Effect of intrathecal morphine and epidural analgesia on postoperative recovery after abdominal surgery for gynecologic malignancy: an open-label randomised trial

Kjølhede, Preben; Bergdahl, Olga; Wodlin, Ninnie Borendal; Nilsson, Lena

doi:10.1136/bmjopen-2018-024484

Cited by 37 publications

(5 citation statements)

References 39 publications

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“…Post‐operative pain, if not treated, has effects ranging from patient dissatisfaction and minor complications to extended healing duration, poor quality of life and post‐operative morbidity (Mizrak Sahin et al, 2021). Pain control after surgery is an important post‐operative determinant that affects patient satisfaction and the length of hospital stay (Armon et al, 2021; Kjølhede et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery: A randomized controlled study

Yılmaz

Terzioğlu

2022

Int J of Nursing Practice

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Aim This study aimed to evaluate the effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery. Methods This randomized controlled study was conducted with 132 participants at a public hospital between June 2017 and 2018. The Kinesio taping method was applied once, immediately after the surgery during the hospital stay and breathing exercises were performed three times a day for 30 min on the first, second and third post‐operative days. Results The median age of the women was 47 years. The mean body mass index was 27.6 ± 5.0 kg/m2. When the intervention and control groups were compared, the level of women's pain in the Kinesio taping group was significantly reduced. There was also a statistically significant difference in terms of the passage of gas and defecation time and wound healing in groups with Kinesio taping. Conclusions Kinesio taping has been shown to be an effective intervention in the management of acute pain after surgery. The results of this study suggest that future studies may be indicated to study taping in other surgical conditions.

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Section: Introductionmentioning

confidence: 99%

The effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery: A randomized controlled study

Yılmaz

Terzioğlu

2022

Int J of Nursing Practice

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“…However, the research methodologies and intended groups of patients differ greatly among these programs. The generalization of applying their suggestions in different medical institutions limited some investigations [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…In order to standardize clinical practice, improve postoperative functional capacity, speed up patient recovery, reduce postoperative length of stay (LOS), cut down medical costs, and improve patient satisfaction, the ERAS concept was established [21][22][23][24]. When considering whether to use a novel comprehensive strategy in elective craniotomy, the neurosurgeon must consider the standard of care, security, and the patient's tolerance for the risk involved in the procedure in question [25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Management of Post-craniotomy Pain in Elective Cases: A Randomized Controlled Trial

Abhinav,

Jadhav,

Andar

et al. 2023

Cureus

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Background: Craniotomy is associated with significant postoperative discomfort. Standardized pain management and enhanced recovery after surgery (ERAS) protocol could improve patient-reported outcomes and lower medical expenses. Aim: The aim of this study is to prospectively assess the effectiveness of an ERAS protocol for neurosurgery in the treatment of postoperative pain following elective craniotomies. Methods and materials: A total of 128 patients were assigned to the ERAS group and received care in accordance with the neurosurgical ERAS regulations, while 130 other participants were assigned to the control group and received traditional postoperative assistance. The participants’ postoperative pain ratings using the numerical rating scale (NRS) were this study’s main outcome of interest. The verbal NRS uses the numbers 0 to 10, with 0 indicating no sensation of pain and 10 indicating the most severe pain. On postoperative day (POD) 1, the patients’ postoperative pain level at the surgical site was evaluated using the NRS. This was repeated every day until the patient either reported feeling no sensation of pain or was discharged home. Results: The mean value of pain on the day of surgery was 4.43 ± 0.43 and 4.72 ± 0.68 for patients in the ERAS and control groups, respectively. The pain values were higher in the control group compared to the ERAS group. However, the difference was not statistically significant (p = 0.478). The mean value of pain on POD1 was 3.13 ± 0.21 and 4.45 ± 0.95 for patients in the ERAS and control groups, respectively. These pain values were higher in the control group compared to the ERAS group, and the difference was statistically significant (p = 0.011). The mean value of pain on POD2 was 2.86 ± 0.3 and 4.33 ± 0.37 for patients in the ERAS and control groups, respectively. The values of pain were higher in the control group compared to the ERAS group, and the difference was statistically significant (p = 0.003). The mean value of pain on POD3 was 2.33 ± 0.52 and 4.04 ± 0.15 for patients in the ERAS and control groups, respectively. The pain values were higher in the control group compared to the ERAS group. The difference was meaningful statistically (p < 0.001). The mean value of pain on POD4 was 2.26 ± 0.9 and 2.84 ± 0.13 for the ERAS and control groups, respectively. However, the difference was not statistically significant (p = 0.274). The ERAS group had a significantly higher proportion of participants rating their pain between 1 and 3 (68.9%) and a lower proportion rating their pain between 4 and 7 (28.2%), compared to the control group (p < 0.001). Differences in the highest pain ratings (8-10) between the groups were not statistically significant. The duration of hospital stay, beginning from surgery to discharge, was lesser among study participants in the ERAS group, and this finding was statistically significant (p < 0.001). Conclusion: The findings of this study imply that the ERAS protocol may aid p...

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“…Epidural analgesia (EDA) is currently the preferred technique in an open radical cystectomy, because of its superior pain control and reduction of complications when compared to systemic opioids [ 4 ]. Even though there may not be much difference in pain between RARC and open radical cystectomy [ 5 ], in many other laparoscopic procedures the use of EDA is not as clearly indicated as in open abdominal surgery [ 6 – 8 ]. Therefore, alternatives to EDA for laparoscopic surgery are currently investigated, which has led to a renewed interest in intrathecal hydrophilic opioids [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Postoperative effects and complications of intrathecal morphine compared to epidural analgesia in patients undergoing intracorporeal robot-assisted radical cystectomy: a retrospective study

2023

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Background Analgesia after robot assisted radical cystectomy aims to reduce postoperative pain and opioid consumption, while facilitating early mobilization and enteral nutrition and minimizing complications. Epidural analgesia is currently recommended for an open radical cystectomy, but it is unclear if intrathecal morphine is a suiting, less-invasive alternative for a robot-assisted radical cystectomy. Methods The analgesic method of choice changed from epidural anesthesia to intrathecal anesthesia for patients undergoing a robot-assisted radical cystectomy. This single-center retrospective study aims to investigate if there is a difference between epidural and intrathecal analgesia in postoperative pain scores, opioid consumption, length of hospital stays and postoperative complications. An Propensity Matched Analysis was added to conventional analysis to consolidate the findings. Results The study population consisted of 153 patients of whom 114 received an epidural catheter with bupivacaine/sufentanil and 39 received a single shot of intrathecal bupivacaine/morphine. Mean pain scores on the first two postoperative days (POD) were slightly higher in the intrathecal analgesia group (epidural versus intrathecal analgesia, NRS POD0: 0(0–2)[0–8] versus 1(0–3)[0–5], p = 0.050; POD1: 2(1–3)[0–8] versus 3(1–4)[0–7], p = 0.058; POD2: 2(0–3)[0–8] versus 3(2–4)[0–7], p = 0.010). Total postoperative morphine consumption was similar over the first seven days: 15 mg (5–35)[0–148] in the epidural group versus 11 mg (0–35)[0–148] in the intrathecal morphine group, p = 0.167. Length of hospital stay and time until fit for discharge where slightly higher in the epidural group (respectively 7 days (5–9)[4–42] versus 6 days (5–7)[4–38], p = 0.006, and 5 days (4–8)[3–30]) versus 5 days (4–6)[3–34], p = 0.018). There was no further difference in postoperative course. Conclusions This study showed that the effects of epidural analgesia and intrathecal morphine are comparable and that intrathecal morphine may be a suiting alternative for epidural analgesia.

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Effect of intrathecal morphine and epidural analgesia on postoperative recovery after abdominal surgery for gynecologic malignancy: an open-label randomised trial

Cited by 37 publications

References 39 publications

The effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery: A randomized controlled study

The effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery: A randomized controlled study

Management of Post-craniotomy Pain in Elective Cases: A Randomized Controlled Trial

Postoperative effects and complications of intrathecal morphine compared to epidural analgesia in patients undergoing intracorporeal robot-assisted radical cystectomy: a retrospective study

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