Articles: postoperative.
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Gabapentin is an antiepileptic drug used in a variety of chronic pain conditions. Increasing numbers of randomized trials indicate that gabapentin is effective as a postoperative analgesic. This procedure-specific systematic review aims to analyse the 24-hour postoperative effect of gabapentin on acute pain in adults. ⋯ Perioperative use of gabapentin has a significant 24-hour opioid sparing effect and improves pain score for both abdominal hysterectomy and spinal surgery. Nausea may be reduced in abdominal hysterectomy.
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Despite the presence of a plethora of publications on the prevention of postoperative nausea and vomiting (PONV) only little is known how to treat established symptoms. Besides the high effort of performing these efficacy trials (much more patients must give their consent than are actually included in a study) and ethical concerns, little is known about the rate of re-occurring PONV/vomiting after placebo. As a consequence investigators will have difficulties defining a clinically relevant effect for the new treatment which is crucial for any planning. A quantitative systematic review was performed in order to provide more reliable estimates of the incidence of re-occurring PONV/vomiting after placebo and to help investigators defining a clinically relevant treatment effect. ⋯ Almost all trials showed a considerable and consistently high rate of recurrence of emetic symptoms after placebo highlighting the need for a consequent antiemetic treatment. Future (placebo) controlled efficacy trials may use the presented empirical estimates for defining clinically relevant effects and for statistical power considerations.
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Rev Bras Anestesiol · Dec 2006
[Postoperative analgesia for orthopedic surgeries of the hip and femur: a comparison between psoas compartment and inguinal paravascular blocks.].
This study evaluated the efficacy of a single injection of 0.25% bupivacaine in the psoas compartment or inguinal paravascular for postoperative analgesia in patients undergoing orthopedic surgeries using a peripheral nerve stimulator. ⋯ Psoas compartment block and inguinal paravascular block are excellent techniques for postoperative analgesia in orthopedic surgeries, decreasing the need for opioids. This study showed that the injection in the psoas compartment was easier and more effective in blocking the five nerves of the lumbar plexus.
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Rev Bras Anestesiol · Dec 2006
[Comparison among three techniques of postoperative regional analgesia with ropivacaine in children.].
Postoperative pain increases cost and generates dissatisfaction among parents regarding to the analgesics prescribed to their children. Ropivacaine has a broad safety margin to be used for regional block in pediatric patients. The aim of this study was to compare caudal epidural block (CE) with ilioinguinal/iliohypogastric nerve block (IINB) and infiltration of surgical wound (ISW) with ropivacaine for postoperative analgesia in children. ⋯ Ilioinguinal/iliohypogastric nerve block was superior to ISW, especially in the first two hours after the surgery. The three anesthetic techniques can be safely and effectively used to control postoperative pain in inguinal herniorrhaphy in children.
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This investigation evaluated the efficacy of nalbuphine in treating postoperative opioid-induced pruritus (Pr) in pediatric patients. ⋯ La nalbuphine iv à 50 µg·kg(-1) n'est pas efficace pour traiter le prurit postopératoire induit par les opioïdes chez des patients pédiatriques. Le score modifié à l'EAC et la DIPr devront être étudiés plus à fond.