Day case laparoscopy: a survey of postoperative pain and an assessment of the value of diclofenac

Edwards, N. D.; Barclay, K.; Catling, S.; Martín, Dionisio; Morgan, Robert

doi:10.1111/j.1365-2044.1991.tb09930.x

Cited by 116 publications

(65 citation statements)

References 7 publications

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“…Clinical experience and other studies [5,6] have shown greater analgesic requirements and pain scores after laparoscopic sterilisation than after diagnostic laparoscopy. Thus this study was designed to assess the efficacy of a single pre-operative dose of morphine given by mouth in a randomised, double-blind, placebo-controlled trial in patients undergoing diagnostic laparoscopy and laparoscopic sterilisation.…”

mentioning

confidence: 87%

Pre‐operative oral administration of morphine in day‐case gynaecological laparoscopy

Rasanayagam

Harrison

1996

Anaesthesia

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The analgesic efect of morphine sulphate 10 mg by mouth given pre-operatively on pain after gynaecological laparoscopy was studied in a randomised, prospective, double-blind, placebo-controlled comparison. Two groups of 56 patients were studied, one group undergoing diagnostic laparoscopy and the other laparoscopic sterilisation. AN patients received a standard anaesthetic after premedication with morphine or placebo I h before the operation. Morphine premedication did not significantly influence postoperatice pain as assessed on a visual analogue scale in either group and posloperative opioid consumption was unaffected.Premedication with morphine 10 mg orally does not sign$cantly decrease pain after day-case gynaecological laparoscopy .

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mentioning

confidence: 87%

Pre‐operative oral administration of morphine in day‐case gynaecological laparoscopy

Rasanayagam

Harrison

1996

Anaesthesia

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“…during surgery provides analgesia following dental surgery [9] but corroborates its demonstrated lack of efficacy for the pain following tonsillectomy [42]. When given rectally, however diclofenac is efficacious in reducing pain after tonsillectomy [43,44] and adenoidectomy [45], though its use by the intramuscular route after a variety of surgeries (hip, abdominal, dental) is both efficacious [46,47] and inefficacious [48,49]. Collated with these contradictory reports our findings suggest that the effect of diclofenac may be related to its route of administration and to the nature of surgery.…”

Section: Discussionmentioning

confidence: 93%

Analgesics and ENT surgery. A clinical comparison of the intraoperative, recovery and postoperative effects of buprenorphine, diclofenac, fentanyl, morphine, nalbuphine, pethidine and placebo given intravenously with induction of anaesthesia.

Berg

Honjol

Prabhu

et al. 1994

Brit J Clinical Pharma

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1 Vomiting and restlessness following ENT and eye surgery are undesirable, and may be related to the emetic and analgesic effects of any analgesic given to augment anaesthesia during surgery. 2 To rationalise the choice of analgesic for routine ENT surgery we examined the intraoperative, recovery and postoperative effects following the administration of either buprenorphine (3.0 to 4.5 pg kg-'), diclofenac (1 mg kg-'), fentanyl (1.5 to 2.0 pg kg-'), morphine (0.1 to 0.15 mg kg-'), nalbuphine (0.1 to 0.15 mg kg-'), pethidine (1.0 to 1.5 mg kg-') or saline (as control) given with the induction of anaesthesia in 374 patients. A standardised anaesthetic technique with controlled ventilation using 0.6-0.8% isoflurane in nitrous oxide and oxygen was employed. The study population constituted 7 similar groups of patients. 3 Intraoperatively, their effects on heart rate and blood pressure, airway pressure and intraocular pressure, were similar. This implies, most surprisingly, that neither their analgesic nor their histamine releasing effects were clinically evident during surgery. By prolonging the time to extubation at the end of anaesthesia, only buprenorphine, fentanyl, morphine and pethidine provided evidence of intraoperative respiratory depression. 4 Postoperatively, buprenorphine was associated with severe respiratory depression, prolonged somnolence, profound analgesia and the highest emesis rate. Diclofenac exhibited no sedative, analgesic, analgesic sparing, emetic or antipyretic effects. Fentanyl provided no sedative or analgesic effects, but was mildly emetic. Morphine provided poor sedation and analgesia, delayed the requirement for re-medication and was highly emetic. Nalbuphine and pethidine produced sedation with analgesia during recovery, a prolonged time to re-medication and a mild emetic effect. None provided evidence, from analysis of postoperative re-medication times and analgesic consumption, of any pre-emptive analgesic effect.5 We conclude that nalbuphine (mean dose 0.13 mg kg-') and pethidine (mean dose 1.35 mg kg-'), given individually as a single i.v. bolus during induction of anaesthesia, are the most efficacious analgesics for routine in-patient ENT surgery.

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“…Spasmodic/cramping pain is the third type of pain, and hardly ever lasts longer than three to four hours (Dobbs et al, 1987;Edwards et al, 1991;Guard & Wiltshire, 1996). The take-home questionnaire revealed that eight subjects (six hours after surgery), four subjects (24 hours), and five subjects (48 hours) reported abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

“…Given immediately prior to the surgical procedure, ketorolac will have a peak action in the postoperative period. However, it was shown to be less effective in decreasing postoperative pain following laparoscopic tub'al ligation (Edwards, Barclay, Catling, Martin & Morgan, 1991;Crocker & Paech, 1992;Shapiro & Duffy, 1994). This may in part be a result of the differences in pain experienced from the various types of laparoscopic procedures available for tubal sterilization.…”

Section: Laparoscopic Tubal Ligation Painmentioning

confidence: 99%

The Effect of Pre-Emptive Administration of Dextromethorphan on Postoperative Pain in Patients Undergoing Interval Laparoscopic Tubal Sterilization

Pitcher¹

2001

PsycEXTRA Dataset

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Public reportino burden for tNs collection of information is estimated to average 1 hour per response, including the time for reviewing inslnictions, searching existing data sources, gathering and maintaining the date needed, and completing and reviewing the collection of information. Send comments regarding tNs burden estimate or any other aspect of tNs collection of information, including suggestions for reducing tNs burden, TITLE AND SUBTITLEThe effect of pre-emptive administration of dextromethorphan on postoperative pain in patients undergoing interval laparoscopic tubal sterilization AUTHOR(S)CPT Brian M. Pitcher PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)University Each year an estimated one million women elect to have surgical sterilization. This is performed by a laparoscopic procedure which can be severe enough to warrant an unplanned admission. With an increased understanding of the physiological basis of pain, classes of drugs not normally associated with pam reduction are now being investigated based on their ability to mteract with receptors in the pain pathway. Experimental studies have shown that the N-methyl-D-aspartate (NMDA) receptor plays a significant role in neuronal "wind-up", a state of hyperalgesia that can last from hours to days following injury or trauma.. Interfering with the NMDA receptor prior to surgical stimuli, wmd-up is prevented resuUing in decreased pain and analgesic requirements followmg surgery. Dextromethorphan, a readily available nonopioid antimssive in clinical use for more than 40 years, is one such NMDA receptor Anticosti. This prospective, randomized, double blind pilot study compared the effects over time when patients received dextromethorphan versus placebo-emptively. The sample was comprised of 14 subjects undergomg laparoscopic tubal ligation under general endotracheal anesthesia at regional military medical center for the Pacific Basin. Patients were ASA physical category I or II and at least 18 years of age and assigned to one of two groups. Group I received 60 mg of dextromethorphan orally, and Group II received an oral placebo. Postoperative pain was assessed using an 11 point Numeric Rating Scale (NRS) at eight time intervals. Additionally, a follow-up questionnaire and 48-hour postoperative telephone call were used to collect data on the patients' satisfaction of being in the study. The Student's t-test was used to determine homogeneity between the two groups. Following analysis, a statistically significant difference was found in two areas. Patients who received dextromethorphan 60 mg orally before surgery had a significant decrease m postoperative pain (p<0.04). The amount of Roxicet required postoperative was statistically less in the dextromethorphan group (p<0.02). The preoperative use of dextromethorphan may significantly decreased the amount of postoperative pain experienced with a resultant decrease in need for narcotic analgesics. This prospective, randomized, double blind pilot study compared the effects over time when patients received de...

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Day case laparoscopy: a survey of postoperative pain and an assessment of the value of diclofenac

Cited by 116 publications

References 7 publications

Pre‐operative oral administration of morphine in day‐case gynaecological laparoscopy

Pre‐operative oral administration of morphine in day‐case gynaecological laparoscopy

Analgesics and ENT surgery. A clinical comparison of the intraoperative, recovery and postoperative effects of buprenorphine, diclofenac, fentanyl, morphine, nalbuphine, pethidine and placebo given intravenously with induction of anaesthesia.

The Effect of Pre-Emptive Administration of Dextromethorphan on Postoperative Pain in Patients Undergoing Interval Laparoscopic Tubal Sterilization

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