Articles: postoperative-pain.
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Review Meta Analysis
Perioperative ketamine for postoperative pain management in patients with preoperative opioid intake: A systematic review and meta-analysis.
Postoperative pain management in opioid users remains challenging. The perioperative administration of ketamine might lead to favourable pain outcomes in these patients. ⋯ Prospero CRD42020185497.
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Minerva anestesiologica · Jun 2022
Randomized Controlled TrialBilateral lumbar ultrasound-guided erector spinae plane block versus local anaesthetic infiltration for perioperative analgesia in lumbar spine surgery: a randomized controlled trial.
Lumbar spinal surgery is associated with severe postoperative pain. We examined the analgesic efficacy of bilateral lumbar ultrasound-guided erector spinae plane block (ESPB) with ropivacaine compared with local infiltration. ⋯ Bilateral ultrasound-guided ESPB offers improved postoperative analgesia compared with local infiltration in patients undergoing lumbar spinal surgery.
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Minerva anestesiologica · Jun 2022
Randomized Controlled TrialAnalgesic benefit of metamizole and ibuprofen vs. either medication alone: a randomized clinical trial.
Postoperative pain relief remains a key problem after surgery. Multimodal pain therapy has proven beneficial in alleviating pain to a certain extent. However, when combining non-opioids, the focus has been on NSAIDs and paracetamol, but effects of combined use are only moderate. Metamizole could be a potent adjunct, due to its preclusion in several countries, data on its combined use are sparse, despite its common use in many countries. The aim of this study was to examine whether the combination of metamizole and ibuprofen is superior in relieving postoperative pain to either drug alone. ⋯ Combined use enables superior pain control compared to ibuprofen after molar extraction and tends to be superior to metamizole alone. The premature study-termination may overestimate this effect.
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Randomized Controlled Trial
Combined Programmed Intermittent Bolus Infusion with Continuous Infusion For The Thoracic Paravertebral Block in Patients Undergoing Thoracoscopic Surgery: A Prospective, Randomized, and Double-blinded Study.
Continuous thoracic paravertebral block (TPVB) connected with patient-controlled analgesia (PCA) pump is an effective modality to reduce postoperative pain following thoracic surgery. For the PCA settings, the programmed intermittent bolus infusion (PIBI) and continuous infusion (CI) are commonly practiced. However, the comparative effectiveness between the 2 approaches has been inconsistent. Thus, the aim of this study was to explore the optimal PCA settings to treat postthoracotomy pain by combing PIBI and CI together. ⋯ The combination of PIBI and CI provides superior analgesic modality to either PIBI or CI alone in patients undergoing thoracoscopic surgery. Therefore, it should be advocated to improve the management of postoperative pain, clinical outcomes, and ultimately patient satisfaction.
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Reg Anesth Pain Med · Jun 2022
Association of opioid exposure before surgery with opioid consumption after surgery.
To determine the effect of prescription opioid use in the year before surgery on opioid consumption after surgery. ⋯ Preoperative opioid use is associated with small increases in patient-reported opioid consumption after surgery for most patients, though greater differences exist for patients with chronic use. For most patients with preoperative opioid exposure, existing guidelines may meet their postoperative needs. However, guidelines may need tailoring for patients with chronic use, and providers should anticipate a higher likelihood of postoperative refills for all opioid-exposed patients.