Perioperative analgesia: Ever-changing technology and pharmacology

Kaye, Alan D.; Ali, Syed Irfan Qasim; Urman, Richard D.

doi:10.1016/j.bpa.2014.03.002

Cited by 6 publications

(5 citation statements)

References 45 publications

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“…All our patients got optimal non‐opioid multimodal premedication analgesic regimes, but despite this, most needed opioid pain medication, as will be expected for major surgical procedures staying overnight . Opioid analgesic is still a cornerstone in postoperative pain treatment and best controlled in the early phase in the PACU with titrated intravenous agents for reliable and rapid action . Adequate early pain management may be associated with a lower incidence of persistent postoperative pain .…”

Section: Discussionmentioning

confidence: 97%

Postoperative quality and safety using Efficacy Safety Score (ESS) and a wireless patient monitoring system at the ward: A randomised controlled study

Skraastad

Borchgrevink

Nilsen

et al. 2019

Acta Anaesthesiol Scand

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Background Postoperative pain, side‐effects and time to mobilisation are indicators for the quality of postoperative recovery. The aim of this randomised controlled study was to investigate if efficacy safety score (ESS) combined with a wireless patient monitoring system would improve these clinical outcomes for patients at a general surgical ward. Methods The trial included 195 patients randomised to a standard care group (SC‐Group) or intervention group (INT‐Group) receiving continuous wireless monitoring of vital signs combined with ESS during the first 24 postoperative hours. The primary outcome was time to mobilisation. Secondary outcomes were average pain, doses of postoperative opioids, unscheduled interventions, side‐effects, patient satisfaction and length of hospital stay (LOS). Results Mean time to postoperative mobilisation was 10.1 hours for patients in the INT‐Group compared to 14.2 hours in the SC‐Group; this corresponds to an adjusted hazard ratio of 1.54 (95% confidence interval 1.04‐2.28). INT‐Group patients received a higher dose of oral morphine equivalents; 26 mg vs 15 mg, P < .001; reported lower intensity of pain on a 0‐10 scale; 2.1 vs 3.3, P < .001; and had higher patient satisfaction on a 5‐point scale; 4.9 vs 4.3, P < .001. The LOS was similar between the groups; 71 hours in INT‐Group vs 77 hours in SC‐Group, P = .58. No serious side‐effects were registered in INT‐Group, whereas two were registered in SC‐Group. Conclusions Introducing ESS as a decision tool combined with a wireless monitoring system resulted in less pain, increased satisfaction and more rapid mobilisation for patients in this study. Trial Registration: http://clinicaltrials.gov Identifier: NCT03438578.

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Section: Discussionmentioning

confidence: 97%

Postoperative quality and safety using Efficacy Safety Score (ESS) and a wireless patient monitoring system at the ward: A randomised controlled study

Skraastad

Borchgrevink

Nilsen

et al. 2019

Acta Anaesthesiol Scand

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“…Over the last decades, important advances in perioperative analgesia have been developed due to the evolution of laparoscopic surgery (less pain, shorter hospital stay, facilitation of multimodal rehabilitation programs) [3,5] and novel strategies proposed to diminish postoperative pain (patient-controlled epidural analgesia, patient-controlled epidural analgesia, elastomeric pain pumps, etc.) [6][7][8]; thus, nowadays, a variety of inpatient analgesia protocols exist. Wound infiltration with local anesthetics proved to be a simple, effective, and inexpensive means of providing good analgesia in laparoscopic cholecystectomy, laparoscopic inguinal hernia repair, and gynecologic laparoscopic surgery [9][10][11][12].…”

mentioning

confidence: 99%

Does Preincisional Infiltration with Bupivacaine Reduce Postoperative Pain in Laparoscopic Bariatric Surgery?

et al. 2015

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“…Multimodal therapy for pain management includes an array of techniques and treatments, not limited to neuraxial analgesia with single shot or continuous epidural, single shot or continuous Peripheral Nerve Blocks (PNB), opioids, acetaminophen, anti-inflammatory agents, anticonvulsants, NMDA inhibitors, antidepressants, and anxiolytics. 4 Multimodal therapy targets many different pathways of pain transmission. 4 As seen in Figure 1, opioids are able to modulate pain in one pathway of the central nervous system at the level of hypothalamic pituitary functions.…”

Section: Introductionmentioning

confidence: 99%

Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction

Kerfeld¹,

Hambsch²,

McEntire³

et al. 2016

Res Pract Anesthesiol Open J

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Citation Kerfeld MJ, Hambsch ZJ, McEntire DM, et al. Physiologic advantages of peripheral nerve blockade translate to decreased length of stay and improved patient satisfaction. ABSTRACTPeripheral nerve blockade is an effective modality involved in controlling perioperative pain. When compared with patient controlled analgesia, neuraxial analgesia, and other anesthetic methods such as periarticular infiltration, peripheral nerve blocks yield superior pain control and reduce length of hospitalization. Not only do these techniques help with patient satisfaction and health care costs, they also have physiologic advantages. In murine models, peripheral nerve blockade reduces expression of different inflammatory markers such as IL-1, IL-6, TNFα and cortisol. Such advantages make this an attractive modality for pain control.

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Perioperative analgesia: Ever-changing technology and pharmacology

Cited by 6 publications

References 45 publications

Postoperative quality and safety using Efficacy Safety Score (ESS) and a wireless patient monitoring system at the ward: A randomised controlled study

Postoperative quality and safety using Efficacy Safety Score (ESS) and a wireless patient monitoring system at the ward: A randomised controlled study

Does Preincisional Infiltration with Bupivacaine Reduce Postoperative Pain in Laparoscopic Bariatric Surgery?

Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction

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