Pain In Postoperative Period Research Articles

A comparative study on the analgesic effect of continuous intraarticular infusion with ropivacaine, ropivacaine/fentanyl and ropivacaine/fentanyl/ketorolac after arthroscopic shoulder surgery.

Arthroscopic shoulder surgery can result in severe postoperative pain. A variety of methods have been used to control pain in postoperative period and the results are variable. The purpose of this study was to compare the relative analgesic efficacies of the postoperative intraarticular infusion of ropivacaine, ropivacaine/fentanyl, and ropivacaine/fentanyl/ketorolac after arthroscopic shoulder surgery. Thirty patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to three groups. At the end of surgery, 0.5% ropivacaine 20 ml was infused into the articular space and a continuous infusion catheter was inserted into intraarticular operated site. After surgery, continuous infusion of 0.5% ropivacaine 100 ml (Group 1, n = 10), 0.5% ropivacaine 100 ml including fentanyl 10 microg/kg (Group 2, n = 10), or 0.5% ropivacaine 100 ml including fentanyl 10 microgram/kg and ketorolac 150 mg (Group 3, n = 10) was started through catheter at rate of 2 ml/hr with bolus dose of 0.5 ml with a lock out time of 15 minutes for 2 days. The level of pain was assessed using a visual analogue scale (VAS) postoperative 2, 6, 12, 24 and 48 hours and the amounts of supplemental analgesics were recorded. The VAS was significantly lower after 2, 6, 12 hours in Group 2 than in Group 1. In Group 3, the VAS was significantly lower all hours than in the other two groups. The combination of fentanyl and ketorolac with ropivacaine did provide better postoperative analgesia than the other groups after arthroscopic shoulder surgery.

Assessment of Postoperative Pain in Nursing

Assessment of Postoperative Pain in Nursing Introduction. Postoperative pain is a typical form of acute pain and is connected with extensive traumatization of tissue and operation wound traumatic edema, which in its turn, becomes a source of permanent nociceptive impulses. Insufficiently controlled postoperative pain is a factor of risk for the development of various pathologies, postoperative complications, as well as chronic pain. Aim of the study. To study the usage of postoperative period pain intensity and quality assessment scales in the clinical practice of nursing, as well as availability of methods. Materials and methods. Inquiry utilized quantitative research method - questionnaire. The questionnaire embraced 263 patients and 309 nurses, working in surgical profile. Survey was carried out in surgical profile wards in Riga and regional clinics of Latvia. Results. Prevalent method, in our investigation of pain intensity evaluation, is patient's oral subjective and objective assessment of condition. Such method is mentioned by 87% (269/309) of respondents. A conventional and acknowledged method of pain objectivization - verbal descriptor pain intensity scale is applied by 22% (69/309) respondents, but visual analogue scale is utilized only by 5% (15/309) respondents. Assessment of postoperative pains as systematic and planed operation was marked by 41% (126/309) of surgical nurses. Conclusions. Prevailing method in the clinical practice of pain assessment is patient's subjective and objective evaluation of condition. However, this method is insufficiently recorded and objectivizated. Therefore, it is an actual problem in surgical patient care and shows necessity for standards and improvement of postoperative pain management.

The Prevalence of Postoperative Pain in a Cross-sectional Group of Patients After Day-case Surgery in a University Hospital

Although a great variety of surgical procedures are performed on an ambulatory basis, little is known about postoperative pain experience at home after ambulatory surgery. This study was performed to assess the prevalence and course of postoperative pain in the early postoperative period after ambulatory surgery. Over a period of 4 months, 648 patients who underwent day-case surgery were included in our study. Data were collected with interviews and questionnaires. Pain intensity was measured using a visual analog scale (VAS) during 4 days after surgery. Side effects of anesthesia and analgesia techniques were also recorded. On the day of the operation, 26% of the patients had moderate to severe pain (defined as mean VAS >40 mm). Mean VAS-scores were greater than 40 mm in 21% on postoperative day (POD) 1, in 13% on POD 2, in 10% on POD 3, and in 9% on POD 4. Operations of nose and pharynx, abdominal operations, plastic surgery of the breasts, and orthopedic operations were the most painful procedures during the first 48 hours. This study showed that an important number of patients still experience moderate to severe pain in the postoperative period after day-case surgery even after a 4-day period. Furthermore, the type of operation should be considered when planning postoperative analgesia for ambulatory surgery.

Gossypiboma in the early postoperative period: computed tomography appearance.

Recognition of postoperatively retained foreign body, referred euphemistically as gossypiboma, is essential but is very often considerably delayed. Legal implications as well as confusing configuration patterns cause considerable dilemma in the accurate diagnosis. A good understanding of the radiological appearances of this foreign body helps in appropriate early management of such patients. We present computed tomographic features of gossypiboma in patient who presented with symptoms of fever and pain in the immediate postoperative period.

Sequential supraclavicular brachial plexus block and intravenous regional anaesthesia for upper limb surgery

Sequential supraclavicular brachial plexus block and intravenous regional anaesthesia for upper limb surgery

Estudo biomecânico e morfológico da cicatrização da parede abdominal sob ação de meloxicam

Foi realizado um estudo biomecânico e morfológico da cicatrização da parede abdominal de ratos sob ação do meloxicam. Os 60 ratos do grupo controle receberam meloxicam na dose única diária de 0,5mg.kg-1 ou 0,3 ml de solução salina de cloreto de sódio a 0,9% via intramuscular por 4 dias consecutivos. Os 60 ratos do grupo experimento foram submetidos a laparotomia e posterior síntese por técnica padronizada. Os animais desse grupo também receberam meloxicam ou solução salina da mesma maneira do grupo controle. No 5° ,10° ou 15° dias de observação os animais foram avaliados quanto a curva ponderal e os segmentos contendo cicatrizes de laparotomias foram submetidos a análise de força de rotura por meio de um tensiômetro e análise histológica (quantificação de colágeno e macrófagos com auxílio de um programa informatizado). Os resultados foram submetidos a testes estatísticos (alfa#0,05). A curva ponderal mostrou menor perda de peso nos animais que receberam meloxicam no 5° dia de observação, provavelmente devido a menor dor pós-operatória. O teste de rotura e a análise histológica não mostraram diferenças significantes entre os grupos, demonstrando que o meloxicam não interfere na cicatrização. Conclui-se que o meloxicam não induz a alterações biomecânicas e morfológicas na cicatrização da ferida operatória da parede abdominal de ratos.