Transdermal Nitroglycerin as an Adjuvant to Patient‐Controlled Morphine Analgesia after Total Knee Arthroplasty

Orbach‐Zinger, Sharon; Lenchinsky, Artium; Paul-Kesslin, Lesley; Velks, Steven; Salai, Moses; Eidelman, Leonid A.

doi:10.1155/2009/817837

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…In the study of Orbach-Zinger et al, nitroglycerin patches showed no advantage in patients receiving PCA of morphine analgesia after total knee replacement. Therefore, they realized that the safety of using nitroglycerin patch after the surgery must be investigated more (11), this finding was inconsistent with our study and it seems the cause of this difference is the dosage of nitroglycerin in these two studies and underlying disease of studied patients as well.…”

Section: Discussioncontrasting

confidence: 89%

The Effect of Nitroglycerine Infusion on Postoperative Pain in Lower Limb Surgery: A Clinical Double-Blind Study

et al. 2019

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BackgroundAcute postoperative pain causes severe discomfort in patients accompanied by hemodynamic and metabolic instability.ObjectivesThe aim of this study was to evaluate the effects of nitroglycerin addition on the infusion of intravenous analgesia pump in patients with lower limb orthopedic surgery.MethodsThis study was a double-blind clinical trial conducted on 75 patients with lower limb fracture. Patients were randomly assigned to receive three regimens for postoperative pain control via intravenous analgesia pump, including group A (fentanyl 10mc/kg + 10 mL distilled water), B (fentanyl 10 mc/kg + nitroglycerin 500 mc), and C (fentanyl 10 mc/kg + nitroglycerin 1000 mc). The patients at the beginning of recovery and prior to putting the pain pump at the time of 4, 8, 12, 24, and 48 hours, were assessed with visual analogue scale (VAS) to measure pain and Ramsay scale to measure sedation.ResultsThe results showed that weight, height, and gender distribution were not significantly different in the three groups. The HR, MAP, and VAS mean scores showed a significant difference for intragroup and intergroup differences in the three groups at many times.ConclusionsLow dose nitroglycerine, as an adjuvant drug, can be added to intravenous patient-controlled analgesia pump in patients undergoing surgery for better analgesic purposes in patients without underlining disease.

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Section: Discussioncontrasting

confidence: 89%

The Effect of Nitroglycerine Infusion on Postoperative Pain in Lower Limb Surgery: A Clinical Double-Blind Study

et al. 2019

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“…Some studies investigated the effectiveness of nitroglycerin in relieving the pain of patients who had arthroscopic knee surgery (6), chronic pain after thoracotomy (7), and diabetic neuropathy (8). Researchers also reported that the systemic use of nitroglycerin was useful in patients who had spinal anesthesia (9).…”

Section: Introductionmentioning

confidence: 99%

Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

et al. 2020

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Background: Some studies have reported the effect of nitroglycerin on the reduction of pain after surgery. Objectives: The primary goal of the current study was to evaluate the addition of nitroglycerin (as a nitric oxide donor) to morphine in patient-controlled analgesia. Besides, its effects on the reduction of pain and stability in hemodynamic indices after abdominal surgery are also investigated. Methods: The current study was performed on 60 patients as candidates for abdominal surgery. Morphine (0.75 mg/mL) and nitroglycerin plus morphine (morphine 0.5 mg/mL + TNG 15 μg/mL) infusions were used for control and case groups, respectively, with the same induction of anesthesia. The severity of postoperative pain, hemodynamic indices of systolic blood pressure, diastolic pressure, heart rate, respiratory rate, and nausea were measured after surgery (immediately, 2, 6, 12, and 24 hours after surgery). Results: The pain score decreased for both groups almost similarly. The mean systolic blood pressure was highly reduced in both groups. However, the mean diastolic blood pressure in the control group was considerably lower than that of the case group. Besides, the respiratory rate in the case group dramatically diminished and approached the normal value. Conclusions: Combined administration of nitroglycerin and morphine had no synergistic effects on reducing postoperative pain. However, it led to more stable hemodynamic indices and improved breathing, without any side effects.

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Nitrates for the prevention of cardiac morbidity and mortality in patients undergoing non-cardiac surgery

Zhao

Singh

et al. 2016

Cochrane Database of Systematic Reviews

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Transdermal Nitroglycerin as an Adjuvant to Patient‐Controlled Morphine Analgesia after Total Knee Arthroplasty

Cited by 5 publications

References 28 publications

The Effect of Nitroglycerine Infusion on Postoperative Pain in Lower Limb Surgery: A Clinical Double-Blind Study

The Effect of Nitroglycerine Infusion on Postoperative Pain in Lower Limb Surgery: A Clinical Double-Blind Study

Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

Nitrates for the prevention of cardiac morbidity and mortality in patients undergoing non-cardiac surgery

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