Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind, randomized trial comparing Ligasure and Harmonic Scalpel hemorrhoidectomy.
The major problem after hemorrhoidectomy is postoperative pain. New techniques have been evolved to circumvent this problem. The present study was conducted to compare the outcomes of Ligasure hemorrhoidectomy and Harmonic Scalpel hemorrhoidectomy. ⋯ Ligasure hemorrhoidectomy reduces the postoperative pain and operating time compared to the Harmonic Scalpel hemorrhoidectomy. It is a safe, effective procedure for treating Grade 3 and 4 hemorrhoids.
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Randomized Controlled Trial Clinical Trial
Impact on postoperative pain of long-lasting pre-emptive epidural analgesia before total hip replacement: a prospective, randomised, double-blind study.
Clinical studies on pre-emptive analgesia have produced inconsistent results. We conducted a clinical study investigating the effect of long-lasting pre-emptive epidural analgesia on consumption of analgesics and acute pain. Forty-two patients scheduled for elective hip replacement for osteo-arthritis were randomly assigned to receive, on the day before operation, either 5 ml.h(-1) ropivacaine 0.2% (study group, n = 21) or 5 ml.h(-1) saline (control group, n = 21). ⋯ Furthermore, bolus requests occurred more frequently in the control group. VAS scores did not differ significantly between groups. Long-lasting "pre-emptive" epidural analgesia decreases postoperative pain with improved pain control.
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Acta Anaesthesiol Scand · Feb 2005
ReviewReduction of opioid-related adverse events using opioid-sparing analgesia with COX-2 inhibitors lacks documentation: a systematic review.
We have reviewed opioid-related adverse events in studies of opioid sparing with cyclooxygenase-2 (COX-2) inhibitors compared with placebo in postoperative pain. ⋯ The limitation of this review is the lack of quality of data of adverse events from the original trials. Although supplementary opioid consumption in all trials was significantly reduced by on average 35% with the COX-2 inhibitors, it was only sporadically possible to demonstrate a clinically important reduction in opioid-related adverse events. Data did not support the common opinion that opioid-sparing with COX-2 inhibitors provides much clinical beneficial effect with respect to opioid-related adverse events. Future studies have to increase the awareness and proper reporting of adverse events in the postoperative period.
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The development of chronic pain after thoracic surgery is a particularly undesirable yet common complication. As the study of the pathophysiology of chronic pain with regard to the plasticity of the central nervous system advances, new insights are being gained into not only the potential origins of chronic postthoracotomy pain, but also its potential treatment options. ⋯ The ongoing research into the development of chronic pain, including that observed after thoracic surgery, portends the development of further advances in options for its control. The employment of multidisciplinary strategies of pharmacologic, behavioral, and interventional procedural techniques provides the current foundation for the management of this challenging condition.