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Postoperative Pain Scores (postoperative + pain_score)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Anesthesia & Pain Management	44%
Surgery & Surgical Specialties	33%

Selected Abstracts

Teenage and adult tonsillectomy: dose,response relationship between diathermy energy used and morbidity

CLINICAL OTOLARYNGOLOGY, Issue 5 2007
A.A.J. Cardozo
Objective:, To determine whether an increase in the use of bipolar diathermy energy to perform a tonsillectomy is associated with an increase in postoperative pain and haemorrhage. Study design:, Prospective study. Setting:, District General Hospital. Methods:, In all, 101 patients above the age of 13 years who underwent a tonsillectomy that involved the use of bipolar diathermy during the study period were included. The cumulative amount of diathermy energy used to perform each tonsillectomy was calculated with the help of a digital stop clock timing device connected to the diathermy foot-pedal. Main outcome measures:, Postoperative pain scores and the incidence of secondary haemorrhage were recorded for each patient at four points in time following surgery, up to the tenth postoperative day. The haemorrhage rates were categorised into three groups (no bleeding, minor bleeding and major bleeding) according to severity. Associations between the diathermy energy used to perform each tonsillectomy and the corresponding postoperative pain scores and secondary bleeding rates were investigated. Results:, There was a statistically significant positive relationship between the total amount of bipolar diathermy energy used per tonsillectomy and the pain scores at all the four recorded points in time (rs = 0.44,0.72, P < 0.001). When the median energy consumption in the three groups (no bleeding, minor bleeding and major bleeding) were compared using the Kruskal,Wallis test, we found that there was limited evidence of a difference between the groups, but this was not statistically significant at the 5% level [H (2) = 5.374, P = 0.065, 99% CI 0.058,0.071]. Conclusions:, Increased use of bipolar diathermy during the performance of a tonsillectomy is associated with a statistically significant increased amount of postoperative pain. The dose,response relationship between diathermy energy and postoperative bleeding is less clear. This suggests that there could be other important factors such as surgical instrument characteristics and degree of tonsillar adherence that have an additional influence and are therefore possible areas for future research. [source]

Superficial selective cervical plexus block following total thyroidectomy: A randomized trial

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2010
Isaak Kesisoglou MD
Abstract Background. Pain after thyroid surgery is of moderate intensity and short duration. Bilaterally superficial cervical plexus block (BSCPB) may reduce analgesic requirements. However, its effectiveness in decreasing pain after thyroidectomy is debated. Methods. This double-blind, randomized placebo-controlled study in 100 patients undergoing total thyroidectomy evaluates the effects of BSCPB done with 20 mL of 0.75% ropivacaine. Additional parecoxib was administrated immediately postoperatively and 12 hours later. Results. Postoperative pain was assessed by visual analogue rating scale. All parameters were recorded at 0, 3, 6, 9, 12, and 24 hours after surgery. The control group had higher values than the ropivacaine group at all moments (p < .05) except H12 (p = .76). Additional analgesia was needed for 7 patients (14%) in the control group and for 8 patients (16%) in the group with ropivacaine (p = .96). Conclusion. Two-point bilateral BSCPB has a major analgesic effect on patients after total thyroidectomy, with a statistically significant reduction in postoperative pain scores. However, no significant difference was noted in the proportion of patients that required additional analgesics. © 2009 Wiley Periodicals, Inc. Head Neck, 2010 [source]

Intrathecal neostigmine with bupivacaine for infants undergoing lower abdominal and urogenital procedures: dose response

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2009
Y. K. BATRA
Background: Intrathecal (IT) neostigmine produces dose-dependent analgesia in adults. However, the dose of spinal neostigmine has not been investigated in infants. The purpose of this study was to assess spinal anesthesia (SA) duration provided by four doses of spinal neostigmine added to bupivacaine for lower abdominal and urogenital procedures in infants. Methods: Seventy-five infants were randomized into five groups. The control group B received IT plain 0.5% hyperbaric bupivacaine. Groups BN.25, BN.50, BN.75, and BN1.0 received bupivacaine with 0.25, 0.5, 0.75, and 1 ,g/kg of neostigmine, respectively. The primary variable was the duration of anesthesia assessed by recovery of hip flexion. Postoperative pain with facial expression, leg activity, arm activity, crying and consolability scale score,and rescue analgesic requirements were the secondary variables measured, and the side effects were noted. Results: Seventy-three infants completed the study. There was a significant linear increase in SA duration with IT neostigmine to 65.2 (4.3) min with 0.5 ,g/kg (P<0.01), 88.2 (5.1) with 0.75 ,g/kg (P<0.001) and 92 (4.3) with 1 ,g/kg (P<0.001) from 52.4 (4.3) min with bupivacaine alone. SA duration showed no significant difference between plain bupivacaine and BN.25 (P=0.100) or between groups BN.75 and BN1.0 (P=0.451). Groups BN.75 and BN1.0 had significantly reduced pain scores, and the median duration before the first dose rescue analgesic was requested prolonged significantly (P<0.001) compared with the other three groups. Conclusions: IT neostigmine at a dose of 0.75 ,g/kg added to bupivacaine significantly prolonged SA duration with reduced postoperative pain scores and rescue analgesic requirements in infants undergoing lower abdominal and urogenital procedures. No additional benefits were provided on increasing it to 1 ,g/kg. [source]

Regional anaesthesia in day-stay and short-stay surgery

ANAESTHESIA, Issue 2010
S. L. Kopp
Summary The goals for ambulatory surgery are rapid recovery with minimal side effects, adequate postoperative pain control, rapid patient discharge and overall cost containment. The addition of regional anaesthetic techniques has been shown to decrease nausea, postoperative pain scores and the need for post-anaesthesia care unit monitoring. The use of regional anaesthesia is increasing as studies confirm the goals for ambulatory anaesthesia can be met with a combination of regional anaesthesia and a multimodal pain management regimen. [source]

Effect of epidural saline washout on regression of sensory and motor block after epidural anaesthesia with 2% lidocaine and fentanyl in elderly patients

ANAESTHESIA, Issue 3 2009
E. Y. Park
Summary Seventy elderly males received lumbar epidural anaesthesia with 12 ml of 2% lidocaine containing fentanyl 50 ,g. At the end of transurethral surgery, the washout group (n = 33) received an epidural bolus of 30 ml saline while the control group (n = 34) did not. Mean (SD) times to 1-grade (17.2 (11.9) vs 32.7 (11.3) min) and 2-grade regression (23.8 (12.2) vs 56.0 (23.9) min) of motor block, 3-dermatomal sensory regression (31.4 (11.6) vs 42.2 (14.4) min for cold and 30.8 (15.6) vs 40.6 (14.2) min for pinprick), and regression to S1 (57.7 (16.1) vs 76.2 (20.2) min for cold and 56.8 (17.3) vs 69.2 (16.2) min for pinprick) were significantly shorter in the washout group than the control group. There were no differences in postoperative pain scores and side effects between the two groups. We concluded that epidural washout facilitates regression of both motor and sensory block following epidural anaesthesia without reducing the postoperative analgesic benefit. [source]

A comparison of dexmedetomidine and midazolam for sedation in third molar surgery,

ANAESTHESIA, Issue 11 2007
C. W. Cheung
Summary This randomised, double-blind study compared dexmedetomidine and midazolam for intravenous sedation during third molar surgery under local anaesthesia. Sixty patients received either dexmedetomidine (up to 1 ,g.kg,1) or midazolam (up to 5 mg), which was infused until the Ramsay Sedation Score was four or the maximum dose limit was reached. Intra-operative vital signs, postoperative pain scores and analgesic consumption, amnesia, and satisfaction scores for patients and surgeons, were recorded. Sedation was achieved by median (IQR (range)) doses of 47 ,g (39,52 (25,76)) or 0.88 ,g.kg,1 (0.75,1.0 (0.6,1.0)) dexmedetomidine, and 3.6 mg (3.3,4.4 (1.9,5.0)) or 0.07 mg.kg,1 (0.055,0.085 (0.017,0.12)) midazolam. Heart rate and blood pressure during surgery were lower in dexmedetomidine group. There was no significant difference in satisfaction or pain scores. Midazolam was associated with greater amnesia. Dexmedetomidine produces comparable sedation to midazolam. [source]

LAPAROSCOPIC VERSUS OPEN VENTRAL HERNIA REPAIR: A RANDOMIZED CONTROLLED TRIAL

ANZ JOURNAL OF SURGERY, Issue 10 2008
Chris M. Pring
Laparoscopic and open techniques are both recognized treatment options for ventral hernias. We conducted a prospective randomized trial of both methods, to assess hernia recurrence, postoperative recovery and complications. Fifty-eight patients with ventral hernias were enrolled into the trial between August 2003 and December 2005. Of these, 31 underwent laparoscopic repair and 27 underwent open repair. Clinical parameters were documented on all patients during a median follow-up period of 27.5 months. The demographics of the two groups were similar. There was one recurrence in each of the laparoscopic and open groups. There was an equivalent rate of operative time, length of stay, postoperative pain scores, return to normal activities, wound infection and seroma formation between the two groups. Laparoscopic and open ventral hernia repair are comparable and offer low recurrence rates. [source]

Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2010
P.-C. Lee
Background: Transumbilical single-incision laparoscopic cholecystectomy (SILC) and minilaparoscopic cholecystectomy (MLC) are both increasingly being used to treat symptomatic gallstones. The present study compared SILC and MLC with respect to outcome in a prospective randomized trial. Methods: Seventy patients with symptomatic cholelithiasis were randomized to SILC or MLC (35 in each group). The primary outcome measure was postoperative pain. Secondary outcomes were duration of operation, complications, postoperative analgesic requirements, length of hospital stay, cosmetic result, wound length and time to return to work. Results: Surgical complications, postoperative pain scores, analgesic requirements and time to return to work were similar for both procedures. Statistically significant advantages of SILC were a shorter hospital stay, shorter total wound length and better cosmetic appearance. Duration of operation was significantly shorter for MLC. Conclusion: SILC is superior to MLC in terms of cosmetic outcome, but not in postoperative pain and requirement for analgesics. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]