scholarly journals Effect of single dose preoperative intravenous ibuprofen on postoperative pain and opioid consumption: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Su Yeon Kim ◽  
Sangseok Lee ◽  
Yeji Lee ◽  
Hyunho Kim ◽  
Kye-Min Kim
Keyword(s):  
Systematic Review ◽  
Single Dose ◽  
Postoperative Pain ◽  
Meta Analysis ◽  
Opioid Consumption ◽  
Intravenous Ibuprofen

scholarly journals Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis

2011 ◽  
Vol 106 (6) ◽  
pp. 764-775 ◽  
Author(s):  
E.D. McNicol ◽  
A. Tzortzopoulou ◽  
M.S. Cepeda ◽  
M.B.D. Francia ◽  
T. Farhat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Single Dose ◽  
Postoperative Pain ◽  
Meta Analysis ◽  
Intravenous Paracetamol

scholarly journals Perioperative Single Dose Systemic Dexamethasone for Postoperative Pain

2011 ◽  
Vol 115 (3) ◽  
pp. 575-588 ◽  
Author(s):  
Gildàsio S. De Oliveira ◽  
Marcela D. Almeida ◽  
Honorio T. Benzon ◽  
Robert J. McCarthy
Keyword(s):  
Single Dose ◽  
Postoperative Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Analgesic Effects ◽  
Preoperative Administration

Background Dexamethasone is frequently administered in the perioperative period to reduce postoperative nausea and vomiting. In contrast, the analgesic effects of dexamethasone are not well defined. The authors performed a meta-analysis to evaluate the dose-dependent analgesic effects of perioperative dexamethasone. Methods We followed the PRISMA statement guidelines. A wide search was performed to identify randomized controlled trials that evaluated the effects of a single dose systemic dexamethasone on postoperative pain and opioid consumption. Meta-analysis was performed using a random-effect model. Effects of dexamethasone dose were evaluated by pooling studies into three dosage groups: low (less than 0.1 mg/kg), intermediate (0.11-0.2 mg/kg) and high (≥ 0.21 mg/kg). Results Twenty-four randomized clinical trials with 2,751 subjects were included. The mean (95% CI) combined effects favored dexamethasone over placebo for pain at rest (≤ 4 h, -0.32 [0.47 to -0.18], 24 h, -0.49 [-0.67 to -0.31]) and with movement (≤ 4 h, -0.64 [-0.86 to -0.41], 24 h, -0.47 [-0.71 to -0.24]). Opioid consumption was decreased to a similar extent with moderate -0.82 (-1.30 to -0.42) and high -0.85 (-1.24 to -0.46) dexamethasone, but not decreased with low-dose dexamethasone -0.18 (-0.39-0.03). No increase in analgesic effectiveness or reduction in opioid use could be demonstrated between the high- and intermediate-dose dexamethasone. Preoperative administration of dexamethasone appears to produce a more consistent analgesic effect compared with intraoperative administration. Conclusion Dexamethasone at doses more than 0.1 mg/kg is an effective adjunct in multimodal strategies to reduce postoperative pain and opioid consumption after surgery. The preoperative administration of the drug produces less variation of effects on pain outcomes.

scholarly journals Pudendal nerve block in hemorrhoid surgery: A systematic review and meta-analysis

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
F Mongelli ◽  
G Treglia ◽  
D La Regina ◽  
M Di Giuseppe ◽  
J Galafassi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Nerve Block ◽  
Readmission Rate ◽  
Pudendal Nerve ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Opioid Consumption ◽  
Pudendal Nerve Block

Abstract Objective Postoperative pain represents an important issue in traditional hemorrhoidectomy. Optimal pain control is mandatory, in particular in a surgical day care setting. The aim of this study was to investigate the use of pudendal nerve block (PNB) in patients undergoing hemorrhoidectomy. Methods PubMed, Google Scholar, Cochrane Library and Web of Science databases were searched up to December 2020. Randomized trials evaluating the PNB use on postoperative outcomes in patients undergoing hemorrhoidectomy were selected. Opioid consumption, pain on the visual analogue scale, length of hospital stay and readmission rate were the main outcomes of interest and were plotted by using a random-effect model. Results The literature search revealed 749 articles, of which 14 with were deemed eligible. A total of 1,214 patients was included, of whom 565 received the PNB and 649 did not. After hemorrhoidectomy, patients in the PNB group received opioids less frequently (RR 0.364, 95%CI 0.292 to 0.454, p < 0.001) and in a lower cumulative dose (SMD -0.935, 95%CI -1.280 to -0.591, p < 0.001). Patients receiving PNB experienced less pain at 24 hours (SMD -1.862, 95%CI -2.495 to -1.228, p < 0.001), had a shorter length of hospital stay (SMD -0.742, 95%CI -1.145 to -0.338, p < 0.001) and a lower readmission rate (RR 0.239, 95%CI 0.062 to 0.916, p = 0.037). Sensitivity analysis excluded the occurrence of publication bias on the primary endpoint and the overall evidence quality was judged “high”. Conclusion This systematic review and meta-analysis shows significant advantages of the PNB use. A reduction in opioid consumption, postoperative pain, complications and length of stay can be demonstrated. Despite limitations, PNB in patients undergoing hemorrhoidectomy should be taken into account.

The analgesic efficacy of liposomal bupivacaine compared with bupivacaine hydrochloride for the prevention of postoperative pain: a systematic review and meta-analysis with trial sequential analysis

2021 ◽  
pp. rapm-2020-102427
Author(s):  
Hanns-Christian Dinges ◽  
Thomas Wiesmann ◽  
Berit Otremba ◽  
Hinnerk Wulf ◽  
Leopold H Eberhart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Pain Score ◽  
Meta Analysis ◽  
End Points ◽  
Liposomal Bupivacaine ◽  
Bupivacaine Hydrochloride ◽  
Pain Scores ◽  
Score Difference ◽  
The Mean

Background/ImportanceLiposomal bupivacaine (LB) is a prolonged release formulation of conventional bupivacaine designed for prolonging local or peripheral regional single injection anesthesia. To this day, the benefit of the new substance on relevant end points is discussed controversial.ObjectiveThe objective was to determine whether there is a difference in postoperative pain scores and morphine consumption between patients treated with LB and bupivacaine hydrochloride in a systematic review and meta-analysis.Evidence reviewRandomized controlled trials (RCT) were identified in Embase, CENTRAL, MEDLINE and Web of Science up to May 2020. Risk of bias was assessed using Cochrane methodology. Primary end points were the mean pain score difference and the relative morphine equivalent (MEQ) consumption expressed as the ratio of means (ROM) 24 and 72 hours postoperatively.Findings23 RCTs including 1867 patients were eligible for meta-analysis. The mean pain score difference at 24 hours postoperatively was significantly lower in the LB group, at −0.37 (95% CI −0.56 to −0.19). The relative MEQ consumption after 24 hours was also significantly lower in the LB group, at 0.85 (0.82 to 0.89). At 72 hours, the pain score difference was not significant at −0.25 (−0.71 to 0.20) and the MEQ ratio was 0.85 (0.77 to 0.95).ConclusionThe beneficial effect on pain scores and opioid consumption was small but not clinically relevant, despite statistical significance. The effect was stable among all studies, indicating that it is independent of the application modality.

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