Effect of Intravenous Acetaminophen and Flurbiprofen on Postoperative Pain after Lumbar Disc Surgery

Aims: Lumbar disc surgery is often associated with moderate to severe postoperative pain. Whether non-steroidal anti-inflammatory drugs or acetaminophen provides effective analgesia following lumbar disc surgery remains controversial. This study aimed to determine whether flurbiprofen produces analgesic effects equivalent to those of acetaminophen after lumbar disc surgery. Study Design: Prospective, randomized, open-label, placebo-controlled trial Place and Duration of Study: Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo, Japan, between April 2018 and March 2019. Methodology: We studied 76 patients who underwent elective lumbar disc surgery under general anesthesia. The patients were randomly allocated to one of three groups. Group A (n=25) received 1000 mg of acetaminophen intravenously every 6 h. Group F (n=25) received 50 mg of flurbiprofen intravenously every 6 h. Group C (n=26) received saline intravenously every 6 h as a placebo. Each drug was started before skin closure 18 h after surgery. All patients were anesthetized under total intravenous anesthesia with propofol and remifentanil and received fentanyl before skin closure. Postoperative pain was evaluated using a numerical rating scale (NRS) at 0, 1, 3, 6, 12, 18, and 24 h postoperatively. The patients were administered diclofenac sodium or loxoprofen, as rescue analgesics, as needed. Results: There were no significant differences in patient characteristics among the three groups. There were no significant differences in NRS scores among the three groups during the study period. However, rescue analgesics were administered significantly less frequently in group F than in groups A and C over 12 h and 24 h, respectively. Conclusion: The results of this study showed that flurbiprofen might provide more effective analgesia than acetaminophen following lumbar disc surgery.

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Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial

Pain Research and Management ◽

10.1155/2020/5853412 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Mohammad Jafar Eghbal ◽

Ali Haeri ◽

Arash Shahravan ◽

Ali Kazemi ◽

Fariborz Moazami ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Root Canal ◽

Rating Scale ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Mineral Trioxide Aggregate ◽

Preoperative Pain ◽

Multicenter Randomized Controlled Trial ◽

The Mean

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative “Pain Intensity” (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients’ demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P<0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.

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Evaluation of Preoperative Administration of the Cyclooxygenase-2 Inhibitor Rofecoxib for the Treatment of Postoperative Pain after Lumbar Disc Surgery

Neurosurgery ◽

10.1227/00006123-200205000-00019 ◽

2002 ◽

Vol 50 (5) ◽

pp. 1053-1058 ◽

Cited By ~ 3

Author(s):

Alex Bekker ◽

Paul R. Cooper ◽

Anthony Frempong-Boadu ◽

Ramesh Babu ◽

Thomas Errico ◽

...

Keyword(s):

Postoperative Pain ◽

Lumbar Disc ◽

Cyclooxygenase 2 ◽

Lumbar Disc Surgery ◽

Disc Surgery ◽

Preoperative Administration

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Lornoxicam and Tramadol applications for postoperative pain management in lumbar disc surgery

Regional Anesthesia and Pain Medicine ◽

10.1016/j.rapm.2005.07.037 ◽

2005 ◽

Vol 30 (5) ◽

pp. 81-81

Author(s):

T KUZUCUOGLU ◽

T YENER ◽

F TEMIZEL ◽

Z ARIKAN

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Lumbar Disc ◽

Postoperative Pain Management ◽

Lumbar Disc Surgery ◽

Disc Surgery

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Electroacupuncture to alleviate postoperative pain after a laparoscopic appendectomy: study protocol for a three-arm, randomised, controlled trial

BMJ Open ◽

10.1136/bmjopen-2016-015286 ◽

2017 ◽

Vol 7 (8) ◽

pp. e015286 ◽

Cited By ~ 3

Author(s):

Seunghoon Lee ◽

Dongwoo Nam ◽

Minsoo Kwon ◽

Won Seo Park ◽

Sun Jin Park

Keyword(s):

Postoperative Pain ◽

Laparoscopic Appendectomy ◽

Pain Control ◽

Rating Scale ◽

Acupuncture Treatment ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Control Group ◽

Acupuncture Points ◽

Postoperative Pain Control

BackgroundThe purpose of this study is to evaluate the efficacy and safety of electroacupuncture (EA) for postoperative pain after laparoscopic appendectomy compared with sham electroacupuncture (SEA) and no acupuncture treatment.Methods and analysisThis study is a protocol for a three-arm, randomised, patient-assessor-blinded (to the type of acupuncture treatment), controlled, parallel trial. 138 participants diagnosed with appendicitis and scheduled for laparoscopic appendectomy will be randomly assigned to the EA group (n=46), SEA group (n=46) or control group (n=46). The EA group will receive acupuncture treatment at both regional and distal acupuncture points with electrostimulation. The SEA group will receive sham acupuncture treatment with mock electrostimulation. Both EA and SEA groups will receive a total of four treatments 1 hour preoperative, 1 hour postoperative and during the morning and afternoon the day after surgery with the same routine postoperative pain control. The control group will receive only routine postoperative pain control. The primary outcome is the 11-point Pain Intensity Numerical Rating Scale (PI-NRS) at 24 hours after surgery. The secondary outcomes are the PI-NRS, analgesic consumption, opioid-related side effects, time to first passing flatus, quality of life and adverse events evaluated 6, 12, 24 and 36 hours and 7 days after surgery.Ethics and disseminationThe study was planned in accordance with the Helsinki Declaration and the Korean Good Clinical Practice Guidelines to protect the participants and was approved by the institutional review board (IRB) of Kyung Hee University Medical Center (KMC IRB-1427–02). The results will be disseminated in peer-reviewed journals and presented at international conferences.Trial registration numberClinical Research Information Service (KCT0001328).

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Effectiveness of behavioral graded activity after first-time lumbar disc surgery: short term results of a randomized controlled trial

European Spine Journal ◽

10.1007/s00586-003-0560-9 ◽

2003 ◽

Vol 12 (6) ◽

pp. 637-644 ◽

Cited By ~ 27

Author(s):

R. W. J. G. Ostelo ◽

H. C. W. de Vet ◽

M. W. Berfelo ◽

M. R. Kerckhoffs ◽

J. W. S. Vlaeyen ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Short Term ◽

Randomized Controlled ◽

Disc Surgery ◽

Graded Activity ◽

First Time

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Clinic-based training in comparison to home-based training after first-time lumbar disc surgery: a randomised controlled trial

European Spine Journal ◽

10.1007/s00586-008-0826-3 ◽

2008 ◽

Vol 18 (3) ◽

pp. 398-409 ◽

Cited By ~ 27

Author(s):

Ann-Christin Johansson ◽

Steven J. Linton ◽

Leif Bergkvist ◽

Olle Nilsson ◽

Michael Cornefjord

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Disc Surgery ◽

Home Based ◽

Randomised Controlled ◽

First Time

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Effectiveness and cost-effectiveness of rehabilitation after lumbar disc surgery (REALISE): design of a randomised controlled trial

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-14-124 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Teddy Oosterhuis ◽

Maurits van Tulder ◽

Wilco Peul ◽

Judith Bosmans ◽

Carmen Vleggeert-Lankamp ◽

...

Keyword(s):

Cost Effectiveness ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Disc Surgery ◽

Randomised Controlled

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Efficacy of intravenous paracetamol, metamizol and lornoxicam on postoperative pain and morphine consumption after lumbar disc surgery

European Journal of Anaesthesiology ◽

10.1097/eja.0b013e32833731a4 ◽

2010 ◽

Vol 27 (5) ◽

pp. 428-432 ◽

Cited By ~ 39

Author(s):

Ozlem Korkmaz Dilmen ◽

Yusuf Tunali ◽

Ozlem S Cakmakkaya ◽

Ercument Yentur ◽

Ayse C Tutuncu ◽

...

Keyword(s):

Postoperative Pain ◽

Lumbar Disc ◽

Morphine Consumption ◽

Lumbar Disc Surgery ◽

Disc Surgery ◽

Intravenous Paracetamol

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Reduction of postoperative lumbar hemilaminectomy pain with Marcaine

Journal of Neurosurgery ◽

10.3171/jns.1979.51.1.0126 ◽

1979 ◽

Vol 51 (1) ◽

pp. 126-127 ◽

Cited By ~ 24

Author(s):

John B. Mullen ◽

Wesley A. Cook

Keyword(s):

Postoperative Pain ◽

Local Anesthetic ◽

Marked Reduction ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Content Type ◽

Disc Surgery ◽

Long Acting ◽

Fine Print

✓ A technique is described using intraoperative infiltration of paravertebral musculature with Marcaine, a long-acting local anesthetic. This has resulted in a marked reduction of postoperative pain following lumbar disc surgery.

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