Regional Anesthesia for Ambulatory Surgery

Gray, Andrew T.; Laur, John J.

doi:10.1097/aia.0b013e31821a00b9

Cited by 7 publications

(1 citation statement)

References 40 publications

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“…However, one of the challenges of ambulatory surgery is the need for a sufficient and safe postoperative pain treatment protocol. Local anesthetics have been widely used, and in recent years, ultrasound-guided techniques have improved the quality of perioperative blockades (3,4). Supplements, pain treatment with paracetamol, and nonsteroidal antiinflammatory drugs (NSAID) constitute the base of postoperative pain treatment (5,6).…”

Section: Introductionmentioning

confidence: 99%

Postoperative Pain Treatment in Day Surgery: A Quality Improvement Study Examining the Needs of Opioid and Effects of Oxycodone and Morphine

Christiansen¹,

Joergensen²,

Jensen³

2019

Ann Anesth Crit Care

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Background: There is sparse literature providing evidence for postoperative pain treatment in day surgery and for differences between morphine and oxycodone. Objectives: The objectives of this study were to examine the need for opioids and the effects of morphine versus oxycodone for pain relief and side effects at home after day surgery. Methods: This study was a prospective observational study with a quasi-randomized approach. Data consisted of self-reported three-day registration of use and the effects of the opioids, their side effects, and patient satisfaction with regards to pain treatment in a Danish day surgery conducting orthopedic and abdominal surgery. The outcomes, including the use of opioids, self-reported pain relief, and related side effects (nausea, fatigue, dizziness, and skin itchiness) were measured by a numeric rating scale and patient satisfaction with regards to pain treatment. Results: Out of the 199 included day surgery patients, 162 (81%) returned self-reported postoperative data. A total of 73% of the patients had used opioids an average of 4 times (range 1-16). Median levels of nausea, dizziness, and skin itching were 0 (IQR 0-3) whereas the median level of fatigue was 3 (IQR 0-6). More than 90% of the patients were satisfied or very satisfied with their postoperative pain treatment. No statistically significant differences were found between oxycodone and morphine in regard to onset time, level, duration of pain treatment, and the experienced side effects. Conclusions: Three-quarters of the patients used opioids after day surgery with a substantially varied number of doses. Few patients experienced substantial side effects, and the patients were generally satisfied with their pain treatment. No significant difference was found between oxycodone and morphine. The need for opioids after day surgery varies substantially and further investigations on individuals and follow-up are needed.

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Section: Introductionmentioning

confidence: 99%

Postoperative Pain Treatment in Day Surgery: A Quality Improvement Study Examining the Needs of Opioid and Effects of Oxycodone and Morphine

Christiansen¹,

Joergensen²,

Jensen³

2019

Ann Anesth Crit Care

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Thermal quantitative sensory testing to assess the sensory effects of three local anesthetic solutions in a randomized trial of interscalene blockade for shoulder surgery

Sermeus

Hans

Schepens

et al. 2015

Can J Anesth/J Can Anesth

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Thermal quantitative sensory testing to assess the sensory effects of three local anesthetic solutions in a randomized trial of interscalene blockade for shoulder surgery Les tests sensoriels quantitatifs thermiques utilisés pour évaluer les effets sensoriels de trois solutions d'anesthésiques locaux dans une étude randomisée de blocs interscaléniques pour les chirurgies de l'épaule Methods This was a prospective randomized trial in patients scheduled for arthroscopic shoulder surgery under general anesthesia and US-ISB. Participants and observers were blinded for the study. We assigned the study participants to one of three groups: 0.5% levobupivacaine 15 mL, 0.5% levobupivacaine 15 mL with 1:200,000 epinephrine, and 0.75% ropivacaine 15 mL. We performed thermal QST within dermatomes C4, C5, C6, and C7 before infiltration and 30 min, six hours, ten hours, and 24 hr after performing the US-ISB. In addition, we used QST, a semi-objective quantitative testing method, to measure the onset, intensity, duration, extent, and functional recovery of the sensory block. We also measured detection thresholds for cold/warm sensations and cold/heat pain. Results Detection thresholds for all thermal sensations within the ipsilateral C4, C5, C6, and C7 dermatomes increased rapidly (indicating the development of a hypoesthetic state) and reached a steady state after 30 min. This lasted for approximately ten hours and returned to normal detection thresholds by 24 hr. There were no differences detected between the three groups at 24 hr

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