Experience in the local use of 0.25% bupivacaine for the treatment of postoperative pain

Babina, Yu M; Konoplitsky, V. S.; Kalinchuk, O.O.; Dmytriiev, Dmytro; Назарчук, Олександр; Andriets, E V

doi:10.31636/pmjua.v4i1.2

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…Це диктує певні особливості його дослідження та оцінки. Цей біль не локалізований, складний для оцінки при пальпації, впливає на ділянку сонячного сплетення, не доступний для візуальної оцінки, складно інтерпретується хворими [8,9]. Наступним важливим фактором є опіковий характер рани на ділянці парієтальної очеревини [10].…”

Section: методи дослідженняunclassified

The Model of Research Post-Cholecystectomic Pain Syndrome in Experiment

Maslii¹,

Gomon²,

Burkovsky³

et al. 2022

CAOS

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The number of surgeries performed by the laparoscopic method is constantly increasing due to the low trauma and fast patients recovery after surgery. However, despite the small surgery traumatism, most patients have the distinct pain syndrome, felt in the post-operative period and directly aﬀ ects the post-operative prognosis. Despite the low trauma, pain after laparoscopic cholecystectomy has two pathways: parietal (somatic) and visceral. Given all the diﬃ culties in assessing the visceral component of post-operative pain, there is an urgent need to create a research model. The mucosa of the rabbit’s cheek was selected to model the visceral component of post cholecystectomy pain. The pain syndrome in the post-operative period was modeled on rabbits due to the formation of a burn wound on the mucosa of the left and right cheeks. The eﬀ ectiveness of its treatment was studied with the help of combinations of analgesics. The burn wound was created by electrocoagulation EHVCH-300 «ELEPS» on the mucous surfaces of the right and left cheeks, under general anesthesia with propofol at a rate of 7.5 mg/kg. On the experimental (left) side, the studied combinations of analgesics were introduced: 1st group application mixture of 2.0 ml 0.5% bupivacaine with 2.0 ml with 5% dexketoprofen; Group 2 with a mixture of 2.0 ml of 0.5% bupivacaine with 0.5 ml of 1% nalbuphine; Group 3 was injected under the mucosa a mixture of 2.0 ml of 0.5% bupivacaine with 0.5 ml of 1% nalbuphine. The wound on the right cheek was a control, used for comparison. Pain syndrome was assessed by the reaction to ﬁ nger pressure on the outside of the right and left cheeks separately, and refusal to eat (based on the dynamics of the daily diet). Pain control was performed in 6, 12, 24, 48, and 72 hours after surgery. Additionally, there was made an analysis of the dynamics of maintaining the daily diet.The ﬁrst group there were revealed distinct diﬀ erences in the severity of pain between the controlled (right) and left (experimental) parts for 6 (p˂0.01) and 12 (p˂0.05) hours after surgery, which indicates the clinical signiﬁ cance of local use of a combination of bupivacaine with dexketoprofen. In the 2nd group, there were distinct diﬀ erences in the severity of pain test between the right controlled cheek and left parts for 6 (p˂0.01), 12 (p˂0.01), and 24 (p˂0.05) hours. That is, the inclusion of a narcotic analgesic prolonged the analgesic eﬀect by 100% (from 12 to 24 hours). In the 3rd group, there were distinct diﬀ erences in the severity of pain for 6 (p˂0.01), 12 (p˂0.01), 24 (p˂0.01), and 48 (p˂0.05) hours. On the third day, all animals (20) did not show pain eﬀ ect on the left (experimental) side. However, the resorptive eﬀ ect of the studied combination of bupivacaine with nalbuphine was revealed by submucosal injection.Analysis of the frequency and duration of rabbits’ refusal to eat revealed this criterion in 16 (80%) animals of the ﬁ rst group, and in 17 (85%) animals of the second group. Thus, the application methods of local anesthesia acted locally but had an insu ﬃ cient analgesic eﬀ ect. In the third group, the refusal to eat was not detected in the majority (60%) of rabbits during this period. This indicates a greater strength and resorptive mechanism of analgesic action in the third group.Therefore, in clinical use, to block the visceral mechanism of suppression of pain impulses in laparoscopic cholecystectomy, it’s prognostically better to use the application method, which provides a certain local analgesic eﬀ ect and clinically insigniﬁ cant resorptive eﬀ ect. This requires an additional and further study of the quantity and quality of analgesics for recommendations on local clinical use.

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Section: методи дослідженняunclassified

The Model of Research Post-Cholecystectomic Pain Syndrome in Experiment

Maslii¹,

Gomon²,

Burkovsky³

et al. 2022

CAOS

View full text Add to dashboard Cite

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«nonsurgical» Aspects of Successful Implementation of Fast Track Principles Into a Surgical Clinic: Our Experience

Stetsenko¹,

Іоффе²,

Кривопустов³

et al. 2020

Pain Anaesth Int Care

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Національний медичний університет імені О.О. Богомольця, м. Київ 2 КНП «Київська міська клінічна лікарня №3», м. Київ Вступ. Головним постулатом Fast track хірургії за H. Kehlet є редукція негативних моментів в післяопераційному періоді шляхом зменшення інтенсивності стресової відповіді організму на хірургічне втручання. Мета роботи. Оцінити ефективність імплементації принципів Fast track в роботу хірургічної клініки. Матеріали і методи. У період з вересня 2011 р. по січень 2019 р. нами виконано 623 планових оперативних втручання з використанням принципів Fast track хірургії, в тому числі -із застосуванням мультимодальної аналгезії (ММА) та нутритивної підтримки пацієнтів.

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Application of principles of multimodal analgesia as the content element of a fast-track surgery program

Ioffe

Stetsenko

Kryvopustov

et al. 2019

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Objective. To estimate the efficacy of postoperative pain reduction in first days after surgical intervention in acceleration of postoperative restoration in patients and reduction of the stationary treatment duration. Materials and methods. In Sept. 2011 - May 2019 yrs period there were performed 569 elective operative interventions, using principles of a Fast Track Surgery program, including those with application of multimodal analgesia. Depending on the kind of operative intervention the indices of pain impulses were determined in accordance to visual-analogous scale and median duration of stationary treatment. Results. On the first day after laparoscopic cholecystectomy the pain impulsation level have constituted 2.87 ± 0.74, on the second day - 2.01 ± 0.50 (p < 0.001). Median duration of the patients’ stationary stay have constituted 1.72 days. After laparoscopic hernioplasty the results of the pain level investigation were: on the first day - 3.44 ± 0.67, on the second day - 2.06 ± 0.51 (p < 0.001). Median duration of postoperative treatment have constituted 1.43 days. After laparoscopic bariatric interventions on large bowel during the first postoperative day the pain level have constituted 4.24 ± 0.75 and 4.39 ± 0.84 accordingly, on the second day it have reduced to 3.48 ± 0.57 (p < 0.001) and 3.48 ± 0.77 (p < 0.001), on the third day - to 2.79 ± 0.67 (p < 0.001) and 2.84 ± 0.69 (p < 0.001). At the same time a median duration of the patients’ stationary stay have constituted (4.99 ± 0.45) and (4.10 ± 0.60) days, accordingly. Conclusion. Efficacy of reduction of postoperative pain in first days after surgical intervention immediately impacts the speed of restoration of the patients’ organism and duration of stationary treatment.

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Experience in the local use of 0.25% bupivacaine for the treatment of postoperative pain

Cited by 4 publications

References 7 publications

The Model of Research Post-Cholecystectomic Pain Syndrome in Experiment

The Model of Research Post-Cholecystectomic Pain Syndrome in Experiment

«nonsurgical» Aspects of Successful Implementation of Fast Track Principles Into a Surgical Clinic: Our Experience

Application of principles of multimodal analgesia as the content element of a fast-track surgery program

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