scholarly journals Effect of Preemptive Flurbiprofen Axetil and Tramadol on Transurethral Resection of the Prostate under Spinal Anesthesia

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Jinguo Wang ◽  
Hongqin Li ◽  
Haichun Ma ◽  
Na Wang

Objective. To investigate the efficacy of preoperative intravenous flurbiprofen axetil and tramadol on spinal anesthesia for transurethral resection of the prostate (TURP). Methodology. In this prospective clinical study, we enrolled 60 patients undergoing TURP under spinal anesthesia with small-dose bupivacaine and sufentanil. Patients were randomly divided in two: group flurbiprofen axetil and tramadol (Group FT) intravenously received 1 mg/kg flurbiprofen axetil and 1 mg/kg tramadol 20 min prior to the surgical procedures and group control (Group C) was given normal saline. The characteristics of spinal anesthesia, blood pressure, heart rate, analgesic requirement, visual analogue scale (VAS), and overall satisfaction degree were collected. Results. Time to the first analgesic requirement was significantly longer in Group FT. Patients who needed postoperative analgesics were fewer in Group FT. VAS scores were lower in Group FT at postoperative time points of 1, 2, 6, and 12 h. The patients in Group FT were more satisfied than in Group C. Conclusions. Preoperative flurbiprofen axetil and tramadol can reduce and delay postoperative pain and then decrease analgesic consumption for TURP under spinal anesthesia without an increase of side effects.

Author(s):  
Shubhi Singhal ◽  
Devang Bharti ◽  
Sangeeta Yadav ◽  
Nitin Hayaran

Background: The current study attempts to evaluate the effect of intravenous (IV) infusion of magnesium sulfate during spinal anesthesia on postoperative pain and postoperative analgesic requirements in lower limb surgeries. Methods: In this double blind, randomized controlled study, 60 patients undergoing elective lower limb surgeries, were selected and randomly divided into two groups. Group I received isotonic saline and group II was administered magnesium sulfate 50 mg Kg-1 IV for 15 min and then 15 mg Kg-1 h-1 by continuous IV infusion till the end of surgery or 2 hours, whichever was earlier. Ramsay sedation scores, VAS scores for pain, time of first administration of rescue analgesic and total analgesic requirement were noted in both the groups. Results: Statistically significant difference was observed in the VAS score between the two groups at 1st, 2nd, 3rd, 6th, 9th and 12th hour intervals; with VAS scores being lower in the magnesium group (p<0.05). The mean time of first rescue analgesic requirement in control group was 144.00 mins, while in magnesium group was 246.00 mins (p<0.05). The total rescue analgesic requirement was found to be 251.67 mg and 181.67 mg at the end of 24 hours, in control and magnesium groups, respectively (p<0.05). Conclusion: This study demonstrates statistically significant lowering of postoperative VAS scores, delayed need of postoperative analgesia and reduced total postoperative analgesic requirement in patients receiving intraoperative IV magnesium sulfate compared to the control group. Magnesium sulfate did not cause sedation or any other significant adverse effect in the doses used in the study.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Muzaffer Gencer ◽  
Ayşe Yeşim Göçmen

Abstract Background In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n = 60) was patients given tramadol (1–2 mg/kg) for post-operative analgesia, and the second group (control group) (n = 60) was initially prescribed only fentanyl (1 μg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results Demographic data and peri-operative variables were similar in both study group (p < 0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94 ± 15.34 pg/mL (max:489.92 ± 22.36 pg/mL, min: 94.56 ± 11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p < 0.05), 1st (p < 0.05) and 3rd hours (p < 0.05).The VAS scores were lower in the tramadol group compared to the control group (p < 0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p < 0.05) for arrival at the recovery room and 1st hour. Patients in the tramadol group needed a second pain killer much later than patients in the control group. Conclusions Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).


2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen

Abstract Background: In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group) (n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results: Demographic data and peri-operative variables was similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/Ml (max:489.92±22.36 pg/mL, min: 94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room, (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group p <0.05.Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration:This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Xiaofeng Jin ◽  
Yanyan Niu ◽  
Wei Gu ◽  
Jian Wang

Objective. To investigate whether preventive administration of a proton pump inhibitor (PPI) can reduce the occurrence and development of traumatic granuloma (TG) following type IV-VI cordectomy. Methods. We retrospectively analyzed the status of postoperative granulomas in 37 patients who underwent type IV-VI cordectomy due to glottic cancer and determined whether postoperative administration of a PPI had any impact on granuloma formation and development. Results. The percentage and number of patients with granuloma in the PPI treatment group (experimental group) at the 1st, 2nd, 3rd, and 6th month following surgery were 81.25% (13/16), 25.00% (4/16), 18.75% (3/16), and 0.00% (0/16), respectively. The percentage and number of patients with granuloma in the no-PPI group (control group) were 95.24% (20/21), 71.43% (15/21), 52.38% (11/21), and 14.29% (3/21), respectively. The granuloma percentage of the PPI treatment group was lower than that of the control group at all postoperative time points assessed. The differences were not statistically significant at the 1st month (p=0.175) but were statistically significant at the 2nd and 3rd months after surgery (p=0.005, p=0.037). Conclusion. Preventive use of a PPI in patients after type IV-VI cordectomy can shorten the TG recovery duration and may reduce the severity of TG, but it cannot prevent TG from occurring. Our results should be confirmed by prospective randomized controlled trials with large sample sizes.


2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen

Abstract Background In this study, the μ-Opioid receptor activity was examined before the septoplasty. We assessed preoperative μ-Opioid receptor activity association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into preop 2 groups. The first group (n=60) was patients given tramadol (1-2 mgr/kg) for postop analgesia, and the second group (control group) (n=60) was initially performed only fentanyl (1 µg/ kg-i.v.) in the induction. The μ-Opioid receptors activities were investigated in preoperative blood samples and compared post-op pain level and requiring time for second analgesic agent. The visual analogue score(VAS) was used to evaluate the postoperative pain degree (0 no pain,10 worst pain). Patients' post op VAS scores were evaluated upon arrival to recovery room, and at 1st, 3rd, 7th, 10th, and 24 th hours in postoperative period. Results Demographic data and perioperative variables was similar in both study group (p<0.05). There was no significant difference between the receptor levels in both two groups and the mean receptor level was 200.94 pg/ml. While the highest receptor level was 489.92 pg/ ml, the lowest receptor level was 94.56 pg/ml. In patients who used tradomal, as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period. Vas scores were lower in the tramadol group compared to the control group. Patients in Tramadol group needed second pain killer later than patients in the Control group. Conclusions In this study, we revealed that postoperative pain level and second analgesic requirement decreased as μ-Opioid receptor levels increased in tramadol group.


Author(s):  
Ianiv Klaber ◽  
Eugene Greeff ◽  
John O’Donnell

Abstract The early post-operative period after hip arthroscopy for femoroacetabular impingement is characterized by pain and swelling. Minimization of pain is of critical importance to the patient, but pain might also reduce patients’ compliance to early physiotherapy, delay rehabilitation and hospital discharge. Avoiding early mobilization represents a risk factor for developing capsulolabral adhesions. Compressive cryotherapy (CC) has been shown to reduce pain after knee and hip replacement surgery. The aim of this study was to assess the effect of the inclusion of CC in the pain management and early discharge after hip arthroscopy. A prospective cohort of 20 patients who received CC and 20 retrospectively matched controls who received standard cryotherapy (SC) were compared. The CC was added to the standard post-operative analgesia and rehabilitation protocol. Using non-parametric tests, the percentage of patients discharged in post-operative day one, pain VAS scores and analgesia requirement were compared. The CC group reported significantly lower pain scores compared to SC; VAS 1 (0–3) and 2 (0–5) (P = 0.0028), respectively. A non-significant reduction in analgesic requirement 1.75 versus 2.8 doses per patient was found and 20/20 patients were discharged on post-operative day one versus 17/20 in the SC group (P = 0.23). Patients treated with CC after hip arthroscopy reported lower levels of pain during the early post-operative phase and were able to be discharged home sooner when compared with a matched control group receiving ice therapy alone. A trend towards lower opioid analgesia requirement was observed.


2020 ◽  
Vol 1;24 (1;1) ◽  
pp. E31-E36

BACKGROUND: During spinal anesthesia, patients may experience pain and discomfort associated with dermal puncture. It may also cause involuntary movement, which often disturbs the patient’s posture thus affecting the success of spinal anesthesia. Different methods have been studied to cope with needle-related pain. “ShotBlocker” is a flexible, plastic, U-shaped device, which has several blunt points. It is suggested that blunt points provide a nonnoxious physical stimulation and inhibit the transmission of injection pain. OBJECTIVES: The purpose of this study was to examine the effectiveness of the ShotBlocker for dermal puncture pain during spinal anesthesia. STUDY DESIGN: Prospective randomized trial. SETTING: University hospital, operating room. METHODS: Ninety-four patients aged 18 to 65 years with physical status American Society of Anesthesiologists (ASA) I or II scheduled for elective surgery under spinal anesthesia were randomly assigned to either a ShotBlocker (n = 47) or control group (n = 47). In the ShotBlocker group, lumbar punctures were performed with the application of ShotBlocker. Needle-associated pain score and patient satisfaction were assessed by the patient, immediately after completion of the spinal anesthesia using a 10-cm Visual Analog Scale (VAS) and a 5-point Likert scale for satisfaction. Patients were also closely observed for symptoms of discomfort such as spontaneous vocalization and involuntary movement. RESULTS: A total of 88 patients completed the study. There was no significant difference in VAS scores, patient satisfaction, or procedure time between groups (P > 0.05). Spontaneous vocalization did not occur in both groups. However, incidence of unintentional movement during dermal puncture was higher in the control group (6.8% vs. 31.8%; P < 0.05). LIMITATIONS: Study was conducted in a single-center with a relatively small population of patients. Only the attending anesthetist collecting data was blinded to the procedure. Patients older than age 65 years were also excluded from the study, thus our results cannot be generalized. CONCLUSIONS: ShotBlocker did not show any advantage on VAS scores but decreased the incidence of unintentional movement during dermal puncture. KEY WORDS: Spinal anesthesia, pain, ShotBlocker, needle, pin-prick pain, dermal puncture, neuraxial block, regional, needle phobia, lumbar puncture


2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen

Abstract Background : In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods : In our prospective study,120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group)(n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24 th hour post-operative period. Results: Demographic data and peri-operative variables were similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/mL (max:489.92±22.36 pg/mL, min:94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group (p<0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1 st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration: This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date:26/11/2019).


2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen

Abstract Background: In this study, the μ-Opioid receptor activity was examined before the septoplasty. We assessed preoperative μ-Opioid receptor activity association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty.Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into preop 2 groups. The first group (n=60) was patients given tramadol (1-2 mgr/kg) for postop analgesia, and the second group (control group) (n=60) was initially performed only fentanyl (1 µg/ kg-i.v.) in the induction. The μ-Opioid receptors activities were investigated in preoperative blood samples and compared post-op pain level and requiring time for second analgesic agent. The visual analogue score(VAS) was used to evaluate the postoperative pain degree (0 no pain,10 worst pain). Patients' post op VAS scores were evaluated upon arrival to recovery room, and at 1st, 3rd, 7th, 10th, and 24th hours in postoperative period.Results: Demographic data and perioperative variables was similar in both study group (p<0.05). There was no significant difference between the receptor levels in both two groups and the mean receptor level was 200.94 pg/ml. While the highest receptor level was 489.92 pg/ ml, the lowest receptor level was 94.56 pg/ml. In patients who used tradomal, as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period. Vas scores were lower in the tramadol group compared to the control group. Patients in Tramadol group needed second pain killer later than patients in the Control group.Conclusions: In this study, we revealed that postoperative pain level and second analgesic requirement decreased as μ-Opioid receptor levels increased in tramadol group.Trial registration: This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).


2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen

Abstract Background: In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty.Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group) (n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period.Results: Demographic data and peri-operative variables were similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/mL (max:489.92±22.36 pg/mL, min: 94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group (p<0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents.Trial registration:This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).


Sign in / Sign up

Export Citation Format

Share Document