Safety Aspects of Postoperative Pain Management

Objective: The purpose of this study was to compare the analgesic efficacy and pain intensity of and patient's satisfaction with non-opioid analgesics while evaluating postoperative piritramide consumption for providing pain relief after abdominal hysterectomy. Design: This was a randomized, double-blinded study. Materials and Methods: With the patient under general anesthesia, surgery was performed on 120 women using propofol, remifentanil, and muscle relaxant. Four patient groups (n = 30 each) were treated over 24 hours with normal saline (NaCl), parecoxib, metamizol, or paracetamol in addition to piritramide using the patient-controlled analgesia (PCA) pump. Postoperatively, patients were asked every 2 hours for the first 6 hours, and afterwards once every 6 hours, to quantify their pain experience at rest on different pain scales, including patient satisfaction. Cumulative piritramide consumption within 24 hours postoperatively was recorded on the display of the PCA pump. Results: The first required amounts of piritramide in the recovery room were similarly high in all groups and the incremental piritramide consumptions after 6, 12 and 24 hours showed no significant difference among the four groups. Also, with cumulative PCA-piritramide consumption no significant difference could be found. In all groups, the highest level of the visual analogue scale (VAS) score was registered upon arrival in the recovery room. However, there was a significant difference only at 6 hours after surgery between the NaCl group and the paracetamol and parecoxib groups. Conclusions: Compared with placebo, there was no significant difference in regard to opioid-sparing effect by administering additional non-opioids, whereas VAS scores were significantly lower in the paracetamol and parecoxib groups at 6 hours after surgery. Any further benefits were marginal and statistically not significant. ( J GYNECOL SURG 28:101)

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“…[26][27][28] The drugs were selected because they are routinely used for the IV treatment of postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Abdulla¹,

Netter²,

Abdulla³

2012

Journal of Gynecologic Surgery

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“…7 Although there are several modes of administration, patient-controlled analgesia (PCA) has become the standard method of administering morphine after major surgery. 5 PCA involves the patient self-administering small doses of morphine by pressing a button connected to a programmable pump. The PCA device is programmed by the health-care provider to deliver a specific amount of medication (a 'bolus') upon each request by the patient.…”

Section: Morphinementioning

confidence: 99%

“…The aim is that the additional and synergistic effects between morphine and nonopioid analgesics allows for optimum analgesia to be maintained, a lower dose of morphine to be used and therefore a lower incidence of morphinerelated adverse effects. [3][4][5] The objective of this review was to evaluate the effectiveness of paracetamol and NSAIDs, including COX-2 inhibitors, in reducing morphine consumption and associated adverse effects when used as part of multimodal analgesia following major surgery. However, it should be noted that there are other non-opioid analgesics that are used as part of multimodal analgesia after major surgery.…”

mentioning

confidence: 99%

Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review

McDaid

Maund²,

Rice³

et al. 2010

Health Technol Assess

140

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAParacetamol and selective and non-selective non-steroidal antiinflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key ...

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“…While paracetamol does allow for a reduction of morphine use, thereby diminishing morphine-related opposing effects [ 47 , 48 , 49 , 50 ], the implicit principle is that the distinct modes of action of morphine and paracetamol provide maximum analgesia to be managed with a lower dose of morphine, and, consequently, a smaller percentage of morphine-related adverse effects occur [ 47 , 48 , 49 , 50 ].…”

Section: Introductionmentioning

confidence: 99%

Design of Organoiron Dendrimers Containing Paracetamol for Enhanced Antibacterial Efficacy

2020

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Paracetamol (acetaminophen) is a common painkiller and antipyretic drug used globally. Attachment of paracetamol to a series of organoiron dendrimers was successfully synthesized. The aim of this study is to combine the benefits of the presence of these redox-active organoiron dendrimers, their antimicrobial activities against some human pathogenic Gram-positive, and the therapeutic characteristics of paracetamol. The antimicrobial activity of these dendrimers was investigated and tested with a minimum inhibitory concentration and this has been reported. Some of these newly synthesized dendrimers exhibited the highest inhibitory activity against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), and Staphylococcus warneri compared to reference drugs. The results of this study indicate that the antimicrobial efficacy of the dendrimers is dependent on the size of the redox-active organoiron dendrimer and its terminal functionalities. The best result has been recorded for the fourth-generation dendrimer 11, which attached to 48 paracetamol end groups and has 90 units composed of the η6-aryl-η5-cyclopentadienyliron (II) complex. This dendrimer presented inhibition of 50% of the growth (IC50) of 0.52 μM for MRSA, 1.02 μM for VRE, and 0.73 μM for Staphylococcus warneri. The structures of the dendrimers were characterized by elemental analysis, Fourier transform infrared (FT-IR), nuclear magnetic resonance (1H-NMR), and 13C-NMR spectroscopic techniques. In addition, all synthesized dendrimers displayed good thermal stability in the range of 300–350 °C following the degradation of the cationic iron moieties which occurred around 200 °C.

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Safety Aspects of Postoperative Pain Management

Cited by 7 publications

References 0 publications

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review

Design of Organoiron Dendrimers Containing Paracetamol for Enhanced Antibacterial Efficacy

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