Effects of Two Different Techniques of Postoperative Analgesia Management in Liver Transplant Donors: A Prospective, Randomized, Double-Blind Study

Aydoğan, Mustafa Said; Bıçakcıoğlu, Murat; Sayan, H.; Durmuş, Mahmut; Yilmaz, Sezai

doi:10.1016/j.transproceed.2014.09.184

Cited by 13 publications

(3 citation statements)

References 11 publications

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“…The effectiveness of TEA in pain management after open liver surgery was evaluated in four studies, which included a total of 393 patients: three compared to systemic opioids (2 RCTs and 1 POS) and one compared to a combination of systemic opioids and WI (RCT) [37][38][39]54]. When compared to systemic opioids, the use of TEA resulted in more effective pain control and in being associated with less opioid consumption and greater patient satisfaction with pain control (Table 3) [38,39,54]. Furthermore, the association of systemic opioids with WI provided greater pain control than TEA.…”

Section: Trials Assessing Teamentioning

confidence: 99%

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Dudek

Zawadka

Andruszkiewicz

et al. 2021

JCM

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Background: The existing recommendations for after open liver surgery, published in 2019, contains limited evidence on the use of regional analgesia techniques. The aim of this systematic review is to summarize available clinical evidence, published after September 2013, on systemic or blended postoperative analgesia for the prevention or treatment of postoperative pain after open liver surgery. Methods: The PUBMED and EMBASE registries were used for the literature search to identify suitable studies. Keywords for the literature search were selected, with the authors’ agreement, using the PICOS approach: participants, interventions, comparisons, outcomes, and study design. Results: The literature search led to the retrieval of a total of 800 studies. A total of 36 studies including 25 RCTs, 5 prospective observational, and 7 retrospective observational studies were selected as suitable for this systematic review. Conclusions: The current evidence suggests that, in these patients, optimal postoperative pain management should rely on using a “blended approach” which includes the use of systemic opioids and the infusion of NSAIDs along with regional techniques. This approach warrants the highest efficacy in terms of pain prevention, including the lower incretion of postoperative “stress hormones”, and fewer side effects. Furthermore, concerns about the potential for the increased risk of wound infection related to the use of regional techniques have been ruled out.

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Section: Trials Assessing Teamentioning

confidence: 99%

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Dudek

Zawadka

Andruszkiewicz

et al. 2021

JCM

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“…In recent decades, continuous or bolus infusions of opioids have been widely used in patient-controlled analgesia after liver resection. However, an increase in analgesic-related side effects, such as sedation, respiratory depression, pruritus, hallucinations and post-operative nausea and vomiting (PONV) has also been reported ( Aydogan et al, 2015 ; Khan et al, 2015 ; Allen et al, 2017 ). It is a challenge for anesthesiologists to perform a technique that could control sedation, analgesia, muscle relaxation, hemodynamic stability during the liver resection, and opioid-sparing analgesia after the surgery.…”

Section: Introductionmentioning

confidence: 99%

The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

et al. 2018

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Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex) combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex group (DEX infusion at an initial loading dose of 0.5 μg⋅kg-1 over 10 min before intubation then adjusted to a maintenance dose of 0.3 μg⋅kg-1⋅h-1 until incision suturing) or control (Con) group (0.9% sodium chloride was administered). Patient-controlled analgesia was administered for 48 h after surgery (Dex group: 60 mg oxycodone and 360 μg DEX diluted to 120 ml and administered at a bolus dose of 2 ml, with 5 min lockout interval and a 1 h limit of 20 ml. Con group: 60 mg oxycodone alone with the same regimen). The primary outcome was post-operative oxycodone consumption. The secondary outcomes included requirement of narcotic and vasoactive drugs, hemodynamics, incidence of adverse effects, satisfaction, first exhaust time, pain intensity, and the Ramsay Sedation Scale.Results: Post-operative oxycodone consumption was significantly reduced in Dex group from 4 to 48 h after surgery (P < 0.05). Heart rate in Dex group was statistically decreased from T1 (just before intubation) to T6 (20 min after arriving at the post-anesthesia care unit), while mean arterial pressure was significantly decreased from T1 to T3 (during surgical incision; P < 0.05). The consumption of propofol and remifentanil were significantly decreased in Dex group (P < 0.05). The VAS scores at rest at 1, 4, and 8 h and with cough at 24, and 48 h after surgery were lower, the first exhaust time were shorter, satisfaction with pain control was statistically higher and the incidence of nausea and vomiting was less in Dex group than in Con group (all P < 0.05).Conclusion: The combination of DEX and oxycodone could reduce oxycodone consumption and the incidence of nausea and vomiting, enhance the analgesic effect, improves patient satisfaction and shorten the first exhaust time.

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“…After detailed evaluation, 12 articles containing 661 patients satisfied the study recruitment criteria (Fig. , Table ).…”

Section: Resultsmentioning

confidence: 99%

Most effective pain‐control procedure for open liver surgery: a network meta‐analysis

Zhou

Huang

Chen

2018

ANZ Journal of Surgery

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Effects of Two Different Techniques of Postoperative Analgesia Management in Liver Transplant Donors: A Prospective, Randomized, Double-Blind Study

Cited by 13 publications

References 11 publications

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

Most effective pain‐control procedure for open liver surgery: a network meta‐analysis

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