scholarly journals A comparison between epidural Butorphanol and Tramadol for postoperative analgesia, sedation and side effects using CSEA technique for surgeries below the level of umbilicus

2016 ◽  
Vol 7 (11) ◽  
pp. 537
Author(s):  
Preeti More ◽  
Charchill Wagh ◽  
Vandana Laheri
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia

scholarly journals Anaesthesia and Postoperative Analgesia Performed by Insertion of a Perineural Catheter at the Brachial Plexus Site - Case Series

2015 ◽  
Vol 61 (3) ◽  
pp. 241-244
Author(s):  
Lazar Alexandra ◽  
Szederjesi Janos ◽  
Copotoiu Sanda Maria ◽  
Simon Noemi Szidonia ◽  
Badea Iudita ◽  
...  
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Case Series ◽  
Postoperative Pain Management ◽  
Perineural Catheter ◽  
Plexus Block ◽  
Systemic Drug

Abstract Postoperative pain management is of major importance and the existence of a device that ensures a good analgesia in the immediate postoperative period and also removes the side effects of the systemic drugs, is becoming a necessity. Objectives: The goal was to obtain a good quality anaesthesia and also a good postoperative analgesia by inserting a perineural catheter at the brachial plexus site. Material and method: This study included adult patients who underwent brachial plexus anaesthesia through a perineural catheter inserted at the brachial plexus site. The perineural catheter was introduced by ultrasound guidance with neurostimulation control. After insertion, a quantity of a an-aesthetic admixture of 0.4mg/kg is administered. The anaesthetic admixture contained Ropivacaine and Lidocaine, equimolar concentration of 0.5% In the postoperative period, the analgesia was ensured trough the already installed catheter. The analgesic mixture contained Ropivacaine and Lidocaine, equivalent concentrations of 0.25%. The administration rate was 5 ml every 4 hours, starting 6 hours postoperatively. Results: The anaesthesia, obtained through the perineural catheter, was a good quality anaesthesia ensuring both, good sensory and motor block. The feedback regarding postoperative analgesia was positive, this type of pain management being efficient and without the systemic drug side effects. This approach of brachial plexus block was accepted easily by the patients and was rated as a very satisfactory method. Conclusions: The insertion of a perineural catheter for anaesthesia and postoperative analgesia represents a safe and efficient method of achieving both analgesia and anaesthesia.

scholarly journals Intermittent Subcutaneous Morphine for Postoperative Analgesia Following Coronary Artery Bypass Grafting

2020 ◽  
Author(s):  
CN Namitha ◽  
Manjunath R Kamath ◽  
Ananda Bangera ◽  
M Gopala Krishnan ◽  
B Amith Kiran
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Side Effects ◽  
Postoperative Pain ◽  
Coronary Artery Bypass ◽  
Postoperative Analgesia ◽  
Artery Bypass ◽  
P Value ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction: An effective postoperative pain management is of utmost importance following cardiac surgery. Various agents, routes and modes are available for the treatment of postoperative pain. Subcutaneous route of administration is an easy and effective method of postoperative analgesia with improved patient satisfaction and lesser side effects compared to intravenous route. Aim: To evaluate the efficacy of Subcutaneous Morphine (SCM) as postoperative analgesia following Coronary Artery Bypass Grafting (CABG). Materials and Methods: This study was designed as a retrospective analytical survey from June 2015 to June 2017. Medical records of all patients over 18 years of age who underwent coronary artery bypass grafting were reviewed. Patients belonging to ASA PS I, II and III, patients above 18 years of age and those posted for coronary artery bypass grafting were included in the study. Patients were divided into two groups: SCM group and Paracetamol (PCT) group, depending on the primary analgesia they received. The two groups were compared using Student’s t-test for normally distributed continuous data or non-parametric tests if the data were not normally distributed. Categorical data were compared by Fisher’s-exact test. The p-values <0.05 were considered statistically significant. Results: A total of 102 records were reviewed, out of which 49 patients received SCM and 53 patients had received PCT as their primary postoperative analgesia. It was observed that PCT group required more additional analgesia (intravenous fentanyl/ tramadol) than SCM group which was statistically significant with p-value of <0.001 and the duration of Cardiac Intensive Care Unit (CICU) stay was more in PCT group with p-value of 0.001. Postoperative side effects were significantly more in PCT group. Conclusion: SCM can be effectively administered intermittently for postoperative analgesia following CABG with similar haemodynamic stability and minimal side effects as compared to intermittent intravenous PCT.

scholarly journals Effect of Dexamethasone as an Adjuncton Efficacy of Ropivacaine in Caudal Block forPostoperative Analgesia in Paediatric Infra-Umbilical Surgeries: A Randomised Double-blind Controlled Study

2021 ◽  
Author(s):  
Veena Patodi ◽  
Kavita Jain ◽  
Mukesh Choudhary ◽  
Surendra Kumar Sethi ◽  
Neena Jain ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Controlled Study ◽  
P Value ◽  
Single Shot ◽  
Caudal Block ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Paediatric Patients ◽  
Haemodynamic Changes

Introduction: Caudal block is a routinely performed analgesic and anaesthetic technique in paediatric population undergoing various infra-umbilical surgeries. Various adjuvants have been used along with local anaesthetics like ropivacaine in single-shot caudal block for enhancing postoperative analgesia in paediatric infra-umbilical surgeries. Aim: To evaluate the efficacy of dexamethasone used as an adjuvant to 0.2% ropivacaine in caudal block for postoperative analgesia in paediatric patients. Materials and Methods: This was a randomised doubleblinded controlled study conducted on 80 paediatric patients (8 months-8 years), with American Society of Anesthesiologists (ASA) physical status I or II undergoing various infra-umbilical surgeries,at a tertiary care teaching institute from April 2019 to September 2019. These total subjects were randomly allocated into two groups. GroupR (n=40) administered 0.2% ropivacaine (1 mL/kg) while GroupRD (n=40) administered 0.2% ropivacaine (1 mL/kg) with dexamethasone (0.1 mg/kg) in caudal block. The duration of analgesia, postoperative pain scores (Face Legs Activity Cry Consolability (FLACC) score), rescue analgesic consumption in 24 hours, haemodynamic changes and side-effects were noted. The rescue analgesic (paracetamol 15 mg/kg oral) was given whenever FLACC ≥4. Standard qualitative and quantitative tests (unpaired student t-test, Chi-square test) were used to analyse and compare the results obtained. Results: The mean duration of analgesia was significantly longer in Group RD (745.21±146.91 min) as compared to GroupR (440.38±76.44 min); (p-value <0.001). The significantly lower FLACC pain scores were noted in patients in Group RD compared to Group R; (p-value <0.05). The rescue analgesic consumption was significantly lesser in Group RD in terms of requirement of number of doses of rescue analgesic than in Group R; (p-value <0.05). No significant haemodynamic changes or side-effects were observed in both groups; (p-value >0.05). Amongst postoperative complications noted, fever was observed in 1 patient (3.33%) and PONV in 2 patients (6.66%) in Group R. None complications were observed in the patients of RD group. Conclusion: Dexamethasone (0.1 mg/kg) was found to be safe and effective adjuvant to 0.2% ropivacaine for caudal block in children undergoing various infra-umbilical surgeries.

scholarly journals The Effect of Systemic and Regional Use of Magnesium Sulfate on Postoperative Tramadol Consumption in Lumbar Disc Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Melek Demiroglu ◽  
Canan Ün ◽  
Dilsen Hatice Ornek ◽  
Oya Kıcı ◽  
Ali Erdem Yıldırım ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Lumbar Disc ◽  
Demographic Data ◽  
The Other ◽  
Lumbar Disc Surgery ◽  
Paraspinal Muscles ◽  
Pain Scores ◽  
Disc Surgery ◽  
C 30

Aim.To investigate the effect of magnesium administered to the operative region muscle and administered systemically on postoperative analgesia consumption after lumbar disc surgery.Material and Method.The study included a total of 75 ASA I-II patients aged 18–65 years. The patients were randomly allocated into 1 of 3 groups of 25: the Intravenous (IV) Group, the Intramuscular (IM) Group, and the Control (C) Group. At the stage of suturing the surgical incision site, the IV Group received 50 mg/kg MgSO4intravenously in 150 mL saline within 30 mins. In the IM Group, 50 mg/kg MgSO4in 30 mL saline was injected intramuscularly into the paraspinal muscles. In Group C, 30 mL saline was injected intramuscularly into the paraspinal muscles. After operation patients in all 3 groups were given 100 mg tramadol and 10 mg metoclopramide and tramadol solution was started intravenously through a patient-controlled analgesia device. Hemodynamic changes, demographic data, duration of anesthesia and surgery, pain scores (NRS), the Ramsay sedation score (RSS), the amount of analgesia consumed, nausea- vomiting, and potential side effects were recorded.Results.No difference was observed between the groups. Nausea and vomiting side effects occurred at a rate of 36% in Group C, which was a significantly higher rate compared to the other groups (p<0.05). Tramadol consumption in the IM Group was found to be significantly lower than in the other groups (p<0.05).Conclusion.Magnesium applied to the operative region was found to be more effective on postoperative analgesia than systemically administered magnesium.

scholarly journals Intraoperative and Postoperative Analgesia Using Intravenous Opioid, Clonidine and Lignocaine

1994 ◽  
Vol 22 (1) ◽  
pp. 15-21 ◽  
Author(s):  
M. de Kock ◽  
P. Lavandhomme ◽  
J. L. Scholtes
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Randomised Trial ◽  
Skin Incision ◽  
Time Interval ◽  
Colonic Surgery ◽  
Double Blind ◽  
Group A ◽  
Group B ◽  
Group D

The postoperative analgesia afforded after colonic surgery by IV opioid, clonidine and lignocaine given intra- and postoperatively was evaluated. In a double-blind randomised trial, 80 male patients scheduled for colonic resection under general anaesthesia received fentany 15 μg.kg−1 at induction and another 4 μg.kg−1 before skin incision (group A) or fentanyl (same dose) plus clonidine 4 μg.kg−1 in 20 min + 2 μg.kg−1.h−1 (group B, C) or fentanyl plus clonidine (same dosage) plus lignocaine 2 mg.kg−1 before skin incision, repeated before peritoneal incision and retractor placement (group D). In the four groups, intraoperative boluses of fentanyl 2 μg.kg−1 were given in response to the painful stimulation of the procedure. Postoperative pain was managed with PCA delivering 2 mg morphine per request in group A, 1.5 mg morphine in group B, 1.5 mg morphine + 15 μg clonidine in group C and 1.2 mg morphine + 15 μg clonidine + 23 mg lignocaine in group D. Postoperative analgesia was assessed by recording the analgesic demands (met and unmet) and the dose of morphine delivered at 6, 12, 18, 24, 36 hours. Side-effects, pain and sedation analogue scores were also recorded. A nalgesic demands and delivered morphine dose were reduced, at any time interval considered, in groups B, C, D, compared with A (P <0.001). No differences were noted between the groups B, C, D. Pain analogue scores were better in groups B, C, D compared with group A (P <0.001). Sedation and side-effects were not increased in groups B, C, D. Intraoperative clonidine was the major determinant of the reduction in analgesic demands and morphine delivered. Lignocaine, at the dose used, failed to afford any additional benefit.

scholarly journals A Trial of Meptazinol for the Relief of Pain after Abdominal Surgery

1980 ◽  
Vol 8 (4) ◽  
pp. 441-444 ◽  
Author(s):  
John M. Gibbs ◽  
Helen D. Johnson
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Abdominal Surgery ◽  
Postoperative Analgesia ◽  
Open Study ◽  
Clinical Impression ◽  
Ventilatory Depression

Meptazinol is an opioid drug having mixed agonist-antagonist properties. Chemically it is a hexahydroazepine derivative. It has been used to provide postoperative analgesia1,2 for patients undergoing abdominal surgery but only in single dose studies. The drug is of particular interest in that the clinical impression of minimal ventilatory depression has been confirmed, 3 60 mg meptazinol showing less ventilatory depression than 10 mg of morphine. To test its efficacy in patients undergoing abdominal surgery and to assess the incidence of side effects, an open study was undertaken in 43 patients.

A Comparison of Naproxen, Indomethacin and Acetylsalicylic Acid in Pain after Varicose Vein Surgery

1978 ◽  
Vol 6 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Ulla Aromaa ◽  
Kari Asp
Keyword(s):  
Side Effects ◽  
Acetylsalicylic Acid ◽  
Postoperative Analgesia ◽  
Varicose Vein ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Varicose Vein Surgery ◽  
Double Blind ◽  
Post Operative Pain ◽  
Minor Surgery

Oral naproxen in doses of 500 mg and 750 mg daily was compared with oral indomethacin, 75 mg daily, in a double-blind, completely randomized study of patients with post-operative pain after out-patient varicose vein surgery. Altogether, 120 patients were studied. In the study 750 mg naproxen proved to be equal in respect of analgesic efficacy to 75 mg indomethacin, and it was clearly superior to 1500 mg acetylsalicylic acid. Naproxen, 500 to 750 mg daily, afforded adequate postoperative analgesia in 98% of patients. The side-effects were mild. On the basis of the study, naproxen can be recommended as a pain-relieving drug after minor surgery, particularly when an antiphlogistic effect is also desirable.

Postoperative analgesia after radical prostatectomy with high-dose intrathecal morphine and intravenous naloxone: A retrospective review

2018 ◽  
Vol 5 (6) ◽  
pp. 331-339 ◽  
Author(s):  
Annette Rebel, MD ◽  
Paul Sloan, MD ◽  
Michael Andrykowski, PhD
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Radical Prostatectomy ◽  
Respiratory Depression ◽  
Postoperative Analgesia ◽  
Intrathecal Morphine ◽  
Major Surgery ◽  
High Dose ◽  
The Mean

Background and methods: Intrathecal opioids (ITOs) have been used for decades to control postoperative pain. Intrathecal opioid dosing is limited, however, by opioid-related side effects, most importantly respiratory depression. To overcome these limitations, we combined intrathecal morphine with a continuous intravenous (IV) postoperative naloxone infusion to control opioid-related side effects. The purpose of this study is to document the efficacy and safety of high-dose intrathecal morphine combined with postoperative naloxone infusion to provide postoperative analgesia after major surgery. After IRB approval, a retrospective chart analysis was performed on 35 patients who had a radical prostatectomy from 2004 to 2006. All patients received a single injection of ITOs before anesthesia, a typical general anesthestic, followed by naloxone infusion at 5 μg/kg/h started 1 hour post-ITOs and continued for 22 hours postoperatively. The following information was collected: patient age, height, weight, anesthesia technique/time, and dose of ITOs given. Postoperative pain relief was assessed for 48 hours using the Visual Analog Score (VAS) for pain (0, no pain; 10, worst pain), perioperative opioid use, NSAID consumption, and ability of patient to ambulate. The safety of this novel treatment was assessed with opioid-related side effects and vital signs. All data are reported as mean (SD).Results: Mean ITOs given were morphine 1.3 (0.3) mg combined with fentanyl 56 (9) μg. The intrathecal morphine dose ranged from 0.8 to 1.7 mg. The mean worst pain VAS in the first 12 hours postoperatively was only 1.0 (1.7). The first NSAID dose was given 6.6 (3.1) hours post-ITOs. The first opioid on the floor was given an average of 22.6 (14.5) hours post-ITOs. A mean of only 5.7 (12.3) morphine equivalents were required on postoperative day 1 (POD 1). On POD 2, the mean worst pain VAS was only 2.6 (2.2) with only 5.7 (6.2) morphine equivalents needed to provide pain relief. On POD 1, 25 patients required no additional opioids for their entire hospital stay. Overall, 11 of 35 patients did not require any additional postoperative opioids. Thirtyfour patients (97 percent) were able to ambulate in the first 12 hours postoperatively. No opioid-induced respiratory depression was observed. Opioid-related side effects (pruritus, nausea) were infrequent and minor.Conclusions: High-dose ITOs combined with postoperative IV naloxone infusion provided excellent analgesia for radical prostate surgery. IV naloxone infusion appeared to control opioid side effects without diminishing the analgesia. No serious adverse effects were noted.

scholarly journals Postoperative analgesia after lumbar disc surgery: A comparison between ketorolac and opioid

2014 ◽  
Vol 23 (2) ◽  
pp. 56-61
Author(s):  
Md Mustafa Kamal ◽  
Abdullah Al Maruf ◽  
Sabina Yeasmeen ◽  
Abdul Hye
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Urinary Retention ◽  
Postoperative Analgesia ◽  
Lumbar Spine Surgery ◽  
Surgical Closure ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Post Operative Nausea

Background Most spinal surgery is painful and good postoperative analgesia is important. Opioids are the traditional first-line treatment. Ketorolac has been used for postoperative pain relief. However, there is no data available about controlling postoperative pain with ketorolac after open lumbar discectomy or laminectomy in Bangladesah. Objective To compare the efficacy of a Parentral ketorolac with conventional opioid for management of postoperative pain after lumbar disectomy or laminectomy. Methods Sixty patients who underwent lumbar disectomy or laminectomy were randomly allocated into two groups. Group A (n = 30) patients received 30 mg intramuscular ketorolac upon surgical closure and every 6 hours for 24 hours and intramuscular pethidine 1.5 mg/kg/b.w. as needed (PRN). Group B (n = 30) patients received only intramuscular pethidine 1.5 mgkg-1/b.w. every 6 hours for 24 hours and as needed (PRN). Postoperative analgesia was assessed in both groups by Visual Analogue Scale at arrival in postoperative ward and at 6, 12 and 24 hours for 24 hours. Total postoperative narcotic consumption and side effects like post operative nausea and vomiting (PONV), dizziness, urinary retention and pruritus were also recorded. Results Baseline data were comparable between the two groups. The mean VAS almost similar and less than 3 at different reading in both groups which indicate adequate postoperative analgesia and the differences were statistically not significant. The mean total cumulative amount of pethidine administered over 24 hrs period was less in group A it was 64.31+19.13 mg where as in group B was 161.23+21.25 mg. and the difference was statistically significant (p<0.01). Incidences of side effects like PONV, urinary retention and pruritus were more in group B than group A and differences were statistically significant (p<0.01). Conclusion For postoperative pain management after lumbar spine surgery both ketorolac and traditional parental opioid found effective. Total opioid consumption is significantly less with ketorolac and side effects like PONV, dizziness, urinary retention and pruritus were more with opioid alone. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18175 Journal of BSA, 2009; 23(2): 56-61

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