Articles: postoperative-pain.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Randomized Controlled TrialThe Impact of Preoperative Combined Pectoserratus and/or Interpectoral Plane (Pectoralis Type II) Blocks on Opioid Consumption, Pain, and Overall Benefit of Analgesia in Patients Undergoing Minimally Invasive Cardiac Surgery: A Prospective, Randomized, Controlled, and Triple-blinded Trial.
Acute postoperative pain remains a major obstacle in minimally invasive cardiac surgery (MICS). Evidence of the analgesic benefit of chest wall blocks is limited. This study was designed to assess the influence of combined pectoserratus plane block plus interpectoral plane block (PSPB + IPPB) on postoperative pain and the overall benefit of analgesia compared with placebo. ⋯ Preoperative PSPB + IPPB reduced 24-hour postextubation opioid consumption, pain at extubation, and OBAS. Given its low risk and expedient placement, it could be a helpful addition to MICS protocols. Future studies should evaluate these findings in multicenter settings and further elucidate the optimal timing of block placement.
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Poorly controlled acute breast surgery postoperative pain is associated with delayed recovery, increased morbidity, impaired quality of life, and prolonged opioid use during and after hospitalization. Recently, ultrasound-guided pectoralis nerve (PECS) I block and serratus anterior plane (SAP) block, together or individually, have emerged as a potential method to relieve pain, decrease opioid requirements, and improve patient outcomes. ⋯ The PECS I/SAP block may potentially reduce pain in patients having breast surgery for cancer by providing analgesia to the lateral and anterior chest wall. While this analysis showed a reduction in intraoperative opioid consumption, no significant postoperative benefit in either pain scores, opioid consumption, or length of stay was observed. This may be in part due to the PECS I/SAP block not providing adequate analgesia to the medial portion of the breast.
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J Coll Physicians Surg Pak · Dec 2024
Comparative Study Observational StudyComparison of Intrathecal Morphine versus Ultrasound-Guided Regional Analgaesia Techniques for Post-Caesarean Recovery Quality.
To investigate the impact of ultrasound-guided regional analgaesia techniques on postoperative recovery and compare them with those of intratecal morphine (ITM) in obstetric patients undergoing elective caesarean delivery (CD). ⋯ Caesarean delivery, Multimodal analgaesia, Patient-reported outcome, Regional analgaesia techniques, Quality of recovery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Predictors of Postoperative Morphine Milligram Equivalents in Cardiac Surgery.
Given both the short- and long-term deleterious effects of opioids, there has been an increased focused on reducing the use of postoperative opioid analgesia. As patients undergoing cardiac surgery often require high levels opioids postoperatively, understanding risk factors for increased postoperative opioid use may be helpful for the development of patient-specific opioid-sparing pain regimens for this patient population. ⋯ CABG, liver disease, patient-controlled analgesia, younger age, and higher BMI are associated with increased narcotic use after cardiac surgery. Implementation of more aggressive perioperative multimodal opioid-sparing regimens should be considered for these patient groups.
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This case series included 10 patients who underwent clavicular fracture surgery under general anesthesia. A novel analgesic approach combining 2 distinct nerve block techniques-serratus posterior superior intercostal plane block (SPSIPB) and clavipectoral plane block (CPPB)-was used for postoperative pain management. ⋯ The combination of SPSIPB and CPPB demonstrated variable efficacy in controlling postoperative pain. Future studies may explore potential improvements through dosage optimization, the use of adjuvants, or targeting higher anatomical levels.