Continuous wound infiltration system for postoperative pain management in gynecologic oncology patients

Lee, Banghyun; Kim, Kidong; Ahn, Soyeon; Shin, Hyun Jung; Suh, Dong Hoon; No, Jae Hong; Kim, Yong Beom

doi:10.1007/s00404-017-4342-8

Cited by 10 publications

(15 citation statements)

References 21 publications

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“…Compared to TAP, single WI showed inferior analgesia [226][227][228]. However, CWI as part of multimodal management showed better [229] or similar analgesic effect as PCA-IV fentanyl [225], and this finding might be important in cancer surgery patients [229]. One meta-analysis showed, that compared with bupivacaine alone, addition of ketamine or dexmedetomidine to bupivacaine for WI showed opioid-sparing effect, delayed first request for rescue analgesia, and attenuated postoperative stress response in total abdominal hysterectomy [54].…”

Section: Gynecological Surgerymentioning

confidence: 94%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.

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Section: Gynecological Surgerymentioning

confidence: 94%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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“…NRS: Numerical rating scale NRS scores at rest were 5 (range: 2-6.5), 0.5 (range: 0-2), and 1 (range: 0-2) at 2, 24, and 48 h postoperatively, respectively. NRS scores on movement were 3 (3-5.5) and 3.5 (3)(4)(5) at 24 and 48 h postoperatively, respectively. NRS scores on movement at 2 h postoperatively were not available; the patients hardly moved within 2 h postoperatively.…”

Section: Resultsmentioning

confidence: 95%

“…However, there are concerns that the effect time of a single shot is short and that the local anesthetic dose per site is inevitably reduced by multiple punctures. The effectiveness of continuous wound in ltration (CWI) through multiple-ori ce catheters has also been reported, [4,5] but the expected even distribution of local anesthetic solution through each pore may not be guaranteed. [6] Thoracoabdominal nerves block through perichondrial approach (TAPA) was described in 2019 by Tulgar as a peripheral nerve block that provides effective analgesia between Th5 and Th12.…”

Section: Trail Registrationmentioning

confidence: 99%

Efficacy of Modified Thoracoabdominal Nerves Block Through Perichondrial Approach in Open Gynecological Surgery: A Prospective Observational Study and a Cadaveric Evaluation

Tanaka

Suzuka

Kadoya

et al. 2021

Preprint

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BACKGROUNDː Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) was first described as a peripheral nerve block by Tulgar in 2019. This technique provides an analgesic effective range from Th7–11 with a single puncture per side. Although the efficacy and effective duration of M-TAPA have been reported, further examination is required. Therefore, this study aimed to evaluate the analgesic range and effective duration of M-TAPA in open gynecologic surgery.METHODSː Following approval, 10 adult female patients scheduled for open radical hysterectomy via a vertical incision or laparotomy using a midline incision from under the xiphoid process to the symphysis pubis were enrolled. The primary outcome was the number of anesthetized dermatomes at 2 and 24 h postoperatively. Secondary outcomes included numerical rating scale scores and the total amount of fentanyl used. Cadaveric evaluation was performed to assess the spread of the dye. RESULTSː The median numbers (interquartile range) of anesthetized dermatomes at 2 and 24 h postoperatively were 6 (5–7) and 6.5 (5–7) in the anterior cutaneous branch area and 5 (4–7) and 7 (5–7) in the lateral cutaneous branch area, respectively. There was an 85% chance of simultaneously acquiring analgesia in areas innervated by Th8–Th11, including complete block in areas innervated by the anterior cutaneous branches of Th9–10. Cadaveric evaluation showed the spread of the dye in Th8–11.CONCLUSIONSːM-TAPA may have analgesic effects in the areas supplied by the anterior cutaneous branches of Th8–11.TRAIL REGISTRATION:IRB approval (No.2700; registered on July 10, 2020) and registration (UMIN Clinical Trials Registry: UMIN000041137; registered on July 17, 2020)

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“…The second cluster was core drugs, which are widely combined with other drugs and are the core analgesics of PCA. Most of them were opioid powerful analgesics, and there were also long-term local anesthetics, which are widely used, such as Morphine, Fentanyl, Ropivacaine, etc., they can be used as a single drug for PCA [17][18][19]. Among these drugs, Dexmedetomidine ranked second in frequency, is not an opioid and has both sedative and analgesic effects.…”

Section: Discussionmentioning

confidence: 99%

Study on the main drugs and drug combinations of patient-controlled analgesia based on text mining

Xing

Hou

2019

Preprint

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Background In recent years, with the continuous understanding of pain knowledge and the continuous improvement of quality of life requirements, patient-controlled analgesia (PCA) has been widely used in a variety of pain patients. In the treatment of PCA, more and more patients use multimodal analgesia (MMA). In this study, text mining technology was used to analyze relevant literatures, try to find out the main drugs of PCA, classify the drugs, and dig out the important drug combination rules. Methods PCA literatures were retrieved from Pubmed database in recent 10 years, and the bibliographic information of the literatures was taken as mining samples. First, the names of the drugs in the sample is identified by MetaMap package, then Bicomb software was used to extract high-frequency drugs for word frequency analysis and to construct a drug-phrase matrix. Finally, ‘hclust’ package and ‘arules’ package of R were used for cluster analysis and association analysis of drugs. Results 39 main PCA drugs were screened out, Morphine, Dexmedetomidine and Fentanyl were the top three drugs. Through cluster analysis, these drugs are divided into two clusters, one containing 26 common drugs and the other containing 13 core drugs. The association analysis of these drugs was carried out and 22 frequent itemsets and 6 association rules were obtained. The maximum frequent 1-itemsets were {Morphine} and the maximum frequent 2-itemsets were {Morphine, Ropivacaine}. Conclusions The research results have certain guidance and reference value for clinicians and researchers. In addition, it provides a way to study the relationship between drugs from the perspective of text mining.

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Continuous wound infiltration system for postoperative pain management in gynecologic oncology patients

Abstract: Combined therapy using CWIS and IV PCA may be a useful strategy for POSP management in gynecologic oncology patients.

Cited by 10 publications

References 21 publications

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Efficacy of Modified Thoracoabdominal Nerves Block Through Perichondrial Approach in Open Gynecological Surgery: A Prospective Observational Study and a Cadaveric Evaluation

Study on the main drugs and drug combinations of patient-controlled analgesia based on text mining

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