Articles: postoperative-pain.
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Minerva anestesiologica · Jan 2020
Randomized Controlled TrialEfficacy of intraperitoneal bupivacaine, hydrocortisone, and magnesium sulfate in different combinations for pain relief after laparoscopic ovarian cystectomy: a double-blind randomized controlled trial.
The aim of this study was to assess the efficacy of intraperitoneal different combinations for postoperative pain relief in patients undergoing laparoscopic unilateral ovarian cystectomy. ⋯ Intraperitoneal bupivacaine-magnesium combination provides better analgesia and reduces postoperative morphine consumption than bupivacaine-hydrocortisone or magnesium-hydrocortisone combinations after laparoscopic ovarian cystectomy.
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Electrochemotherapy (ECT) is a symptom control method for inoperable or exulcerating cutaneous metastases or skin cancer. With the help of electroporation, an enhancement of the efficacy of the administered chemotherapeutic agent, bleomycin or cisplatin, is achieved, which leads to a local reduction of the metastases and thereby has a low impact on the systemic health. ECT can be performed under local, regional or general anaesthesia, whereby the form of anaesthesia depends on the number and extent of the metastases as well as the affected body site. ⋯ To prevent lung damage from bleomycin, the patient has to be ventilated with a low FiO2 (< 0.3), or preferably with room air. To avoid drug interactions and postoperative pain, general anaesthesia is performed as TIVA in deep relaxation. The anaesthesia team should be aware of the necessary precautions when applying chemotherapeutic agents and should recognize contraindications to performing anaesthesia in ECT in advance.
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Ulus Travma Acil Cer · Jan 2020
Randomized Controlled TrialThe effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial.
Hip fracture is a common clinical problem which causes severe pain in geriatric patients. However, severe pain following fracture may bring on mental disorders and delirium. A neuroinflammatory response with IL-6 and IL-8 has been shown to be associated with the pathophysiology of delirium. In this study, our primary hypothesis is that preoperative femoral nerve block (FNB) intervention in geriatric patients will more effectively attenuate pain following trochanteric femur fracture than the preoperative paracetamol application. Our secondary hypothesis is that interleukin levels (IL-6, IL-8) in cerebrospinal fluid (CSF) will be lower in the femoral nerve block group than the paracetamol group. Our tertiary hypothesis is that the incidence of postoperative delirium will be lower in the femoral nerve block group. ⋯ The femoral nerve block was more effective in preoperative pain management of trochanteric femur fracture and preventing pain during regional anesthesia application. The mean IL-8 level was lower in the femoral nerve block group when compared to the paracetamol group. There is no difference in the postoperative delirium incidence between groups.
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Observational Study
The association between genome-wide polymorphisms and chronic postoperative pain: a prospective observational study.
Chronic postoperative pain is common and can have a negative impact on quality of life. Recent studies show that genetic risk factors are likely to play a role, although only gene-targeted analysis has been used to date. This is the first genome-wide association study to identify single-nucleotide polymorphisms associated with the development of chronic postoperative pain based on two independent cohorts. ⋯ A single-nucleotide polymorphism in NAV3 was significantly replicated with chronic postoperative pain in the replication cohort (p = 0.009). Meta-analysis revealed that two loci (IQGAP1 and CRTC3) were significantly associated with chronic postoperative pain at 3 months (IQGAP1 p = 3.93 × 10-6 β = 2.3863, CRTC3 p = 2.26 × 10-6 , β = 2.4209). The present genome-wide association study provides initial evidence for genetic risk factors of chronic postoperative pain and supports follow-up studies.
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Comparative Study
Efficacy of pectoral nerve block type II versus thoracic paravertebral block for analgesia in breast cancer surgery.
Ultrasound-guided pectoral nerve block type II is a recently proposed technique for postoperative analgesia after breast cancer surgery. The thoracic paravertebral block is widely used for this purpose by decades. The presented study compares the efficacy of these two techniques for postoperative analgesia. ⋯ In breast cancer surgery, the pectoral nerve block type II with ropivacaine 0.375% can provide postoperative analgesia that is comparable to the single-level thoracic paravertebral block.