Articles: postoperative-pain.
-
Randomized Controlled Trial
The effect of a low-dose naloxone infusion on the incidence of respiratory depression after intrathecal morphine administration for major open hepatobiliary surgery: a randomised controlled trial.
Intrathecal morphine is an analgesic option for major hepatopancreaticobiliary procedures but is associated with a risk of respiratory depression. We hypothesised that a postoperative low-dose naloxone infusion would reduce the incidence of respiratory depression without an increase in pain scores. Patients scheduled for major open hepatopancreaticobiliary surgery and who were receiving 10 μg.kg-1 intrathecal morphine were eligible for inclusion. ⋯ The incidence of respiratory depression was lower in the naloxone group compared with the control group (10/48 vs. 21/47 patients, respectively; p = 0.037, relative risk 0.47 (95%CI 0.25-0.87). Maximum pain scores were greater for patients allocated to the naloxone group compared with control (median 5 (95%CI 4-6) vs. 4 (95%CI 2-4), respectively; p < 0.001). A low-dose naloxone infusion decreases the incidence of respiratory depression following intrathecal morphine administration in patients having major hepatopancreaticobiliary surgery at the expense of a small increase in postoperative pain.
-
J Pain Palliat Care Pharmacother · Jun 2020
Randomized Controlled Trial Clinical TrialProphylactic Effects of Intravenous Dexamethasone and Lidocaine on Attenuating Hemodynamic-Respiratory and Pain Complications in Children Undergoing Cleft Palate Repair Surgery With General Anesthesia.
This study aimed to compare the prophylactic effects of intravenous (IV) dexamethasone and lidocaine on hemodynamic condition, respiratory complications, pain control, and vomit incidence following cleft palate repair surgery. This double-blind randomized controlled trial was carried out on 87 children assigned to three groups. Prior to anesthesia, subjects in groups D and L received 0.2 and 1 mg/kg IV dexamethasone and lidocaine, respectively. ⋯ Premedication with both IV dexamethasone and lidocaine provided similar stable hemodynamic and respiratory conditions during the surgical time. However, the use of dexamethasone developed more desirable effects on HR and SPO2 than administration of lidocaine during the recovery time. Both drugs significantly lessened postoperative pain compared to the placebo group at this time.
-
Anesthesia and analgesia · Jun 2020
Multicenter Study Observational StudyMulticenter Perioperative Outcomes Group Enhanced Observation Study Postoperative Pain Profiles, Analgesic Use, and Transition to Chronic Pain and Excessive and Prolonged Opioid Use Patterns Methodology.
To study the impact of anesthesia opioid-related outcomes and acute and chronic postsurgical pain, we organized a multicenter study that comprehensively combined detailed perioperative data elements from multiple institutions. By combining pre- and postoperative patient-reported outcomes with automatically extracted high-resolution intraoperative data obtained through the Multicenter Perioperative Outcomes Group (MPOG), the authors sought to describe the impact of patient characteristics, preoperative psychological factors, surgical procedure, anesthetic course, postoperative pain management, and postdischarge pain management on postdischarge pain profiles and opioid consumption patterns. ⋯ Therefore, the study serves as a model for future studies using this innovative method. Full results will be reported in future articles; the purpose of this article is to describe the methods of this study.
-
Reg Anesth Pain Med · Jun 2020
Comparing outcomes after peripheral nerve block versus general anesthesia for lower extremity amputation: a nationwide exploratory retrospective cohort study in Japan.
The health benefits of peripheral nerve block (PNB) on postoperative complications after lower extremity amputation (LEA) compared with general anesthesia (GA) remains controversial. We performed a retrospective propensity score-matched cohort analysis to compare major outcomes after LEA with PNB versus GA. ⋯ There was no significant difference between groups in 30-day mortality or composite morbidity. The PNB group showed a significantly lower risk of postoperative delirium than the GA group. Our findings suggest that PNB may have advantages over GA in preventing postoperative delirium among patients undergoing LEA.