Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Background: Acute postoperative pain is a common problem in clinical practice and merits attention considering its potential long-term adverse effects. This systematic review covers current knowledge on methods for individual prediction of postoperative pain. Methods: A systematic literature search was conducted using the PubMed, EMBASE, and CINAHL databases for original studies with adult patients published in English between 2016 and 2022. ⋯ The focus has shifted from procedure-specific to individualized strategies to improve early management of pain. However, many traditional predictive methods still have a questionable role in clinical practice. Trial Registration: ClinicalTrials.gov identifier: CRD42022298479.
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Background: Acute postoperative pain is a common problem in clinical practice and merits attention considering its potential long-term adverse effects. This systematic review covers current knowledge on methods for individual prediction of postoperative pain. Methods: A systematic literature search was conducted using the PubMed, EMBASE, and CINAHL databases for original studies with adult patients published in English between 2016 and 2022. ⋯ The focus has shifted from procedure-specific to individualized strategies to improve early management of pain. However, many traditional predictive methods still have a questionable role in clinical practice. Trial Registration: ClinicalTrials.gov identifier: CRD42022298479.
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Review Meta Analysis
Preoperative Ketamine Gargle for Prevention of Postoperative Sore Throat After Tracheal Intubation in Adults: A Meta-Analysis.
Objective: This meta-analysis aims to evaluate the impact of preoperative ketamine gargle on postoperative throat pain in patients undergoing general anesthesia with endotracheal intubation (ETI). Methods: A comprehensive search was conducted in databases including PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ClinicalTrials.gov, and others. Data analysis was performed using RevMan 5.4 and Stata Statistical Software 18 (StataCorp., Texas., United States of America). ⋯ The results demonstrated a significant reduction in the incidence of postoperative sore throat at 0, 2, 4, 8, and 24 h after the operation (0 h: OR: 0.14; 95% CI: 0.04-0.47; p=0.002; I 2 = 67%; 2 h: OR: 0.30; 95% CI: 0.17-0.52; p < 0.0001; I 2 = 31%; 4 h: OR: 0.32; 95% CI: 0.20-0.52; p < 0.00001; I 2 = 0%; 8 h: OR: 0.40; 95% CI: 0.23-0.70; p=0.001; I 2 = 29%; 24 h: OR: 0.36; 95% CI: 0.25-0.51; p < 0.00001; I 2 = 0%) in patients who received ketamine gargle compared to those who received a placebo. In addition, our meta-analysis indicated that ketamine gargle did not result in a reduction in anesthesia time (min) (MD: -1.16; 95% CI: -6.44-4.11; p=0.67). Conclusion: Our meta-analysis demonstrated the efficacy of prophylactic ketamine gargle in reducing the incidence of POST across all studied time intervals in patients requiring tracheal intubation of general anesthesia compared to placebo.
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General anaesthesia (GA) as a pharmacological behaviour management strategy may be indicated for dental extractions in children unable to cooperate in the dental chair. Pain is the most common postoperative complication in children following dental GA. There is conflicting evidence available on the efficacy of local anaesthetic (LA) agents for postoperative pain management following dental extraction. ⋯ Methods of pain assessment varied greatly across included studies, with 14 different pain scales used across the 15 studies. Included studies suggest preoperative oral paracetamol and oral ibuprofen as well as postoperative topical bupivacaine lowered pain scores. This review underscores the challenges in reliably assessing pain in children and highlights the necessity for age-specific validated pain assessment tools.
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General anaesthesia (GA) as a pharmacological behaviour management strategy may be indicated for dental extractions in children unable to cooperate in the dental chair. Pain is the most common postoperative complication in children following dental GA. There is conflicting evidence available on the efficacy of local anaesthetic (LA) agents for postoperative pain management following dental extraction. ⋯ Methods of pain assessment varied greatly across included studies, with 14 different pain scales used across the 15 studies. Included studies suggest preoperative oral paracetamol and oral ibuprofen as well as postoperative topical bupivacaine lowered pain scores. This review underscores the challenges in reliably assessing pain in children and highlights the necessity for age-specific validated pain assessment tools.