Articles: postoperative-pain.
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Meta Analysis
The Efficacy and Safety of Gabapentinoids in Total Joint Arthroplasty: Systematic Review and Direct Meta-Analysis.
Gabapentinoids are commonly used as an adjunct to traditional pain management strategies after total joint arthroplasty (TJA). The purpose of this study is to evaluate the efficacy and safety of gabapentinoids in primary TJA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and the American Society of Regional Anesthesia and Pain Management. ⋯ Moderate evidence supports the use of pregabalin in TJA to reduce postoperative pain and opioid consumption. Gabapentinoids should be used with caution, however, as they may lead to an increased risk of sedation and respiratory depression especially when combined with other central nervous system depressants such as opioids.
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The purpose of this study is to define the impact of preoperative opioid use on postoperative opioid use, patient-reported outcomes, and revision rates in a cohort of patients receiving arthroscopic shoulder surgery. ⋯ Level III, retrospective cohort study.
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Pain is the most common symptom among inpatients, and patient-controlled analgesia (PCA) is one of the effective pain management methods for postoperative patients. ⋯ The present findings provide valuable information for the effective postoperative administration of intravenous PCA and may contribute to the development of customized patient-centered pain management intervention by nurses through more accurate predictions of analgesic consumption based on individual characteristics, the surgical site, and the type of surgery-especially organ donation surgery. This study could contribute to improving preventive interventions by general nurses as well as pain control nurses by enabling more accurate predictions of patients' pain and consumption of self-controlled analgesic agents based on personal characteristics and surgical characteristics.
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Journal of anesthesia · Oct 2020
Observational StudyOpioid-free anesthesia under single injection paravertebral block combined with sevoflurane for pediatric renal surgery: a prospective observational pilot study.
Even though several studies have demonstrated the effectiveness of opioid free anesthesia (OFA) strategies in pediatric patients, OFA has not been studied in pediatric renal surgery. We, therefore, conducted a prospective observational pilot study on a total of 26 children to assess the feasibility and efficacy of using a single injection ultrasound-guided paravertebral block (PVB) at T10 level with 0.4 mL/kg bupivacaine 0.25% in combination with sevoflurane as an OFA technique in elective open renal surgery. A successful PVB (defined in terms of both hemodynamic change after the skin incision and the use of rescue analgesia) was observed in 25 children (96%). ⋯ Blood pressure falls were not significant at different measurement times. None of the patients had complications related to PVB, and only one patient had post-operative vomiting. PVB is an attractive method that can procure an effective OFA in combination with sevoflurane in pediatric renal surgery.
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Comparative Study
Postoperative Pain Scores After Open Inguinal Hernia Repair: Comparison of Three Postoperative Analgesic Regimens.
Pain management after open inguinal hernia repair has become an issue that physicians deal with on a daily basis. ⋯ The combinations of IV acetaminophen with either intramuscular pethidine or IV parecoxib are superior to IV acetaminophen monotherapy in achieving pain control in patients undergoing open inguinal hernia repair.