Revisiting the WHO Analgesic Ladder for Surgical Management of Pain

McGuire, Laura Stone; Slavin, Konstantin V.

doi:10.1001/amajethics.2020.695

Cited by 13 publications

(3 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As per the WHO analgesic ladder guidelines for pain management [12], multiple routes can be taken for good analgesic control ranging from patient-controlled analgesia to oral plus parenteral NSAIDs, opioids, coanalgesics (anti-depressants), and local anesthesia. Other measures already used for post-MRM pain control include local anesthesia infiltration, infusion, intercostal blocks, paravertebral block, thoracic epidural anesthesia, inter-pleural block, and ultrasound-guided inter-fascial block are also used.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Analgesia in Modified Radical Mastectomy Patients After Instillation of Bupivacaine Through Surgical Drains

Seth¹,

Perveen²,

Ahmed³

et al. 2022

Cureus

View full text Add to dashboard Cite

Background: In contrast to other breast surgeries, modified radical mastectomy (MRM) with axillary lymph node clearance involves intense tissue dissection, with postoperative seroma formation and pain being the major complaints affecting patients. Among these, 40% of females experience acute postoperative pain, and between 25 to 60% develop persistent chronic postsurgical pain. The rationale of this study was that minimally invasive procedures can result in immediate pain relief in patients undergoing mastectomy, which has been proven to satisfy their needs and lead to early discharge in the local population.Objective: This study determined to find out the efficacy of instilling bupivacaine on wounds by means of surgical drains in controlling pain after MRM.Methodology: This was a randomized control study trial that was carried out in Surgical Unit 1, Ward 3, Jinnah Postgraduate Medical Centre, Karachi, from November 2020 to April 2021. All patients tested negative for coronavirus disease 2019 (COVID-19) by PCR test before randomly allocating them into two groups. Thirty women in Group B received 40 ml of 0.25% injection bupivacaine, and 30 in Group C received no drug. Duration of analgesia was recorded as time in hours when the patient was received after surgery in the post-anesthesia care unit until the patient felt ache and discomfort of > three scores according to the visual analog pain score chart (VAS).Results: The average age was 52.48±4.76 years. The mean period of time during which analgesia was observed was significantly higher in Group B as compared to Group C (10.93±1.84 vs 5.03±1.35 hours, p=0.0005).Conclusion: There is improvement in postoperative analgesia after instilling bupivacaine through surgical drains on wound beds in MRM patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Postoperative Analgesia in Modified Radical Mastectomy Patients After Instillation of Bupivacaine Through Surgical Drains

Seth¹,

Perveen²,

Ahmed³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Paracetamol, nonsteroide antiinflammatoriske stoffer og opioder Paracetamol, nonsteroide antiinflammatoriske stoffer og opioder I 1986 introducerede WHO smertetrappen, og behandlingen af akutte smerter efter TKA hviler på principperne i denne [6]. Her indgår paracetamol og nonsteroide antiinflammatoriske stoffer (NSAID) i en grundsmertepakke, hvor der tillaegges opioider efter behov og som »rescue drug« ved gennembrudssmerter.…”

Section: Ugeskrift For Laeger Ugeskrift For Laegerunclassified

Pain management in total knee arthroplasty

Hald,

Møller

2024

Ugeskr Læger

View full text Add to dashboard Cite

Total knee arthroplasty is a frequently performed orthopaedic surgery and the trend indicates an increase in annual procedures. Many patients experience severe postoperative pain. In this review article, a review of the literature reveals evidence supporting a multimodal approach to pain management, which involves basic analgesic treatment in combination with glucocorticoids and local infiltration analgesia. Effective pain control can reduce postoperative pain, lower opioid consumption, and its associated adverse effects, and enhance postoperative rehabilitation and patient satisfaction.

show abstract

“…Krok ten ma pomóc w minimalizacji skutków ubocznych i ryzyka związanego z uzależnieniem. Dotyczy on głownie pacjentów z opornym na leczenie bólem [10]. Stopień ten uwzględnia zabiegi interwencyjne i minimalnie inwazyjne, do których należą znieczulenie zewnątrzoponowe, dokanałowe podawanie leków przeciwbólowych i miejscowo znieczulających z pompą lub bez, zabiegi neurochirurgiczne (np.…”

Section: Drabina Analgetycznaunclassified

Pain - ways to determine the intensity and the choice of the appropriate form of treatment

Grabek,

Babiak,

Bajak

et al. 2023

J Educ Health Sport

View full text Add to dashboard Cite

Introduction and purpose of the study: The problem of pain occurs in many patients, and its perception is a subjective aspect. This is a big problem because it negatively affects not only the patient's health but also many aspects of his life: physical activity, social relations, mental and emotional state. Physicians of many specialties face the problem of treatment both in doctor's offices and in hospital rooms. The choice of the appropriate form of therapy can be facilitated by scales and pain assessment questionnaires. This paper presents ways to determine the severity of pain that can be used in contact with both children and the elderly. Proper determination of the degree of pain intensity enables the selection of the appropriate threshold of the analgesic ladder. Materials and methods: The review was based on the analysis of materials collected in the "PubMed" database and WHO guidelines. The work uses the latest scientific works, review articles. The search was carried out using the keywords: "pain management", "analgesic ladder", "pain management scales", "pain management questionnaires", "neuropathic pain", "opioids". Summary: Treatment is a big challenge because each patient feels pain differently, which means that each patient must be approached individually. In order to facilitate and systematize the treatment to some extent and, above all, to choose the best therapeutic method for the patient, pain scales and questionnaires should be used to assess pain intensity and observe the results of the treatment. The variety of methods of imaging the pain intensity scale allows us to choose the most appropriate one for a given patient, depending on his cognitive abilities and age. The choice of treatment method should be based on the analgesic ladder. It is necessary to take into account both the patient's condition, his diseases, treatment and side effects of the introduced treatment.

show abstract

Revisiting the WHO Analgesic Ladder for Surgical Management of Pain

Cited by 13 publications

References 33 publications

Postoperative Analgesia in Modified Radical Mastectomy Patients After Instillation of Bupivacaine Through Surgical Drains

Postoperative Analgesia in Modified Radical Mastectomy Patients After Instillation of Bupivacaine Through Surgical Drains

Pain management in total knee arthroplasty

Pain - ways to determine the intensity and the choice of the appropriate form of treatment

Contact Info

Product

Resources

About