Postoperative Pain Management in Spanish Hospitals: A Cohort Study Using the PAIN-OUT Registry

Polanco-García, Mauricio; García-Lopez, Jaume; Fàbregas, Neus; Meißner, W.; Puig, Margarita M.

doi:10.1016/j.jpain.2017.05.006

Cited by 39 publications

(62 citation statements)

References 51 publications

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“…In his 2010 review, Sinatra (8) complained about the unsatisfactory situation of patients with severe postoperative pain, and concerns are still shared by others (7,9,10). The team of Gan published several surveys describing the situation of postoperative patients in the United States.…”

Section: Current Situation Of Postoperative Pain Controlmentioning

confidence: 99%

Regional Catheters for Postoperative Pain Control: Review and Observational Data

Suksompong

Bormann

2020

Anesth Pain Med

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Context: Perioperative analgesia is an essential but frequently underrated component of medical care. The purpose of this work is to describe the actual situation of surgical patients focusing on effective pain control by discarding prejudice against 'aggressive' measures. Evidence Acquisition: This is a narrative review about continuous regional pain therapy with catheters in the postoperative period. Included are the most-relevant literature as well as own experiences. Results: As evidenced by an abundance of studies, continuous regional/neuraxial blocks are the most effective approach for relief of severe postoperative pain. Catheters have to be placed in adequate anatomical positions and meticulously maintained as long as they remain in situ. Peripheral catheters in interscalene, femoral, and sciatic positions are effective in patients with surgery of upper and lower limbs. Epidural catheters are effective in abdominal and thoracic surgery, birth pain, and artery occlusive disease, whereas paravertebral analgesia may be beneficial in patients with unilateral approach of the truncus. However, failure rates are high, especially for epidural catheter analgesia. Unfortunately, many reports lack a comprehensive description of catheter application, management, failure rates and complications and thus cannot be compared with each other. Conclusions: Effective control of postoperative pain is possible by the application of regional/neuraxial catheters, measures requiring dedication, skill, effort, and funds. Standard operating procedures contribute to minimizing complications and adverse side effects. Nevertheless, these methods are still not widely accepted by therapists, although more than 50% of postoperative patients suffer from 'moderate, severe or worst' pain.

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Section: Current Situation Of Postoperative Pain Controlmentioning

confidence: 99%

Regional Catheters for Postoperative Pain Control: Review and Observational Data

Suksompong

Bormann

2020

Anesth Pain Med

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“…Nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 selective NSAIDs, and opioids should be individualized for the multimodal technique [9]. Opioid and non-opioid analgesics have been administered to 58.9% and 96.5% of patients to manage postoperative pain in general surgery, respectively [10]. However, in contrast to postoperative pain, CRBD has been under-treated and may be resistant to conventional pain management such as opioids because different mechanisms are involved in developing postoperative pain and CRBD [1].…”

Section: Introductionmentioning

confidence: 99%

Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study

Park

Hong

et al. 2019

JCM

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Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, p = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.

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“…Also, severe pain during the postoperative period can be a risk factor for chronic postoperative pain [31]. An extensive study across several hospitals in Spain detected severe pain in 39.4% of patients following surgery [32].…”

Section: Discussionmentioning

confidence: 99%

Diverse characters of Brennan’s paw incision model regarding certain parameters in the rat

et al. 2019

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Background Brennan’s rodent paw incision model has been extensively used for understanding mechanisms underlying postoperative pain in humans. However, alterations of physiological parameters like blood pressure and heart rate, or even feeding and drinking patterns after the incision have not been documented as yet. Moreover, though eicosanoids like prostaglandins and leukotrienes contribute to inflammation, tissue levels of these inflammatory mediators have never been studied. This work further investigates the antinociceptive effect of protein C after intra-wound administration. Methods Separate groups of Sprague–Dawley rats were used for quantitation of cyclooxygenase (COX) activity and leukotriene B4 level by enzyme-linked immunosorbent assay, as well as estimation of cardiovascular parameters and feeding and drinking behavior after paw incision. In the next part, rats were subjected to incision and 10 μg of protein C was locally administered by a micropipette. Both evoked and non-evoked pain parameters were then estimated. Results COX, particularly COX-2 activity and leukotriene B4 levels increased after incision. Hemodynamic parameters were normal. Feeding and drinking were affected on days 1 and 3, and on day 1, respectively. Protein C attenuated non-evoked pain behavior alone up to day 2. Conclusions Based upon current observations, Brennan’s rodent paw incision model appears to exhibit a prolonged period of nociception similar to that after surgery, with minimal interference of physiological parameters. Protein C, which is likely converted to activated protein C in the wound, attenuated the guarding score, which probably represents pain at rest after surgery in humans.

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Postoperative Pain Management in Spanish Hospitals: A Cohort Study Using the PAIN-OUT Registry

Cited by 39 publications

References 51 publications

Regional Catheters for Postoperative Pain Control: Review and Observational Data

Regional Catheters for Postoperative Pain Control: Review and Observational Data

Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study

Diverse characters of Brennan’s paw incision model regarding certain parameters in the rat

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