Preemptive Analgesia and Local Anesthesia as a Supplement to General Anesthesia: A Review

Kaufman, Erin A.; Epstein, Joel B.; Gorsky, Meir; Jackson, David; Kadari, Avishag

doi:10.2344/0003-3006(2005)52[29:paalaa]2.0.co;2

Cited by 57 publications

(43 citation statements)

References 29 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A variety of strategies including spinal anesthesia, intercostal nerve block, systemic opioids, and non-steroidal anti-inflammatory drugs and alpha-2 agonist are used to control pain 3. There is debate about the effectiveness of various types of preventive analgesia; but the combination of local anesthesia and general anesthesia may improve pain control after surgery 4. An effective analgesia protocol improves lung function and allows physiotherapy to start sooner after the surgery 5.…”

Section: Introductionmentioning

confidence: 99%

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery

et al. 2017

View full text Add to dashboard Cite

Background and Objective:Pain control during surgery in order to cause analgesia and reduce the somatic and autonomic response may decrease the morbidity. Intrapleural catheter embedding during surgery under direct vision of surgeon is safe and easy and without potential risk of thoracic epidural block. The aim of this study was to investigate the effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypass surgery.Methods:In this prospective randomized double blind clinical trial,130 adult patients undergoing elective CABG with age range of 20 to 60 years were divided into two groups receiving either lidocaine and fentanyl (group A) or lidocaine (group B). The analgesia was evaluated every two hours in all intubated and non-intubated patients using Visual analog scale (VAS) and data were analyzed using SPSS software package.Results:Of all patients, 67 (51.5%) were males and 63 (48.5%) were females. The average age of subjects was 53.49 ± 5.099 years. Mean pain score six hours after the surgery was statistically different between the groups at all times.Conclusion:The pain in patients receiving combination of lidocaine and fentanyl is less than patients receiving only lidocaine.

show abstract

Section: Introductionmentioning

confidence: 99%

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery

et al. 2017

View full text Add to dashboard Cite

show abstract

“…We also studied the effi cacy of two different doses of ropivacaine and any postoperative complications This study showed that the duration of postoperative analgesia in the ropivacaine group, with lower pain scores and reduced consumption of supplementary analgesics, extended beyond the 8 hours cited in studies of single-shot peripheral nerve blocks [9]. These data suggest that the ropivacaine parasternal intercostal block may have a preemptive analgesic effect, preventing establishment of altered central processing of afferent input, which amplifi es postoperative pain [10].…”

Section: Discussionmentioning

confidence: 93%

Parasternal Block with Two Different Concentration of Ropivacaine for Post-Operative Analgesia in Patient Undergoing Coronary Artery Bypass Grafting: A Randomized Double Blind Controlled Trial

Choudhury¹

2017

Open J Pain Med

View full text Add to dashboard Cite

Background: Postoperative sternal pain is one of the most important factors affecting patients' quality of life during the early post-operative days. Optimal pain management after cardiac surgery improve comfort and wellbeing of the patients. Conventionally used techniques of postoperative analgesia mostly provided by intravenous route, have their own side effects, causing a delay in tracheal extubation. Parasternal intercostals block is one such technique which has several potential advantages and devoid of the above side effects. Objective:To study the effect and effi cacy of parasternal intercostals block analgesia with two different doses of ropivacaine for post-operative analgesia in patients undergoing coronary artery bypass grafting (CABG).Design: Randomized, prospective, double blind study Setting: Tertiary health care teaching hospital Participants: One hundred and twenty adult cardiac surgical patients scheduled for elective coronary artery bypass grafting.Intervention: 0.75% ( group R1) and 0.5% (group R2) ropivacaine injection with 5 doses of 4 ml each on each side of Parasternal intercostals space with a total dose of ropivacaine 200 mg and 300 mg respectively or same volume of saline (group S) prior to surgical incision. Measurements and results:The average time of extubation was signifi cantly lower in R1 and R2 group compared to S group, being 5.15±1.13,5.24±0.88 and 7.29±1.41 hours respectively (p <0.0010).The length of ICU stay was 1.67±0.57 days in group R1,2.0±0.61 days in group R2 and 2.11±0.64 days in group S ( p=0.007) . A similar fi nding was also present when the duration of hospital stay was concerned. The cumulative 24 hr fentanyl dose was signifi cantly higher in group S compared to that of R1 and R2. (186.73±28.3, 217±36.8 and 344±68.2 μ gm respectively, p, 0.01).VAS score was highest in S group of patients with a mean of 5.08±0.82 for all the time periods, whereas that for group R1 and R2 was 3.64±0.84 and 3.77±0.71 respectively except that at post extubation. Statistical signifi cance was observed for VAS score during inter group comparison (R1 vs S, p<0.001, R2 vs. S,p<0.001). The mean heart rate and mean arterial pressure remained in higher side in group S patients when compared to the other two groups (p < 0.01 in each case). One patient in group R1, three in group R2 and seven in group S had arrhythmia during their ICU stay. Two patients from each R2 and S group had evidence of pneumonia and none of the patients in any group had evidence of sternal wound infection during the course of stay and one month follow up period. Conclusion:Parasternal intercostals block for postoperative pain relief for adult cardiac surgical patients is a simple technique, which is easy to perform and appears to be a useful adjunct to post-operative pain relief during the postoperative period. 0.75 % ropivacaine is more effi cacious than that of 0.5% when used in the same route without any additional side effects. Unlike neuroaxial blocks, it can be used in patients who are anti-coagulated per...

show abstract

“…대한 기억을 방해하거나 통증 인지를 저하시키는 것으로 정의된 다 (Kaufman, Epstein, Gorsky, Jackson, & Kadari, 2005;Marret et al, 2005;Norman et al, 2001;Ochroch, Mardini, & Gottschalk, 2003). 몇몇 선행 연구에서 선행진통법이 수술 후 진통제 투여량을 감소시키고 부작용을 완화시키는 것으 로 보고하고 있다 (Grass, 2005;Kim & Yoon, 2006;Marret et al, 2005;White, 2005).…”

Section: 선행진통법은 외과적 자극을 주기 전 제통 요법을 통해 통증에unclassified

The Effects of Preemptive Analgesia of Morphine and Ketorolac on Postoperative Pain, Cortisol, O2 Saturation and Heart Rate

Seo

Yoon

2008

J Korean Acad Nurs

View full text Add to dashboard Cite

Purpose: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, O2 saturation and heart rate for the first 24 hr after abdominal surgery. Methods: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, O2 saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, 2 test, repeated measures ANOVA, and Bonferroni methods. Results: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and O2 saturation between the experimental group and control group. Conclusions: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or O2 saturation for 24 hr after abdominal surgery.

show abstract

Preemptive Analgesia and Local Anesthesia as a Supplement to General Anesthesia: A Review

Cited by 57 publications

References 29 publications

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery

Parasternal Block with Two Different Concentration of Ropivacaine for Post-Operative Analgesia in Patient Undergoing Coronary Artery Bypass Grafting: A Randomized Double Blind Controlled Trial

The Effects of Preemptive Analgesia of Morphine and Ketorolac on Postoperative Pain, Cortisol, O2 Saturation and Heart Rate

Contact Info

Product

Resources

About