Postoperative pain, nausea and vomiting in neurosurgical patients

Leslie, Kate; Di, Williams

doi:10.1097/01.aco.0000182564.25057.fa

Cited by 37 publications

(21 citation statements)

References 58 publications

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“…The view that craniotomy is almost never associated with postoperative pain because the brain tissue has no pain perception per se, seems very common. [3][4][5][6][7][8] However, neither did these studies change awareness of the problem nor did they result in any treatment recommendations. Similarly, pain-induced arterial hypertension increases the risk of secondary intracranial hemorrhage.…”

mentioning

confidence: 99%

Prospective Assessment of Postoperative Pain After Craniotomy

Mordhorst¹,

Latz²,

Kerz³

et al. 2010

Journal of Neurosurgical Anesthesiology

114

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logistic regression and chi using SPSS program (Windows, version 12.0). During the first 24 hours 87% of the patients experienced pain (NRS 1 to 3: 32%, NRS 4 to 7: 44%, NRS 8 to 10: 11%). For postoperative analgesia, the opioid piritramide (a mu-receptor agonist) was administered to 70% and nonopiod analgesics to 73% of the patients. The probability of experiencing postcraniotomy pain was reduced by 3% for each year of life. Maintenance of anesthesia with sevoflurane increased the probability of suffering from postcraniotomy pain by 147% and the absence of corticosteroids by 119%. Other investigated parameters did not influence pain after craniotomy. This study shows that pain is experienced by the majority of patients after craniotomy, despite conventional pain management, emphasizing the necessity for improved and individualized pain management in this special group of patients.

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mentioning

confidence: 99%

Prospective Assessment of Postoperative Pain After Craniotomy

Mordhorst¹,

Latz²,

Kerz³

et al. 2010

Journal of Neurosurgical Anesthesiology

114

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“…Opioidlerin en önemli yan etkilerinden biri de bulantı-kusmadır ve kullanılan ilaç dozuna, miktarına bağlı olarak görülme sıklığı artmaktadır. 23 Çalışmamızda toplam morfin tüke-timi açısından gruplar arasında belirgin bir fark olmadığı için de postoperatif bulantı-kusma oranlarının benzer ve dolayısıyla bu ikisinin birbirleriyle ilişkili olduğu düşünülmektedir.…”

Section: Discussionunclassified

Comparison of Postoperative Period in Patients Having a Robotic-Assisted Total Laparoscopic Hysterectomy and Multi-Port Total Laparoscopic Hysterectomy

Alçay¹,

Sargın²,

Fırat³

et al. 2017

Turkiye Klinikleri J Anest Reanim

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Ö ÖZ ZE ET T A Am ma aç ç: : Robot yardımlı ve multiport laparoskopik total histerektomi operasyonu uygulanan iki grup hastanın postoperatif ağrı skorları, total morfin tüketimleri, yan etkiler ve komplikasyonlar açısından karşılaştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif çalışmaya ""American Society of Anesthesiology (ASA)" I ve II olmak üzere toplam 60 hasta dâhil edildi ve hastalar otuzar kişilik iki gruba ayrıldı. Cerrahi ekip tarafından hastalara hangi tekniğin uygulanacağına karar verildi. Hastaların postoperatif değerlendirilmeleri operasyona katılmayan bir anestezist tarafından yapıldı. Her iki grup hastaya da aynı standart anestezi protokolü uygulandı. Postoperatif dönemde hasta kontrollü analjezi yöntemi ile morfin başlandı. Operasyon sonrası ilk 24 saat sedasyon ve ağrı skorları, morfin tüketimi, yan etkiler, hasta memnuniyeti ve hastanede kalış süreleri kaydedildi. Postoperatif 3, 7 ve 15. günlerde yüz yüze ya da telefonla iletişime geçilerek hastaların ağrı skorları ve memnuniyet düzeyleri, sorgulandı. B Bu ul lg gu ul la ar r: : Multiport laparoskopik histerektomi uygulanan grupta sadece 24. saat ağrı skorları daha yüksek saptanırken, morfin tüketimleri açısından gruplar arasında anlamlı bir farklılık görülmedi. Demografik veriler, sedasyon skorları, yan etkiler ve hasta memnuniyeti açısından gruplar arasında fark yoktu. S So on nu uç ç: : Literatürde jinekolojik robotik cerrahi uygulamalarının, postoperatif ağrı, komplikasyonlar ve hasta memnuniyeti açısından avantajlı olduğu belirtilse de çalışmamızda her iki yöntemin birbirlerine üstünlükleri olmadığı sonucuna varılmıştır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Robotik; laparoskopi; histerektomi; postoperatif ağrı; morfin A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The objective of our study was to compare postoperative pain score, advers effects, total morphine consumption and complications between two groups patients who had robotic-assisted total laparoscopic hysterectomy and conventional multi-port access total laparoscopic hysterectomy M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Sixty patients between the class of American Society of Anesthesiology (ASA) I and II were included in this prospective study and divided into two groups. The decision to apply the technique of surgery by the surgical team and the postoperative evaluation of patients was performed by an anesthesiologist that does not participate to operation. All patients received a standardized anesthetic protocol. In the postoperative period, the method of patient-controlled analgesia with morphine was applied. Sedation scores, pain scores, total morphine consumption, side effects, patient satisfaction and duration of hospital stay were recorded for the first 24 hours in the postoperative period. In the postoperative 3, 7 and 15 th days pain score and satisfaction were asked by phone contacting and face-to-face interview. R Re es su ul lt ts s: : The robotic-assisted laparoscopic group had a long...

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“…In addition, longer duration of observation for PONV lasting 48 h could also be responsible for the relatively higher incidence of PONV in this study compared to that of previous studies in which patients were mostly observed only for 24 h postoperatively. And total IV anesthesia with propofol or neuraxial analgesia also may be helpful in lowering the incidence of relatively high rates of PONV [7,28]. …”

Section: Discussionmentioning

confidence: 99%

“…PONV is a significant problem for neurosurgical patients affecting patient outcome which mandates therapies aimed at active prevention. Thus, recommendations for the treatment of established PONV based on trials in neurosurgical patients may be flawed [7]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy of dexamethasone added to ramosetron for preventing postoperative nausea and vomiting in highly susceptible patients following spine surgery

Jun

Choi

Kim

et al. 2012

Korean J Anesthesiol

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BackgroundOpioid-based patient controlled analgesia (PCA) provides adequate pain control following spinal surgeries at the expense of increased risk of postoperative nausea and vomiting (PONV). We evaluated the efficacy of dexamethasone added to ramosetron, which is a newly developed five-hydroxytryptamine receptor 3 antagonist with a higher receptor affinity and longer action duration compared to its congeners, on preventing PONV in highly susceptible patients receiving opioid-based IV PCA after spinal surgery.MethodsOne hundred nonsmoking female patients undergoing spinal surgery were randomly allocated to either a ramosetron group (group R) or a ramosetron plus dexamethasone group (group RD)., Normal saline (1 ml) or 5 mg of dexamethasone was injected before anesthetic induction, while at the end of the surgery, ramosetron (0.3 mg) was administered to all patients and fentanyl-based IV PCA was continued for 48 hrs. The incidence and severity of PONV, pain score and the amount of rescue antiemetics were assessed for 48 hours after surgery.ResultsThe number of patients with moderate to severe nausea (20 vs. 10, P = 0.029), and overall incidence of vomiting (13 vs. 5, P = 0.037) were significantly lower in the group RD than in the group R, respectively. Rescue antiemetic was used less in the RD group without significance.ConclusionsCombination of ramosetron and dexamethasone significantly reduced the incidence of moderate to severe nausea and vomiting compared to ramosetron alone in highly susceptible patients receiving opioid-based IV PCA after surgery.

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Postoperative pain, nausea and vomiting in neurosurgical patients

Cited by 37 publications

References 58 publications

Prospective Assessment of Postoperative Pain After Craniotomy

Prospective Assessment of Postoperative Pain After Craniotomy

Comparison of Postoperative Period in Patients Having a Robotic-Assisted Total Laparoscopic Hysterectomy and Multi-Port Total Laparoscopic Hysterectomy

Efficacy of dexamethasone added to ramosetron for preventing postoperative nausea and vomiting in highly susceptible patients following spine surgery

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