Postoperative Pain Management

Mazda, Yusuke; Jadin, Sandra; Kahn, James S.

doi:10.22374/cjgim.v16isp1.529

Cited by 7 publications

(20 citation statements)

References 122 publications

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“…POP is caused by surgical incision, inflammation, and nerve injury as a result of different pathophysiological mechanisms. Acute POP is described as nociceptive pain that is well localized and characterized as sharp, aching, and throbbing, triggered by myelinated A-delta and slow conducting unmyelinated C-fiber nociceptors that are sensitized by an incision [6] and this is better known as nociceptive pain [7]. Nociceptive input from A-delta and C fibers enters the spinal cord via the dorsal horn and synapses with second-order neurons at A-delta at laminae II and V, and C and laminae II.…”

Section: Anatomy and Physiologymentioning

confidence: 99%

Introductory Chapter: Understanding Postoperative Pain

M. Whizar-Lugo,

Domínguez-Cherit,

Minutti-Palacios

et al. 2023

Topics in Postoperative Pain

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Section: Anatomy and Physiologymentioning

confidence: 99%

Introductory Chapter: Understanding Postoperative Pain

M. Whizar-Lugo,

Domínguez-Cherit,

Minutti-Palacios

et al. 2023

Topics in Postoperative Pain

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“…Postoperative pain results from tissue damage caused after surgical procedures [1]. Inadequate pain management can lead to slower recovery, prolonged hospitalization, and even death.…”

Section: Introductionmentioning

confidence: 99%

Fabrication and Development of Dissolving Microneedle Patch of Butorphanol Tartrate

Tiwari¹,

Sharma²,

SONI³

et al. 2023

Int J App Pharm

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Objective: Butorphanol is a commonly used medication for the management of postoperative pain and suffers low bioavailability and high first-pass metabolism. The objective of the current studies was to develop a butorphanol tartrate-loaded dissolving microneedle patch to overcome the limitation of first-pass metabolism without causing any discomfort to the patient. Methods: Butorphanol tartrate-loaded microneedle patch was prepared using Lapox resin micro-molds. The microneedle patch was optimized using the box-Behnken design and the quantity of PVA, HPMC K4M, and HPMC K15M was optimized and evaluated for fractured axial force, microscopic evaluation, in vitro drug permeation studies, and ex-vivo permeation experiments. Results: The developed microneedle patch meets all the evaluation parameters within the desired range. The height and tip diameter of the microneedles were found to be 700 µm to 800 µm and 60 µm to 61 µm. An axial fractured force of the optimized microneedle patch was found to be 189.67 N, suitable for penetrating the stratum corneum. The in vitro cumulative % drug permeated showed the permeation of the drug for 8 h with a total of 89.12 %, which shows the permeation of the drug occurred in a controlled manner. Conclusion: Butorphanol tartrate-loaded microneedle patch was successfully developed and the results concluded that the microneedles were hard enough to pass the stratum corneum and release the drug into the systemic circulation without reaching the pain receptors; further, the release study suggested that the drug was released for a prolonged period eliminating the problem of first-pass effect and frequent administration.

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“…The pain prevents deep breathing and coughing up of the secretions from the bronchial tree, which may result in pneumonia. Effective pain control is a prerequisite for the prevention of complications and ensuring the patient’s mental and physical well-being in the postoperative period [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial

Fenikowski

Tomaszek

Mazurek

et al. 2022

JCM

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The aim of the study was to investigate whether the use of pre- and postoperative gabapentin can decrease postoperative pain, morphine consumption, anxiety and side effects, as well as improve patient satisfaction. A total of 56 patients, 9–17 years of age, undergoing a modified Ravitch procedure, were randomised (allocation ratio 1:1) to receive multiple perioperative doses of gabapentin (preoperatively 15 mg/kg, postoperatively 7.5 mg/kg, two times per day for three days) or a placebo. All the patients received intravenous infusion of morphine, paracetamol and non-steroidal anti-inflammatory drugs. Metamizole was given as a “rescue drug”. The observation period included the day of surgery and three postoperative days. The primary outcomes were postoperative pain intensity (at rest, during deep breathing and coughing). Additional outcomes included the consumption of morphine, the total number of doses of metamizole, anxiety, postoperative side effects and patient satisfaction. Median average and maximal pain scores (on the day of surgery and on the second postoperative day) were significantly lower only in the gabapentin group at rest (p < 0.05). Compared to the placebo group, gabapentin treatment reduced the demand for morphine on the first postoperative day (median 0.016 vs. 0.019 mg/kg/h; p = 0.03) and the total number of metamizole doses (median 1 vs. 2 p = 0.04). Patient satisfaction was significantly greater in the gabapentin group (median 10 vs. 9; p = 0.018). Anxiety and postoperative side effects were similar in both groups (p > 0.05). Pre- and postoperative gabapentin administration as part of a multimodal analgesic regimen may decrease postoperative pain, opioid consumption and demand for a “rescue drug”, as well as improve patient satisfaction.

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Postoperative Pain Management

Cited by 7 publications

References 122 publications

Introductory Chapter: Understanding Postoperative Pain

Introductory Chapter: Understanding Postoperative Pain

Fabrication and Development of Dissolving Microneedle Patch of Butorphanol Tartrate

The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial

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