Amount Of Analgesic Medication Research Articles

Effectiveness of scheduled postoperative intravenous acetaminophen for colon cancer surgery pain

BackgroundClinical cases are often observed when patients are in need of repeated use of analgesic infusion to manage pain after colon cancer surgery. This paper investigates analgesic frequency as well as safety of postoperative intravenous (IV) acetaminophen in colon cancer surgery where epidural anesthesia is used.MethodsAmong patients who received epidural anesthesia during colon cancer surgery, one group of twenty eight (28) patients received acetaminophen while another group of patients (30) did not receive it. The groups were analyzed from the surgery day to two days after for the postoperative occurrence and frequency of liver dysfunction in relation to analgesic usage.ResultsThe patient group with acetaminophen infusion significantly reduced the amount of analgesic medication compared to the group without the treatment (p = 0.008). Furthermore there was a significantly larger number of patients in the group receiving acetaminophen treatment with the baseline increase of alanine aminotransferase (p = 0.043). In most of the cases, however, the rate of the increase is mild and the patients did not need medication and subsequently recovered quickly.ConclusionsScheduled IV infusion of acetaminophen after colon cancer surgey is concluded an effective method of pain control and alleviation of postoperative discomfort from the surgery day to two days after the surgery.

A Study on Distress and State Anxiety Level in Gynecological Postoperative Patients under PCA Management

Purpose: A descriptive study was conducted to examine the levels of distress, state anxiety, and physiologic responses in postoperative patients under patient controlled analgesia (PCA), and to determine correlations among the variables. Method: The study sample included women who underwent an elective hysterectomy procedure or other gynecologic surgeries(N=100). Subjective distress was assessed by visual analog scales around 8 hours postoperatively. Trained nurses collected objective distress data through observation of subject's behavior and vital signs. Data were analyzed with frequencies, percentages, means, Pearson correlation coefficients, ANOVA, and the Scheffe post test using SPSS/PC 11.0. Result: Subjective distress, objective distress, and state anxiety scores were relatively low, except pain scores(5.31 out of 10.0) among sub-scales of subjective distress. Women who had a total abdominal hysterectomy showed significantly higher levels of both subjective distress and state anxiety than those after a minor gynecologic surgery. In relationships among variables, subjective distress correlated positively with postoperative state anxiety, but not with the amount of analgesic medication, verified by further analysis on sub-scales of subjective and objective distress. The higher the levels of state anxiety, the higher the levels of tension, dyspnea, facial change, and systolic blood pressure observed. Conclusion: Regardless of effective pain management, most postoperatively experienced distress in gynecological patients was derived from surgery associated anxiety and pain. Specific psychological strategies should be established as well for those with high levels of state anxiety to facilitate prompt recovery.

Postoperative Recovery after Cholecystectomy by Minilaparotomy: A Randomized Double‐Blind Comparison between α‐Trinositol and Placebo

AbstractAn opioid‐sparing effect of α‐trinositol (D‐myo‐inositol 1,2,6‐trisphosphate) following cholecystectomy in otherwise healthy patients was suggested by a pilot study. In order to verify this result, pain, pain relief and nausea were studied in patients undergoing elective cholecystectomy by minilaparotomy. The patients were randomized using double‐blind design to receive an intravenous infusion of either α‐trinositol or sodium chloride (placebo) for eight hr after the operation. Pain, pain relief and nausea were evaluated up to 72 hr after surgery using visual analogue scales (VAS). Rescue analgesic medication was registered. As a further measure of pain and/or restrictions caused by pain, peak expiratory (low, walking distance and pressure pain thresholds were assessed. There was no difference between the groups in ratings of pain, pain relief, nausea or amount of analgesic medication given. The mean ratings of pain were significantly higher in the sitting position compared to lying down. Neither pressure pain thresholds, nor the walking distance differed between the patients given α‐trinositol and placebo, respectively. There were significant reductions of peak expiratory flow and of pressure pain thresholds under both costal margins up to 72 hr after surgery compared to prcsurgcry values. As a conclusion, no analgesic effect of α‐trinositol at the dosage used was observed in the postoperative patients studied.

A double-blinded evaluation of intraperitoneal bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy

Intraperitoneal local anesthesia has been reported to reduce postoperative pain after laparoscopy for gynecologic procedures that do not require a great deal of dissection or manipulation of viscera. This study was performed to determine the efficacy of intraperitoneal bupivacaine in laparoscopic cholecystectomy (LC). Fifty-five patients were evaluable in this randomized, double-blind, placebo-controlled study. Twenty-six patients received bupivacaine (0.1%) and 29 patients received placebo (saline). Prior to any dissection of the gallbladder, the surgeon irrigated 100 ml of experimental solution under the right hemidiaphragm, over Glisson's capsule, over the gallbladder serosa, and into the subhepatic space. The operation was then performed as usual. Postoperatively, analgesic medication usage, nausea, vomiting, and pain scores were determined during hospitalization. A questionnaire was given to each patient upon discharge from the hospital in order to continue monitoring medications and pain for the first 48 h at home. Postoperative pain was reduced significantly (P < 0.05) in the patients who received bupivacaine, but the effect was modest and observable only during the first 6 h after surgery. Despite this difference, there was no significant reduction in the amount of analgesic medication used by the patients who received bupivacaine, nor was there any reduction in nausea, vomiting, or shoulder pain when queried specifically. Intraperitoneal bupivacaine offered a detectable, albeit subtle benefit to patients undergoing LC. However, the effect was transient and had little impact upon the patient's convalescence.

Patients' and nurses' ratings of pain and anxiety during burn wound care

Although adequate assessment of pain and anxiety during burn wound care serves important clinical and scientific goals (e.g., determination of medication dosage and evaluation of treatment effects), few data are actually available. Studies which compare self-reported pain with observational ratings frequently suffer from small sample sizes or questionable data analysis techniques. This paper presents a study in which 126 burn wound dressing changes were independently rated by patient and nurse(s). Variables investigated were overall pain, worst pain, overall tension and tension just before the procedure. Also studied were the effects of age, extent of bum damage, medication use and nurses' experience with burn patients. It is concluded that although there are significant relationships between patients' and nurses' ratings, these relationships are not very strong. In contrast to self-reports, observational ratings seem to be affected by patient's age. Patients' ratings of tension correlate with the amount of analgesic medication used. It is argued that it is not useful to discuss the present and earlier studies only in terms of correctness or incorrectness of observational ratings. Recommendations for future studies include the study of pain-related behaviors, coping mechanisms and effects of treatments. Considering the vast differences in prescription regimes among centers, a multicenter trial would be particularly interesting.

Temperature Biofeedback Treatment for Migraine Headache: A Controlled Multiple Baseline Study

SYNOPSISA multiple baseline, within subject, controlled design was used to examine the effectiveness of a temperature biofeedback procedure augmented with autogenic and relaxation training, in the treatment of four patients who met the criteria for the migraine syndrome. Before treatment was begun, each patient recorded baseline data on hourly ratings of headache intensity and amount of analgesic medication used. The treatment package consisted of: (1) instructions aimed at generating favorable therapeutic expectations; (2) modified relaxation training; (3) use of autogenic phrases; and, (4) fingertip temperature feedback. In accord with the multiple baseline design, this package was introduced to individual patients sequentially in such a way that the effect of treatment was observed in headache and medication records of one patient before treatment was introduced to the next patient.Results indicated that the treatment package had an impact on ratings of headache intensity and medication usage. The data showed idiosyncratic variations and individual differences among subjects in the response to treatment.