Comparison Of Postoperative Analgesia Research Articles

Comparison of postoperative analgesia by thoracoscopic-guided thoracic paravertebral block and thoracoscopic-guided intercostal nerve block in uniportal video-asssited thoracic surgery: a prospective randomized controlled trial

BackgroundThoracoscopic-guided thoracic paravertebral nerve block (TG-TPVB) and thoracoscopic-guided intercostal nerve block (TG-INB) are two postoperative analgesia technology for thoracic surgery. This study aims to compared the analgesic effect of TG-TPVB and TG-INB after uniportal video-asssited thoracic surgery (UniVATS).MethodsFifty-eight patients were randomly allocated to the TG-TPVB group and the TG-INB group. The surgical time of nerve block, the visual analog scale (VAS) scores, the consumption of sufentanil and the number of patient-controlled intravenous analgesic (PCIA) presses within 24 h after surgery, the incidence of adverse reactions were compared between the two groups.ResultsThe VAS scores were significantly lower during rest and coughing at 2, 6, 12, and 24 h in the TG-TPVB group than in the TG-INB group (P < 0.05). The consumption of sufentanil and the number of PCIA presses within 24 h after surgery were significantly lower in the TG-TPVB group than in the TG-INB group (P < 0.001).The surgical time of nerve block was significantly shorter in the TG-TPVB group than in the TG-INB group (P < 0.001). The incidence of bleeding at the puncture point was lower in the TG-TPVB group than that in the TG-INB group (P < 0.05).ConclusionTG-TPVB demonstrated superior acute pain relieve after uniVATS, shorter surgical time and non-inferior adverse effects than TG-INB.

Comparison of Postoperative Analgesia Between Intrathecal Nalbuphine and Intrathecal Fentanyl in Infraumbilical Surgeries: A Double-Blind Randomized Controlled Trial.

Spinal anesthesia is a widely used regional anesthesia technique for surgeries below the umbilicus, butpostoperative analgesia is of major concern due to the relatively short duration of the local anesthetic. Various drugs were used as an additive to local anesthetic to prolong the duration of postoperative analgesia. This study aims to compare the efficacy ofnalbuphine and fentanyl as an intrathecal additive along with local anesthetic. A total of 166 patients aged between 18 and 65 years belonging to the American Society of Anesthesiologists(ASA) I and II undergoing elective infraumbilical surgeries were included in the prospective double-blind randomized controlled trial. The patients were allocated into two groups of 83 each. Group N was given 2.5 mL of 0.5% bupivacaine + 1 mg of nalbuphine (0.5 mL), and group F received 2.5 mL of 0.5% bupivacaine + 25 mcg fentanyl (0.5 mL). Both groups were compared for postoperative analgesia, onset and duration ofboth sensory and motor blockade, intraoperative hemodynamics, and side effects. All demographic data, hemodynamic parameters, and side effects were not statistically significant among the two groups. However, other parameters, such as the mean duration of analgesia, which was 267.27 ±172.099 minutes in group N and 161.35 ±14.957 minutes in group F; meantime for the onset of sensory blockade, whichwas 3.94 ±1.769 minutes in group N and 5.94 ±0.929 minutesin group F; onset of complete motor blockade, which was 7.10 ±1.858 minutes in group N and 11.61 ±1.218 minutes in group F; duration of motor blockade, which was 182.57 ±13.011 minutes in group N and 112.53 ±7.389 minutes in group F;and mean time taken for two-segment regression, which was 118.20 ±12.61 minutes in group N and 113.72 ±8.84 minutes in group F, were all comparable between the two groups. Nalbuphine was found to be more efficacious for prolongation of postoperative analgesia with better hemodynamic stability.

Comparison of post-operative analgesia with caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia

Post-operative pain relief following pediatric abdominal surgery is of paramount consideration and caudal block is still a popular, easy as well as safe analgesic technique for effective analgesia in children. With the advent of newer local anaesthetics, there has been a renewed interest in pediatric caudal blocks after lower abdominal surgeries following general anaesthesia. The aim of our study was to compare the efficacy and duration of postoperative analgesia using caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia.: The study was conducted on sixty, ASA grade 1, pediatric patients of age 2 to 6 years, of either sex, posted for elective infraumbilical surgery under general anaesthesia. They were randomly divided in two groups of 30 patients each. Group 1: - (n = 30) received caudal block with injection Ropivacaine, 0.25%, 1ml/kg. Group 2: - (n = 30) received caudal block with injection Levobupivacaine, 0.25%, 1ml/kg. Comparative, randomized, single blinded, observational study. : The demographic data was comparable in both the groups. Postoperatively, the quality of analgesia was assessed by the MOP (Modified Objective Pain Scale) score. Duration of postoperative analgesia was assessed by noting the time of giving rescue analgesia in the post-operative period. We also noted side effects, if any in both the groups. The quality of analgesia was found to be similar with both the drug groups (p value &amp;#62;0.05). The duration of analgesia was longer and statistically significant (p value = 0.0006) in the Ropivacaine group (8.43 ± 0.77 hours) as compared to the Levobupivacaine group (7.03 ± 2.03 hours). Statistically significant difference (P value = 0.026) was seen in the requirement rescue analgesia between Ropivacaine (3.33%) and Levobupivacaine (26.67%) groups. There were no major side effects in either of the groups, apart from a single patient out of 30 patients of Levobupivacaine group who had vomiting, compared with none in the Ropivacaine group.We conclude that caudal block with 0.25% Ropivacaine has a longer duration of action as compared to 0.25% Levobupivacaine in children undergoing infraumbilical surgery under general anaesthesia. Both Ropivacaine and Levobupivacaine, have similar quality of postoperative analgesia and side effect profile.

Comparison of postoperative analgesia and side effects in pediatric laparoscopic surgery with morphine and nalbuphine

There is currently no consensus on the optimal perioperative pain management strategy involving specific opioids. This study aims to compare the postoperative analgesia, the associated side effects between nalbuphine and morphine in children undergoing laparoscopic surgery. One hundred ninety children were randomly assigned to nalbuphine (0.2mg/kg) or morphine (0.2mg/kg). Nalbuphine's analgesic effect was non-inferior to morphine, with similar total rescue analgesic consumption during PACU stay (0.03± 0.05mg vs. 0.04± 0.06mg, p>0.05). Nalbuphine group had a lower incidence of respiratory depression (RR ≤ 10/min) (4.8% vs. 38.6%, p<0.001), PONV (2.4% vs. 18.1%, p= 0.002), and pruritus (0% vs. 16.9%, p<0.001) than morphine. Additionally, nalbuphine showed a shorter laryngeal mask airway removal time (13.9 [12.7, 15.1]) compared with morphine (17.0 [15.1, 18.9], p= 0.011). Nalbuphine provides equipotent analgesia with significantly lower incidences of respiratory depression, PONV, and pruritus compared with morphine in pediatric laparoscopic surgery.

Comparison of postoperative analgesia in children following ropivacaine and lidocaine surgical field infiltration with epinephrine for cleft palate repair: A double-blinded, randomized controlled trial

Study objectiveThe study aimed to evaluate the efficacy of ropivacaine in providing postoperative analgesia for children undergoing cleft palate repair. MethodsA double-blinded, randomized controlled trial was conducted on sixty-four children scheduled for cleft palate repair. The patients received either local infiltration with 1% lidocaine or 0.2% ropivacaine before incision. The primary outcome was the postoperative average pain score, and secondary outcomes included pain scores at various time points, consumption of flurbiprofen and hydromorphone, effectiveness of nurse-controlled analgesia pump, and incidence of bradycardia, vomiting, and respiratory depression. Main resultsThe results showed that the postoperative average pain score was significantly lower in the ropivacaine group compared to the lidocaine group (1.27±0.28 vs. 1.75±0.29, P<0.001). Pain scores at multiple postoperative time points were also lower in the ropivac:aine group. Additionally, consumption of flurbiprofen and hydromorphone was lower, and ineffective compressions of the nurse-controlled analgesia pump were reduced in the ropivacaine group. The incidence of vomiting, bradycardia, and respiratory depression did not show significant differences between the two groups. ConclusionLocal infiltration with ropivacaine effectively provided postoperative analgesia for children undergoing cleft palate repair without major side effects. It was found to be superior to lidocaine in reducing the need for additional rescue analgesia.

Comparison of postoperative analgesia by preemptive use of intravenous paracetamol and intravenous ketorolac in patients undergoing elective laparoscopic surgeries

Comparison of postoperative analgesia by preemptive use of intravenous paracetamol and intravenous ketorolac in patients undergoing elective laparoscopic surgeries

Comparison of Post-operative analgesia with Bupivacaine versus Ropivacaine for Caudal block in pediatric patients

Objectives: To compare the post-operative pain relief with Bupivacaine and Ropivacaine for caudal block in children in terms of mean duration of analgesia.&#x0D; Study design: Prospective comparative study.&#x0D; Place and duration: Department of Anesthesia, Combined Military Hospital Rawlakot from July 2021 till June 2022.&#x0D; Methodology: A total of 100 patients undergoing infra-umbilical Surgery as circumcision, herniotomy, orchidopexy and of age 1 to 10 years were included. After induction of general anesthesia, caudal block was given. Group B patients were given 1 ml/kg of 0.25% bupivacaine whereas group R patients were given 1 ml/kg of 0.25% ropivacaine. Modified Hnnallah Pain Score was used to observe the post-operative analgesic effects of the block. Score was noted every 30 minutes. Pain free duration was considered from time of caudal block till the modified Hannallah pain score of 4 or more. Injectable paracetamol 10 mg/kg was given as rescue analgesia as required.&#x0D; Results: Demographic data was comparable in both groups with no statistical significance. In our study, we have found duration of analgesia as 219.78 ± 35.42 minutes in the bupivacaine group compared with 198.24 ± 34.5 minutes in patients with ropivacaine group with p-value of 0.54 which is statistically significant.&#x0D; Conclusion: In this study, we concluded that the ropivacaine is as effective as bupivacaine in terms of post-operative pain relief for caudal block in children.

Abstract No.: ABS2571: Comparison of postoperative analgesia and opioid requirement with thoracic epidural vs. continuous rectus sheath infusion in midline incision laparotomies under general anaesthesia. A prospective randomised controlled study.

Background & Aims:To assess and compare the effect of bilateral continuous rectus sheath infusion (CRSB) for postoperative analgesia with continuous thoracic epidural infusion (TEA) in patients undergoing midline incision laparotomiesMethods:A prospective, randomised study involving 60 patients with American Society of Anesthesiologists physical status I to III, planned for elective laparotomy were enrolled for the study. Patients were randomly allocated into two groups: TEA group: an epidural was sited before induction of general anaesthesia (GA); CRSB group: bilateral ultrasound-guided RSB catheters were placed at the end of the surgical procedure, before extubation. Both groups received continuous 0.2% ropivacaine infusion. They were followed for two post-operative days (POD). Opioid requirement and post-operative pain at rest, coughing and moving were noted. Statistical analysis was done using SPSS 21.0Results:Opioid consumption in both groups was comparable, for the first two post-operative days with no statistically significant difference. Pain scores were comparable among the groups at all times except POD 0 (4 h and 12 h postop) and POD 1 (8 AM and 12PM), where lower pain scores were observed in CRSB Group.Conclusion:As a part of the multimodal analgesia technique, CRSB offers a reliable, safe, and effective alternative to TEA

Comparison of postoperative analgesia with two different doses of dexmedetomidine as an adjuvant to ropivacaine in adductor canal block for unilateral total knee replacement surgery: A randomized double-blinded study.

Multimodal analgesia is used to treat severe postoperative pain (POP) in total knee replacement (TKR) surgery. Adjuvants are used with local anesthetics to improve the quality and duration of pain relief. Studies comparing different doses of dexmedetomidine in adductor canal block (ACB) are sparse to date. This study compares postoperative analgesia with two different doses of dexmedetomidine as an adjuvant to 0.2% ropivacaine in ACB for unilateral TKR. In this prospective, randomized, double-blinded comparative study, sixty patients were divided into two groups: A and B. Postoperatively perineural catheter was inserted and all patients received 0.2% ropivacaine 20 mL bolus followed by an infusion of 0.2% ropivacaine with dexmedetomidine (0.5 µg/Kg in Group A and 1 µg/Kg in Group B) at 8 mL/h. Postoperative pain, motor blockade, rescue analgesia, hemodynamic parameters, sedation, and adverse effects were recorded. Student t, Chi-square, and Mann-Whitney tests were used. Most patients were elderly females (M:15, F:45). Postoperatively, from 2nd to 24th hour, pain score was less in Group B (P < 0.05). The requirement of rescue analgesic was also less in Group B (A:B 330 µg:60 µg; 23%:6%). Motor blockade assessed using modified Bromage scale and sedation using Richmond agitation sedation scale did not show any statistical difference. Dexmedetomidine infusion at 1 µg/Kg is a better adjuvant to 0.2% ropivacaine than 0.5 µg/Kg in ACB. It provides better analgesia without producing sedation, motor blockade, hemodynamic changes, or any adverse effects.

Comparison of Post-Operative Analgesia with Transdermal Fentanyl Patch and Epidural Fentanyl in Lower Limb Orthopaedic Surgeries: A Prospective Randomised Trial

Comparison of Post-Operative Analgesia with Transdermal Fentanyl Patch and Epidural Fentanyl in Lower Limb Orthopaedic Surgeries: A Prospective Randomised Trial

Comparison of Postoperative Analgesia by Intraperitoneal Infiltration of Bupivacaine versus Bupivacaine with Dexmedetomidine in Laparoscopic Surgeries

Comparison of Postoperative Analgesia by Intraperitoneal Infiltration of Bupivacaine versus Bupivacaine with Dexmedetomidine in Laparoscopic Surgeries

Comparison of postoperative analgesia between greater palatine nerve block with local infiltration and local infiltration alone in septoplasty surgeries

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Post-operative pain (POP) management is an important factor for the satisfaction after any surgery to patients. The purpose of this study was to evaluate the effect in the post op pain levels by addition of greater palatine nerve block (GPNB) to the local mucosal infiltrative anaesthesia during septoplasty surgery.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective study of 108 patients undergoing septoplasty surgery were divided into 2 groups. Group A with 52 patients and B with 56 patients. Group A received GPNB along with local infiltrative anaesthesia while group B received only the local infiltrative anaesthesia. The POP was studied in them using visual analogue score (VAS) at the 2nd, 5th and 8th post-operative hour. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The median VAS of group A at the 2nd, 5th and 8th hour were 2, 2 and 1 respectively while of the group B were 6, 6 and 5 during the same timeline assessment. The decreased POP in group A over B was statistically significant during all the assessments with (p&amp;lt;0.001). The post-operative pain was significantly lesser with no increase in time of surgery, with negligible expenditure and no complications.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Greater palatine nerve block can be utilized as an effective addition to septoplasty surgery utilizing the same drug along with local infiltration and give a simple, cost effective and safe addition for a comfortable pain free post op period for a prolonged duration.&lt;/p&gt;

Comparison of postoperative analgesia and opioid requirement with thoracic epidural vs. continuous rectus sheath infusion in midline incision laparotomies under general anaesthesia - A prospective randomised controlled study.

Background and Aims:To assess and compare the effect of bilateral continuous rectus sheath infusion (CRSB) for postoperative analgesia with continuous thoracic epidural infusion (TEA) in patients undergoing midline incision laparotomies.Methods:A prospective, randomised study involving sixty patients with Indian Society of Anesthesiologists (ASA) grade I to III, planned for elective laparotomy were enrolled for the study. Patients were randomly allocated into two groups. In the TEA group, an epidural was sited before induction of general anaesthesia (GA), whereas in the CRSB group, bilateral ultrasound-guided RSB catheters were placed at the end of the surgical procedure, before extubation. Both groups received continuous 0.2% Ropivacaine infusion for postoperative analgesia. They were followed for two post-operative days (POD), for the opioid requirement and post-operative pain at rest, coughing, and moving. Age and body mass index (BMI) were compared using independent t-test and visual analogue scale (VAS) scores were compared by the Mann–Whitney test between the two groups. Opioid consumption, gender, and type of surgery were compared using the Chi-Square test. Statistical analysis was done using Statistical Package for Social Sciences (SPSS 21.0).Results:Opioid consumption in both groups was comparable, for the first two post-operative days with no statistically significant difference. Pain scores were comparable among the groups at all times except postoperative day (POD) 0 (4 h and 12 h postop) and POD 2 (8 AM and 12 PM), where lower pain scores were observed in CRSB Group.Conclusions:As a part of the multimodal analgesia technique, CRSB offers a reliable, safe, and effective alternative to TEA.

Comparison of Postoperative Analgesia amongst Subjects Receiving Ropivacaine and Clonidine versus Ropivacaine Alone: A Hospital Based Study

Comparison of Postoperative Analgesia amongst Subjects Receiving Ropivacaine and Clonidine versus Ropivacaine Alone: A Hospital Based Study

Comparison of postoperative analgesia after intraarticular injection of two different doses of morphine (5 mg) and Morphine (10 mg) with 0.5% bupivacaine in arthroscopic knee surgery : Randomized, double blinded prospective study

Comparison of postoperative analgesia after intraarticular injection of two different doses of morphine (5 mg) and Morphine (10 mg) with 0.5% bupivacaine in arthroscopic knee surgery : Randomized, double blinded prospective study - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/j.

Comparison of Post-Operative Analgesia after Single Shot Caudal Epidural Block Using Ropivacaine with or without Clonidine in Children

Comparison of Post-Operative Analgesia after Single Shot Caudal Epidural Block Using Ropivacaine with or without Clonidine in Children

Comparison of Postoperative Analgesia in Patients Undergoing Ileostomy Closure with and Without Dual Transversus Abdominis Plane (TAP) Block – Prospective Randomized Controlled Trial

Comparison of Postoperative Analgesia in Patients Undergoing Ileostomy Closure with and Without Dual Transversus Abdominis Plane (TAP) Block – Prospective Randomized Controlled Trial

Comparison of Postoperative Analgesia in Patients Undergoing Ileostomy Closure with and Without Dual Transversus Abdominis Plane (TAP) Block: A Randomized Controlled Trial.

Background and AimsMultimodal analgesia comprising opioid, paracetamol, and non-steroidal anti-inflammatory drugs is used for managing postoperative surgical pain after ileostomy closure (IC). We investigated the efficacy of unilateral dual transversus abdominis plane (TAP) block to reduce morphine consumption in the first 24 hours along with a reduction in visual analogue score for pain and in postoperative nausea/vomiting.MethodsThis was a single-center, investigator-initiated, prospective, parallel-group, placebo-controlled randomized study involving patients undergoing IC under general anesthesia. We recruited 55 patients in two groups: 28 in a TAP group and 27 in a placebo group. The TAP group patients received 30 mL of 0.375% bupivacaine: 15 mL by a posterior TAP approach and 15 mL by a subcostal approach using ultrasonography. Patients in the placebo group received 30 mL normal saline (placebo) using the same approaches. Blocks were administered at the end of surgery before extubation. To monitor for the primary outcome—24-hour morphine consumption for both groups—patients were transferred to a high-dependency unit. The secondary outcome was to compare postoperative nausea/vomiting in both groups.ResultsThe demographic data, gender distribution, ASA physical status, duration of surgery, and time of first morphine dose was comparable in both groups. The 24-hour morphine consumption was 3.29±2.78 mg and 9.23±2.94 mg for the TAP and placebo groups, respectively, which was statistically significant (P=0.001).ConclusionDual TAP block reduces opioid consumption in the first 24 hours after an IC and can facilitate early recovery with less adverse effects seen than with opioids and NSAIDs.

A Prospective Study of Comparison of Analgesic Efficacy of Dexamethasone as an Adjuvant in Supraclavicular Block with Intravenous Dexamethasone after Supraclavicular Block in Patients Undergoing Forearm Surgeries.

Context:Brachial plexus block is a preferred anesthesia technique for upper limb surgeries below the shoulder joint. Drugs used as adjuvants in block enhance the postoperative analgesia significantly.Aim:We aimed to evaluate the analgesic efficacy, of perineural dexamethasone used as an adjuvant to supraclavicular block as against systemic dexamethasone after supraclavicular block. Time for rescue analgesia was also noted in both groups.Subjects and Methods:In our randomized study, 60 patients belonging to the American Society of Anesthesiologist physical status Classes I and II were randomly allocated in two groups of thirty. Group BD received supraclavicular block with local anesthetic and dexamethasone 0.05 mg/kg as an adjuvant. Group BI received supraclavicular block with local anesthetic and intravenous (IV) dexamethasone 0.05 mg/kg after the block. In both groups, the comparison of postoperative analgesia and time for first rescue analgesic was noted.Statistical Analysis Used:Data analysis was done using SPSS version 20.0. Demographic data and continuous variables were analyzed by independent sample t-test. Categorical data were analyzed by unpaired t-test.Results:Group BD showed significantly prolonged postoperative analgesia as compared to Group BI. Time for rescue analgesic in Group BD was (15.8 ± 2.6) H as compared to Group BI (10.3 ± 1.07) H.Conclusions:Dexamethasone, when used in supraclavicular block significantly, prolongs the duration of analgesia as against IV dexamethasone after supraclavicular block.

Comparison of Post-Operative Analgesia in Laparoscopic Surgeries with Intraperitoneal Dexmedetomidine with Bupivacaine and Bupivacaine Alone

Comparison of Post-Operative Analgesia in Laparoscopic Surgeries with Intraperitoneal Dexmedetomidine with Bupivacaine and Bupivacaine Alone