Postoperative pain management

Stasiowska, Maria; Ng, Su Cheen; Gubbay, Anthony N; Cregg, Roman

doi:10.12968/hmed.2015.76.10.570

Cited by 33 publications

(46 citation statements)

References 22 publications

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“…The fundamental aim of effective postoperative analgesia is to provide the patient with subjective comfort, facilitate the recovery process, and reduce the risk of complications, including the development of persistent postoperative pain. 112 , 113 Effective treatment of postoperative pain should be multidimensional and based on three main therapeutic principles: administration of analgesics, multimodal analgesia, and regional anesthesia techniques. 112 …”

Section: Methods Of Postoperative Analgesiamentioning

confidence: 99%

Assessment and pathophysiology of pain in cardiac surgery

Zubrzycki¹,

Liebold²,

Skrabal³

et al. 2018

JPR

139

106

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Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain. Ineffective postoperative analgesic therapy may cause several complications that are dangerous to a patient. Inappropriate postoperative pain management may result in chronic pain, immunosuppression, infections, and less effective wound healing. Understanding and better knowledge of physiological disorders and adverse effects resulting from surgical trauma, anesthesia, and extracorporeal circulation, as well as the development of standards for intensive postoperative care units are critical to the improvement of early treatment outcomes and patient comfort.

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Section: Methods Of Postoperative Analgesiamentioning

confidence: 99%

Assessment and pathophysiology of pain in cardiac surgery

Zubrzycki¹,

Liebold²,

Skrabal³

et al. 2018

JPR

139

106

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“…Durante el tratamiento de mantenimiento, el médico intervi-niente deberá reevaluar periódicamente al paciente, pudiendo re estratificar según la evolución clínica, la aparición de efectos adversos medicamentosos y el grado de alivio sintomático presentado. En este momento del seguimiento, toman especial relevancia la utilización de las escalas validadas para la evaluación del dolor [38][39][40][41][42][43] • Alergis e hipersensibilidad.…”

Section: Desarrollounclassified

Manejo del dolor agudo posoperatorio en pacientes adultos no ARM

Raña¹,

Turiaci²,

Waisman³

et al. 2018

RFEM

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“…Resection of a mediastinal mass by median sternotomy imparts substantial pain, which increases during movement and typically leads to chronic post-sternotomy pain as well as reduced pulmonary function caused by atelectasis and pneumonia (3,4). A multimodal analgesia regimen including opioids, nonopioid analgesics, such as nonsteroidal anti-in ammatory drugs (NSAIDs), antidepressants and local anesthetics (either via infusion or bolus doses), and various truncal blocks under ultrasound guidance are typical modalities used in combination to decrease postoperative pain to tolerable levels, enhance the recovery process, and reduce the need for opioid analgesia and the associated risk (5,6).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided Parasternal Intercostal Nerve Block for Postoperative Analgesia in Mediastinal Mass Resection by Median Sternotomy: a Randomized, Double-blind, Placebo-controlled Trial

Chen

Song

Wang

et al. 2020

Preprint

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Background: Ultrasound-guided parasternal intercostal nerve block is rarely used for postoperative analgesia, and its value remains unclear. This study aimed to evaluate the effectiveness of ultrasound-guided parasternal intercostal nerve block for postoperative analgesia in patients undergoing median sternotomy for mediastinal mass resection.Methods: This randomized, double-blind, placebo-controlled trial performed in Renmin Hospital, Wuhan University, enrolled 41 participants aged 18-65 years. The patients scheduled for mediastinal mass resection by median sternotomy were randomly assigned were randomized into 2 groups, and preoperatively administered 2 injections of ropivacaine (PSI) and saline (control) groups, respectively, in the 3rd and 5th parasternal intercostal spaces with ultrasound-guided (USG) bilateral parasternal intercostal nerve block. Sufentanil via patient-controlled intravenous analgesia (PCIA) was administered to all participants postoperatively. Pain score, total sufentanil consumption, and postoperative adverse events were recorded within the first 24 hours.Results: There were 20 and 21 patients in the PSI and control group, respectively. The PSI group required 20% less PCIA-sufentanil compared with the control group (54.05 ± 11.14 μg vs. 67.67 ± 8.92 μg; P < 0.001). In addition, pain numerical rating scale (NRS) scores were significantly lower in the PSI group compared with control patients, both at rest and upon coughing within 24 postoperative hours. Postoperative adverse events were generally reduced in the PSI group compared with controls. Conclusions: USG bilateral parasternal intercostal nerve block effectively reduces postoperative pain and adjuvant analgesic requirement, with good patient satisfaction, therefore constituting a good option for mediastinal mass resection by median sternotomy.

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Postoperative pain management

Cited by 33 publications

References 22 publications

Assessment and pathophysiology of pain in cardiac surgery

Assessment and pathophysiology of pain in cardiac surgery

Manejo del dolor agudo posoperatorio en pacientes adultos no ARM

Ultrasound-guided Parasternal Intercostal Nerve Block for Postoperative Analgesia in Mediastinal Mass Resection by Median Sternotomy: a Randomized, Double-blind, Placebo-controlled Trial

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