Raising the Standard… to unachievable heights?

Noblet, J.; Plaat, Felice van der

doi:10.1111/j.1365-2044.2009.06175.x

Cited by 7 publications

(12 citation statements)

References 3 publications

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“…Much better results from the VAS scoring was reported by Blanco et al, where, for the QLB group, the maximum pain intensity score was 3 points, with a median of 0; and in the Control group the maximum pain intensity score was 5 points, with a median of 3 points [29]. According to the recommendations of Hartrick et al, and Noblet et al, the pain therapy is well run in the postoperative period if the assessment of NRS or VAS does not exceed 3 points [29,30]. Our literature review shows that many other authors of clinical trials of postoperative analgesia after a C-section also struggled with insufficiently effective pain treatment, showing results of NRS or VAS > 3 [31].…”

Section: Discussionmentioning

confidence: 93%

“…Over the next 48 hours, all patients received 1 g of paracetamol iv at constant intervals of time (every 6 hours) and 5 mg of morphine subcutaneously depending on their intensity of pain (NRS > 3), or, on demand with the proviso of a 4-hour administration frequency. Next, the the level of pain intensity was evaluated, only in rest among the newly delivered mothers (using NRS scale 0-10 in which 0 = no pain and 10 = worst pain imaginable) and consecutively after 2,4,8,12,16,20,24,30,36, 42 and 48 hours. At every postoperative time-point the following parameters were measured: sedation (Ramsey scale); nausea, vomiting and itching (0 = none, 1 = mild, 2 = moderate, 3 = severe); the possibility of the free movement of limbs or any other possible side effects.…”

Section: Interventionsmentioning

confidence: 99%

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Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

et al. 2018

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Objectives: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients undergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period. Material and methods:Sixty patients undergoing caesarean section under spinal anesthesia were randomly and equally assigned to one or other of two groups: QLB I (who received Bilateral Quadratus Lumborum Block type I with the use of 24 mL 0.375% ropivacaine per side) or a Control group. In both groups, on-demand morphine analgesia was administered postoperatively within the first 48 hours. The following were measured: the morphine consumption; the time elapsed from the C-section until the first dose of morphine; and the levels of pain intensity among patients in rest (numeral pain rating scale).Results: There were no statistically significant demographic data differences between the QLB I and Control groups. The following significant differences were observed in the 48-hour postoperative period: morphine consumption was higher in the Control group (p = 0.000); the time elapsed from the C-section until the first dose of morphine was longer in QLB I group (p < 0.05); and the median of the pain numeric rating scale was higher in the Control group (p < 0.05). Conclusions:Quadratus Lumborum Block type I significantly reduces morphine consumption and pain levels up to 48 hours postoperatively.

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Section: Discussionmentioning

confidence: 93%

Section: Interventionsmentioning

confidence: 99%

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

et al. 2018

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“…A previous audit we carried out revealed that we failed to meet this standard [2], even though our regimen included a standard combination of regular and on-demand analgesics. We found that drugs were frequently wrongly prescribed or omitted entirely.…”

Section: Baxtermentioning

confidence: 99%

“…The Intensive Care National Audit and Research Centre (ICN-ARC) has reported an incidence of critical care admissions among pregnant or recently pregnant women to adult critical care units of 260 per 100 000 maternities [1]. However, it is only recently that a definition of 'critical care' in the delivery suite has been published [2]; this document describes four levels of care (0-3) according to the Intensive Care Society's (ICS's) 'Level of Care' document [3], in which levels-2 and -3 are 'critical' care. We used this classification to identify the…”

Section: Pca Test Protocol Delivers Potentially Fatal Morphine Overdosementioning

confidence: 99%

Postoperative analgesia – still failing to meet the standard

Silva¹,

Plaat²

2012

Anaesthesia

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“…There has recently been some discussion in this journal regarding the standards set by the Royal College of Anaesthetists (RCA) for analgesia after caesarean section [1], suggesting that they may be unachievable [2][3][4]. We would like to highlight another area where we are consistently failing to reach the RCA standard.…”

Section: J Smithmentioning

confidence: 99%