A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients

2018 ◽  
pp. 1
Author(s):  
Brijesh Kumar ◽  
Suresha Ramakrishnappa ◽  
Maina Bekal
Keyword(s):  
Clinical Study ◽  
Pain Management ◽  
Analgesic Efficacy ◽  
Major Surgery ◽  
Patient Controlled Analgesia ◽  
Randomized Clinical Study ◽  
Post Operative Pain

scholarly journals A randomized clinical study to compare pre-emptive analgesic efficacy of clonidine and diclofenac sodium in patients undergoing major surgeries at a tertiary care hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Prachi Jain ◽  
Uma Bhosale ◽  
Shashank Desai
Keyword(s):  
Clinical Study ◽  
Literature Review ◽  
Rating Scale ◽  
Diclofenac Sodium ◽  
Tertiary Care ◽  
Analgesic Efficacy ◽  
Care Hospital ◽  
Pain Scores ◽  
Randomized Clinical Study ◽  
Study Results

Background: Pre-emptive analgesia is a method to achieve analgesia even before exposure to a noxious stimulus The purpose of pre-emptive analgesia is to reduce pain caused due to surgical incision triggered inflammatory mechanism activation; and to ensure a good post-operative pain control so that there is no development of chronic pain. Clonidine is an α2 adrenergic agonist thus it decreases the sympathetic outflow, while Diclofenac is a non-steroidal anti-inflammatory agent. Our literature review showed that both clonidine (150 μg) and diclofenac are efficacious pre-emptive analgesics. Literature review also revealed that there is no study available to compare pre-emptive analgesic efficacy as well as safety of oral clonidine with diclofenac, therefore present study was designed to compare pre emptive analgesic efficacy of these two drugs.Methods: This randomized clinical study included 100 patients from surgical departments, of either sex, between 18 to 70 years age and of American society of anesthesiologists (ASA) I/II grade. Patients were randomly allocated to two groups and received either of the treatments 30 minutes prior to induction of anesthesia. Pain scores were recorded using visual analog scale, facial rating scale and behavioral rating scale at awakening and at 1, 2, 4, 6 and 24 hours. Postoperative analgesic requirement over 24 hours was recorded. Data were analyzed using OpenEpi statistical softwares.Results: Significantly lower pain scores were observed in clonidine group as compared to Diclofenac at 4 and 6 hours (p<0.05) on all the pain scales. Clonidine group also required less postoperative analgesic as compared to diclofenac (p<0.05).Conclusions: Study results are strongly suggestive of greater pre-emptive analgesic efficacy of clonidine over diclofenac in major surgeries done under spinal anesthesia.

scholarly journals A comparative evaluation of diclofenac and tramadol as post-operative analgesics along with causality and severity assessment of ADRs

2019 ◽  
Vol 8 (4) ◽  
pp. 725
Author(s):  
Iram Shaifali ◽  
Suruchi Prakash ◽  
Shalini Chandra ◽  
Jagdamba Saran
Keyword(s):  
Analgesic Efficacy ◽  
Rank Test ◽  
Severity Assessment ◽  
Comparative Efficacy ◽  
Randomized Clinical Study ◽  
Post Operative Pain ◽  
Maximum Benefit ◽  
Signed Rank ◽  
Signed Rank Test ◽  
Mesh Hernioplasty

Background: Diclofenac and Tramadol are well established analgesics for post-operative pain management, yet some adverse effects are associated with their use which govern their tolerability. The objective of the study was to evaluate the comparative efficacy of the two drugs and to assess the causality and severity of documented Adverse Drug Reactions (ADRs).Methods: An open labelled, prospective, interventional, simple randomized clinical study to compare efficacy and safety of diclofenac and tramadol was conducted by the Department of Pharmacology in collaboration with the Department of Surgery. Post-operative pain intensity was measured on Visual Analogue Scale (VAS). Causality and severity assessment of the recorded ADRs was done using WHO-UMC scale and modified Hartwig and Seigel Scale respectively.Results: A total of 211 patients underwent different surgeries. The most common surgery performed was mesh hernioplasty 78 (36.96%). VAS score was used as data to determine the analgesic efficacy of two drugs. Wilcoxon Signed Rank test showed significant reduction in pain on all days for each group individually while Mann Whitney U test compared both the groups and revealed that both the drugs i.e. diclofenac and tramadol were equally efficacious in reducing post-operative pain. Causality assessment showed that all the documented ADRs fall in POSSIBLE category while severity assessment revealed that all the ADRs were MILD in nature.Conclusions: Diclofenac and tramadol proved to be equi-effective in reducing post-operative pain . The study also emphasized that active surveillance of ADRs can lead to timely intervention and provide maximum benefit to the patient.

POST-OPERATIVE PATIENT-CONTROLLED ANALGESIA

2021 ◽  
Vol 21 (3) ◽  
pp. 280-284
Author(s):  
O.O. Pochynok ◽  
I.A. Kuchynska ◽  
D.O. Dziuba
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Pharmacokinetic Profile ◽  
Modern Method ◽  
Patient Controlled Analgesia ◽  
Routes Of Administration ◽  
Post Operative Pain ◽  
Poor Treatment ◽  
Keyword Searching

Background. Unsatisfactory cases of pain management resulted in poor treatment outcomes have been reported in the last quarter of XX century and unfortunately the number of the cases is not decreasing nowadays. Moderate or severe pain are critical causes of complications, increase in morbidity and mortality in the postoperative period after surgical procedures. Patient-controlled analgesia (PCA) is an effective strategy for postoperative pain management as it may provide suitable analgesic dose just after system activation thus reducing periods of pain and an increasing patients’ satisfaction. The purpose of this study is to elucidate the optimal and modern method of postoperative pain-controlled pain managements. Materials and methods. The study material was selected by keyword searching throughout databases Google, PubMed, journal "Anaestesia and Analgesia". Keywords entered into the database search boxes were as following: "patient- controlled analgesia", "postoperative anesthesia", "postoperative anesthesia". The study provides the lattest approaches, benefits and shortcomings in post-operative pain management. Conclusions. Ptient-controlled analgesia is a promisitng mode to control acute pain. A few advantages of this technique can be distinguished, for example, a higher analgesic level with a patient&apos;s satisfactions. Today, there is still no single opinion on which way or medicine is the best to be used in clinical practice because clinical efficiency / safety depends on a complex understanding of the pharmacokinetic profile of medicines for various routes of administration. In addition, pharmacoeconomic research is needed to assess the economic efficiency of these approaches.

Post-operative pain

2018 ◽  
Author(s):  
Jane Quinlan
Keyword(s):  
Epidural Analgesia ◽  
Pain Control ◽  
Severe Pain ◽  
Major Surgery ◽  
Patient Controlled Analgesia ◽  
New Techniques ◽  
Main Form ◽  
Post Operative Pain ◽  
The Mean

The landmark paper discussed in this chapter, published in 2002 by Dolin et al., examines the incidence of moderate-to-severe pain and severe pain after major surgery with three analgesic techniques: intramuscular analgesia, patient-controlled analgesia, and epidural analgesia. Up until 1990, intramuscular morphine was the main form of post-operative pain control, with patient-controlled analgesia and epidural analgesia as relatively new techniques. The authors found that the mean incidence of moderate-to-severe pain was more common with intramuscular analgesia (67%) than with patient-controlled analgesia (36%) or epidural analgesia (21%), while the incidence of severe pain was similar, with the incidence of pain with intramuscular analgesia being highest (29%), followed by that associated with patient-controlled analgesia (10%) and epidural (8%). Of note, only patient-controlled analgesia and epidural achieved the Audit Commission’s 1997 standard of no more than 20% of patients experiencing severe pain, while no technique reached their 2002 standard of less than 5%.

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