scholarly journals Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures

ISRN Urology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Stavros I. Tyritzis ◽  
Konstantinos G. Stravodimos ◽  
Ioanna Vasileiou ◽  
Georgia Fotopoulou ◽  
Georgios Koritsiadis ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Analogue Scale ◽  
Bladder Tumour ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Tumour Volume ◽  
Tumour Resection ◽  
Transurethral Prostatectomy ◽  
Vas Score

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy ( and resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10  exhibited a VAS score >3 at 8 h and 24 h (, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification.

scholarly journals PREOPERATIVE KETOROLAC EFFECT ON POSTOPERATIVE PAIN ON TURP PATIENTS

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Choirul Hadi ◽  
Trisula Utomo
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Prostatic Hyperplasia ◽  
Transurethral Prostatectomy ◽  
Cross Sectional ◽  
Vas Score ◽  
Group I ◽  
Post Operative Pain ◽  
Group Ii

Objective: The aim of this study is to study the effect of preoperative Ketorolac on postoperative pain after transurethral prostatectomy at Sardjito Hospital Yogyakarta. Material & Methods: This is a cross sectional, analytic, prospective study. We divided benign prostatic hyperplasia patients, from October 2011 until February 2012 into two groups. Group I was given Ketorolac 30 mg intravenously twice daily starting one day before operation and in the morning before procedure. Group II did not receive Ketorolac preoperatively. Patients underwent transurethral operation with spinal anesthesia. We assessed postoperative pain at 24 hours using Visual Analogue Scale (VAS). Results: Twenty four patients were included in this study with mean age 66 years old with the youngest 45 years old and the oldest 80 years old (SD 8,77744). Group I (17 patients), VAS score 1 to 7 with median 3 and mean 3,4118 (SD 1,66053). Group II (7 patients) VAS score 1 to 8 with median 3 and mean 3,8571 (SD 2,8357). We count it using Mann-Whitney U (p = 0,951). Conclusion: There is no significance difference in post-operative pain after transurethral prostatectomy with preoperative ketorolac administration.Keywords: Ketorolac, bupivacaine, visual analogue scale, transurethral prostatectomy.

scholarly journals Ultrasound-Guided Funicular Block: Ropivacaine Injection into the Tissue around the Spermatic Cord to Improve Analgesia during Orchiectomy in Dogs

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1275
Author(s):  
Vincenzo Cicirelli ◽  
Pasquale Debidda ◽  
Nicola Maggio ◽  
Michele Caira ◽  
Giovanni M. Lacalandra ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Spermatic Cord ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Ultrasound Guided ◽  
Hemodynamic Stability ◽  
Pain Scores ◽  
Lower Pain ◽  
Ropivacaine Hydrochloride

Orchiectomy is a common surgical procedure performed on small animals, and it requires postoperative pain management despite its relative simplicity. This study aimed to evaluate the hemodynamic stability, intraoperative administration of additional hypnotic and/or analgesic drugs, and postoperative pain scores following the combination of ultrasound-guided injection of ropivacaine hydrochloride into the spermatic cord and infiltration by the same anaesthetic of the incisional prescrotal line (ROP) or general anaesthesia. Dogs in the ROP group showed greater intraoperative hemodynamic stability and lower pain scores than the control group. The locoregional approach used in this study proved effective in minimising the responses to the surgical stimulus and ensured adequate analgesia intra- and postoperatively. This method, called ultrasound-guided funicular block, allows orchiectomy to be performed under deep sedation without general anaesthesia.

scholarly journals Efficacy of ketamine for postoperative pain following robotic thyroidectomy: A prospective randomised study

2017 ◽  
Vol 46 (3) ◽  
pp. 1109-1120 ◽  
Author(s):  
Jiwon Lee ◽  
Hee-Pyoung Park ◽  
Mu-Hui Jeong ◽  
Je-Do Son ◽  
Hyun-Chang Kim
Keyword(s):  
Postoperative Pain ◽  
Severe Pain ◽  
Analogue Scale ◽  
Postoperative Pain Management ◽  
Robotic Thyroidectomy ◽  
Control Group ◽  
Randomised Study ◽  
Pain Scores ◽  
Vas Scores ◽  
Induction Of Anaesthesia

Objective Although robotic thyroidectomy (RoT) is a minimally invasive surgery, percutaneous tunneling causes moderate to severe pain immediately postoperatively. We evaluated the efficacy of ketamine for postoperative pain management in patients following RoT. Methods Sixty-four patients scheduled for RoT were randomly divided into two groups. In the ketamine group (n = 32), ketamine was infused from induction of anaesthesia until the end of the procedure (0.15-mg/kg bolus with continuous infusion at 2 µg/kg/min). In the control group (n = 32), the same volume of saline was infused. Visual analogue scale (VAS) scores for acute and chronic pain, the incidence of hypoesthesia, postoperative analgesic requirements, and complications related to opioids or ketamine were compared between the two groups. Results The VAS pain scores were significantly lower in the ketamine group up to 24 h postoperatively. The VAS pain score when coughing was significantly higher in the control group than in the ketamine group at 24 h postoperatively. A significantly greater proportion of patients in the control group required rescue analgesics. Complications were comparable in both groups. Conclusions Ketamine infusion decreased pain scores for 24 h postoperatively and reduced analgesic requirements without serious complications in patients following RoT. Trial Registration: Clinicaltrials.gov Identifier: NCT01997801

scholarly journals Oral Oxycodone for Acute Postoperative Pain: A Review of Clinical Trials

2017 ◽  
Vol 2 (20;2) ◽  
pp. sE33-sE52 ◽  
Author(s):  
Chi-Wai Cheung
Keyword(s):  
Clinical Trials ◽  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Acute Postoperative Pain

Background: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. Objectives: To evaluate the use of oral oxycodone for acute postoperative pain management. Study Design: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. Methods: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were “oral strong opioids,” “postsurgical,” “postoperative,” “post-surgical,” and “postoperative.” Treatment interventions were compared for analgesic efficacy, rescue medication use, side effects, recovery, length of hospital stay, and patient satisfaction. Results: There were 26 clinical trials included in the review. Oral oxycodone showed superior postoperative analgesic efficacy compared with placebo in patients undergoing laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous opioids, oral oxycodone provided better or comparable pain relief following knee arthroplasty, spine surgery, caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery pain reported inferior pain control with oral oxycodone versus rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue analgesia and total opioid consumption were reduced in the oxycodone treatment arm. Patients receiving oral oxycodone experienced fewer opioid-related side effects than those on other opioids, and had a similar occurrence of postoperative nausea and vomiting as patients on placebo. Furthermore, oral oxycodone did not prolong hospital stay and was associated with lower drug costs compared with epidural and intravenous analgesics. Oxycodone administered as part of a multimodal analgesic regimen produced superior pain relief with fewer side effects and a reduced hospital stay. Limitation: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions. Conclusion: Oral oxycodone appears to offer safe and effective postoperative analgesia, and is a well-accepted and reasonable alternative to standard intravenous opioid analgesics. Key words: Postoperative, pain, analgesia, oral oxycodone, opioid

scholarly journals A Randomised Controlled Study to Evaluate Efficacy of the Landmark Guided Erector Spinae Plane Block for Postoperative Pain in Percutaneous Nephrolithotomy Surgeries in Kolhapur District in Western Maharashtra

2021 ◽  
Vol 8 (20) ◽  
pp. 1559-1564
Author(s):  
Rashmee Vijay Chavan ◽  
Archita Rajaram Patil ◽  
Anupama Deepak Sahasrabudhe ◽  
Aarati Bhaskar Jadhav ◽  
Prithiv Rishardhan Prabhakaran
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
General Anaesthesia ◽  
Percutaneous Nephrolithotomy ◽  
Erector Spinae ◽  
Control Group ◽  
Study Group ◽  
Vas Score ◽  
Erector Spinae Plane Block ◽  
Post Operative Pain

BACKGROUND Post-operative pain and discomfort is a common side effect of percutaneous nephrolithotomy (PCNL) surgery. The study intended to evaluate the efficacy of landmark guided erector spinae plane block (ESPB) in early post-operative pain relief following (PCNL) surgery. METHODS In this randomised prospective, single blind, interventional study, 70 patients aged 20 - 60 years of ASA grade I and II, scheduled for elective percutaneous nephrolithotomy (PCNL) surgery under general anaesthesia were included. Patients were randomly allotted into two groups of 35 each. Group 1 was the control group and received parenteral analgesia according to institutional protocol for postoperative pain relief. Group 2 was the study group and received landmark guided erector spinae plane block (ESPB) with 20 cc of 0.25 % bupivacaine for postoperative pain relief. Post-operatively patients were monitored for pain and Visual Analogue Scale (VAS) score was noted at 2nd, 4th and 6th hr and was maintained below 4 by providing them with additional analgesics if required. Time and doses of analgesics required were recorded. RESULTS All the statistical analysis was done using R-Studio 1.2.5001 software. MannWhitney-U test was used for quantitative variables of pain score. Proportion test was used for qualitative demographic data and for post-operative analgesics requirement. Both the groups were comparable on demographic variables. The average VAS score at 2nd and 4th hr was significantly lower in the study group than in the control group (P < 0.05). The VAS score at 6th hr was comparable in both the groups. The analgesic requirement was significantly lower in study group as compared to the control group. CONCLUSIONS The landmark guided ESPB is an effective and simple method to alleviate immediate postoperative pain in PCNL surgeries under general anaesthesia. KEYWORDS Erector Spinae Plane Block, Percutaneous Nephrolithotomy Surgery, Postoperative Pain

Analgesic efficacy and safety of single-dose intramuscular ketorolac for postoperative pain management in children following tonsillectomy

Pain ◽  
1995 ◽  
Vol 61 (1) ◽  
pp. 145-153 ◽  
Author(s):  
Kimberly A. Sutters ◽  
Jon D. Levine ◽  
Suzanne Dibble ◽  
Marilyn Savedra ◽  
Christine Miaskowski
Keyword(s):  
Single Dose ◽  
Pain Management ◽  
Postoperative Pain ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Efficacy And Safety ◽  
Intramuscular Ketorolac

scholarly journals Comparison among subarachnoid opioid mix for cesarean section – An observational study

2020 ◽  
Author(s):  
Cristina Isabel Osorio-Gutiérrez ◽  
Guillermo Alberto Ortiz-Gómez ◽  
Juan Felipe Valencia-Ríos ◽  
Fernando Arango-Gómez
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Adverse Effects ◽  
Cesarean Section ◽  
Analogue Scale ◽  
Safety Data ◽  
Analgesic Efficacy ◽  
Rapid Onset ◽  
Onset Of Action ◽  
Experienced Pain

Introduction: Classically, the local anesthetic (LA) has been combined with one lipophilic and another hydrophilic opioid for neuraxial anesthesia in cesarean section. In Colombia, the practice has been the use of morphine hydrochloride with fentanyl, but the occasional shortage of the former triggered an interest in new options. In response to the shortage of morphine in 2017-2018, a contingency plan was developed at the SES Hospital in Caldas, prefilling syringes at the hospital compounding central, with: bupivacaine, morphine y fentanyl (BMF); bupivacaine, fentanyl and hydromorphone (BHF); and bupivacaine and hydromorphone (BH). Hydromorphone has a rapid onset of action, long-lasting effect and is indicated for spinal administration in the safety data sheet; therefore, the advantages of adding fentanyl to this mix are questionable. Objective: To compare the clinical analgesic efficacy at the time of the incision and during the first 12 hours after surgery. Methods: An observational, analytical study was conducted, using the mixtures BMF, BHF and BH in patients receiving subarachnoid anesthesia for cesarean section. Pain was assessed at the time of the incision, as well as any adverse effects and the pain visual analogue scale over the following 12 hours. Results: Of the 71 patients participating in the study, 40.9 % received BMF; 22.5 %, BHF; and 36.6 %, BH. None of the patients experienced pain at the time of the incision. There was no difference in terms of adverse effects among the three groups. The mean difference in the visual analogue scale (VAS) for postoperative pain at 3, 6 and 12 hours was lower in the groups in which hydromorphone was used. Conclusions: BHF and BH combinations are comparable to the original preparation in terms of adverse effects, with the advantage of being more effective in controlling postoperative pain.

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