scholarly journals A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Seung Cheol Lee ◽  
Jeong Ho Kim ◽  
So Ron Choi ◽  
Sang Yoong Park
Keyword(s):  
Low Dose ◽  
Femoral Nerve ◽  
Onset Time ◽  
Controlled Study ◽  
Control Group ◽  
Bolus Administration ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Vas Scores

Femoral nerve blocks (FNBs) are used as safe and useful procedures to control severe postoperative pain from total knee arthroplasty (TKA). Various adjuvants have been used to prolong the duration of the local anesthetic blockade. This study evaluated whether a low dose of naloxone administered with local anesthetics prolongs the duration of FNB. A prospective, randomized double-blind controlled study was conducted with 74 patients undergoing unilateral TKA. Through a single-bolus administration guided by ultrasound, the control group (group C) received 20 mL of 0.375% ropivacaine, while the naloxone group (group N) received 20 mL of 0.375% ropivacaine with 100 ng of naloxone. The time elapsed before the first analgesia request, the total amount of opioids consumed at 24 h postoperatively, the onset time of the sensory blockade, the visual analog pain scale (VAS) scores after arriving at the recovery room, after 6, 12, 18, and 24 h at rest and after 12, 18, and 24 h of activity, the quadricep strength before the FNB procedure and at 12 and 24 h postoperatively, the quality of sleep on the first night after surgery, the satisfaction score, and the incidence of postoperative complications were recorded. The time elapsed before the first analgesia request was significantly longer in group N (735.5 ± 187.2 min) than that in group C (602.6 ± 210.4 min) ( P = 0.003 ). The total dose of supplementary opioids consumed at 24 h postoperatively was significantly lower in group N (312.4 ± 141.7 μg) than that in group C (456.5 ± 279.5 μg) ( P = 0.007 ). Lower VAS scores were recorded in group N than that in group C at rest and during knee activity (rest, 12 h, P = 0.001 , 18 h, P = 0.043 ; activity, 12 h, P = 0.001 ). The addition of a low dose of naloxone to ropivacaine for FNB significantly delayed the first request for rescue analgesia and decreased the opioid consumption within 24 h, without significant complications.

scholarly journals The Effect of Ultrasound Guided Superficial Cervical Plexus Block on Postoperative Opioid Consumption in Patients Undergoing Anterior Cervical Discectomy and Fusion Surgery: A Prospective, Randomized Controlled Study

2021 ◽  
Author(s):  
İrem Ateş ◽  
Erkan Cem Çelik ◽  
Ufuk DEmir ◽  
Muhammed Enes Aydın ◽  
Ali Ahiskalıoğlu
Keyword(s):  
Opioid Consumption ◽  
Anterior Cervical Discectomy ◽  
Controlled Study ◽  
Control Group ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Cervical Discectomy ◽  
Pain Scores ◽  
Significant Difference ◽  
Vas Scores

INTRODUCTION: Anterior cervical discectomy and fusion (ACDF) surgery is a procedure that can cause moderate pain in the postoperative period. Superficial cervical block (SCB) is a regional anesthesia technique that can provide analgesia during and after surgery. The aim of this study is to investigate the effect of ultrasound-guided SCB block on pain scores and postoperative opioid consumption in patients undergoing ACDF surgery. METHODS: 48 patients planned to undergo single or two levels of ACDF surgery were randomly divided into two groups, SCB and Control (C). Ultrasonography (USG) guided SCB was performed in the SCB group (n=24) with 10 mL of 0.25% bupivacaine. No attempt was made to the control group (n=24) before the operation. Intravenous 50 mg dexketoprofen was administered to both groups half an hour before the end of the operation and at the 12th hour postoperatively. Patient controlled analgesia (PCA) device containing fentanyl was initiated. Postoperative visual analog scale (VAS) scores, opioid consumption, need for rescue analgesia and side effects were recorded. RESULTS: There was no statistically significant difference between the groups in terms of demographic data, anesthesia and surgery times. Compared to the control group, VAS scores were statistically low at all measurement times in the SCB group (p <0.05). The 24-hour total opioid consumption was statistically significantly higher in the control group than in the SCB group (375.83±235.96 µg vs. 112.50±102.41 µg, respectively p<0.001). The need of rescue analgesia was statistically higher in the control group than the SCB group (12/24 vs. 0/24, respectively, p <0.001). DISCUSSION AND CONCLUSION: We believe that USG-guided SCB can be an effective component of the multimodal analgesia protocol by reducing opioid consumption and pain scores in patients undergoing ACDF surgery.

Use of Propentofylline in Feline Bronchial Disease: Prospective, Randomized, Positive-Controlled Study

2010 ◽  
Vol 46 (5) ◽  
pp. 318-326 ◽  
Author(s):  
Ulrike Stursberg ◽  
Isabella Zenker ◽  
Silke Hecht ◽  
Katrin Hartmann ◽  
Bianka S. Schulz
Keyword(s):  
Combination Therapy ◽  
Low Dose ◽  
Respiratory Pattern ◽  
Controlled Study ◽  
Control Group ◽  
Bronchial Disease ◽  
Observation Period

Propentofylline is a methylxanthine derivative with bronchodilating actions similar to those of theophylline. Nineteen cats with bronchial disease were enrolled in this study. All cats received a low dose of prednisolone; 10 of the cats additionally received propentofylline. Propentofylline-treated cats significantly improved in their auscultation scores, respiratory pattern scores, and radiological bronchial markings score over the observation period, and they coughed less and slept less at the end of the study. No significant changes were noted in the control group. This study provides evidence that a combination therapy with prednisolone and propentofylline in cats with bronchial disease might be superior over monotherapy with prednisolone.

scholarly journals COMPARISON OF FENTANYL AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMIZED-DOUBLE BLIND PROSPECTIVE STUDY

2016 ◽  
Vol 9 (5) ◽  
pp. 74 ◽  
Author(s):  
Daisy Karan ◽  
Swastika Swaro ◽  
Swarna Banerjee
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Nerve Blocks ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACTObjectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Using adjuvant to localanesthetics, blocks can be prolonged to long durations. Peripheral nerve blocks thus help in avoiding the hazards of general anesthesia. We comparedthe sensory blockade, motor blockade, and duration of analgesia with the addition of fentanyl or dexmedetomidine to bupivacaine for supraclavicularbrachial plexus block.Methods: A total of 50 American Society of Anesthesiologist’s Physical Status I and II patients scheduled for elective upper limb surgeries undersupraclavicular brachial plexus block were divided into two equal groups in a randomized double-blinded fashion. Group BF received 30 mlbupivacaine with fentanyl 50 µg and Group BD received 30 ml bupivacaine with dexmedetomidine 50 µg. The characteristics for anesthesia andanalgesia were assessed in both groups.Results: Duration of sensory and motor block was 363.4±38.36 minutes and 357±36.77 minutes, respectively, in Group BF while it was452.96±77.12 minutes and 441.52±48.46 minutes in Group BD. There was a statistically significant difference in onset of sensory and motorblock between the two groups. The duration of analgesia (time to requirement of rescue analgesia) in Group BD was longer than in Group BF(471.44±65.88 minutes vs. 366.48±38.02 minutes) with (p<0.0001). There were minimum hemodynamic disturbances and side effects in any groupexcept for Grade 3 sedation score which was more in Group BD.Conclusion: Dexmedetomidine, when added to bupivacaine in supraclavicular brachial plexus block, enhanced the duration of sensory and motorblock and also the duration of analgesia, more than when fentanyl was added to bupivacaine.Keywords: Fentanyl, Dexmedetomidine, Bupivacaine, Supraclavicular brachial block.

scholarly journals Intraoperative Intercostal Nerve Block for Postoperative Pain Control in Pre-Pectoral versus Subpectoral Direct-To-Implant Breast Reconstruction: A Retrospective Study

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 325 ◽  
Author(s):  
Jin-Woo Park ◽  
Jeong Hoon Kim ◽  
Kyong-Je Woo
Keyword(s):  
Postoperative Pain ◽  
Breast Reconstruction ◽  
Intercostal Nerve ◽  
Control Group ◽  
Intercostal Nerve Block ◽  
Nerve Blocks ◽  
Vas Score ◽  
Vas Scores ◽  
Lower Maximum ◽  
And Control

Background and Objectives: Patients undergoing mastectomy and implant-based breast reconstruction have significant acute postsurgical pain. The purpose of this study was to examine the efficacy of intercostal nerve blocks (ICNBs) for reducing pain after direct-to-implant (DTI) breast reconstruction. Materials and Methods: Between January 2019 and March 2020, patients who underwent immediate DTI breast reconstruction were included in this study. The patients were divided into the ICNB or control group. In the ICNB group, 4 cc of 0.2% ropivacaine was injected intraoperatively to the second, third, fourth, and fifth intercostal spaces just before implant insertion. The daily average and maximum visual analogue scale (VAS) scores were recorded by the patient from operative day to postoperative day (POD) seven. Pain scores were compared between the ICNB and control groups and analyzed according to the insertion plane of implants. Results: A total of 67 patients with a mean age of 47.9 years were included; 31 patients received ICNBs and 36 patients did not receive ICNBs. There were no complications related to ICNBs reported. The ICNB group showed a significantly lower median with an average VAS score on the operative day (4 versus 6, p = 0.047), lower maximum VAS scores on the operative day (5 versus 7.5, p = 0.030), and POD 1 (4 versus 6, p = 0.030) as compared with the control group. Among patients who underwent subpectoral reconstruction, the ICNB group showed a significantly lower median with an average VAS score on the operative day (4 versus 7, p = 0.005), lower maximum VAS scores on the operative day (4.5 versus 8, p = 0.004), and POD 1 (4 versus 6, p = 0.009), whereas no significant differences were observed among those who underwent pre-pectoral reconstruction. Conclusions: Intraoperative ICNBs can effectively reduce immediate postoperative pain in subpectoral DTI breast reconstruction; however, it may not be effective in pre-pectoral DTI reconstruction.

scholarly journals The Effects of the Single or Multiple Injection Technique on the Onset Time of Femoral Nerve Blocks with 0.75% Ropivacaine

2000 ◽  
Vol 91 (1) ◽  
pp. 181-184
Author(s):  
Andrea Casati ◽  
Guido Fanelli ◽  
Paolo Beccaria ◽  
Gianluca Cappelleri ◽  
Marco Berti ◽  
...  
Keyword(s):  
Femoral Nerve ◽  
Onset Time ◽  
Injection Technique ◽  
Multiple Injection ◽  
Nerve Blocks

scholarly journals Role of Preoperative Pregabalin in Reducing Inhalational Anaesthetic Requirements in Abdominal Hysterectomy: Randomized Controlled Trial

2019 ◽  
Author(s):  
Ahmed Abdalla Mohamed ◽  
Gehan Helmy Ibrahim ◽  
Nesrine Abd Elrahman El Refai ◽  
Tamer Mousaad Abdelhamid Gamaleldin ◽  
Reham Ali Abdelrahman Abdelrahman ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Bispectral Index ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Neurological Dysfunction ◽  
Hypoglycemic Agents ◽  
Controlled Study ◽  
Control Group ◽  
Rescue Analgesia

Abstract Background: preoperative oral pregabalin controls postoperative pain & decreases anesthetic requirements in total intravenous anaesthesia . In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements. Methods: Study was conducted in a university hospital, included 50 women (18-60 yrs.), ASA I or II, admitted to undergo elective abdominal hysterectomy under general anaesthesia. Time of study: June to September 2017. Exclusion criteria were allergy or hypersensitivity to pregabalin; patients on calcium channel blockers, antiepileptic drugs, antidepression drugs, any analgesics or sedatives, or oral hypoglycemic agents; and patients with severe cardiovascular, renal, hepatic or neurological dysfunction. Interventions: giving either oral pregabalin 150 mg or placebo to patients of both groups. Primary outcome measures: inhaled isoflurane requirements to maintain haemodynamics ± 20% of baseline& bispectral index (BIS) of 40 - 60, measured using MAQUET Flow-I anaesthetic machine. Secondary outcomes : attenuation of pressor response to intubation, postoperative pain, first time for rescue analgesia, total anaglesics and adverse effects. Results: Isoflurane consumption was significantly less in pregabalin group (7.80 ± 1.27ml h -1) versus (12.27 ± 2.49 ml h-1) in control group, (P= 0.00). Better haemodynamic stability was in pregabalin group after intubation. First postoperative hour :the mean VAS score was significantly higher in control group (7.10 ± 1.20) compared to pregabalin group (4.50 ± 1.70), P<0.001. All patients in control group received pethidine intramuscular. More patients in pregabalin group suffered dizziness. Conclusion: preoperative pregabalin 150 mg ,1 h before total abdominal hysterectomy has an inhaled anaesthetic-sparing effect, maintain haemodynamics and optimizes postoperative analgesia. Keywords: Gabapentinoids, Pregabalin; Inhalation Anaesthetics, Isoflurane; Monitoring, Bispectral Index; Surgery, Abdominal Hysterectomy Objectives: We aimed to investigate the effectiveness and safety of preoperative oral pregabalin 150 mg in women undergoing elective total abdominal hysterectomy under general anaesthesia. Design: A prospective, randomized, double-blind, controlled study. Trial Registry Number: ClinicalTrials.gov: NCT 03302208

scholarly journals Preoperative low-dose ketamine has no preemptive analgesic effect in opioid-naïve patients undergoing colon surgery when nitrous oxide is used - a randomized study

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 226 ◽  
Author(s):  
Beatriz Nistal-Nuño ◽  
Enrique Freire-Vila ◽  
Francisco Castro-Seoane ◽  
Manuel Camba-Rodriguez
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Low Dose ◽  
Randomized Study ◽  
Colon Surgery ◽  
Morphine Consumption ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Rescue Analgesia

Background: The analgesic properties of ketamine are associated with its non-competitive antagonism of the N-methyl-D-aspartate receptor; these receptors exhibit an excitatory function on pain transmission and this binding seems to inhibit or reverse the central sensitization of pain. In the literature, the value of this anesthetic for preemptive analgesia in the control of postoperative pain is uncertain. The objective of this study was to ascertain whether preoperative low-dose ketamine reduces postoperative pain and morphine consumption in adults undergoing colon surgery.Methods: In a double-blind, randomized trial, 48 patients were studied. Patients in the ketamine group received 0.5 mg/kg intravenous ketamine before surgical incision, while the control group received normal saline. The postoperative analgesia was achieved with a continuous infusion of morphine at 0.015 mg∙kgˉ¹∙hˉ¹ with the possibility of 0.02 mg/kg bolus every 10 min. Pain was assessed using the Visual Analog Scale (VAS), morphine consumption, and hemodynamic parameters at 0, 1, 2, 4, 8, 12, 16, and 24 hours postoperatively. We quantified times to rescue analgesic (Paracetamol), adverse effects and patient satisfaction.Results: No significant differences were observed in VAS scores between groups (P>0.05), except at 4 hours postoperatively (P=0.040). There were no differences in cumulative consumption of morphine at any time point (P>0.05). We found no significant differences in incremental postoperative doses of morphine consumption in bolus, except at 12 h (P =0.013) and 24 h (P =0.002). The time to first required rescue analgesia was 70 ± 15.491 min in the ketamine group and 44 ± 19.494 min in the control (P>0.05). There were no differences in hemodynamic parameters or patient satisfaction (P>0.05).Conclusions: Preoperative low-dose-ketamine did not show a preemptive analgesic effect or efficacy as an adjuvant for decreasing opioid requirements for postoperative pain in patients receiving intravenous analgesia with morphine after colon surgery.

scholarly journals Clinical Efficacy of Ultrasound-Mediated Transdermal Lidocaine and Capsaicin Delivery for the Treatment of Allodynia Caused by Herpes Zoster

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3739-3746
Author(s):  
Yue-e Dai ◽  
Shao-Xing Liu ◽  
Ling Ye ◽  
Yun-Xia Zuo
Keyword(s):  
Drug Delivery ◽  
Herpes Zoster ◽  
Adverse Events ◽  
Emotional Functioning ◽  
Final Analysis ◽  
Intradermal Injection ◽  
Controlled Study ◽  
Control Group ◽  
Group I ◽  
Vas Scores

Abstract Objective To investigate the efficacy of ultrasound-mediated drug delivery for allodynia caused by herpes zoster. Design Unblinded randomized controlled study with two treatment groups and an additional control group. Subjects Patients hospitalized with allodynia caused by herpes zoster were enrolled. Methods Patients were randomly assigned to three groups: ultrasound-mediated transdermal drug delivery (group U), lidocaine intradermal injection (group I), or control group (group C). The primary outcome was pain intensity associated with allodynia, assessed with the visual analog scale (VAS) while brushing the skin with clothing after treatment stimulated allodynia. The secondary outcomes included an emotional functioning score (ES), average gabapentin consumption, and incidence of adverse events of each group. Results Sixty patients were enrolled in the study, but two of them failed to complete the treatment process. Therefore, 58 patients were included in the final analysis. All groups had lower VAS and ES scores after treatment compared with baseline. The VAS scores in groups U and I decreased significantly more than in group C (P &lt; 0.05). Mean VAS scores in group U on days 1, 2, and 3 were lower than in group C (P &lt; 0.01). ES was significantly lower in group U compared with groups I and C after treatment (P &lt; 0.001). Average gabapentin consumption and incidence of adverse events in group C were higher than in the other two groups. Conclusions In this study of treatment of allodynia caused by herpetic zoster, ultrasound-mediated lidocaine and capsaicin delivery provided better pain relief and improved emotional functioning compared with intradermal blockade with local anesthetics.

Evaluating Femoral-Sciatic Nerve Blocks, Epidural Analgesia, and No Use of Regional Analgesia in Dogs Undergoing Tibia-Plateau-Leveling-Osteotomy

2016 ◽  
Vol 52 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Pedro Boscan ◽  
Sara Wennogle
Keyword(s):  
Sciatic Nerve ◽  
Epidural Analgesia ◽  
Multimodal Analgesia ◽  
Control Group ◽  
Alternative Technique ◽  
Regional Analgesia ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Sciatic Nerves ◽  
Tibia Plateau

This is a retrospective study evaluating femoral-sciatic nerve blocks (FSBs), epidural analgesia, and non-regional analgesia (NRA) in dogs undergoing tibia-plateau-leveling-osteotomy surgery. Thirty-five records met the criteria for each of the FSB and epidural analgesia groups. Seventeen anesthesia records met the criteria for the NRA or control group. The parameters reported were: isoflurane vaporizer setting, rescue analgesia/anesthesia drugs received, heart rate, systolic blood pressure, and recovery quality (0–4, with 0 being poor and 4 being good). Rescue analgesia-anesthesia during surgery was performed with either fentanyl, ketamine, or propofol. A larger percentage of dogs in the NRA group required rescue analgesia during surgery. The FSB group had a higher recovery quality with median (95% confidence interval of four (±0.3) when compared to two (±0.8) in NRA (p &lt; 0.01). No difference between groups was observed on any other parameter reported. As part of a multimodal analgesia approach for tibia-plateau-leveling-osteotomy surgery, the use of femoral and sciatic nerves blocks with bupivacaine appears to be an alternative technique to help with analgesia and anesthesia during surgery.

Sign in / Sign up

Export Citation Format

Share Document