A prospective randomized study to analyze the efficacy of balanced pre-emptive analgesia in spine surgery

Raja, S Dilip Chand; Shetty, Ajoy Prasad; Subramanian, B.; Kanna, Rishi Mugesh; Rajasekaran, S.

doi:10.1016/j.spinee.2018.10.010

Cited by 41 publications

(40 citation statements)

References 21 publications

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“…Panoramic radiographs are commonly used for this purpose; however, it is not possible to visualise the vascular and nerve ramifications present in some cases, which are more easily identified by means of CT 6‐8 . In addition, preemptive analgesia methods—such as correct anaesthetic block and/or prescription of pre‐surgical analgesics, including opioids prescription and anti‐inflammatory medication—must be used in order to decrease post‐operative pain by diminishing the sensitization of peripheral nerves 9,93 . These methods could reduce the risk of persistent pain in patients with chronic pain in other parts of the body, with sleep disorders and presenting psychosocial factors such as catastrophising, depression and anxiety‐related disorders.…”

Section: Ptnp Prevention and Managementmentioning

confidence: 99%

Pain complications of oral implants: Is that an issue?

Conti

Bonjardim

Stuginski‐Barbosa

et al. 2020

J of Oral Rehabilitation

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The use of oral implants as a form of replacing missing teeth in partial or total edentulous patients is considered the gold standard in oral rehabilitation. Although considered a history of success in contemporary dentistry, surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures. Persistent pain and abnormal somatosensory responses after the surgery ordinary healing time are also potential problems and may lead to the development of a condition named posttraumatic trigeminal neuropathic pain (PTNP). Though relatively rare, PTNP has a profound impact on patient’s quality of life. Appropriated previous image techniques, effective anaesthetic procedures and caution during the surgical procedure and implant installation are recommended for the prevention of this condition. In case of the PTNP, different management modalities, including antidepressant and membrane stabilizer medications, as well as peripheral strategies, as the use of topical medication and the botulin toxin are presented and discussed.

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Section: Ptnp Prevention and Managementmentioning

confidence: 99%

Pain complications of oral implants: Is that an issue?

Conti

Bonjardim

Stuginski‐Barbosa

et al. 2020

J of Oral Rehabilitation

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“…Multiple studies have previously demonstrated a decrease in postoperative opioid requirements after implementation of an MMA protocol. 12,13,[16][17][18] This QI project resulted in a significant decrease in postoperative by mouth opioid requirements and a trending decrease in postoperative IV opioid and combined by mouth and IV opioid requirements. Although not a primary aim of this project, intraoperative opioid requirements were also significantly decreased after protocol implementation.…”

Section: Discussionmentioning

confidence: 99%

“…17 An RCT of 100 patients undergoing spinal fusion procedures demonstrated significantly decreased pain scores and lowered total opioid consumption among those patients placed on a multimodal analgesic protocol. 18 Another RCT involving 80 patients undergoing posterior lumbar interbody fusion found similar results, with the MMA group reporting significantly lower postoperative pain scores than the group that only received morphine. 19 A similar study involving patients undergoing multilevel spine surgery showed a significant decrease in opioid consumption in the postoperative period and decreased opioid-related side effects, such as nausea.…”

mentioning

confidence: 83%

Implementation of a Multimodal Analgesia Protocol Among Outpatient Neurosurgical Patients Undergoing Spine Surgery to Improve Patient Outcomes

Tucker

Thompson

Muckler

2021

Journal of PeriAnesthesia Nursing

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This quality improvement project implemented an evidence-based multimodal analgesia protocol among patients undergoing outpatient spine surgery in an attempt to decrease postoperative opioid requirements, postoperative pain scores, and facility and postanesthesia care unit length of stay (LOS). Design: Two independent samples were compared with a preimplementation and postimplementation design. There were 37 patients in the preimplementation group and 36 patients in the postimplementation group. Methods: Data were collected by a retrospective chart review of neurosurgical patients undergoing spine surgery and included postoperative opioid requirements, postoperative pain scores, facility and postanesthesia care unit LOS, and the number of protocol components implemented on each patient. Findings: Intraoperative and postoperative by mouth opioid requirements were significantly decreased postimplementation. Postoperative opioid requirements decreased, and postimplementation pain scores were reduced across all time points. LOS did not significantly change. Conclusions: This multimodal analgesia protocol significantly decreased opioid consumption among neurosurgical patients at this surgery center.

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“…Preemptive analgesia refers to taking certain measures to block the noxious stimulation and to reduce the sensitivity of the central nervous system and peripheral nervous system to these stimulations in order to relieve pain or postoperative analgesia, make the analgesic effect more obvious, and reduce the dosage of analgesics[13,14]. When the body tissues are traumatized, inflammatory mediators will be released.…”

Section: Discussionmentioning

confidence: 99%

Analgesic effect of parecoxib combined with ropivacaine in patients undergoing laparoscopic hepatectomy

Huang

Liu

et al. 2019

WJCC

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BACKGROUNDCurrently, there is no uniform standard for analgesia during laparoscopic hepatectomy. Most of the analgesia schemes adopt epidural analgesia after laparotomy. Although the analgesia is effective, it has a great impact on the recovery of patients after laparoscopic hepatectomy and is not completely suitable for analgesia after laparoscopic hepatectomy. Although multimodal perioperative analgesia can significantly relieve postoperative pain, there is no relevant study of parecoxib combined with ropivacaine for post-laparoscopic hepatectomy analgesia.AIMTo study the analgesic effect of the preoperative intravenous injection of parecoxib combined with long-acting local anesthetic ropivacaine for incision infiltration in patients undergoing laparoscopic hepatectomy.METHODSForty-eight patients undergoing laparoscopic hepatectomy were randomly divided into a combined group (parecoxib combined with ropivacaine) and a control group. The visual analogue scale (VAS) at rest and during movement was used to compare the analgesic effect of the two groups. Meanwhile, the cumulative sufentanil, the recovery time for enterokinesia, the length of postoperative hospital stay, and the adverse reactions (nausea and vomiting) were recorded and compared between the two groups.RESULTSThe change tendency in VAS scores for both groups was similar after operation. At rest, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, 24 and 36 h, and during movement, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, and 24 h. The recovery time for enterokinesia in the combined group was 2.9 d, which was significantly shorter than that in the control group. The cumulative sufentanil in the combined group decreased significantly at 24, 36, and 48 h after operation.CONCLUSIONPreoperative intravenous injection of parecoxib combined with ropivacaine for incision infiltration is a simple and effective method for postoperative analgesia in laparoscopic hepatectomy, which could relieve pain and promote recovery.

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A prospective randomized study to analyze the efficacy of balanced pre-emptive analgesia in spine surgery

Cited by 41 publications

References 21 publications

Pain complications of oral implants: Is that an issue?

Pain complications of oral implants: Is that an issue?

Implementation of a Multimodal Analgesia Protocol Among Outpatient Neurosurgical Patients Undergoing Spine Surgery to Improve Patient Outcomes

Analgesic effect of parecoxib combined with ropivacaine in patients undergoing laparoscopic hepatectomy

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