The novel use of different bupivacaine preparations with combined regional techniques for postoperative pain management in non–opioid-based laparoscopic inguinal herniorrhaphy

Eppstein, Andrew C.; Sakamoto, Bryan

doi:10.1016/j.jclinane.2016.05.011

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…BLIS should not be mixed with lidocaine as this can cause significant disruption of the liposomes (Kharitonov, 2014). However, an admixture of BLIS with bupivacaine HCl is proposed to decrease the onset time of BLIS in humans (Eppstein & Sakamoto, 2016) and the guideline from human medicine is to mix no more than an equal volume (1:1) of 0.5% bupivacaine HCl:liposomal bupivacaine. Mixing has not been studied in animals but the fast onset of BLIS, as reported in humans (Apseloff et al, 2013), may preclude the need for this technique.…”

Section: Box 5 Properties Of Bupivacaine Liposome-encapsulated Suspenmentioning

confidence: 99%

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Grubb

Lobprise

2020

Veterinary Medicine & Sci

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Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose‐related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two‐part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome‐encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020).

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Section: Box 5 Properties Of Bupivacaine Liposome-encapsulated Suspenmentioning

confidence: 99%

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Grubb

Lobprise

2020

Veterinary Medicine & Sci

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“…The proportion of patients receiving opioid medication in the current study was higher than, but the dose was similar to, a comparable study that reported 40% of patients took opioid analgesics (most common total intake of 10-20 mg) for up to 1 week post-surgery. 26 Given the widespread opioid tolerance and abuse and the increasing move to avoid opioids for surgical pain, including after inguinal hernia repair, 27 it is crucial that opioid consumption is assessed, particularly when comparing surgical modalities. Further, in the current study there was a significant effect of BMI on the analgesic profile during the hospital stay, with overweight and obese participants more likely to require a combination of opioid and NSAIDs, rather than just NSAIDs or paracetamol alone, or no analgesia.…”

Section: Discussionmentioning

confidence: 99%

Open vs Laparoscopic Inguinal Hernia Repair: Influences of Patient Age and BMI on Analgesic Requirements and Hospital Stay Duration

Mwagiru¹,

Larkin²

2020

World Journal of Laparoscopic Surgery With DVD

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Aim:Comparisons between open vs laparoscopic surgical methods for inguinal hernia repair have yielded inconsistent results with respect to patients' pain levels and analgesic requirements post-surgery. This study compared open vs laparoscopic inguinal hernia repair in terms of types and quantity of analgesics administered during the postoperative recovery period and the hospital stay, including the influences of patient characteristics such as age, BMI, and previous inguinal hernia repair. Materials and methods: This was a cross-sectional study of retrospective analysis of data pertaining to inguinal hernia repairs in a rural hospital in Australia. Results: Among 63 patients (60 males), 62% had undergone open and 38% laparoscopic surgery for inguinal hernia repair. Type and dose of analgesic medications given during both the postoperative recovery period and the hospital ward stay and the duration of the hospital stay were not significantly different between open and laparoscopic groups. However, there were significant influences of BMI, with significantly more overweight and obese patients requiring a combination of opioids with nonsteroidal anti-inflammatory drug (NSAID) or paracetamol during the hospital stay, and with obese patients having the longest hospital stay, followed by overweight patients. Patients who had open surgery were significantly older and less likely to have had a previous inguinal hernia repair than those who had laparoscopic surgery, and there was a significant correlation between age and duration of hospital stay. Conclusion:Patient characteristics of age, BMI, and previous inguinal hernia repair are confounding factors when comparing analgesic requirements and hospital stay duration after open vs laparoscopic inguinal hernia repair.

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“…More elapsing time was likely needed to achieve the peak effect of the drug and this probably explains the late but not early analgesic effect of the drug in the current study. For short surgical procedures—such as outpatient breast surgery—earlier administration of the drug (ie surgical start) may be a more effective strategy to obtain better analgesic outcomes in the immediate postsurgical period . Nonetheless, one could argue that the postdischarge period should be prioritized in ambulatory surgery, as patients are required to treat their pain with less potent oral analgesics …”

Section: Discussionmentioning

confidence: 99%

“…For short surgical procedures-such as outpatient breast surgery-earlier administration of the drug (ie surgical start) may be a more effective strategy to obtain better analgesic outcomes in the immediate postsurgical period. 21,22 Nonetheless, one could argue that the postdischarge period should be prioritized in ambulatory surgery, as patients are required to treat their pain with less potent oral analgesics. 23,24 Few studies have specifically tested the efficacy of interventions to improve patient reported quality of recovery after ambulatory surgery.…”

Section: Discussionmentioning

confidence: 99%

Single dose systemic acetaminophen to improve patient reported quality of recovery after ambulatory segmental mastectomy: A prospective, randomized, double-blinded, placebo controlled, clinical trial

et al. 2017

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Few systemic drug interventions are efficacious to improve patient reported quality of recovery after ambulatory surgery. We aimed to evaluate whether a single dose systemic acetaminophen improve quality of recovery in female patients undergoing ambulatory breast surgery. We hypothesized that patients receiving a single dose systemic acetaminophen at the end of the surgical procedure would have a better global quality of postsurgical recovery compared to the ones receiving saline. The study was a prospective randomized double blinded, placebo controlled, clinical trial. Healthy female subjects were randomized to receive 1 g single dose systemic acetaminophen at the end of the surgery or the same volume of saline. The primary outcome was the Quality of Recovery 40 (QOR-40) questionnaire at 24 hours after surgery. Other data collected included opioid consumption and pain scores. Data were analyzed using group t tests and the Wilcoxon exact test. The association between opioid consumption and quality of recovery was evaluated using Spearman rho. P < .05 was used to reject the null hypothesis for the primary outcome. Seventy subjects were randomized and sixty-five completed the study. Patients' baseline characteristics and surgical factors were similar between the study groups. There was a clinically significant difference in the global QoR-40 scores between the acetaminophen and the saline groups, median (IQR) of 189 (183 to 194) and 183 (175 to 190), respectively, P = .01. In addition, there was an inverse relationship (Spearman's rho= -0.33) between oral opioid consumption at home (oral morphine equivalents) and 24 hour postoperative quality of recovery, P = .007. A single dose of systemic acetaminophen improves patient reported quality of recovery after ambulatory breast surgery. The use of systemic acetaminophen is an efficacious strategy to improve patient perceived quality of postsurgical recovery and analgesic outcomes after hospital discharge for ambulatory breast surgery.

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The novel use of different bupivacaine preparations with combined regional techniques for postoperative pain management in non–opioid-based laparoscopic inguinal herniorrhaphy

Cited by 9 publications

References 7 publications

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Open vs Laparoscopic Inguinal Hernia Repair: Influences of Patient Age and BMI on Analgesic Requirements and Hospital Stay Duration

Single dose systemic acetaminophen to improve patient reported quality of recovery after ambulatory segmental mastectomy: A prospective, randomized, double-blinded, placebo controlled, clinical trial

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