scholarly journals Efficacy of methadone for the management of postoperative pain in laparoscopic cholecystectomy: A randomized clinical trial

Medwave ◽  
2021 ◽  
Vol 21 (02) ◽  
pp. e8134-e8134
Author(s):  
Nicolás Arriaza ◽  
Cristian Papuzinski ◽  
Matías Kirmayr ◽  
Marcelo Matta ◽  
Fernando Aranda ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Pain Management ◽  
Postoperative Pain ◽  
Randomized Clinical Trial ◽  
Postoperative Pain Management ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Methadone Group ◽  
Eye Opening

Background Postoperative pain management contributes to reducing postoperative morbidity and unscheduled readmission. Compared to other opioids that manage postoperative pain like morphine, few randomized trials have tested the efficacy of intraoperatively administered methadone to provide evidence for its regular use or be included in clinical guidelines. Methods We conducted a randomized clinical trial comparing the use of intraoperative methadone to assess its impact on postoperative pain. Eighty-six patients undergoing elective laparoscopic cholecystectomy were allocated to receive either methadone (0.08 mg/kg) or morphine (0.08 mg/kg). Results Individuals who received methadone required less rescue morphine in the Post Anesthesia Care Unit for postoperative pain than those who received morphine (p = 0.0078). The patients from the methadone group reported less pain at 5 and 15 minutes and 12 and 24 hours following Post Anesthesia Care Unit discharge, exhibiting fewer episodes of nausea. Time to eye-opening was equivalent between the two groups. Conclusion Intraoperative use of methadone resulted in better management of postoperative pain, supporting its use as part of a multimodal pain management strategy for laparoscopic cholecystectomy under remifentanil-based anesthesia.

scholarly journals Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial

2017 ◽  
Vol 45 (2) ◽  
pp. 100-107
Author(s):  
Adriana Cadavid-Puentes ◽  
Francisco José Bermúdez-Guerrero ◽  
Olga Giraldo-Salazar ◽  
Fabio Muñoz-Zapata ◽  
Juan Otálvaro-Henao ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
Severe Postoperative Pain

scholarly journals The clinical application of preoperative self-anticipated pain score and the correlation with surgical pain after elective surgery - a prospective observational study

2020 ◽  
Author(s):  
Wei-Shu Chang ◽  
Yi-Ting Hsieh ◽  
Moa-Chu Chen ◽  
Shu-Ching Chang ◽  
Tzu-Shan Chen ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Observational Study ◽  
Pain Score ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Elective Surgery ◽  
Perioperative Period ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit

Abstract Background Current principles of postoperative pain management are primarily based on the types and extent of surgical intervention. This clinical study measured patient’s self-anticipated pain score before surgery, and correlated the scores with the pain levels and analgesic requirements after surgery. Methods This prospective observational study recruited consecutive patients who received elective surgery in the E-Da Hospital, Taiwan from June to August 2018. Patients were asked to subjectively rate their highest anticipated pain level (numerical rating scale, 0-10) for the scheduled surgical interventions during their preoperative anesthesia assessment. After the operation, the actual pain intensity (NRS 0-10) experienced by the patient in the post-anesthesia care unit and the total dose of opioids administered during the perioperative period were recorded. Results A total of 996 patients were included in the study. Most of the patients (86%) received general anesthesia and 73.9% of them had a history of previous operation. Younger patients (<40 years) (P=0.042) and those took regular benzodiazepine at bedtime (P=0.043) anticipated significantly higher pain levels. Male patients anticipated significantly lower pain intensities than females (odd ratio 1.710; 95% CI 1.254-2.331, P=0.001). Patients who scheduled for laparotomies (P=0.037), orthopedic surgeries (P=0.040) or long procedures (P<0.001) reported higher anticipated pain. Although higher anticipated pain scores were associated with higher postoperative pain levels (P=0.021) and higher total equivalent opioid dose (P=0.001) for acute pain management during the perioperative period, these surgical patients actually experienced less pain than they anticipated at the post-anesthesia care unit. Conclusion This observational study found that patients who are female, younger age (<40 years), use regular benzodiazepines at bedtime and scheduled for long procedures (>2 h), laparotomies or orthopedic surgeries anticipate significantly higher surgery-related pain. Therefore, appropriate preoperative counseling for analgesic control and the management of exaggerated pain expectation in these patients is necessary to improve the quality of anesthesia delivered and patient’s satisfaction.

Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial☆

2017 ◽  
Vol 45 (2) ◽  
pp. 100-107
Author(s):  
Adriana Cadavid-Puentes ◽  
Francisco José Bermúdez-Guerrero ◽  
Olga Giraldo-Salazar ◽  
Fabio Muñoz-Zapata ◽  
Juan Otálvaro-Henao ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
Severe Postoperative Pain
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