Risk factors associated with postoperative pain and discomfort in oculoplastic surgery with general anesthesia: a prospective study

Ye, Huijing; Chen, Rongxin; Lian, Xiufen; Huang, Jijie; Mao, Yuxiang; Lu, Rong; Ai, Siming; Ma, Wenfang; Lin, Jingyi; Yang, Huasheng; Guo, Wenjun

doi:10.2147/jpr.s156104

Cited by 30 publications

(34 citation statements)

References 24 publications

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“…From our observations, the surgeries caused increases in the levels of CRP and IL-6 in all patients; however, the levels of CRP and IL-6 in the patients in group E were significantly lower than those in the patients in group P, suggesting that epidural analgesia is better for controlling inflammation than intravenous analgesia. Pain is a post-operative risk factor for POCD (2,20). Effective post-operative analgesia does not only relieve pain and improve comfort, but also reduces the release of catecholamines and other stress hormones during the post-operative period (21), and these factors should reduce the incidence of POCD.…”

Section: Discussionmentioning

confidence: 99%

Effects of different analgesia regimens on early post‑operative cognitive dysfunction in elderly patients undergoing radical resection of cervical carcinoma

2019

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This study was designed to compare the effects of epidural and intravenous analgesia on early post-operative cognitive dysfunction (POCD) in elderly patients undergoing radical resection of cervical cancer. For this purpose, 74 patients aged 60-78 years [body mass index (BMI), 18-25 kg/m 2 ; American Society of Anesthesiologists (ASA) classification score of I-III) undergoing radical resection of cervical cancer were divided into the epidural group (group E) and parenteral group (group P) groups (37 patients in each group). All patients underwent their surgical procedures under epidural anesthesia and intravenously-delivered general anesthesia. Patient-controlled analgesia (PCA) was supplied for 72 h after the surgery. Epidural analgesia was provided for the patients in group E and intravenous analgesia was provide for those in group P. General patient information was recorded and peripheral blood neutrophil counts, C-reactive protein (CRP) levels and interleukin (IL)-6 concentrations were measured immediately prior to the surgery (T 0), and at 24, 48 and 72 h after the procedure (T 1 , T 2 and T 3 , respectively). Visual analog scale (VAS) scores were also recorded at T 1 , T 2 and T 3 , and the mini-mental state evaluation (MMSE) scores at T 0 , T 1 , T 2 , and T 3 were calculated. Patients were diagnosed as having POCD according to their MMSE score differences between the peri-operative and post-operative values. The results revealed that the levels of CRP and IL-6 significantly increased in both groups after the surgery (T 1-3). However, the CRP and IL-6 levels in group E were significantly lower than those in group P at all time points examined (P<0.05). The VAS scores in group E at T 1 , T 2 and T 3 were significantly lower than those in group P (P<0.05). Finally, the incidence of POCD in group E was significantly lower than that in group P (P<0.05). On the whole, the post-operative epidural analgesia reduced the systemic inflammatory response, the perceived pain, and the incidence of POCD in patients undergoing radical resection of cervical cancer, when compared with the effects of intravenous analgesia.

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Section: Discussionmentioning

confidence: 99%

Effects of different analgesia regimens on early post‑operative cognitive dysfunction in elderly patients undergoing radical resection of cervical carcinoma

2019

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“…Moreover, the drug has shown no irreversible carcinogenic, teratogenic, or hepatotoxic effects. However, in our recent study,2 45.7% patients experienced significant postoperative pain with preoperative administration of intravenous flurbiprofen axetil.…”

Section: Introductionmentioning

confidence: 78%

“…Postoperative pain may result in patient discomfort and decrease patient satisfaction 1. Bone removal orbital decompression, being a complex ophthalmic surgery, can lead to severe pain, with significantly higher postoperative pain scores than other oculoplastic surgeries 2,3. Postoperative pain is a major problem following orbital decompression.…”

Section: Introductionmentioning

confidence: 99%

<p>Intraoperative administration of intravenous flurbiprofen axetil with nalbuphine reduces postoperative pain after orbital decompression: a single-center, prospective randomized controlled trial</p>

Lian

Chen

et al. 2019

JPR

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Purpose This study aimed to investigate postoperative analgesia achieved with intraoperative administration of intravenous flurbiprofen axetil and nalbuphine in patients undergoing orbital decompression. Methods Sixty-three patients undergoing orbital decompression under general anesthesia at the Zhongshan Ophthalmic Center at Sun Yat-sen University (Guangzhou, China) were randomly allocated into one of the following three groups (1:1:1): intraoperative flurbiprofen axetil 100 mg (Group 1); intraoperative nalbuphine 0.1 mg/kg (Group 2); or intraoperative flurbiprofen axetil 100 mg combined with nalbuphine 0.1 mg/kg (Group 3). The primary end point was mean postoperative pain intensity during the first 24 hours. The secondary efficacy end points were the intensity of pain and discomfort at 0, 2, 6, 10, and 24 hours after surgery and side effects at 24 hours after surgery. Results The demographic characteristics were similar among the three groups. Mean and peak postoperative pain scores during the first 24 hours in Group 3 were lower than those in Group 1 ( P =0.007 and P =0.003, respectively) and Group 2 ( P =0.001 and P =0.000, respectively). Additionally, the pain scores in Group 3 were significantly lower than those in Group 1 during the first 6 hours after surgery ( P =0.003, 0.002, and 0.022 at 0, 2, and 6 hours, respectively) and those in Group 2 during the first 10 hours after surgery ( P =0.008, 0.000, 0.001, and 0.019 at 0, 2, 6, and 10 hours, respectively). Discomfort scores were not significantly different among the three groups during the observation period, except at 2 hours after surgery, at which time the scores in Group 3 were significantly lower than those in Group 2 ( P =0.033). Postoperative adverse effects and analgesic requirements were similar among the three groups. Conclusion Intraoperative administration of a combination of intravenous flurbiprofen axetil and nalbuphine is superior to single-dose flurbiprofen axetil or nalbuphine in patients undergoing orbital decompression.

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“…This scale has been confirmed to be sensitive and reliable. 7,13 The degree of postoperative discomfort was measured 0, 2, 6, 10, and 24 hours after postanesthesia care unit (PACU). Discomfort included nausea, vomiting, dizziness, and headache, within 24 hours after PACU.…”

Section: Study Protocolmentioning

confidence: 99%

“…6 Discomfort, which was defined as "sensation other than pain", and included nausea, vomiting, dizziness, and headache, may play an important role. 7 Furthermore, postoperative nausea and vomiting (PONV) are the most common complications after strabismus surgery under general anesthesia, with an incidence of 37-80%. 8,9 The mechanism for the high rate of PONV following strabismus surgery has not been clearly defined, but appears to involve several factors, such as oculoemetic reflex, an optokinetic imbalance, and a disturbance of visual axes.…”

Section: Introductionmentioning

confidence: 99%

<p>Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia</p>

Huang

Lin

Xiong

et al. 2020

JPR

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The aim of this study was to evaluate postoperative discomfort in patients undergoing ambulatory strabismus under general anesthesia, and to identify risk factors associated with the discomfort. Patients and Methods: A cross-sectional study was conducted among 210 consecutive patients undergoing ambulatory strabismus under general anesthesia. Postoperative discomfort including nausea, vomiting, dizziness, and headache was recorded and quantified. Univariable and multivariable logistic regression were performed to detect the risk factors associated with postoperative discomfort. Results: Of 210 participants, 199 (94.76%) patients experienced mild discomfort after ambulatory strabismus surgery under general anesthesia, and 31 (14.76%), 11 (5.24%), 60 (28.57%), 23 (10.95%) patients suffered from nausea, vomiting, dizziness, and headache, respectively. A multivariate analysis indicated that female sex, the surgery on inferior rectus, and the surgery on inferior oblique were the independent risk factors for postoperative vomiting while, mild anxiety was the independent risk factor for postoperative dizziness. Conclusion: Patients undergoing ambulatory strabismus surgery tended to experience postoperative nausea and dizziness. Female sex, the surgery on inferior rectus, mild anxiety, and the surgery on inferior oblique were the independent predictors of postoperative discomfort.

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Risk factors associated with postoperative pain and discomfort in oculoplastic surgery with general anesthesia: a prospective study

Cited by 30 publications

References 24 publications

Effects of different analgesia regimens on early post‑operative cognitive dysfunction in elderly patients undergoing radical resection of cervical carcinoma

Effects of different analgesia regimens on early post‑operative cognitive dysfunction in elderly patients undergoing radical resection of cervical carcinoma

<p>Intraoperative administration of intravenous flurbiprofen axetil with nalbuphine reduces postoperative pain after orbital decompression: a single-center, prospective randomized controlled trial</p>

<p>Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia</p>

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