Does a single dose of pregabalin help with postoperative pain after septoplasty?

Chen, Ni; Soneru, Christian P.; Kacker, Ashutosh

doi:10.1002/lary.26915

Cited by 8 publications

(4 citation statements)

References 3 publications

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“…Medication is not usually needed, apart from postoperative analgesics. As maximum pain is commonly experienced within the first 24 to 48 hours after septoplasty, we assumed that patients would need mild analgesics (that is acetaminophen) during the first two postoperative days …”

Section: Methodsmentioning

confidence: 99%

“…As maximum pain is commonly experienced within the first 24 to 48 hours after septoplasty, we assumed that patients would need mild analgesics (that is acetaminophen) during the first two postoperative days. 9 Additional follow-up is needed in case of short-term adverse events, that is, complications occurring within 6 weeks after septoplasty: nasal infection, epistaxis, septal haematoma, or adhesions. 10 Furthermore, nasal infection or septal haematoma requires medication.…”

Section: Septoplastymentioning

confidence: 99%

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Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost‐effectiveness

Egmond¹,

Rongen²,

Hedeman³

et al. 2018

Clinical Otolaryngology

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Objective The objective of this study was to demonstrate how decision‐analytic modelling can help to determine circumstances under which surgery may become cost‐effective, using septoplasty as an example. Design We developed a decision‐analytic model comparing septoplasty to non‐surgical management for nasal obstruction in adults with a deviated septum. Based on the estimated cost difference between both treatments, we calculated the minimal (a) gain in quality‐adjusted life‐years, or (b) reduction in productivity losses needed for septoplasty to be cost‐effective. Input was derived from literature and publicly available data sources. The time horizon of our model was one year, and the willingness‐to‐pay per quality‐adjusted life‐year was €20 000, in accordance with current guidelines. Results The cost difference between septoplasty and non‐surgical management for nasal obstruction due to a deviated nasal septum was €2227 per patient from a healthcare perspective (including direct healthcare costs) and €3288 per patient from an extended perspective (additionally including travel expenses and productivity losses due to poor health). In comparison with non‐surgical management, septoplasty needed to gain 0.11 to 0.16 QALYs or save 13 sick days for nasal obstruction. The longer septoplasty's effect lasts, the more time it will have to compensate its extra costs. Conclusion This study shows that the known cost difference between treatments can be used as the starting point to determine beneficial effects needed for cost‐effectiveness of surgical interventions. The effect required by septoplasty from a healthcare perspective seems potentially achievable, meaning that it would be useful to perform an RCT assessing the actual benefits of septoplasty.

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Section: Methodsmentioning

confidence: 99%

Section: Septoplastymentioning

confidence: 99%

Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost‐effectiveness

Egmond¹,

Rongen²,

Hedeman³

et al. 2018

Clinical Otolaryngology

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show abstract

“…Despite considerable improvements in analgesia and surgical techniques, there is no consensus for pain control and avoidance of overprescription after nasal surgery. Numerous pain medications, such as nonsteroidal anti‐inflammatory drugs (NSAIDS), gabapentin with or without intravenous dexamethasone, opioids, and multimodal or balanced analgesic protocols that include non‐opioid analgesic drugs such as paracetamol, and various NSAIDS in combination with low doses of opioids were previously studied for postoperative pain management after nasal surgery . However, systemic use of these agents is associated with potential side effects .…”

mentioning

confidence: 99%

The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain after septal surgery

Ekici

Alagöz

2019

Int Forum Allergy Rhinol

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Background: This study evaluated the effect of bilateral endoscopic sphenopalatine ganglion block (SPGB) for management of postoperative pain in patients undergoing septoplasty.Methods: Sixty septoplasty patients (51.7% male, 48.3% female, aged 18 to 45 years) were randomly assigned to general anesthesia (GA) alone (control) (n = 30) or GA plus endoscopic SPGB (n = 30). Demographic data, duration of surgery, blood loss, postoperative visual analogue scale (VAS) pain scores (upon arrival at the postanesthesia care unit [PACU] and 2, 6, 12, and 24 hours after surgery), overall analgesic usage (end of 24 and 168 hours a er surgery), overall satisfaction with the pain control (end of 24 and 168 hours a er surgery), and complications (bleeding, nausea and vomiting, and visual disturbance) were recorded.Results: Pain scores upon arrival to the PACU and 2, 6, 12, and 24 hours a er surgery were significantly lower in the SPGB group compared to the control group (p < 0.001). Moreover, the SPGB group had significantly lower anal-gesic requirements and higher satisfaction scores with their pain control at the end of 24 and 168 hours a er surgery compared to the control group (p < 0.001). The 2 groups significantly differed in terms of intraoperative blood loss (p = 0.024), and surgery time was longer in the SPGB group compared to the control group (p < 0.001).Conclusion: SPGB with bupivacaine is a safe and effective method to reduce pain a er septoplasty, and it is a costeffective alternative to high doses of analgesics. C 2019 ARS-AAOA, LLC. How to Cite this Article: Ekici NY, Alagöz S. The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain a er septal surgery. Int Forum Allergy Rhinol. 2019;9:1521-1525.E ffective management of postoperative pain is a critical component of nasal surgery. Insufficient pain management can lead to poor outcomes, including decreased patient satisfaction, long-term hospitalization and delayed resumption of work, treatment with high doses of analgesics, and increased healthcare costs. Despite considerable improvements in analgesia and surgical techniques, there is no consensus for pain control and avoidance of overprescription after nasal surgery. Numerous pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDS), gabapentin with or without intravenous dexamethasone,

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“…In a recently published article, it was seen that pregabalin use at least one hour prior to Septoplasty reduced post-operative pain significantly, although the required dosage and associated adverse effects need further scientific probing. 23 According to a set of recent guidelines published by The American Pain society and based on an extensive review of literature, it was suggested that optimal postoperative pain management begins in the preoperative period. This observation is made on the basis of an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved, with follow-up assessments and adjustments as needed.…”

Section: Discussionmentioning

confidence: 99%

Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

Hussain¹,

Mir²,

Zahir

et al. 2019

JIMDC

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Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.

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Does a single dose of pregabalin help with postoperative pain after septoplasty?

Cited by 8 publications

References 3 publications

Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost‐effectiveness

Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost‐effectiveness

The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain after septal surgery

Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

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