Articles: postoperative-pain.
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Reg Anesth Pain Med · Jan 2023
Observational StudyEvaluating the role for regional analgesia in children with spina bifida: a retrospective observational study comparing the efficacy of regional versus systemic analgesia protocols following major urological surgery.
Regional techniques are a key component of multimodal analgesia and help decrease opioid use perioperatively, but some techniques may not be suitable for all patients, such as those with spina bifida. We hypothesized peripheral regional catheters would reduce postoperative opioid use compared with no regional analgesia without increasing pain scores in pediatric patients with spina bifida undergoing major urological surgery. ⋯ Continuous regional analgesia following major urological surgery in children with spina bifida was associated with a 70% intraoperative and 78% postoperative reduction in opioids without higher pain scores. This approach should be considered for similar surgical interventions in this population.
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Differences in neonatal pharmacokinetics are known to cause systemic accumulation of levobupivacaine with adverse effects during epidural analgesia. Therefore, it is not recommended to surpass 48 hours of administration in neonates. Free and total levobupivacaine levels are considered as predictors of toxicity. ⋯ Caudal epidural analgesia with levobupivacaine lasting longer than 48 hours appears to be safe providing that free levobupivacaine levels are below the presumed threshold for toxicity (Tab. 1, Fig. 1, Ref. 29). Text in PDF www.elis.sk Keywords: free levobupivacaine, total levobupivacaine, neonate, caudal continuous epidural analgesia, postoperative pain.
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Randomized Controlled Trial
Comparison of the Postoperative Analgesic Effects between Ultrasound-Guided Transmuscular Quadratus Lumborum Block and Thoracic Paravertebral Block in Laparoscopic Partial Nephrectomy Patients: A Randomized, Controlled, and Noninferiority Study.
This prospective, randomized, double-blinded, noninferiority study aimed to compare the effects of analgesia and recovery between transmuscular quadratus lumborum block (TMQLB) and paravertebral block (PVB). ⋯ The postoperative 48-hour analgesic effect of TMQLB was noninferior to that of PVB in laparoscopic partial nephrectomy. This trial is registered with NCT03975296.
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Postgraduate medicine · Jan 2023
Extraperitoneal versus transperitoneal cesarean section: a retrospective study.
To evaluate extraperitoneal cesarean section as a routine elective surgery. ⋯ While extraperitoneal cesarean section can be safely performed as a routine procedure in the surgical delivery of primiparas, it must be performed by well-trained surgeons. In view of its advantages, it is worth being promoted in senior general hospitals as a routine choice.Abbreviations: CS: Cesarean section; ECS: Extraperitoneal; TCS: Transperitoneal; VAS: Visual analogue scale.
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Rev Assoc Med Bras (1992) · Jan 2023
Assessment of pain and quality of life in patients undergoing cardiac surgery: a cohort study.
This study aimed to evaluate postoperative pain and quality of life in patients undergoing median sternotomy. ⋯ Proper management of post-sternotomy pain in the Intensive Care Unit may imply better quality of life at out-of-hospital follow-up.