Effect of preoperative rectal indomethacin on postoperative pain reduction after open appendectomy

While postoperative pain management was shown to reduce unwanted physiological and emotional outcomes, pediatric postoperative pain management remains suboptimal. Medical-clowns were shown to be beneficial in many medical contexts including reduction of stress, anxiety and pain. This study was set to assess the effectiveness of medical-clowns on pediatric postoperative pain reduction. Children age 4 or above, planned for elective hernia repair surgery were recruited. Children were randomly divided to a control or medicalclown escorted groups. Demographical and clinical data were collected using questionnaires and electronic sheets. Children escorted by clowns reported lower levels of pain upon admittance, discharge and 12-hours post-surgery. Statistically significant reduction of parental distress and significantly higher serum cortisol levels were observed in the clown-therapy group. Although small, our study supports the possibility that preoperative medical-clown therapy might be a cheap, safe and yet beneficial method for postoperative pain reduction.

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Intraoperative Esmolol as an Adjunct for Perioperative Opioid and Postoperative Pain Reduction

Anesthesia & Analgesia ◽

10.1213/ane.0000000000002469 ◽

2018 ◽

Vol 126 (3) ◽

pp. 1035-1049 ◽

Cited By ~ 29

Author(s):

Amanda M. Gelineau ◽

Michael R. King ◽

Karim S. Ladha ◽

Sara M. Burns ◽

Timothy Houle ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Reduction

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Effect of bupivacaine versus lidocaine local anesthesia on postoperative pain reduction in single-port access laparoscopic adnexal surgery using propensity score matching

Obstetrics & Gynecology Science ◽

10.5468/ogs.2020.63.3.363 ◽

2020 ◽

Vol 63 (3) ◽

pp. 363-369

Author(s):

Ji Hyun Lee ◽

Sang Hyun Cho ◽

Kyung Jin Eoh ◽

Jung-Yun Lee ◽

Eun Ji Nam ◽

...

Keyword(s):

Postoperative Pain ◽

Propensity Score ◽

Propensity Score Matching ◽

Local Anesthesia ◽

Single Port ◽

Pain Reduction ◽

Single Port Access ◽

Port Access ◽

Adnexal Surgery

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Laparoscopic versus open appendectomy retrospective study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20172259 ◽

2017 ◽

Vol 4 (3) ◽

pp. 620

Author(s):

Haitham S. Rbihat ◽

Khaled M. Mestareehy ◽

Mohammad S. Al lababdeh ◽

Talal M. Jalabneh ◽

Mohammad E. Aljboor ◽

...

Keyword(s):

Retrospective Study ◽

Postoperative Pain ◽

Laparoscopic Appendectomy ◽

Open Appendectomy ◽

Advantages And Disadvantages ◽

Abdominal Abscesses ◽

Zero Rate ◽

The Mean ◽

The Cost ◽

Mean Time

Background: Laparoscopic cholecystectomy is taken into account as a standard method of performing cholecystectomy and has substituted the old method throughout the world, while laparoscopic appendectomy still not attaining that reputation. In this paper, a retrospective study was done to compare between both laparoscopic and open appendectomy.Methods: Two hundred eighty-five patients were analyzed after appendectomy using either open or laparoscopic procedures. The data was compared over a period of 36 months. Surgical technique was the same among 6 surgeons, standard postoperative care for all patient groups. The outcome measures included comparing of mean operative time, days of hospitalization, postoperative pain and rate of wound infection.Results: Concerning open appendectomy the mean time was 28 minutes with 2 days of hospitalization. The postoperative pain extent was for 36 hours and rate of wound infection was 8/159. While in laparoscopic appendectomy the mean time was 55 minutes with one day hospitalization. The postoperative pain was for 12 hours and zero rate of wound infection.Conclusions: In general laparoscopy has plenty of gains over open surgery as discussed before but laparoscopic appendectomy is not easier, nor does it avoid general anesthesia. The cost for laparoscopic appendectomy is higher than for open appendectomy. The operative and post-operative complications are more critical (e.g.: intra-abdominal abscesses & perforation of bowel) as compared to open appendectomy. We have to assess the advantages and disadvantages, indications and contraindications when taking a decision for laparoscopic surgery. We suppose it would be very early to say that laparoscopic appendectomy is superior or can replace open appendectomy.

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Antidepressant Drugs for Prevention of Acute and Chronic Postsurgical Pain

Anesthesiology ◽

10.1097/aln.0000000000000307 ◽

2014 ◽

Vol 121 (3) ◽

pp. 591-608 ◽

Cited By ~ 33

Author(s):

Karen Wong ◽

Rachel Phelan ◽

Eija Kalso ◽

Imelda Galvin ◽

David Goldstein ◽

...

Keyword(s):

Postoperative Pain ◽

Therapeutic Potential ◽

Antidepressant Treatment ◽

Antidepressant Drugs ◽

Safety Evaluation ◽

Pain Reduction ◽

Chronic Postoperative Pain ◽

Postsurgical Pain ◽

Chronic Postsurgical Pain ◽

Antidepressant Use

Abstract Background: This review evaluates trials of antidepressants for acute and chronic postsurgical pain. Methods: Trials were systematically identified using predefined inclusion and exclusion criteria. Extracted data included the following: pain at rest and with movement, adverse effects, and other outcomes. Results: Fifteen studies (985 participants) of early postoperative pain evaluated amitriptyline (three trials), bicifadine (two trials), desipramine (three trials), duloxetine (one trial), fluoxetine (one trial), fluradoline (one trial), tryptophan (four trials), and venlafaxine (one trial). Three studies (565 participants) of chronic postoperative pain prevention evaluated duloxetine (one trial), escitalopram (one trial), and venlafaxine (one trial). Heterogeneity because of differences in drug, dosing regimen, outcomes, and/or surgical procedure precluded any meta-analyses. Superiority to placebo was reported in 8 of 15 trials for early pain reduction and 1 of 3 trials for chronic pain reduction. The majority of positive trials did not report sufficient data to estimate treatment effect sizes. Many studies had inadequate size, safety evaluation/reporting, procedure specificity, and movement-evoked pain assessment. Conclusions: There is currently insufficient evidence to support the clinical use of antidepressants—beyond controlled investigations—for treatment of acute, or prevention of chronic, postoperative pain. Multiple positive trials suggest the therapeutic potential of antidepressants, which need to be replicated. Other nontrial evidence suggests potential safety concerns of perioperative antidepressant use. Future studies are needed to better define the risk–benefit ratio of antidepressants in postoperative pain management. Higher-quality trials should optimize dosing, timing and duration of antidepressant treatment, trial size, patient selection, safety evaluation and reporting, procedure specificity, and assessment of movement-evoked pain relevant to postoperative functional recovery.

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A Clinical Trial of Adding Morphine to Levobupivacaine in TAP Block for Open Appendectomy

QJM ◽

10.1093/qjmed/hcab086.038 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Sherif Farouk Ibrahim ◽

Kareem Youssef Kamal Hakim ◽

Wael Sayed Ahmed Abdelghaffar Elgharabawy ◽

Hebatullah Ramadan Muhammad

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Abdominal Wall ◽

Postoperative Analgesia ◽

Open Appendectomy ◽

Transversus Abdominis ◽

Controlled Clinical Trial ◽

Tap Block ◽

Nerve Blocks ◽

Double Blind

Abstract Background Postoperative pain management is becoming an integral part of anaesthesia care. Various techniques of pain relief have been designed among which the most commonly practiced are peripheral nerve blocks. We have designed the study to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, and total need of analgesics and opioids after adding morphine to levobupivacaine in TAP block for open appendectomy. A substantial component of the pain experienced by patients after major abdominal surgery is derived from the abdominal wall incision. The abdominal wall consists of three muscle layers, the external oblique, the internal oblique and the transversus abdominis, and their associated fascial sheaths. This muscular wall is innervated by nerve afferents that course through the transversus abdominis neuro-fascial plane. Different adjuvants have been studied to improve the quality and increase the duration of local anaesthetics during various nerve block techniques. Aim of the work The aim of this study is to assess the analgesic effect of peripherally administered morphine with levobupivacaine for ipsilateral TAP block in patients undergoing appendectomy under general anaesthesia. Patient and Methods Type of Study prospective, randomized and double blind controlled clinical trial. Study Setting Ain Shams University Hospitals. Study Period 6 months. Sampling Method randomized double blind clinical trial. suction evacuation for molar pregnancy, all cases were included in the study were agreed on a consent for inclusion in the current study after explanation for the details of the study. Conclusion TAP block was effective in reducing postoperative pain scores, lowering total 24-h postoperative analgesic consumption. Morphine as an adjunct to levobupivacaine in ipsilateral ultrasound guided transversus abdominis plane block as more effective postoperative analgesia with reduced analgesic requirement in patients undergoing appendectomy.

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