Comparative evaluation of efficacy of preventive analgesia with diclofenac and buprenorphine patch versus single diclofenac patch for postoperative pain following general anesthesia for laparoscopic cholecystectomy

Nanda, Ananya; Sangineni, Kalyani Surya Dhanalakshmi; Pakhare, Vandana; Gopinath, R.

doi:10.4103/aer.aer_109_20

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…The second group received a placebo patch that was applied to the upper third of the lateral arm (on any side) the evening before surgery and was worn for seven days. Prior to surgery, a 100 mg diclofenac patch was inserted on the left or right lateral flank and removed after 24 hours [16]. In the end, it was statistically significant that the placebo group needed more rescue analgesia than the buprenorphine plus diclofenac patch group did.…”

Section: Postoperative Considerationsmentioning

confidence: 99%

“…In the end, it was statistically significant that the placebo group needed more rescue analgesia than the buprenorphine plus diclofenac patch group did. In postoperative laparoscopic cholecystectomy patients, multimodal analgesia with transdermal buprenorphine (TDB) and diclofenac can be a novel yet straightforward alternative to injectable opioids while delivering effective analgesia [16].…”

Section: Postoperative Considerationsmentioning

confidence: 99%

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The Efficacy of Buprenorphine in Preoperative and Postoperative Patients: A Literature Review

Patel,

Lee,

Witherspoon

et al. 2024

Cureus

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Although research suggests that less than half of individuals who have surgical procedures report effective postoperative pain alleviation, the majority of patients endure acute postoperative discomfort. To lessen and manage postoperative pain, a variety of preoperative, intraoperative, and postoperative treatments and management methods are available. For several years an opioid called buprenorphine has become an effective tool to treat opioid use disorder (OUD) in patients across many different demographics. It has however endured barriers to its usage which can be seen when treating patients with chronic pain or postoperative pain, who also have an OUD. While buprenorphine may be underutilized within the clinical setting, the significantly low rates of chronic abuse when using the drug allow it to be an attractive treatment option for patients. This paper aims to explore a wide range of studies that examine buprenorphine as an analgesic and how it can be used for preoperative pain and postoperative pain. This paper will give an in-depth analysis of buprenorphine and its use in patients with chronic pain as well as OUD.A systematic literature review was performed by identifying studies through the database PubMed. The data from various publications were gathered with preference being given to publications within the last three years. We reviewed studies that examined the pain level of the patients after having buprenorphine.Despite long-available pharmacologic evidence and clinical research, buprenorphine has maintained a mystique as an analgesic. Its usage in the treatment of OUD was further influenced by its well-known safety benefits and relative lack of psychomimetic side effects compared to other opioids. For patients accustomed to long-term, high-dose opioids who may be experiencing hyperalgesia but have not been informed about this phenomenon by their doctors or the potential for buprenorphine to resolve it, buprenorphine's pronounced antihyperalgesic effect is a compelling pharmacologic characteristic that makes it particularly attractive as an option.When used in pre-, peri-, and postoperative circumstances, buprenorphine provides various painmanagement benefits and patients can still benefit from effective pain management from mu-opioid agonists while remaining on buprenorphine.Buprenorphine can be continued at a reduced dose as needed to avoid withdrawal symptoms and to improve the analgesic efficiency of mu-opioid agonists used in combination with acute postoperative pain in light of the evidence at hand. Buprenorphine administration needs a patient-centered, multidisciplinary strategy that considers the benefits and drawbacks of the many perioperative therapy options to have the best chance of success.

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Section: Postoperative Considerationsmentioning

confidence: 99%

Section: Postoperative Considerationsmentioning

confidence: 99%

The Efficacy of Buprenorphine in Preoperative and Postoperative Patients: A Literature Review

Patel,

Lee,

Witherspoon

et al. 2024

Cureus

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“…Finally, this study showed that preemptive intravenous nalbuphine improved the quality of sleep on the night of surgery and reduced the occurrence of postoperative nausea and vomiting. However, the authors did not assess and compare the quality of postoperative recovery and clinical outcomes of patients, as performed in other studies comparing analgesic efficacy of different techniques after laparoscopic cholecystectomy [ 5 , 6 ]. In fact, these variables are very important for determining efficacy and clinical availability of an intervention.…”

Section: To the Editormentioning

confidence: 99%

Letter to the Editor Regarding “Preemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial”

Tan

Xue

2022

Pain Ther

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This letter was written in response to the recent article by Liu et al ''Preemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial'', in which preemptive intravenous nalbuphine at a dose of 0.2 mg kg -1 was shown to significantly decrease visceral pain and rescue analgesic use in the first 24 h after laparoscopic cholecystectomy. TO THE EDITOR,By a multicenter, double-blind, placebo-controlled, randomized clinical trial including 2094

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“…[ 3 ] Several studies have evaluated post-laparoscopic pain relief methods such as intravenous analgesics, analgesic patches, steroids, and intra-peritoneal instillation of local anaesthetics alone or with additives such as morphine, dexmedetomidine, or steroids. [ 4 , 5 ] Intra-peritoneal injection of local anaesthetics such as lidocaine, ropivacaine, and bupivacaine has been used for post-laparoscopy pain relief. A single dose of dexamethasone injected intra-peritoneally has been reported to relieve pain after gynaecological laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of intra-peritoneal instillation of dexamethasone and bupivacaine versus bupivacaine following laparoscopic cholecystectomy – A randomised, double-blind controlled study

Vandana,

Ananya,

Muralikrishna

et al. 2023

Indian Journal of Anaesthesia

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Background and Aims: Laparoscopy is associated with acute pain. We compared the effectiveness of intra-peritoneal dexamethasone with bupivacaine versus bupivacaine in patients undergoing laparoscopic cholecystectomy for postoperative analgesia. Methods: This randomised study was conducted after approval from the institutional ethics committee and 84 patients were randomly allocated into bupivacaine with dexamethasone group (BD) (received 40 mL of 0.25% bupivacaine with 16 mg dexamethasone), and bupivacaine group (BB) (received 40 mL of 0.25% bupivacaine intra-peritoneally). Data analysis was done using R version 4.2.1. The visual analogue scale (VAS) score, total rescue analgesic dose, and time required for the first analgesic between groups were compared using the Wilcoxon rank sum test or t-test appropriately. Results: VAS score was significantly lower in the BD group compared to the BB group until 2 h post-operatively with a mean difference of − 1.0 (95% confidence interval [CI] −1.5, −0.53), P < 0.001. The total rescue analgesic dose consumed was lower in the BD group (60.71 mg [29.80]) compared to the BB group (73.20 mg [11.57]) with a mean difference of − 12.5 mg (95% CI − 22.3, −2.68), P = 0.013. In addition, the time taken for the requirement of the first rescue analgesic was significantly longer in the BD group (417.1 min [276.0]) compared to the BB group (219.4 min [226.1]) with a mean difference of 197.7 (95% CI 75, 320), P = 0.002. Conclusion: Intra-peritoneal instillation of 16 mg dexamethasone with 0.25% bupivacaine in laparoscopic cholecystectomy significantly reduces post-operative pain and requirement of rescue analgesic compared to 0.25% bupivacaine alone.

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Comparative evaluation of efficacy of preventive analgesia with diclofenac and buprenorphine patch versus single diclofenac patch for postoperative pain following general anesthesia for laparoscopic cholecystectomy

Cited by 6 publications

References 21 publications

The Efficacy of Buprenorphine in Preoperative and Postoperative Patients: A Literature Review

The Efficacy of Buprenorphine in Preoperative and Postoperative Patients: A Literature Review

Letter to the Editor Regarding “Preemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial”

Analgesic efficacy of intra-peritoneal instillation of dexamethasone and bupivacaine versus bupivacaine following laparoscopic cholecystectomy – A randomised, double-blind controlled study

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