scholarly journals The Effect of General Anesthesia and General Anesthesia Plus Epidural Levobupivacaine or Bupivacaine on Hemodynami Stress Response and Postoperative Pain

Author(s):  
Semra Calimli ◽  
Ahmet Topal ◽  
Atilla Erol ◽  
Aybars Tavlan ◽  
Seref Otelcioglu
2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher Allen-John Webb ◽  
Paul David Weyker ◽  
Shara Cohn ◽  
Amanda Wheeler ◽  
Jennifer Lee

Paravertebral blocks are becoming increasingly utilized for breast surgery with studies showing improved postoperative pain control, decreased need for opioids, and less nausea and vomiting. We describe the anesthetic management of an otherwise healthy woman who was 12 weeks pregnant presenting for treatment of her breast cancer. For patients undergoing breast mastectomy and reconstruction with tissue expanders, paravertebral blocks offer an anesthetic alternative when general anesthesia is not desired.


2017 ◽  
Vol 102 (7-8) ◽  
pp. 377-381
Author(s):  
Jinguo Wang ◽  
Yaowen Fu ◽  
Haichun Ma ◽  
Na Wang

The objective of this study was to investigate the effect of intravenous oxycodone administered before transurethral resection of prostate (TURP) on postoperative pain and tramadol consumption. Preemptive analgesia can decrease postoperative pain and analgesic consumption. Sixty patients undergoing elective TURP were divided into 2 groups: group O (n = 30) received intravenous oxycodone (0.1 mg/kg) 10 minutes before surgery over 2 minutes and group C (n = 30) received normal saline as a placebo. A standardized general anesthesia method was performed with a laryngeal mask airway device. Data with respect to pain intensity, incidence of lower urinary tract discomfort, time to the first tramadol requirement, tramadol consumption, overall patient satisfaction, and adverse effects were collected. Preoperative oxycodone contributed to better analgesia at 1, 2, 6, and 12 hours after shifting the patients to the recovery room, a longer time interval to the first tramadol request, fewer patients requiring tramadol analgesia, and reduced tramadol consumption. Adverse effects were comparable between the 2 groups. Preoperative intravenous oxycodone (0.1 mg/kg) 10 minutes before TURP improves postoperative analgesia, prolongs time to the first tramadol request, and reduces tramadol consumption without an influence on lower urinary tract discomfort and adverse effects.


2020 ◽  
Author(s):  
Haichen Chu ◽  
He Dong ◽  
Yongjie Wang ◽  
Zejun Niu

Abstract Background: Local anesthesia can reduce the response to surgical stress and decrease the consumption of opioids, which may reduce immunosuppression and potentially delay postoperative tumor recurrence. We compared paravertebral block(PVB) combined with general anesthesia(GA) and general anesthesia regarding their effects on matrix metalloproteinase-9 (MMP-9) and postoperative pain after video-assisted thoracoscopic surgery(VATS) lobectomy. Methods: 54 patients undergoing elective VATS lobectomy at a single tertiary care, teaching hospital located in Qingdao between May 2 2018 and Sep 28 2018 were randomised by computer to either paravertebral block combined with general anesthesia or general anesthesia. The primary outcome was pain scores during postoperative 48h. The secondary outcome were plasma concentrations of MMP-9, complications, and duration of postoperative hospital stay. Results: 75 were enrolled to the study, of whom 21 were excluded before surgery. We analyzed lobectomy patients undergoing paravertebral block combined with general anesthesia (n=25) or general anesthesia (n=24). Both groups were similar regarding baseline characteristics. Pain scores were lower at 4h and 24h in PVB/GA group, compared with GA group (2.53±0.83 vs 3.4±0.91; 2.2±0.94 vs 3.0±0.93, respectively, P <0.05). There were no difference at 1h and 48h between groups. Patients in the PVB/GA group showed a greater decrease in plasma MMP-9 level at T1 and T2 after VATS lobectomy ( P <0.05). Postoperative complications and length of stay did not differ by anesthetic technique. Conclusions: The paravertebral block/general anesthesia can provide statistically better pain relief and attenuate MMP-9 response to surgery and after VATS lobectomy. This technique may be beneficial for patients to recover rapidly after lung surgery and reduce postoperative tumor recurrence.


Author(s):  
Mynka N. V. ◽  
Kobelyatskyy Yu. Yu.

Despite the significant advances made by modern anesthesiology in the perioperative management of patients, surgical interventions are still accompanied by a high proportion of complications and even deaths. At the same time, it is known that in 50% of cases mortality and serious postoperative complications could be prevented. After performing a thorough study of the factors affecting the increase in hospitalization and postoperative recovery (Kehlet H., 1997; Kehlet H., Wilmore D., 2002), it was determined that the surgical stress response is the most significant inducer of dysfunction of various organs. and systems. To date, it has been established that general anesthesia in its classical sense does not allow achieving complete protection of the patient from surgical trauma. More complete protection can be achieved by combining general anesthesia with regional blockages and adjuvant drugs with stress-protective properties. In the present study, we compared the severity of the surgical stress response and pain syndrome in patients operated on under conditions of multicomponent balanced general anesthesia (group K) with patients who received a stress-limiting anesthesia regimen (group DB). In both groups, multicomponent anesthesia was performed, in group K, sibazone was used for sedation, in group DB, dexmedetomidine was used. Also, patients of the DB group underwent regional blockade (blockade of the pterygo-palatine fossa) before surgery. The main criteria for evaluating the results were: hemodynamic stability, blood glucose, the level of venous blood leukocytes and the severity of pain according to the VAS in the postoperative period. Both schemes made it possible to avoid pronounced fluctuations in hemodynamic and gas exchange parameters at all stages of the study. When analyzing blood glucose and leukocyte counts, it was found that patients in the control group had a more significant deviation of both indicators from the preoperative level than in the stress-limiting anesthesia group. In the study of pain syndrome, it was determined that in the control group the level of pain according to the VAS was higher at all stages of the study compared to patients in the group of stress-limiting anesthesia.


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