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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For pain relief after thoracotomy, intercostal nerve block with etidocaine 1% and bupivacaine 0.5%, both containing adrenaline 5 mug/ml, was used. Duration of skin analgesia for sharp pain was around 11 hours for both solutions. Post-operative pain was noted 6 and 5 hours after injection for etidocaine and bupivacaine respectively. No pathological changes in acid-base balance or ventilation were observed. Peak expiratory flow decreased to 35-40% of the pre-operative values and remained at this level for about 12 hours. Arterial and venous blood levels of the local anaesthetics were low and no signs of toxicity were noted. All patients experienced a certain pain relief from the blocks. Because of shoulder pain in some patients intercostal nerve block alone does not seem to be a perfect post-operative method for pain relief after thoracotomies.
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PMID:Etidocaine in intercostal nerve block for pain relief after thoracotomy; a comparison with bupivacaine. 24 Nov 97

Postoperative pain is an important factor in the management of children undergoing thoracotomy. Intercostal nerve block has been used in adult patients, but its applicability in the pediatric age group has not been previously evaluated. Eighty-nine children (85 girls and 31 boys) aged 6 months to 16 years (mean age 4.7 years) underwent ligation of a patent ductus arteriosus (PDA) through a left thoracotomy. Twenty-nine children received intercostal blocks with bupivacaine from the level of the second to sixth thoracic vertebrae. Sixty cases constituted the control group. The patients with intercostal block had fewer doses of pain medication postoperatively, 2.7 mean (0 to 9), than did the control patients, 3.9 mean (0 to 21). The mean hospital stay was shortened in the patients with nerve block, 5.1 days versus 7.3 days for the control group. No ill effects of bupivacaine were noted. We conclude that intercostal nerve block is a valuable procedure reducing the need for postoperative analgesia and shortening hospital stay.
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PMID:Kindness pays dividends: the medical benefits of intercostal nerve block following thoracotomy. 88 80

Twenty-nine upper dorsal sympathectomies have been carried out in 18 patients and a comparison made of the supraclavicular with the axillary approach to the upper thoracic sympathetic chain. Thirteen of these operations were carried out for essential hyperhidrosis, 15 for ischaemia in the hand and one for post-traumatic pain syndrome. Fourteen sympathectomies were carried out through the axilla and 15 through the supraclavicular approach. Post-operative pain was felt to be somewhat more severe when the axillary approach was used, but other complications were infrequent and hospital stay was slightly shorter in the axillary group. The axillary approach was felt to offer superior exposure, the capability for wider sympathetic excision, good cosmetic results, avoidance of Horner's syndrome and low morbidity. In the absence of lung disease or the need for a direct exploration of the root of the neck, the axillary approach is to be preferred for upper dorsal sympathectomy.
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PMID:A comparison of the supraclavicular and axillary approaches to upper thoracic sympathectomy. 105 96

Postoperative discomfort following cholecystectomy has diminished considerably since laparoscopic surgery was introduced. This study assessed the degree of postoperative pain and nausea when, during the operation, the trocar sites had been infiltrated with bupivacaine and antiemetics (ondansetron) had been administered. Postoperative pain intensity was moderate as 20% of the patients were managed without any opiates postoperatively and 88% did not require any opiates after discharge from the recovery room. Postoperative nausea and vomiting is known to be a problem that occasionally has been reported to delay discharge from the hospital. A single dose of ondansetron at the end of the operation seems to reduce postoperative nausea effectively. Two-thirds of the patients had no complaints of nausea, and the majority of the remainder experienced only mild and transitory nausea. We recommend that stab-wound sites be infiltrated with local anesthetics and that antiemetics be administered at the end of the operation.
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PMID:Postoperative pain and nausea after laparoscopic cholecystectomy. 134 50

We have examined the analgesic effects of indomethacin in a double-blind study of 56 patients undergoing surgery for lumbar disc prolapse. The patients were allocated randomly to receive either indomethacin 100 mg i.v. before surgery, followed by 100 mg rectally 6 and 12 h after surgery and at 08:00, 16:00 and 23:00 on the next day, or placebo. Postoperative pain was assessed using a 10-cm visual analogue scale at fixed times. Side effects and consumption of supplementary analgesics were recorded. Patients receiving placebo had significantly greater pain scores and significantly more patients in the placebo group required supplementary analgesics.
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PMID:Indomethacin in the management of postoperative pain. 138 48

Prophylactic administration of analgesics before surgery can decrease the intraoperative anaesthetic requirement and decrease pain during the early postoperative period. In a double-blind, placebo-controlled study involving 90 healthy ASA physical status I or II children undergoing bilateral myringotomy, we compared the postoperative analgesic effects of oral acetaminophen and ketorolac, when administered 30 min before induction of anaesthesia. Patients were randomized to receive saline (0.1 ml.kg-1), acetaminophen (10 mg.kg-1) or ketorolac (1 mg.kg-1) diluted in cherry syrup to a total volume of 5 ml. Anaesthesia was induced and maintained with halothane and nitrous oxide via a face mask. Postoperative pain was assessed by a blinded observer using an objective pain scale. The three study groups were similar with respect to demographic data, duration of anaesthesia and surgery, induction behaviour, oxygen saturation, incidence of postoperative emesis and, recovery times. The ketorolac group had lower postoperative pain scores and required less frequent analgesic therapy in the early postoperative period compared with the acetaminophen and placebo groups. In contrast, there were no differences in pain scores or analgesic requirements between the acetaminophen and the placebo groups. We conclude that the preoperative administration of oral ketorolac, but not acetaminophen, provided better postoperative pain control than placebo in children undergoing bilateral myringotomy.
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PMID:Perioperative effects of oral ketorolac and acetaminophen in children undergoing bilateral myringotomy. 139 50

Postoperative pain after surgery in the cerebellopontine angle (CPA) is acknowledged to occur, but is rarely taken into account as a factor in the analysis of morbidity of such surgery. It is widely acknowledged that some patients, having undergone such surgery, particularly by means of the suboccipital approach, report significant post-operative pain and headache. This study was undertaken to determine the incidence and severity of pain after excision of acoustic neuromas and to establish whether this differed between the suboccipital and translabyrinthine routes. Ninety-one percent of all patients (n = 58), who had the suboccipital approach used for removal of their tumor, were surveyed. A smaller group (n = 40), matched for tumor size, age, and sex, but in whom the translabyrinthine approach was used, was similarly studied. A standard questionnaire, designed to detect and quantify postoperative pain, was administered to each patient. Of patients who underwent tumor excision by means of the suboccipital approach, 63.7% experienced significant local discomfort and headache, whereas this was notably absent in all those who had undergone translabyrinthine excision. In view of the significant morbidity noted to follow the suboccipital approach, several modifications of the surgical technique used were devised.
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PMID:Pain after surgery for acoustic neuroma. 140 29

Twenty-eight patients scheduled for lung resection with lateral thoracotomy and postoperative chest drains during combined thoracic epidural bupivacaine plus morphine and general anaesthesia were studied. Postoperative pain treatment was continuous epidural infusion of bupivacaine 0.25% 5 ml h-1 plus morphine 0.2 mg h-1 for 48 h and, in addition, the patients received rectal piroxicam 40 mg randomly and double-blind 12 h and 1 h before surgery and 20 mg 24 h-1 postoperatively or placebo. Pain was evaluated at rest, during cough and mobilisation, together with pulmonary function (FEV1, FVC, PEFR) and sensory level of analgesia repeatedly for 48 h. The results showed efficient pain relief, but without differences in pain scores or need for supplementary analgesics between the two groups. Pulmonary function decreased similarly in the two groups. Thus we were unable to show enhanced analgesia by supplementing an otherwise effective low-dose epidural bupivacaine and morphine treatment with piroxicam after thoracic surgery with chest drains.
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PMID:Effect of piroxicam in addition to continuous thoracic epidural bupivacaine and morphine on postoperative pain and lung function after thoracotomy. 821 34

The primary or secondary reconstruction of the facial access after Caldwell-Luc and the more selective resection of sinusal mucous membranes can be important in the therapy and prevention of postoperative complications such as neuralgic facial pain, formation of cysts and chronic sinusitis. The different osteoplastic sinus operations are described and the use of a pedicled bonelid is illustrated. The most common accepted ethiology of post-operative pain is based on the formation of scar-tissue. Postoperative pain is first being treated conservatively, while in case of persisting pain an exploration with dissection of the infra-orbital nerve and reconstruction of the facial defect can be indicated. In a retrospective study of 36 patients the results of our surgical therapy are illustrated.
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PMID:[Pedicled facial bone flap for closure of the approach in Caldwell-Luc type sinus operations. Its role in the prevention of postoperative complications]. 144 90

Postoperative pain control can be unsatisfactory for a variety of reasons, including patients' attitudes towards pain treatment itself. To assess patients' expectations and their influence on postoperative analgesia, as well as the prevalence of pain following common gynaecological surgery, a prospective study was performed in 166 patients with either abdominal hysterectomy, mastectomy, laparoscopy or uterine curettage. After a first postoperative period with routine on-demand analgesia, a nurse specialised in pain treatment discussed the purposes and risks of pain treatment with the patients and cared for these patients in the second, subsequent study period. Following this discussion, 30 of 40 patients refusing analgesics in the first study period agreed to be given pain medication. In the groups with hysterectomy or mastectomy, pain control improved in the second postoperative period, even though the doses of analgesics administered were generally lower. Education of patients regarding the aims and risks of pain therapy is an essential part of pain control and can lead to an improvement of postoperative analgesia.
Pain 1992 Sep
PMID:Postoperative analgesia: pain by choice? The influence of patient attitudes and patient education. 145 82


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