Articles: postoperative-pain.
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Randomized Controlled Trial
Efficacy of Perineural Dexmedetomidine in Ultrasound-guided Interscalene Block on Rebound Pain after Shoulder Arthroscopy.
This prospective, randomized, double-blind trial was performed to investigate the effect on rebound pain incidence of mixing dexmedetomidine (DEX) with local anesthetics in a combined injection interscalene block (ISB) during shoulder arthroscopy. ⋯ Perineural DEX added to ISB exerts a beneficial effect on the incidence of rebound pain after ISB in patients undergoing shoulder arthroscopy. Perineural DEX facilitated the implementation of multimodal analgesia in the early stage after operation.
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A single-center, prospective, comparative study. ⋯ Level III.
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Anesthesia and analgesia · Feb 2025
Meta AnalysisOpioid-Sparing Anesthesia Versus Opioid-Free Anesthesia for the Prevention of Postoperative Nausea and Vomiting after Laparoscopic Bariatric Surgery: A Systematic Review and Network Meta-Analysis.
Patients who undergo laparoscopic bariatric surgery (LBS) are susceptible to postoperative nausea and vomiting (PONV). Opioid-free anesthesia (OFA) or opioid-sparing anesthesia (OSA) protocols have been proposed as solutions; however, differences between the 2 alternative opioid protocols for anesthesia maintenance in obese patients remain uncertain. A network meta-analysis was conducted to compare the impacts of OFA and OSA on PONV. ⋯ OFA is more effective than OSA in reducing the occurrence of PONV during the early postoperative period of LBS, although it may associate with an increased risk of bradycardia. Patients who received either opioid-alternative strategy demonstrated similar effects in reducing postoperative opioid consumption and alleviating pain intensity.
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Prescription rates for buprenorphine in opioid use disorder are increasing, and recent guidelines recommend its continuation during and after surgery; however, evidence from clinical outcome studies is limited. The authors tested the hypotheses (1) that perioperative continuation of buprenorphine does not result in higher pain scores and (2) that this approach does not result in higher supplemental postoperative opioid requirements. ⋯ Continuation of buprenorphine is not associated with higher average pain scores or postoperative opioid requirements, supporting recently published guidelines.
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Curr Opin Anaesthesiol · Feb 2025
ReviewPro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery.
Although there are a lot of studies examining the effects of different blocks for postoperative analgesia after video-assisted thoracic surgery (VATS), the results are controversial. ⋯ All three blocks can be suggested for daily practice, the choice should be based on personal experience and preference of the anesthetist. Better studies are required for objective decision.