Articles: analgesics.
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Minerva anestesiologica · Nov 2023
Randomized Controlled TrialComparison of the effects of subcostal anterior quadratus lumborum block and thoracic paravertebral block in laparoscopic nephrectomy: a randomized study.
Thoracic paravertebral block (TPVB) may provide sufficient postoperative analgesia in laparoscopic nephrectomy (LSN) by ensuring ipsilateral somatic and visceral analgesia. However, there are serious reservations due to the complexity of the technique, and various complications thereof. Subcostal anterior quadratus lumborum block (S-QLB3) may be a safe alternative in LSN procedures. Therefore, this study aimed to compare the postoperative analgesic effects of TPVB and S-QLB3. ⋯ In this study, NRS and APS-POQ-R-TR scores were similar in the S-QLB3 and TPVB groups, whereas cumulative morphine consumption was modestly lower in the TPVB group. This suggested that S-QLB3 could be an alternative to TPVB in patients undergoing LSN.
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While opioid prescribing has significantly decreased from a peak in 2012, less is known about the national utilization of non-opioid analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (APAP) in the context of the opioid crisis. The objective of this study is to characterize the prescribing trends of NSAIDs and APAP in the US ambulatory care setting. We conducted repeated cross-sectional analyses using the 2006-2016 National Ambulatory Medical Care Survey. ⋯ PERSPECTIVE: This study shows an overall increasing trend in NSAID use reported in nationally representative ambulatory care visits in the United States. This increase coincides with previously reported significant decreases in opioid analgesic use, particularly after 2012. Given the safety concerns related to chronic or acute NSAID use, there is a need to continue monitoring the use trends of this class of medication.
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This study aimed to investigate the perioperative analgesic effects of anterior quadratus lumborum block (QLB) for total laparoscopic hysterectomy (TLH). ⋯ Preoperative bilateral anterior QLB only reduced intraoperative opioid demand and postoperative abdominal visceral pain scores at 1 hour after surgery. Thus, the clinical significance of anterior QLB in TLH may be limited.
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Retrospective cohort study. ⋯ Patients receiving greater amounts of nonopioid intraoperative medications utilized 20% fewer postoperative morphine milligram equivalents, were discharged 22.3 hours earlier and had earlier recorded evidence of mobility. Postoperatively, nonopioid analgesics were as effective as opioids in the reduction of subjective pain ratings. This study further demonstrates the efficacy of multimodal pain management regimens in pediatric patients receiving PSF for AIS.