Surgery In Post-anesthesia Care Unit Research Articles

Oxycodone versus morphine for titration analgesia after laparoscopic gynecologic surgery in postanesthesia care unit: A prospective, randomized trial

We want to compare the efficacy and side effects of oxycodone and morphine in the management of postoperative pain by titration in patients who underwent laparoscopic gynecologic surgery because of neglect of postoperative analgesia and rare literature of intravenous oxycodone used in PACU, China. Thirty adult female patients were scheduled for elective laparoscopic gynecologic surgery under general anesthesia. The patients were randomly assigned to either morphine sulfate injection group (Group M, n = 15 cases) or oxycodone hydrochloride injection group (Group O, n = 15 cases). All the patients were given an intravenous PEG nanometer drug delivery system. Furthermore, when they arrived at the postanesthesia care unit (PACU), a visual analog scale (VAS) was used to evaluate postoperative pain. Also, the patients were given 3 mg oxycodone or morphine for titration when the pain VAS score was more than 30 mm, and the pain and sedation scores were re-evaluated after 5 minutes. The titration stopped if the VAS score was ≤ 30 mm otherwise the titration continued as per the above method until the VAS score was less than 30 mm. The required titration dosage, times, and time of oxycodone titration were noted and they were all remarkably lower than those of morphine titration group (P < 0.05). The incidence of side effects in Group M was statistically significantly higher in Group O (P < 0.05). More so, oxycodone titration showed faster analgesic effects, less analgesic drug consumption, and lower incidence of adverse complications during postoperative pain management when compared to morphine titration. The reliability and effectiveness of the PEG nanometer drug delivery system were simultaneously proved.

Predictors of catheter-related bladder discomfort after gynaecological surgery

BackgroundUrinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the incidence and predictors of postoperative CRBD after gynaecological surgery in the post-anesthesia care unit (PACU).MethodsThis was a prospective observational study. Patients undergoing gynaecological surgery under general anesthesia with intra-operative urinary catheterization were enrolled. We collected the clinical data, incidence and severity of CRBD, and postoperative pain for the patients. Predictive factors of CRBD were analysed by univariate and multivariate analysis.ResultsA total of 407 patients were included in this study. The incidence of CRBD after gynaecological surgery was 64.6% (mild CRBD: 22.8%; moderate CRBD: 34.2%; and severe CRBD: 7.6%). Univariate analysis showed that age, type of surgery, type of laparoscopic surgery, additional analgesics, and postoperative pain were influencing factors for CRBD. Based on multivariate logistic regression analysis, age ≥ 50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of moderate or severe CRBD.ConclusionsThis observational study revealed that the incidence of CRBD after gynaecological surgery in PACU was very high. Age ≥ 50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of CRBD.Trial registrationChiCTR1800016390. Registered on 30 May 2018.

Corneal injury and its protection using hydro-gel patch during general anesthesia.

To evaluate corneal injury during general anesthesia and analyze the protective effect of medical hydro-gel eye patch in clinics. Seventy-six patients with 152 eyes undergoing general anesthesia were included. None had positive corneal fluorescein staining before surgery. Both eyes of each patient were analyzed, with one randomly allocated to receive medical hydro-gel eye patch, and the other to receive common adhesive tape as a control. Corneal injuries were evaluated by scoring fluorescein staining under a hand-held slit lamp immediately after surgery in postanesthesia care unit and 24h thereafter. Patients' discomforts were also evaluated. Twelve eyes (15.8%) in the hydro-gel patch group and 30 eyes (39.5%) in the adhesive tape group showed corneal injury immediately after surgery. The eyes protected with hydro-gel patch showed statistically less corneal fluorescein staining than the control group. Four eyes in hydro-gel patch group and 6 eyes in adhesive tape group suffered discomfort immediately after surgery without intergroup difference and all discomforts disappeared after 24h (P=0.257). No side effect was observed in hydro-gel patch group, while 5 eyes had brow avulsion and 2 got skin itching in adhesive tape group. Corneal injury complication was more frequent than we thought following general anesthesia. The medical hydro-gel eye patch can protect the occurrence of corneal injury following general anesthesia.