scholarly journals Impact of Ketamine on Opioid Use and Persistent Pain After Cytoreductive Surgery with Hyperthermic Chemotherapy

2021 ◽  
Vol Volume 14 ◽  
pp. 2433-2439
Author(s):  
Juan P Cata ◽  
Pascal Owusu-Agyemang ◽  
Dhanalakshmi Koyyalagunta ◽  
German Corrales ◽  
Lei Feng ◽  
...  
Keyword(s):  
Cytoreductive Surgery ◽  
Persistent Pain ◽  
Opioid Use ◽  
Hyperthermic Chemotherapy

Comparison of patient reported symptom burden in patients with ovarian cancer undergoing primary vs. interval tumor reductive surgery.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5557-5557 ◽  
Author(s):  
Larissa Meyer ◽  
Qiuling Shi ◽  
Maria Iniesta ◽  
Melinda Harris ◽  
Charlotte C. Sun ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Enhanced Recovery ◽  
Symptom Burden ◽  
Urinary Urgency ◽  
Opioid Use ◽  
Emotional Symptoms ◽  
Mixed Effect ◽  
Work Activity ◽  
Patient Reported

5557 Background: Patient-reported outcomes (PROs) are important in comparative effectiveness research. We compared symptom burden and functional recovery in pts undergoing primary cytoreductive surgery (PCS) or neoadjuvant chemotherapy (NACT) and interval cytoreductive surgery (ICS) within an enhanced recovery after surgery program (ERAS). Methods: Perioperative PROs were measured for women with ovarian cancer undergoing PCS or ICS using the MD Anderson Symptom Inventory- Ovarian Cancer, a 27-item validated tool which was administered preoperatively, daily in hospital, and at least weekly for 8 weeks post-op. Mixed-effect modeling was performed. Results: 108 pts (45 PCS, 63 ICS) participated. There was no difference in median age, Charlson comorbidity index, ASA status, history of chronic opioid use, length of stay or readmission rate. At pre-op baseline assessment, the mean pain score was higher in the PCS group (3.8 vs. 1.8, p = .0005). ICS pts had a lower median surgical complexity score (4.0 vs. 2.0, p = .03), and shorter median surgical time (260 min vs. 223 min, p = .05). During hospitalization, pts undergoing PCS reported significantly more bloating, urinary urgency, distress, sadness and mood disturbance. Women who received NACT had a significantly higher symptom burden of neuropathy, leg cramps and memory disturbances. There was no difference in pain, fatigue, drowsiness, nausea, or emesis within the first 5 days postoperatively. While there was no significant differences in the physical interference composite score, (walking, work, activity), those who underwent ICS had improved affective interference scores (mood, relations, enjoyment of life). Conclusions: Within an ERAS program, there were few significant differences in surgery related symptoms related to physical recovery between pts undergoing PCS or ICS. The differences in overall symptom burden suggest that disease related symptoms (pain, bloating, urinary urgency) and emotional symptoms may be related to recent diagnosis and higher tumor burden in pts undergoing PCS while the increased numbness, leg cramps and memory issues reflect chemo-related effects in the ICS cohort.

scholarly journals Correlates of Prescription Opioid Initiation and Long-term Opioid Use in Veterans With Persistent Pain

2013 ◽  
Vol 29 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Steven K. Dobscha ◽  
Benjamin J. Morasco ◽  
Jonathan P. Duckart ◽  
Tara Macey ◽  
Richard A. Deyo
Keyword(s):  
Persistent Pain ◽  
Prescription Opioid ◽  
Opioid Use

Impact of transversus abdominis plane blocks versus non-steroidal anti-inflammatory on post-operative opioid use in ERAS ovarian cancer surgery

2019 ◽  
Vol 29 (9) ◽  
pp. 1372-1376
Author(s):  
Steven Peter Bisch ◽  
Joni Kooy ◽  
Sarah Glaze ◽  
Anna Cameron ◽  
Pamela Chu ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Regression Analysis ◽  
Length Of Stay ◽  
Cytoreductive Surgery ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Opioid Use ◽  
Transversus Abdominis Plane ◽  
Anti Inflammatory

BackgroundTreatment of ovarian cancer often requires extensive surgical resection. The transversus abdominis plane (TAP) block has been utilized in benign gynecologic surgery to decrease post-operative pain and opioid use. We hypothesized that TAP blocks would decrease total opioid use in the first 24 hours and decrease length of stay following staging and cytoreductive surgery for ovarian cancer compared with either no local anesthetic or local wound infiltration alone.MethodsAll patients undergoing surgery for ovarian cancer from November 2016 to June 2017 were included in this retrospective cohort study. Median opioid use at 24, 48, and 72 hours post-operatively, as well as length of stay, were assessed. Multivariate median regression analysis was performed to adjust for potential confounders: post-operative non-steroidal anti-inflammatory drug (NSAID) usage, pre-operative opioid consumption, and extent of cytoreductive surgery. Length of stay was compared using Cox regression analysis.ResultsOne-hundred-and-twenty patients were included in the analysis. Eighty-two patients had a TAP block, while 38 did not. After adjusting for potential confounders there was no difference in median 24 hours opioid consumption (p=0.29) or length of stay (HR 0.95, p=0.78) between patients receiving TAP block compared with those without. After adjusting for potential confounders, patients receiving scheduled NSAIDs had a 2.6-fold greater likelihood of being discharged (p<0.0005) and a significant reduction in median opioid use at 24 hours (23.5 vs 14.5 mg) (p=0.017) compared with those patients without NSAIDs.DiscussionPost-operative administration of NSAIDs, but not TAP block, was associated with a decrease in post-operative opioid use and length of stay following surgery for ovarian cancer. Further investigation into alternative regional anesthetics for Enhanced Recovery after Surgery (ERAS) protocols is warranted.

Monitoring Health Outcomes Following Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Chemotherapy for Peritoneal Carcinomatosis

2007 ◽  
Vol 14 (3) ◽  
pp. 1105-1113 ◽  
Author(s):  
Richard P. McQuellon ◽  
Suzanne C. Danhauer ◽  
Gregory B. Russell ◽  
Perry Shen ◽  
Joyce Fenstermaker ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Peritoneal Carcinomatosis ◽  
Cytoreductive Surgery ◽  
Intraperitoneal Hyperthermic Chemotherapy ◽  
Hyperthermic Chemotherapy
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