Lower limb orthopedic surgery in geriatric patients under paravertebral blocks: A prospective feasibility study

Singh, Rajesh Kumar; Chaturvedi, Jaya; Agrawal, H.S.; Agrawal, Nikhil

doi:10.1016/j.mjafi.2016.02.015

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…There are various methods to relieve postoperative pain following lower limb orthopedic surgery, including the epidural infusion of local anesthetics and opioids, pericapsular nerve blocks, intravenous (IV) patient-controlled analgesia, and paravertebral nerve blocks. Each method has its advantages and disadvantages (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

Savitha

et al. 2023

Anesth Pain Med

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Background: Postoperative analgesia is of utmost importance in the treatment of patients undergoing surgery. Good postoperative pain management reduces hospital stay and improves early ambulation. This study compared the efficacy of epidural bupivacaine with buprenorphine to butorphanol in lower limb orthopedic surgery. Objectives: This study was carried out to investigate the onset of analgesia, the extent of analgesia, sedation score, and side effects of butorphanol with bupivacaine versus buprenorphine with bupivacaine. Methods: In a clinical trial study, 100 patients who underwent elective orthopedic lower limb surgery were randomly allocated to two groups. A total of 100 patients with American Society of anesthesiologists grades I and II posted for lower limb orthopedic surgery were enrolled in this randomized, double-blind study. The patients were divided into groups A and B. Subarachnoid block was achieved with 3.4 mL of 0.5% bupivacaine. The pain was monitored by the visual analog scale postoperatively. The patients in group A received bupivacaine with buprenorphine, and group B received bupivacaine with butorphanol when they complained of pain in the postoperative period. The onset of analgesia, duration of analgesia, sedation score, and side effects were compared between the two groups. Results: The onset of analgesia was observed earlier in group A than in group B (7.7 ± 1.6 vs. 12.6 ± 1.7 minutes, P < 0.001). The duration of analgesia was longer in group A than in group B (590 ± 40 vs. 480 ± 54 minutes, P < 0.001). Pulse rates and mean arterial pressures were significantly different (P < 0.001). Side effects were common in both groups. Conclusions: Buprenorphine added to bupivacaine provides earlier onset and longer postoperative epidural analgesia than epidural butorphanol with bupivacaine.

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Section: Introductionmentioning

confidence: 99%

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

Savitha

et al. 2023

Anesth Pain Med

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“…Published by Francis Academic Press, UK -15-such as respiratory depression, nausea, vomiting and dizziness after analgesia is relatively high, so the application of this method has certain limitations [3]. In recent years, with the mature application of ultrasound technology, FICB has been promoted as a valuable technique for regional anesthesia and analgesia in lower limb orthopedic surgery [4].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided pericapsular nerve group block versus fascia iliac compartment block for pain control in lower limb orthopedic surgery: A meta-analysis from randomized controlled trials

2023

FMSR

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Ultrasound-guided pericapsular nerve group block (PENG) and fascia iliac compartment block (FICB) are alternative methods of pain relief during lower limb orthopedic surgery. However, the efficacy and safety of PENG compared with FICB have not been fully established.We comprehensively searched randomized controlled trials (RCTs) about comparing PENG with FICB for patients with lower limb orthopedic surgery through the databases of Pubmed, Embase, Cochrane Library, CNKI and Wanfang database with no limitation of language from their inception date to December 2022. Two reviewers were independently involved in the process of data extraction. The main outcome measures were pain scores in resting state and exercise state at different time points. Secondary outcome indexes were the first analgesia time, intraoperative remfentanil consumption, fentanyl consumption at 24 hours after surgery, morphine consumption at 24 hours after surgery, satisfaction score for postoperative analgesia, quadriceps muscle strength at 6 and 24 hours after surgery, incidence of adverse reactions such as nausea and vomiting. The Rev Man 5.3 software was used for meta-analysis of the data.Finally, a total of 8 RCTs with 210 patients in PENG group and 201 patients in FICB group were included in this meta-analysis. Pooled analysis indicated that there were no significant differences between the two groups in resting state and exercise state pain scores before nerve block and postoperative incidence of nausea and vomiting (P>0.05). Compared with FICB, pain scores at 10nim, 20min and 30min after nerve block, at 6h, 12h, 24h and 48h after surgery at resting state and exercise state, intraoperative remifentanil consumption, total sufentanil consumption and morphine consumption at 24h after surgery were significantly reduced in PENG group (P<0.05). In addition, compared with FICB group, the first postoperative analgesia time, postoperative analgesia satisfaction score, and quadriceps muscle strength 6h and 24h after surgery were significantly improved in PENG group (P<0.05) .Existing clinical evidence shows that compared with FICB , ultrasus-guided PENG has better analgesic effect in lower limb orthopedic surgery, patients need less intraoperative and postoperative opioid analgesic drugs, the duration of analgesia is longer, the effect on postoperative lower limb muscle strength of patients is less, and the occurrence of adverse reactions of nausea and vomiting is not increased.

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Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region

et al. 2017

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Lower limb orthopedic surgery in geriatric patients under paravertebral blocks: A prospective feasibility study

Abstract: m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 ( 2 0 1 6 ) 2 1 5 -2 1 9 a r t i c l e i n f o

Cited by 3 publications

References 20 publications

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

Ultrasound-guided pericapsular nerve group block versus fascia iliac compartment block for pain control in lower limb orthopedic surgery: A meta-analysis from randomized controlled trials

Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region

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