Articles: postoperative-pain.
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Curr Opin Anaesthesiol · Dec 2020
ReviewProcedure-specific and patient-specific pain management for ambulatory surgery with emphasis on the opioid crisis.
Postoperative pain is frequent while, on the other hand, there is a grooving general concern on using effective opioid pain killers in view of the opioid crisis and significant incidence of opioid abuse. The present review aims at describing nonopioid measures in order to optimize and tailor perioperative pain management in ambulatory surgery. ⋯ Basic multimodal analgesia should start preoperatively or peroperatively and include paracetamol, cyclo-oxygenase (COX)-2 specific inhibitor or conventional nonsteroidal anti-inflammatory drug (NSAID) and in most cases dexamethasone and local anaesthetic wound infiltration. If any of these basic analgesics are contraindicated or there is an extra risk of severe postoperative pain, further measures may be considered: nerve-blocks or interfascial plane blocks, gabapentinnoids, clonidine, intravenous lidocaine infusion or ketamine infusion. In the abuse-prone patient, a preferably nonopioid perioperative approach should be aimed at.
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Curr Opin Anaesthesiol · Dec 2020
ReviewPeripheral nerve blockade and novel analgesic modalities for ambulatory anesthesia.
Despite peripheral nerve blockade offering analgesic benefits and improving patient satisfaction, it has not been well adopted in ambulatory anesthesia. In this review, we aim to summarize the evidence underlying peripheral nerve blockade, local anesthetic adjuncts, continuous peripheral nerve blockade and novel analgesic modalities, with the objective to provide recommendations on postoperative analgesia optimization after peripheral nerve blockade in an ambulatory setting. ⋯ Educational programs and parallel processing may promote peripheral nerve blockade in an ambulatory setting, improving the patient experience in the postoperative period. Intravenous dexamethasone should be considered wherever appropriate as part of a multimodal analgesic strategy to optimize postoperative pain control.
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Randomized Controlled Trial
The Effect of Position Support During Orthopedic Surgery on Postoperative Pain: A Randomized Controlled Trial.
Positional pain affect the patient's healing process after the operation. Anti-pressure positioning pads are medical products used to support the patient positioning during surgical procedures. ⋯ The conclusion of this study demonstrated that postoperative pain related to positioning, not the surgical procedure itself, was decreased when antipressure gel pads and viscoelastic sponge support were used together. An unanticipated benefit discovered during the study was earlier mobilization of the study group compared to the control group.
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We aimed to characterise the population pharmacokinetics of fentanyl in adults and to determine the minimum effective concentration (MEC) and minimum effective analgesic concentration (MEAC) of i.v. fentanyl in patients after major abdominal open surgery. ⋯ KCT0003273 (http://cris.nih.go.kr).
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Korean J Anesthesiol · Dec 2020
Case ReportsRhomboid intercostal and subserratus plane block: a case series.
The rhomboid intercostal and subserratus plane (RISS) block is a new interfascial block technique that has shown promising results for abdominal and thoracic surgeries. Our objective was to describe the improved analgesia and dermatomal coverage in patients who received bilateral RISS blocks after a major abdominal surgery. ⋯ The RISS block in abdominal surgery seems to have an important role in perioperative pain management, complementing the multimodal analgesic regimen. To determine the efficacy of the RISS block for abdominal surgery, we need further randomized control trials.