The Effect of Pain on Health-Related Quality of Life in the Immediate Postoperative Period

Wu, Christopher L.; Naqibuddin, Mohammad; Rowlingson, Andrew J.; Lietman, Steven A.; Jermyn, Roland; Fleisher, Lee A.

doi:10.1213/01.ane.0000081722.09164.d5

Cited by 166 publications

(84 citation statements)

References 17 publications

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“…It has been proposed that liposomal bupivacaine can improve the duration of effectiveness for PAI and thus may provide sufficient analgesia while also reducing the amount of opioid medications delivered for effective pain control. The current study occurred in settings that already had established total joint pathways in place, including preoperative education [70], patient-focused care initiatives [3,17,19,36,43,45,60,67,87], multimodal analgesia regimens [9,10,16,20,24,26,35,38,53,72,76,78,80,83], and postoperative rehabilitation pathways [16,51,77] to focus the results on the three randomized treatment groups described. We found that the primary outcome measure of pain control was better at 6 and 12 hours postoperatively in the liposomal bupivacaine PAI and spinal morphine groups compared with the ropivacaine PAI group.…”

Section: Discussionmentioning

confidence: 99%

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Barrington

Emerson

Lovald

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Opioid analgesics have been a standard modality for postoperative pain management after total knee arthroplasty (TKA) but are also associated with increased risk of nausea, pruritus, vomiting, respiratory depression, prolonged ileus, and cognitive dysfunction.There is still a need for a method of anesthesia that can deliver effective long-term postoperative pain relief without incurring the high cost and health burden of opioids and nerve blocks. Questions/purposes (1) Is liposomal bupivacaine-based periarticular injection (PAI) more effective than morphinebased spinal anesthesia or ropivacaine-based PAI in

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Section: Discussionmentioning

confidence: 99%

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Barrington

Emerson

Lovald

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…This reduction in pain intensity may play a critical role in a patient's recovery process, and it has been shown in one study that pain severity postoperatively correlates with health-related quality of life. 22 Additionally, pain is one of the most common reasons for hospital readmissions. 23 All review studies but one 17 reported a decreased requirement for rescue analgesia among patients receiving femoral nerve blocks.…”

Section: Discussionmentioning

confidence: 99%

Use of Femoral Nerve Blocks to Manage Hip Fracture Pain among Older Adults in the Emergency Department: A Systematic Review

Riddell

Ospina

Holroyd‐Leduc

2015

CJEM

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Objective: Hip fractures are a common source of acute pain amongst the frail elderly. One potential technique to adequately manage pain in this population is the femoral nerve block. The objective of this systematic review was to provide updated evidence for the use of femoral nerve blocks as a pain management technique for older hip fracture patients in the emergency department (ED). Data Sources: Searches of Medline, EMBASE, and the Cochrane Central Register of Controlled Trials were conducted between December 2010 and May 2014. The reference list of a previous systematic review was also searched. Study Selection: We included randomized control trials examining the use of femoral nerve blocks in the ED among older adults (65 years of age or older) with acute hip fracture. Data Extraction: Among 93 citations reviewed, seven trials were included. Four studies employed a single femoral nerve block, while three studies employed continuous (catheterplaced) femoral blocks. All but one of the studies were found to have a high risk of bias. Data Synthesis: All studies reported reductions in pain intensity with femoral nerve blocks. All but one study reported decreased rescue analgesia requirements. There were no adverse effects found to be associated with the femoral block procedure; rather, two studies found a decreased risk of adverse events such as respiratory and cardiac complications. Conclusions: Femoral nerve blocks appear to have benefits both in terms of decreasing the pain experienced by older patients, as well as limiting the amount of systemic opioids administered to this population. RÉSUMÉObjectif: Les fractures de la hanche sont une cause fréquente de douleur aiguë chez les personnes âgées fragiles. L'un des moyens possibles de soulager efficacement la douleur dans ce groupe de personnes est le bloc fémoral. La revue systématique visait à recueillir des données probantes à jour sur le bloc fémoral comme moyen de soulagement de la douleur causée par les fractures de la hanche, chez les personnes âgées, au service des urgences (SU). Aucun effet indésirable n'a été associé au bloc fémoral; au contraire, les auteurs ont même constaté, dans deux études, une diminution du risque d'événement indésirable tel que des complications cardiaques ou respiratoires. Conclusions: Les blocs fémoraux semblent avantageux tant sur le plan du soulagement de la douleur chez les personnes âgées que sur celui de l'administration d'opioïdes à action générale, dans ce segment de la population.

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“…The favourably low incidence of nausea and vomiting was probably multifactorial. Associated factors might have included the dexamethasone-ondansetron combination in the control group, 25,26 use of ondansetron within the first six hours, 27 and improved analgesia and reduced opioid consumption 28 in Groups D1 and D2.…”

Section: (D1) Group 3 (D2) (N = 30) (N = 30) (N = 30) Vas (Rest) Vas mentioning

confidence: 99%

L’administration péridurale de dexaméthasone réduit la douleur et la demande d’analgésiques postopératoires

Thomas

Beevi

2006

Can J Anesth/J Can Anesth

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Purpose: Epidural steroids may have potential advantages for providing postoperative analgesia. We therefore undertook a study to evaluate the efficacy of epidurally administered dexamethasone in reducing postoperative morphine requirements, as a measure of analgesia following laparoscopic cholecystectomy. Methods:In a randomized, double-blind study, 94 patients undergoing laparoscopic cholecystectomy were randomly assigned to one of three groups. Group 1 (Control) patients received dexamethasone 5 mg iv with epidural injection of 0.25% bupivacaine 8 mL and normal saline 2 mL, Group 2 (D1) patients received normal saline 2 mL iv with epidural injection of 0.25% bupivacaine 8 mL and dexamethasone 5 mg in normal saline 2 mL, and Group 3 (D2) patients received normal saline 2 mL iv with epidural injection of dexamethasone 5 mg in normal saline 10 mL. After surgery, morphine 2-4 mg iv was administered as needed for analgesia. Postoperative morphine requirements, visual analogue scale (VAS) pain scores at rest and with effort, and time to first analgesic administration were recorded by a blinded observer. Results:Total morphine consumption for the first 24 hr following surgery was lower in both epidural dexamethasone groups (D1, D2) compared to the control group (P < 0.05). The percentage reduction in morphine consumption in Group D1 was 53.9% and in Group D2 was 52.9% in the first 24 hr. Postoperatively at 12 hr, 18 hr and 24 hr, the VAS scores at rest and during effort were also lower in the epidural dexamethasone groups (D1, D2) compared to the control group (P < 0.05). The percentage reductions in VAS scores with effort at 12 hr, 18 hr and 24 hr in Group D1 were 50%, 52.9% and 50% respectively, and in Group D2 percentage reductions in pain scores with effort were 54.8%, 58.8% and 55.5% at corresponding sampling intervals. Conclusion:Preoperative epidural administration of dexamethasone 5 mg, with or without bupivacaine, reduces postoperative pain and morphine consumption following laparoscopic cholecystectomy. Objectif

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The Effect of Pain on Health-Related Quality of Life in the Immediate Postoperative Period

Abstract: Severity of postoperative pain may affect quality of life.

Cited by 166 publications

References 17 publications

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Use of Femoral Nerve Blocks to Manage Hip Fracture Pain among Older Adults in the Emergency Department: A Systematic Review

L’administration péridurale de dexaméthasone réduit la douleur et la demande d’analgésiques postopératoires

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