Associations of Multimodal Analgesia With Postoperative Pain Trajectories and Morphine Consumption After Hepatic Cancer Surgery

Yeh, Chih-Ting; Chang, Wen-Kuei; Wu, Hsiang-Ling; Chau, Gar‐Yang; Tai, Ying Hsuan; Chang, Kuang-Yi

doi:10.3389/fmed.2021.777369

Cited by 3 publications

(2 citation statements)

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“…Međutim, mutimodalna analgezija nije dala konzistentan uspeh, zato što su rezultati ovog pristupa povezani sa velikim brojem varijabli (različite doze, različiti medikamenti i tehnike, različite vrste operacija), pa je teško sve te podatke validno obraditi u studijama. Ipak, neke studije pokazuju jasne prednosti multimodalne analgezije u pogledu poboljšanja analgezije i ishoda lečenja, pa čak pokazuju i sma- 34,35 njenje incidence pojave hroničnog postoperativnog bola.…”

Section: Terapija Zasnovana Na Mehanizmima Nastanka Bola Podrazumeva ...unclassified

Importance of postoperative pain and possibilities of prevention and treatment

Tošković,

Stojanović,

Jovanović

et al. 2021

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The paper presents the importance of acute postoperative pain, the risk factors for its occurrence and intensity, instruments for its measurement and assessment, as well as the possibilities of prevention and treatment. The fact that post-surgical pain represents not only a subjective unpleasant experience for the patient, but also a factor that significantly contributes to complications and unfavorable outcomes of surgical treatment is well known. Despite that, postoperative pain can be seen very often. To successfully prevent and relieve pain, it is necessary to establish a possible cause-and-effect relationship between the occurrence and intensity of postoperative pain, type of surgical intervention, anesthesia technique, demographic characteristics of patients, comorbidities, chronic therapy, and family and socioeconomic factors. Besides the application of recommendations from the current guidelines and protocols for the prevention and treatment of post-surgical pain to achieve positive treatment outcomes, an individual approach to each patient and the application of multimodal analgesia techniques that include the use of different classes of analgesics, co-analgesics, and non-pharmacological measures, based on modern ERAS-protocols aimed at accelerated recovery after surgical intervention should also be employed.

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Section: Terapija Zasnovana Na Mehanizmima Nastanka Bola Podrazumeva ...unclassified

Importance of postoperative pain and possibilities of prevention and treatment

Tošković,

Stojanović,

Jovanović

et al. 2021

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“…Post-operative pain is an unavoidable consequence of surgical procedures. Poor pain management in the initial post-operative period has been connected with a number of post-operative complications and poor clinical results, which would prolong the length of hospitalisation, increase healthcare costs, reduce quality of life and increase the risk of developing chronic pain (Baca et al, 2021;Yeh et al, 2021). To decrease the potential short-and long-term negative effects, the optimization of post-operative pain management is necessary.…”

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confidence: 99%

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Wang,

Qin,

Zhen

et al. 2024

Journal of Clinical Nursing

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AimsTo develop a nomogram to provide a screening tool for recognising patients at risk of post‐operative pain undergoing abdominal operations.BackgroundRisk prediction models for acute post‐operative pain can allow initiating prevention strategies, which are valuable for post‐operative pain management and recovery. Despite the increasing number of studies on risk factors, there were inconsistent findings across different studies. In addition, few studies have comprehensively explored predictors of post‐operative acute pain and built prediction models.DesignA prospective observational study.MethodsA total of 352 patients undergoing abdominal operations from June 2022 to December 2022 participated in this investigation. A nomogram was developed for predicting the probability of acute pain after abdominal surgery according to the results of binary logistic regression. The nomogram's predictive performance was assessed by discrimination and calibration. Internal validation was performed via Bootstrap with 1000 re‐samplings.ResultsA total of 139 patients experienced acute post‐operative pain following abdominal surgery, with an incidence of 39.49%. Age <60, marital status (unmarried, divorced, or widowed), consumption of intraoperative remifentanil >2 mg, indwelling of drainage tubes, poor quality sleep, high pain catastrophizing, low pain self‐efficacy, and PCIA not used were predictors of inadequate pain control in patients after abdominal surgery. Using these variables, we developed a nomogram model. All tested indicators showed that the model has reliable discrimination and calibration.ConclusionsThis study established an online dynamic predictive model that can offer an individualised risk assessment of acute pain after abdominal surgery. Our model had good differentiation and calibration and was verified internally as a useful tool for risk assessment.Relevance to Clinical PracticeThe constructed nomogram model could be a practical tool for predicting the risk of experiencing acute post‐operative pain in patients undergoing abdominal operations, which would be helpful to realise personalised management and prevention strategies for post‐operative pain.Reporting MethodThe Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.Patient or Public ContributionBefore the surgery, research group members visited the patients who met the inclusion criteria and explained the purpose and scope of the study to them. After informed consent, they completed the questionnaire. The patients' pain scores (VAS) were regularly assessed and documented by the bedside nurse for the first 3 days following surgery. Other information was obtained from medical records.

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Multimodal Anesthesia as an Important Component of Eras

Chernii

2024

Clin. and prev. med.

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Introduction. The ideology of Fast Track-Surgery (FTS) and Enhanced Recovery After Surgery (ERAS) represents modern trends in global surgical practice. Anesthesiology aims to provide ideal and universal solutions for protecting patients from surgical aggression. A multimodal approach, which includes multilevel, multifaceted antinociception, is well-founded, where maximum effectiveness is combined with minimal side effects. The aim. To analyze the issue of multimodal pain management as an important component of ERAS (Enhanced Recovery After Surgery) from modern sources of literature for optimizing perioperative care in the minimally invasive surgery department. Materials and methods. Bibliosemantic, comparative, and systemic analysis methods were employed. The proposed recommendations were developed based on an analysis of modern literature, the results of randomized trials and meta-analyses, as well as our own studies dedicated to the study of perioperative pain issues. The results. It has been proven that the use of opioids in anesthesia practice is decreasing. New and modern methods of continuous monitoring of vital organs in patients are being introduced as supplements to classical monitoring protocols. These methods are used to avoid excessive or inadequate dosing of anesthetics, adjust the concentration of substances used, reduce post-anesthesia complications, and improve patient comfort. The method of perioperative energy monitoring significantly complements the "International Standards for Safe Anesthetic Practice", WFSA (2010), and enhances perioperative patient safety by detecting metabolic disturbances and implementing appropriate pathogenetic correction. The importance of regional anesthesia under ultrasound control, nociception-antinociception balance management, and the impact of these methods on opioid consumption, patient satisfaction, and postoperative recovery have been proven. Conclusions. The most commonly used combination of drugs for multimodal analgesia often includes acetaminophen and NSAIDs (strong recommendation). It has been proven that deep and prolonged sedation in intensive care unit (ICU) patients is associated with worse outcomes, longer mechanical ventilation duration, extended ICU and hospital stays, and higher rates of complications, including infections and sometimes even death.

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Associations of Multimodal Analgesia With Postoperative Pain Trajectories and Morphine Consumption After Hepatic Cancer Surgery

Cited by 3 publications

References 35 publications

Importance of postoperative pain and possibilities of prevention and treatment

Importance of postoperative pain and possibilities of prevention and treatment

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Multimodal Anesthesia as an Important Component of Eras

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