scholarly journals A Study on Post Operative Pain Assesment on Arrival Using Vas Score among Urological Procedures after general Anaesthesia vs. Regional Anaesthesia

Author(s):  
K. S. Jaya Madhumithra ◽  
Mohana Priya

Background: A Visual Analogue Scale (VAS) is a measurement that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured [1]. The 100 mm visual analogue scale (VAS) score is widely used to measure pain intensity after surgery. The main objective here is to compare the effectiveness and safety of general anaesthesia (GA) vs. regional anaesthesia (RA) in urological procedures with the help of VAS. Methods: We enrolled a sequential, unselected cohort of fifty-two patients on arrival from surgery and used a VAS to quantify pain intensity. We compared changes in the VAS among patients who received either GA or RA for urological procedures. Patient’s comorbidities, vitals, pain visual analogue scale (VAS) are evaluated. Intraoperative and post-operative complications were recorded. Results: Vital parameters were maintained at safe values throughout the procedure in both groups. Visual analogue pain score was lower in regional anaesthesia  till one hour mark of post-operative period as compared with GA cluster (P <0.05). Patients in regional anaesthesia recorded lower consumption of analgesics during the post-operative day-0 as compared with GA cluster (P < 0.05). Post-operative shivering was higher in RA cluster  than GA cluster (8% vs. 2%) whereas nausea and fever was higher in GA cluster than RA cluster (5% vs. 2% and 4% vs. 1% respectively). However, Patients in GA cluster recorded higher overall satisfaction scores than RA cluster. Conclusion: Both GA and RA were effective and safe in Percutaneous Nephrolithotomy. It is observed that PCNL under RA was associated with significantly shorter operative time and hospital stay. Furthermore, postoperative pain scores were low, lower nausea and/or vomiting, and reduced analgesic requirements were noted in the RA group. However, GA provides heaps of satisfaction for patients.

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Choirul Hadi ◽  
Trisula Utomo

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.


1998 ◽  
Vol 112 (1) ◽  
pp. 41-44 ◽  
Author(s):  
P. Murthy ◽  
M. R. Laing

AbstractA prospective study of 99 adults undergoing tonsillectomy was carried out to determine the pattern of post-operative pain, intake of medication and timing of return to work and normal swallowing. The differences in the pain scores, as measured by a visual analogue scale, between every third consecutive day following post-operative day four were found to be highly significant (p<0.001). Sixty-six patients (66.6 per cent) required medication in the form of analgesics and/or antibiotics after the first post-operative day. Sixty-four out of a total of 82 patients (78.2 per cent) returned to work within 14 days of surgery. Ninety-six patients (97 per cent) reported normal swallowing within 14 days of surgery. These results suggest that the majority of adult patients undergoing tonsillectomy can be appropriately advised pre-operatively regarding the probable pattern and duration of post-operative pain and the timescales they can expect to return to work and normal swallowing.


2018 ◽  
Vol 8 (5) ◽  
pp. 37-41
Author(s):  
Minh Nguyen Van ◽  
Nga Bui Thi Thuy ◽  
Thinh Tran Xuan

Background: The transversus abdominis plane block (TAP block), a regional block, provides effective analgesia after lower abdominal surgeries. The objective of this study was to assess whether transversus abdominis plane block is effective as part of multimodal pain management following Cesarean section. Materials and Method: Totally, 60 ASA I and II parturients for Cesarean section via Pfannenstiel incision under spinal anesthesia were randomly allocated to either the TAP block group or the control. The TAP block group received a landmark-orientated, bilateral TAP block with 0.25% levobupivacain 17,5ml each side in the triangle of Petit. Postoperative pain treatment followed the same protocole for both groups with 1gram paracetamol intravenously and received patrient-controlled analgesia with intravenous morphine. The time to first request of analgesic, morphine consumption, visual analogue scale (VAS) pain scores and side effects were scored at 2, 4, 6, 8, 12 h postoperatively. Results: The time to first request of analgesic was longer, morphine consumption was lower in TAP group than in the control (p < 0.05). Visual analogue scale (VAS) pain scores at rest and on mouvement were similar in two groups at 2h, but lower in TAP group from 4h (p < 0.05). No severe adverse effects were detected in two groups. Conclusion: TAP block prolonged the time to fisrt request of analgesic and reduced morphine consumption, the VAS pain scores significantly both at rest and on mouvement. Therefore, TAP block is feasible and effective as part of a multimodal analgesia regimen after Caesarean section. Key words: Caesarean section, multimodal pain management, transversus abdominis plane block


2016 ◽  
Vol 97 (2) ◽  
pp. 217-221
Author(s):  
V N Shilenok ◽  
E V Nikitina

Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.


2018 ◽  
Vol 6 (2) ◽  
pp. 6
Author(s):  
Kalpana Kharbuja ◽  
Mahesh Sharma ◽  
Nil Raj Sharma

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy. Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant. Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.   Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.


2015 ◽  
Vol 1 (2) ◽  
pp. 80
Author(s):  
Mastan Saheb Shaik ◽  
Venkata Rama Rao M ◽  
Sailaja K

Context: There are limited studies indicating the incideance of post operative morbidity and mortality in high risk patients. Urological procedures constitute a major portion of geriatric surgeries where a cardiac obligation is almost inevitable and selected for this study purpose.Aims: To compare the incidence of post operative cardiovascular complications during regional and general anesthetic techniques in patients with known cardiac risk undergoing urological surgeriesSettings and Design: Prospective randomized double blind study.Methods and Material: 40 patients aged above 50 years posted for elective urological surgeries were enrolled in the study after obtaining approval from hospital ethics committee and written informed consent from the patients. Patients were divided into two groups A& B. Group A (n=20) received general and group B (n=20) received regional anaesthesia (spinal/ Epidural). All the patients received standard premedication and their basal vitals( BP, HR, ECG pattern) were recorded. The same parameters were monitored in the post operative period at regular intervals.Statistical analysis used: Student T test is used to test the significance of stastical difference in the variables between the two groups.Results: The mean heart rate and the mean arterial blood pressure were increased (P<0.01) in the general anaesthesia group. Group A showed 10% incidence of ECG changes and group B showed 35% incidence of ECG changes. But the changes in the hemodynamics were not significant.Conclusions: There is no difference between regional anaesthesia and general anaesthesia regarding the post operative outcome after urological procedures with respective hemodynamic changes.


2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.


2015 ◽  
Vol 20 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Tuba Berra Saritas ◽  
Hale Borazan ◽  
Selmin Okesli ◽  
Mustafa Yel ◽  
Seref Otelcioglu

BACKGROUND: Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, aN-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements.METHODS: A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg/mL; group M, n=34) or 10 mL of normal saline (group C, n=33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores >5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times).RESULTS: Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range.CONCLUSIONS: Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects.


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