scholarly journals A Comparison of Effects of Scalp Nerve Block and Local Anesthetic Infiltration on the Inflammatory Response, Hemodynamic Response, and Postoperative Pain in Patients undergoing Craniotomy for Cerebral Aneurysms: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Xi Yang ◽  
Jing Ma ◽  
Ke Li ◽  
Rui Dong ◽  
Lei Chen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Inflammatory Response ◽  
Pain Intensity ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Cerebral Aneurysms ◽  
Hemodynamic Response ◽  
Group I ◽  
Local Anesthetic Infiltration

Abstract BACKGROUND: The purpose of this study was to compare the effects of scalp nerve block (SNB) and local anesthetic infiltration (LA) with 0.75% ropivacaine on postoperative inflammatory response, intraoperative hemodynamic response, and postoperative pain control in patients undergoing craniotomy. METHODS: Fifty-seven patients were admitted for elective craniotomy for surgical clipping of a cerebral aneurysm. They were randomly divided into three groups: Group S (SNB with 15 mL of 0.75% ropivacaine), group I (LA with 15 mL of 0.75% ropivacaine) and group C (that only received routine intravenous analgesia). Pro-inflammatory cytokine levels in plasma for 72 hrs postoperatively, hemodynamic response to skin incision, and postoperative pain intensity were measured. RESULTS:The SNB with 0.75% ropivacaine not only decreased IL-6 levels in plasma 6 hrs after craniotomy but also decreased plasma CRP levels and increased plasma IL-10 levels 12 and 24 hrs after surgery compared to LA and routine analgesia. There were significant increases in mean arterial pressure 2 and 5 mins after the incision and during dura opening in Groups I and C compared with Group S. Group S had lower postoperative pain intensity, longer duration before the first dose of oxycodone, less consumption of oxycodone and lower incidence of PONV through 48 hrs postoperatively than Groups I and C. CONCLUSION: Preoperative SNB attenuated inflammatory response to craniotomy for cerebral aneurysms, blunted the hemodynamic response to scalp incision, and controlled postoperative pain better than LA or routine analgesia.

scholarly journals A Comparison Between Scalp Nerve Block and Local Anesthetic Infiltration on the Inflammatory Response, Hemodynamic Response, and Postoperative Pain in Patients undergoing Craniotomy for Cerebral Aneurysms: A Randomized Controlled Trial

2018 ◽  
Author(s):  
Xi Yang ◽  
Jing Ma ◽  
Lei Chen ◽  
Rui Dong ◽  
Ke Li ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Inflammatory Response ◽  
Pain Intensity ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Cerebral Aneurysms ◽  
Hemodynamic Response ◽  
Group I ◽  
Local Anesthetic Infiltration

Abstract BACKGROUND: The purpose of this study was to compare the effects of the scalp nerve block (SNB) and local anesthetic infiltration (LA) with ropivacaine 0.75% on postoperative inflammatory response, intraoperative hemodynamic response, and postoperative pain control in patients undergoing craniotomy. METHODS: Fifty seven patients admitted for elective craniotomy for surgical clipping of an cerebral aneurysm. They were randomly divided into three groups: Group S (SNB with 15mL of ropivacaine 0.75%), group I (LA with 15mL of ropivacaine 0.75%) and group C (only received routine intravenous analgesia). The pro-inflammatory cytokines levels in plasma during postoperative 72 hrs, the hemodynamic response to the skin incision, as well as postoperative pain intensity were measured. RESULTS: The SNB with 0.75% ropivacaine not only decreased IL-6 level in plasma at 6 hrs after craniotomy, but also decreased plasma CRP level and increased plasma IL-10 level at 12 and 24 hrs after surgery, as compared to LA and routine analgesia. There were significant increases in mean arterial pressure at 2, and 5 mins after the incision and during dura opening in group I and C compared with group S. Group S had a lower postoperative pain intensity, longer duration of time before the first dose of oxycodone, less consumption of oxycodone and lower incidence of PONV during 48 hrs postoperatively than group I and C. CONCLUSION: Preoperative SNB attenuated inflammatory response to craniotomy for cerebral aneurysms, as well as blunted hemodynamic response to the scalp incision, and controlled postoperative pain better than LA or routine analgesia.

scholarly journals A Comparison Between Scalp Nerve Block and Local Anesthetic Infiltration on the Inflammatory Response, Hemodynamic Response, and Postoperative Pain in Patients undergoing Craniotomy for Cerebral Aneurysms: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Xi Yang ◽  
Jing Ma ◽  
Lei Chen ◽  
Rui Dong ◽  
Ke Li ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Inflammatory Response ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Cerebral Aneurysms ◽  
Hemodynamic Response ◽  
Postoperative Pain Control ◽  
Randomized Controlled ◽  
Local Anesthetic Infiltration

Abstract BACKGROUND The purpose of this study was to compare the effects of the scalp nerve block (SNB) and local anesthetic infiltration (LA) with ropivacaine 0.75% on postoperative inflammatory response, intraoperative hemodynamic response, and postoperative pain control in patients undergoing craniotomy.

scholarly journals Comparison of the Effect of Lidocaine versus a Lidocaine-Bupivacaine Combination in a Periprostatic Nerve Block Undergoing Transrectal Ultrasound-Guided Prostate Biopsy: A Double-Blind Randomized Controlled Trial

2015 ◽  
Vol 9 (3) ◽  
pp. 153-158 ◽  
Author(s):  
Ali H. Yilmaz ◽  
Elif Ziypak ◽  
Tevfik Ziypak ◽  
Mehmet Aksoy ◽  
Senol Adanur ◽  
...  
Keyword(s):  
Nerve Block ◽  
Local Anesthetic ◽  
Pain Control ◽  
Controlled Trial ◽  
Late Phase ◽  
Patient Comfort ◽  
Double Blind ◽  
Vas Scores ◽  
Long Acting ◽  
Periprostatic Nerve Block

Introduction: To determine whether a combination of the long acting local anesthetic, bupivacaine, and lidocaine is better than lidocaine alone in the long-term pain control, which is a short-acting anesthetic. Materials and Methods: In group 1, periprostatic nerve block was applied to both neurovascular areas with 2% lidocaine (5 ml) in an isotonic solution (5 ml). In group 2, the combination of 2% lidocaine (5 ml) and 5mg/ml bupivacaine (5 ml) was used for the PPNB. Results: In the first 30 minutes the mean VAS scores of groups 1 and 2 were 2.1 ± 0.2 and 1.2 ± 0.1, respectively (p = 0.002). VAS scores of group II determined at 1, 2, 4, 6, and 8 hours after the biopsy were significantly lower since it was (p < 0.05). Conclusion: While periprostatic nerve block for late phase pain control, applying a combination of a long-acting local anesthetic, such as bupivacaine, is effective in terms of pain control and patient comfort.

scholarly journals Minimum Effective Concentration of Bupivacaine in Ultrasound-Guided Femoral Nerve Block after Arthroscopic Knee Meniscectomy: A Randomized, Double-Blind, Controlled Trial

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E79-E86
Author(s):  
Rioko K. Sakata
Keyword(s):  
Pain Intensity ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Controlled Trial ◽  
Femoral Nerve ◽  
Pain Intensity Score ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Intensity Score ◽  
Arthroscopic Knee

Background: Adequate analgesia is important for early hospital discharge after meniscectomy. A femoral nerve block may reduce the need for systemic analgesics, with fewer side effects; however, motor block can occur. Ultrasound-guided femoral nerve block may reduce the required local anesthetic concentration, preventing motor block. Objective: The primary objective of this study was to determine the lowest effective analgesic concentration of bupivacaine in 50% (EC50) and in 90% (EC90) of patients for a successful ultrasoundguided femoral nerve block in arthroscopic knee meniscectomy. Study Design: This was a prospective, randomized, double-blind, controlled trial. Settings: This study was conducted at Hospital São Domingos. Methods: A total of 52 patients undergoing arthroscopic knee meniscectomy were submitted to ultrasound-guided femoral nerve block using 22 mL bupivacaine. The bupivacaine concentration given to a study patient was determined by the response of the previous patient (a biased-coin design up–down sequential method). If the previous patient had a negative response, the bupivacaine concentration was increased by 0.05% for the next case. If the previous patient had a positive response, the next patient was randomized to receive the same bupivacaine concentration (with a probability of 0.89) or to have a decrease by 0.05% (with a probability of 0.11). A successful block was defined by a numerical pain intensity scale score < 4 (0 = no pain; 10 = worst imaginable pain) in 3 different evaluations. If the pain intensity score was ≥ 4 (moderate or severe pain) at any time, the block was considered failed. General anesthesia was induced with 30 μg/kg alfentanil and 2 mg/ kg propofol, followed by propofol maintanance, plus remifentanil if needed. Postoperative analgesia supplementation was performed with dipyrone; ketoprofen and tramadol were given if needed. Data Measurements: The following parameters were evaluated: numerical pain intensity score, duration of analgesia, supplementary analgesic dose in 24 hours, and need for intraoperative remifentanil. Results: The EC50 was 0.160 (95% CI: 0.150 – 0.189), and EC90 was 0.271 (95% CI: 0.196 – 0.300). There was no difference in numerical pain intensity score for the different concentrations of bupivacaine. A successful block was achieved in 45 patients, with no difference according to bupivacaine concentration. Time to first analgesic supplementation dose was longer for bupivacaine concentrations ≥ 0.3% (543.8 ± 283.8 min.), compared to 0.25% (391.3 ± 177.8 min.) and < 0.25% (302.3 ± 210.1 min.). There were no differences in supplementary analgesic dose in 24 hours nor in the use of intraoperative remifentanil according to bupivacaine concentration. Limitations: The analgesic effect was measured only during the first 2 hours. Conclusions: Bupivacaine EC50 for ultrasound-guided femoral nerve block was 0.160 (95% CI: 0.150 – 0.189), and EC90 was 0.271 (95% CI: 0.196 – 0.300). Key words: Postoperative analgesia, femoral block, ultrasound-guided, bupivacaíne minimum concentration, arthroscopic meniscectomy

scholarly journals The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1051
Author(s):  
Zenon Pogorelić ◽  
Tea Gaberc ◽  
Miro Jukić ◽  
Goran Tintor ◽  
Ana Nevešćanin Biliškov ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Randomized Clinical Trial ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Control Group ◽  
Number Of Patients ◽  
Intraperitoneal Instillation ◽  
Time Point

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (p = 0.001) was found. Additionally, the interaction between time and different local analgesics (p < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (p < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine – n = 4, 20%; 0.5% levobupivacaine – n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (p < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine.

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