A comparison between fentanyl plus celecoxib therapy and epidural anesthesia for postoperative pain management following laparoscopic gastrectomy

Shibasaki, Susumu; Kawamura, Hideki; Homma, Shigenori; Yosida, Tadashi; Takahashi, Shusaku; Takahashi, Masahiro; Takahashi, Norihiko; Taketomi, Akinobu

doi:10.1007/s00595-015-1290-4

Cited by 5 publications

(5 citation statements)

References 32 publications

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“…Measures that have been reported to assist in the treatment of postoperative pain include inducing local anesthesia, decreasing pneumoperitoneum pressure[3], and administering non-steroidal anti-inflammatory drugs (NSAIDs) and opioids[10]. We found several trials that assessed the effects of local anesthesia in intraperitoneal, subdiaphragmatic, and trocar sites, which significantly decreased postoperative pain scores[11,12].…”

Section: Discussionmentioning

confidence: 99%

Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy

Zhang¹,

Du²,

Liu³

et al. 2019

WJG

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BACKGROUNDCompared with traditional open surgery, laparoscopic surgery is preferred due to the advantages of less trauma, less pain, and faster recovery. Nevertheless, many patients still suffer from postoperative pain resulting from the surgical incision and associated tissue injury. Many researchers have reported methods to improve postoperative pain control, but there is not a simple and effective method that can be clinically adopted in a widespread manner. We designed this study to prove the hypothesis that application of ropivacaine in the port site and operative site in patients is an effective and convenient method which can decrease postoperative pain and accelerate recovery.AIMTo evaluate the effects of ropivacaine on pain control after laparoscopic hepatectomy and its contribution to patient recovery.METHODSFrom May 2017 to November 2018, 146 patients undergoing laparoscopic hepatectomy were randomized to receive infiltration of either 7.5 mg/mL ropivacaine around the trocar insertions, incision, and cutting surface of the liver (with a gelatin sponge soaked with ropivacaine) at the end of surgery (ropivacaine group), or normal saline (5 mL) at the same sites at the end of surgery (control group). The degree of pain, nausea, vomiting, heart rate (HR), and blood pressure were collected. The length of postoperative hospitalization, complications, and the levels of stress hormones were also compared between the two groups.RESULTSCompared with the control group, the ropivacaine group showed reduced postoperative pain at rest within 12 h (P < 0.05), and pain on movement was reduced within 48 h. The levels of epinephrine, norepinephrine, and cortisol at 24 and 48 h, HR, blood pressure, and cumulative sufentanil consumption in the ropivacaine group were significantly lower than those in the control group (P < 0.05). In the ropivacaine group, hospitalization after operation was shorter, but the difference was not statistically significant. There were no significant differences in postoperative nausea, vomiting, or other complications, including hydrothorax, ascites, peritonitis, flatulence, and venous thrombus (P > 0.05), although fewer patients in the ropivacaine group experienced these situations.CONCLUSIONInfiltration with ropivacaine in the abdominal wound and covering the cutting surface of the liver with a gelatin sponge soaked with ropivacaine significantly reduce postoperative pain and the consumption of sufentanil.

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Section: Discussionmentioning

confidence: 99%

Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy

Zhang¹,

Du²,

Liu³

et al. 2019

WJG

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“…It has also been reported that non-steroidal anti-inflammatory drugs (NSAIDs) exert synergistic analgesic effects when used concomitantly with opioids [20]. We previously reported the efficacy of our new analgesic protocol using celecoxib and fentanyl after laparoscopic gastrectomy [21]. However, to date, there are no reports on the analgesic effects of celecoxib after laparoscopic colorectal surgery.…”

Section: Introductionmentioning

confidence: 93%

Postoperative analgesia using fentanyl plus celecoxib versus epidural anesthesia after laparoscopic colon resection

et al. 2016

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Purpose Effective postoperative analgesia is essential to a patient's recovery after laparoscopic colon resection (LCR). We introduce a new analgesic protocol using fentanyl plus celecoxib following LCR.Methods The subjects of this retrospective comparative study were 137 patients who underwent LCR, 63 of whom were treated with 72 h of epidural anesthesia (group E), and 74 of whom were treated with 24 h of fentanyl intravenous injection followed by 7 days of oral celecoxib (group FC). We evaluated the safety and efficacy of this new protocol.Results The combination of fentanyl and celecoxib maintained a low postoperative pain score (<1.5, evaluated by the FACES Pain Scale) and reduced the need for rescue analgesic drugs for 7 days (groups E vs. FC: 5.39±3.77 vs. 2.79±2.92, p<0.001). The postoperative hospital stay was almost equal for the two groups (E vs. FC: 11.1±4.5 vs. 10.3±4.8 days, p=0.315). The operating room stay other than for surgery was significantly shorter for group FC (E vs. FC: 128.7±30.5 vs. 107.2±17.0 min, p<0.001). Neither group experienced complications, apart from one group FC patient, who suffered nausea and experienced vertigo. ConclusionsThe new analgesic protocol using fentanyl plus celecoxib is an effective and time-saving strategy for LCR.3

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“…En esta revisión se incluyeron cinco revisiones sistemáticas (7-11); once estudios de cohorte retrospectiva (1,12-21); tres de cohorte prospectiva (3,22,23); siete ensayos clínicos controlados aleatorizados (24-30); dos ensayos clínicos no aleatorizado (31,32); un reporte de caso (33); y un metaanálisis de ensayos clínicos controlados aleatorizados (34).…”

Section: Calidad De Estudios Y Sesgounclassified

“…La anestesia espinal torácica, al producir un bloqueo selectivo de la inervación simpática cardíaca (T1-T5), produce disminución del efecto adrenérgico, reduciendo la presión arterial, frecuencia y contractibilidad cardíaca, que son los mayores determinantes de la demanda de oxígeno miocárdico durante la intervención quirúrgica. Adicionalmente, el bloqueo produce vasodilatación coronaria y sistémica, aumentando el flujo sanguíneo en las regiones isquémicas del miocardio, y también una reducción en la precarga y poscarga (3,4).…”

Section: Introductionunclassified

Ventajas del uso de anestesia epidural en cirugía abdominal

Ortega¹,

Paucar²

2021

RECIMUNDO

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Antecedentes: Desde 1980, la anestesia epidural se ha propuesto para controlar el dolor post- operatorio, consiste en administrar un anestésico local a nivel del espacio peridural con el fin de bloquear la transmisión del impulso doloroso. Objetivo: Describir las ventajas acerca del uso de anestesia epidural en cirugía abdominal. Fuente de datos: Se trata de una revisión bibliográfica durante los meses de julio – agosto 2020, en las bases de datos Google Scholar, PubMed y Elsevier obteniendo 352 trabajos, que tras la eliminación de resultados duplicados y análisis de calidad de evidencia generaron 30 estudios que se incluyeron como fuente de datos. Resultados: La anestesia epidural puede ser indicada en cirugía vascular abdominal, cirugía renal, cirugía ginecológica, y cirugía emergente en el contexto de COVID-19, además de todos aquellos pacientes con disminución previa de la función pulmonar que tengan contraindicaciones para anestesia general. El uso combinado con la anestesia general se asoció con importantes beneficios de la ventilación mecánica y una disminución de la estancia hospitalaria en pacientes críticos. Sin disminuir la inmunosupresión y pudiendo continuarse para aliviar el dolor posoperatorio. Limitaciones: La evidencia estudiada pertenece a poblaciones no latinas. El tipo de investigaciones incluidos para la revisión bibliográfica no fue homogéneo en su modalidad ni en el procedimiento quirúrgico en el cual se indicó. Conclusiones: La anestesia epidural por si sola presenta varias ventajas en múltiples procedimientos quirúrgicos abdominales, especialmente en aquellos realizados en pacientes con deterioro previo de la función pulmonar o alto riesgo de complicaciones, posee altos niveles de seguridad y viabilidad de utilización, sin embargo, su uso deberá estar basado en un protocolo que permita seleccionar los pacientes que se beneficiaran de ella.

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A comparison between fentanyl plus celecoxib therapy and epidural anesthesia for postoperative pain management following laparoscopic gastrectomy

Cited by 5 publications

References 32 publications

Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy

Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy

Postoperative analgesia using fentanyl plus celecoxib versus epidural anesthesia after laparoscopic colon resection

Ventajas del uso de anestesia epidural en cirugía abdominal

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