Analgesia In Abdominal Hysterectomy Research Articles

Intrathecal clonidine versus intrathecal midazolam with hyperbaric bupivacaine for post operative analgesia in abdominal hysterectomy

Objectives: This randomised study was conducted to compare the effects of intrathecal clonidine and midazolam with hyperbaric bupivacaine for post operative analgesia in patients undergoing abdominal hysterectomy. Materials and Methods: 60 patients of ages between 40 and 60 years of ASA grade I/II undergoing abdominal hysterectomy were randomly divided into two equal groups. Group C and group M received 0.5% hyperbaric bupivacaine 3ml with either clonidine 45µg with 0.2 ml saline or midazolam 2.5mg respectively intrathecally. Onset and duration of sensory blockade, haemodynamic changes, duration of post operative analgesia, number of rescue analgesics and side effects if any, were observed. Results: There was statistically significant difference in the onset and duration of sensory block (p<0.001) between the two groups. Duration of post operative analgesia was significantly longer in midazolam group (373.33±24.22 minutes) than in clonidine group (328.5±21.78 minutes). Conclusion: Spinal anaesthesia with 2.5 mg midazolam as an adjuvant to 3ml hyperbaric bupivacaine provides longer duration of post operative analgesia compared to 45µg clonidine with 3ml hyperbaric bupivacaine with better haemodynamic stability without any adverse effects.

Tramadol for Early Postoperative Analgesia in Abdominal Hysterectomy: Comparison of Different Administration Techniques

Tramadol for Early Postoperative Analgesia in Abdominal Hysterectomy: Comparison of Different Administration Techniques

A Randomised Controlled Trial to Compare Preemptive Pregabalin with Gabapentin for Post-Operative Analgesia in Abdominal Hysterectomy

A Randomised Controlled Trial to Compare Preemptive Pregabalin with Gabapentin for Post-Operative Analgesia in Abdominal Hysterectomy

Comparison of Diclofenac Patch and Intramuscular Diclofenac for Postoperative Analgesia in Abdominal Hysterectomy under Spinal Anesthesia: A Prospective, Randomized Clinical Study

Introduction: Immediate postoperative period is very crucial and pain is maximum during first 24 hours. If patients are kept pain free during this period, it leads to vitally stable postoperative period, which in turn leads to early recovery. The aim of this study was to compare the analgesic efficacy of diclofenac sodium via two different routes, intramuscular (IM) and transdermal, in the management of postoperative pain. Materials and methods: After informed written consent, 60 patients of American Society of Anesthesiologists (ASA) grades I to III scheduled for abdominal hysterectomy under subarachnoid blockade were randomized into two groups. Group TP (n= 30) received transdermal diclofenac patch 3 hours before surgery and group IM (n = 30) received IM diclofenac sodium 30 minutes before the end of surgery. Transdermal or IM diclofenac was repeated 12 hours later. Postoperative visual analog scale (VAS) scores, hemodynamic data, requirement of rescue analgesic, patient satisfaction, and adverse reaction if any were recorded every 2 hourly over 24 hours period. If VAS values were >4, 2 mg/kg tramadol was given intravenously as rescue analgesia. Results: Postoperative VAS, hemodynamic data, requirement of rescue analgesia, and patients' satisfaction were comparable in both the groups (p > 0.05). Intramuscular diclofenac has more side effects. Conclusion: Diclofenac transdermal patch provided postoperative pain relief as effectively as IM diclofenac for abdominal hysterectomy, without any significant side effects.

A comparative study of three different doses of nalbuphine as an adjuvant to intrathecal bupivacaine for postoperative analgesia in abdominal hysterectomy

Background: Spinal anesthesia is still the most commonly used technique for lower abdominal surgeries as it is very economical and easy to administer. Its main disadvantage remains the short duration of action. Hence, different additives have been used. Nalbuphine is an agonist-antagonist opioid that binds to μ-receptors, as well as to κ-and δ-receptors. The aim of this randomized, double-blind study was to evaluate the potentiating effect of intrathecal nalbuphine with bupivacaine for postoperative analgesia in three different doses. Materials and Methods: A total of 100 patients were randomized into four groups. Group A: Patients received 15 mg of 0.5% hyperbaric bupivacaine, group B: Patients received 15 mg of 0.5% hyperbaric bupivacaine plus 0.8 mg of nalbuphine, group C: Patients received 15 mg of hyperbaric bupivacaine plus 1.6 mg of nalbuphine, and group D: Patient received 15 mg of hyperbaric bupivacaine plus 2.4 mg of nalbuphine intrathecally. Results: The onset of sensory and motor block and duration of motor block were comparable in all groups. Two-segment regression was statistically significant when group A was compared to groups B, C, and D. The total durations of analgesia were 133.8 + 28.3 min, 199.8 + 25.9 min, and 166.8 + 27.8 min in groups B, C, and D, respectively. Conclusion: Our study showed that the combination of intrathecal bupivacaine with nalbuphine significantly prolonged postoperative analgesia as compared to the control group, and a 1.6 mg dose of nalbuphine administered intrathecally showed the best results among all other study groups.

Effectiveness and safety of epidural bolus injection of low dose morphine combined with transnasal butorphanol on postoperative analgesia in abdominal hysterectomy

Objective To compare the efficacy of epidural morphine with and without transnasal butorphanol on postoperative pain relief following abdominal hysterectomy.Methods This is A single-blind design,randomized,placebo controlled study. 50 patients (ASA Ⅰ～Ⅱ)undergoing total abdominal hysterectomies was conducted to group A and group B (n=25). Following elective abdominal hysterectomy with epidural anesthesia via L2-3,group A of 25 patients received a single epidural bolus of morphine (0.5 mg) with transnasal saline as placebo analgesia (0.1 ml,q4 h),and group B received a single epidural bolus of morphine (0.5 mg) combined with transnasal butorphanol 1 mg ( 0.1 ml,q4 h) for postoperative analgesia. Parameters monitored were pain pulse,respiratory rate,SPO2 and side effects such as nausea,emesis,skin itching and delayed score (Visual Analogue Scale,VAS),sedation score (Remesay sedation score,RSS),blood pressure,respiratory depression.Results Compared with group A,the VAS scores were found to be decreased in group B significantly from 20 h to 32 h after epidural analgesia (P＜ 0.01 ). There was a significant difference in analgesics-effect curve (AUC) (P＜ 0.01 ) between two groups. The incidences of complications were equally comparable in both two groups.Conclusion Single epidural bolus of morphine 0.5 mg with regularly transnasal Butorphanol (1mg,q4h) had a better analgesic effect than placebo analgesia,which is easier to perform in pain management and is practicable for abdominal hysterectomy in the primary hospital. Key words: Morphine; Epidural; Post-operative anesthesia; Transnasal butorphanol; Combined analgesia; Placebo analgesia

Effect of Combined Spinal - Epidural Anesthesia Followed by Patient Controlled Epidural Analgesia in Abdominal Hysterectomy

Effect of Combined Spinal - Epidural Anesthesia Followed by Patient Controlled Epidural Analgesia in Abdominal Hysterectomy