinus Surgery ◽  
Pain Control ◽  
Postoperative Bleeding ◽  
Perioperative Period ◽  
Preemptive Analgesia ◽  
Sinus Surgery ◽  
Common Disease ◽  
Postoperative Pain Control

Background: Chronic rhinosinusitis (CRS) is a common disease, and endoscopic sinus surgery (ESS) is widely performed. However, there is no consensus regarding postoperative pain control after ESS, and postoperative opioid abuse is a problem in many countries. Acetaminophen is reportedly effective for postoperative pain control. Preemptive analgesia has received more attention lately, wherein pain is prevented before it occurs. In this study, we assessed the use of acetaminophen for preemptive analgesia during the perioperative period in ESS. Methodology: This is a retrospective study of 175 patients who underwent ESS, septoplasty, and bilateral inferior turbinate mucosal resection at our hospital from April 2016 to February 2018. In total, 82 patients received 1,000 mg of acetaminophen during surgery and 4 hours after the first dose, while 93 patients did not receive it routinely. We compared these two groups. The primary outcome was the need to use additional analgesics prescribed by the ward physician and the secondary outcomes included postoperative pain, postoperative bleeding, reoperation, blood pressure, and body temperature. Results: The use of additional oral and intravenous analgesics was significantly reduced in the patients who received acetaminophen perioperatively. Conclusion: Preemptive analgesia during the perioperative period of ESS could lead to satisfactory postoperative pain control.

scholarly journals Is a Single Low Dose of Intrathecal Morphine a Useful Adjunct to Patient-Controlled Analgesia for Postoperative Pain Control Following Lumbar Spine Surgery? A Preliminary Report

2015 ◽  
Vol 20 (3) ◽  
pp. 129-132 ◽  
Author(s):  
David Yen ◽  
Kim Turner ◽  
David Mark
Keyword(s):  
Lumbar Spine ◽  
Postoperative Pain ◽  
Respiratory Depression ◽  
Spine Surgery ◽  
Pain Control ◽  
Low Dose ◽  
Intrathecal Morphine ◽  
Lumbar Spine Surgery ◽  
Patient Controlled Analgesia ◽  
Postoperative Pain Control

BACKGROUND: Several studies addressing intrathecal morphine (ITM) use following spine surgery have been published either involving the pediatric population, using mid- to high-dose ITM, or not in conjunction with morphine patient-controlled analgesia (PCA).OBJECTIVES: To determine whether low-dose ITM is a useful adjunct to PCA for postoperative pain control following elective lumbar spine surgery in adults.METHODS: Thirty-two patients were enrolled in a double-blinded randomized controlled trial, and received either ITM or intrathecal placebo. Postoperatively, all patients were given a PCA pump and observed for the first 24 h in a step-down unit. Measurements of: total PCA morphine consumed in the first 24 h; intensity of pain; pruritus; nausea at 4 h, 8 h and 24 h; time to first ambulation; length of hospital stay; and occurrences of respiratory depression were recorded.RESULTS: The total PCA use was significantly lower in the ITM group. There were lower average pain scores in the ITM group, which increased to that of the intrathecal placebo group over 24 h; however, this failed to attain statistical significance. There were no differences in nausea, pruritus, time to first ambulation or hospital length stay. There were no cases of respiratory depression in either group.CONCLUSIONS: ITM may be a useful adjunct to PCA, but did not decrease time to ambulation or length of stay.

Comparative study between: Epidural bupivacaine versus Patient Controlled Analgesia for postoperative pain control in total knee arthroplasty

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A T A Elkhouly ◽  
M A Bassiony ◽  
M M N Elshafey ◽  
K M Khalaf ◽  
A M Alansary
Keyword(s):  
Total Knee Arthroplasty ◽  
Stress Response ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Pain Control ◽  
Patient Controlled Analgesia ◽  
Postoperative Pain Control ◽  
Epidural Bupivacaine ◽  
Total Knee ◽  
Cortisol Levels

Abstract Introduction Effective postoperative pain control in total knee arthroplasty is important, especially with starting physiotherapy and early ambulation, which enhances recovery and reduces hospital length of stay. The risk of postoperative complications, such as deep venous thrombosis and nosocomial infections, has also been shown to decrease with early mobilization. Aim The aim of this study is to assess the analgesic efficacy of epidural bupivacaine compared with intravenous patient controlled analgesia (opioid and NSAIDs) during postoperative period in total knee arthroplasty. Patients Forty patients, ranging in age from 20 to 70 yr, scheduled to receive total knee replacements with spinal anesthesia were randomly assigned to this study. Methods patients received epidural bupivacaine 0.125% alone in (group epa) or iv nalbuphine 50mg, ketorolac 60mg via pca device. The quality of postoperative analgesia was assessed by the anesthesiologist according to Visual Analogue Score (VAS), Cortisol level 24 hours preoperative and 2 hours postoperative for stress response. Results The efficacy of both epidural Bupivacaine and i.v nalbuphine & ketorolac via PCA device in controlling pain after total Knee arthroplasty however PCA was slightly less efficient especialy during the 12 hr after surgery. We found that one of the main draw backs of epidural analgesia using bupivacaine were arterial hypotension and urinary retention which required catheterization of many patients for voiding of urine. Results were comparable between the 2 groups and were against group EPA, Serum cortisol levels were elevated 2h post-surgery in all patients. This elevation is in accordance with the well-established stress response to surgery. Furthermore, cortisol levels were significantly less elevated in the group EPA, compared with group PCA. Conclusion The results of the study revealed both Epidural bupivacaine and systemic opioids combined with NASID via PCA device are effective of pain control post TKA.

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