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

Pain in the muscles and the feeling of tension in the lower legs along the varicose veins brings many patients, especially women to an operation, usually after previous attempts of conservative treatment. The aim of the work was to present the choice of analgesia for the operation of the veins of the lower limbs with the control of the post-operative analgesia. The methods included two groups of patients. One group received halothane inhalation anaesthesia in combination with nitrous oxide and oxygen, and the other ketamine hydrochloride anaesthesia applied intravenously. Postoperative pain was graded as strong, medium, mild, and painfree state. The pain intensity was assessed for each patient by the hours, and by multiplying the obtained score by the number of patients, we got the total pain scores. The pain relief 1, 2, 3, and 4 hours after the administration of propoxiphen napsilate with paracetamol was calculated according to the formula: Br = Bo-B1 (2,3,4). As compared to the placebo, we got p.o.05 in favour of the active substance after ketamine hydrochloride anaesthesia. The results have shown that postoperative pain was much lower in the group of patients who had ketamine hydrochloride anaesthesia, what together with increased oxygen saturation during anaesthesia leads to the conclusion that this anaesthesia is appropriate for operations on the veins of the lower limbs because it ensures postoperative analgesia and oxygenation without oxygen inhalation. This is important because in the region attacked by varicosity the tissue metabolism is disturbed, oxygenation decreased and the values of pCO2 increased, frequently followed by skin atrophy, lower limb edema and lymphostasis.
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PMID:[Anesthesia in patients with varicose syndrome]. 261 18

Postoperative pulmonary complications are not uncommon, and the factors that contribute to lung dysfunction are well documented. Postoperative pain, spasm, and paralysis are all known to reduce lung function, although relief of pain does not completely restore function. Rather, diaphragmatic dysfunction has been found to persist even with adequate pain relief. Functional residual capacity is reduced both by the supine position and anesthesia. During anesthesia, the reduced FRC can contribute to airway closure during expiration and to a compression atelectasis that in turn precipitates hypoxemia and infection. Muscle paralysis can also create or contribute to atelectasis. Microthromboembolism impedes perfusion distribution, adding to the other causes of a ventilation-perfusion mismatch. Different anesthetic techniques and intraoperative management may help prevent or reduce the incidence of postoperative lung complications.
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PMID:Mechanisms of postoperative pulmonary dysfunction. 265 66

The use of collagen as a bone substitute was examined in a clinical study involving 70 patients. In a standardized operation impacted mandibular third molars were removed simultaneously. Collagen fleece was implanted in one osseous defect while the other defect was packed with iodoform gauze. Postoperative pain, swelling and complications were analyzed. There were significant differences between the two methods. The use of collagen fleece to obturate bony defects following surgical removal of impacked molars appeared to be of no advantage. On the contrary, there was a considerably higher rate of postoperative bleeding and complications. This could probably be related to the poor stability of the implanted material.
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PMID:[Insertion of collagen matrix into open bony defects]. 270 58

Three retrospective studies were conducted at St. Vincent's Hospital to compare the outcomes of colorectal anastomoses, with and without resections, with respect to anesthetic technique. Operations were performed upon patients anesthetized with either combined regional (epidural) and general anesthesia (CRAG) or general anesthesia alone (GA). Postoperative pain relief was achieved with either continuous epidural analgesia (CEA) in the CRAG group or with postoperative narcotics in the GA groups (GA/PN). In one group, a different regimen was introduced: combined epidural and general anesthesia with postoperative epidural morphine (CRAG/EDM). Overall, anastomotic leak rates and death rates were lower in the CRAG group, and the lowest incidence of anastomotic leak was reported in the patients receiving CEA. Thus the reduced leak rate was associated more with the postoperative analgesia regimen than with the anesthetic technique. An increased incidence of wound dehiscence occurred with postoperative epidural morphine analgesia.
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PMID:Combined epidural and general anesthesia versus general anesthesia in patients having colon and rectal anastomoses. 271 11

Postoperative pain management protocols have been examined in a total of 212 patients from three Spanish hospitals. Metamizole was the analgesic drug most frequently prescribed (50%) followed by pethidine (18.4%). To a lesser degree, aspirin, pentazocine, lysine acetylsalicylate, paracetamol and buprenorphine were used. Important differences among the hospitals were found when choosing the analgesic. The dosage prescribed varied and in general, drugs were prescribed at lower doses than the daily defined dose (DDD). Intramuscular route was the most used. Only 27.6% of the patients received the prescribed doses and 43.3% received a lower one. This was basically due to a greater interval of dosing. 14.6% of the patients were painless while 25.5% showed intense and unbearable pain. From this study one may conclude that when metamizole is preferably used as an analgesic drug, it is given at a smaller dose than that recommended and in addition, nurses decrease even more the doses. An important number of patients were found with intense pain even though analgesic drugs were given.
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PMID:[Analysis of the treatment of postoperative pain at 3 hospitals]. 274 May 43

In January 1986 we initiated a prospective study in our center to evaluate the results of surgery in patients with anal fissure. Three groups were considered according to type of surgery: internal lateral sphincterotomy (ELI), lateral sphincterotomy and resection of cutaneous fibroma (ELI + FC), and sphincterotomy with hemorrhoidectomy (E + H). The basic objective was to evaluate postoperative pain, days of hospitalization and out-patient follow-up, complications and number of recurrences. Postoperative pain occurred in 12% of internal lateral sphincterotomies, in 42% of lateral sphincterotomies with resection of cutaneous fibroma in 50% of sphincterotomies with hemorrhoidectomy, as measured by the number of patients who requested analgesics. The hospital stay was similar in the first two groups (96 and 90% less than 24 hours) and longer in the third (50% greater than 24 hours). Out-patient follow-up was limited to one visit in 90% of internal lateral sphincterotomies, while 85% of internal lateral sphincterotomies + fibroma resection required more than two visits and 100% of sphincterotomies with hemorrhoidectomy needed three or more. Nine percent of those operated had mild complications like low fever, ecchymoses, fistula or wound infection. No patient presented incontinence or recurrence of the fissure. We conclude that internal lateral sphincterotomy is an ideal procedure for the treatment of anal fissure and, if possible, additional surgery should be avoided, however insignificant it may appear.
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PMID:[Internal lateral sphincterectomy. Results]. 276 41

A prospective comparative study was carried out between two anesthetic techniques for chemonucleolysis. Patients were divided into 2 groups of 50 patients each. Group A were submitted to general anesthesia and group B to epidural anesthesia with 0.5% bupivacaine, 2% mepivacaine and buprenorphine. Group B was divided into 2 subgroups: in B1, buprenorphine was administered with the local anesthetics, while in B2 buprenorphine was administered postoperatively when pain appeared. Postoperative pain and side effects like anaphylaxis were evaluated. No anaphylactic reactions occurred. Severe lumbar pain appeared in 22% of patients in group A in spite of systematic analgesics, while group B lumbalgia was not severe in any case. Patients in subgroup B1 did not have pain during the 24 first hours and 47.8% of patients in subgroup B2 needed in most of the cases only a dose of buprenorphine. We conclude that epidural anesthesia is a good technique in chemonucleolysis and that the association bupivacaine, mepivacaine and buprenorphine provides a good postoperative pain relief.
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PMID:[Chemonucleolysis. Peridural anesthesia versus general anesthesia]. 278 Oct 93

Postoperative pain relief and stress hormones were examined during the use of continuous epidural infusion of morphine at a rate of 0.1 mg/hr in 30 patients (Group B) after coronary artery bypass grafting. This was compared to our routine method of postoperative analgesia of intravenous morphine 2 mg/2 hr and as needed in another 30 patients (Group A). Continuous epidural morphine infusion required occasional supplementation with intravenous morphine and achieved effective analgesia in 80% of the patients. Pain relief was adequate in 50% of the patients in Group A. The mean dose of morphine used in Group B during the first 3 postoperative days was 5 mg per patient per day and was significantly lower than that used in Group A (mean 18 mg per patient per day). Serum morphine was undetectable (below 2.5 ng/ml) in Group B and was significantly lower than that in Group A (17 ng/ml). Epidural analgesia was associated with adequate postoperative pulmonary and cardiovascular functions; nausea and vomiting occurred in two patients. Levels of postoperative stress, serum cortisol, and beta-endorphin were significantly lower in Group B than in Group A. This study shows that continuous epidural infusion of morphine at a rate of 0.1 mg/hr provides selective and effective pain relief and reduces postoperative stress after cardiac operations. This method of analgesia was also associated with minimal side effects and provides an alternate approach for treatment of pain after cardiac operations.
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PMID:Continuous epidural infusion of morphine for pain relief after cardiac operations. 295 42

Secretion of pituitary immunoreactive beta-endorphin is hypothesized to modulate the perception of pain. The present study examined this question by evaluating the effects of intravenous placebo or dexamethasone (0.1, 0.32, or 1.0 mg) on suppression of immunoreactive beta-endorphin secretion and development of postoperative pain after the surgical removal of impacted third molars in 48 patients. Compared with placebo, all doses of dexamethasone suppressed the postoperative increase in circulating levels of immunoreactive beta-endorphin. Patients administered 0.1 mg dexamethasone reported greater levels of pain, compared with those given placebo, from 60 through 120 minutes after surgery. Postoperative pain for the 0.32 and 1.0 mg doses did not differ from that for the placebo group. The increased pain after suppression of beta-endorphin release by the low dose of dexamethasone suggests that pituitary secretion of immunoreactive beta-endorphin alleviates postoperative pain under these conditions.
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PMID:Dexamethasone alters plasma levels of beta-endorphin and postoperative pain. 296 1

In a double-blind, randomized study of 29 patients who underwent orthopedic procedures we studied the additional effect of intrathecal buprenorphine on isobaricpinal anesthesia and postoperative analgesia. The injections were 20 mg tetracaine (19 patients) or 20 mg tetracaine plus 0.15 mg buprenorphine (10 patients). In both groups the drugs were contained within a total volume of 4 ml cerebrospinal fluid. Progression and regression of the sensory blockade of spinal anesthesia were estimated with pinprick; the motor blockade was judged by the Bromage scheme. Postoperative pain was evaluated by the patients using an analogue scale after Scott and Huskisson. Arterial blood gases, respiratory rate, blood pressure, and heart rate were measured and other side-effects determined. Both groups were comparable in age, body weight, height and duration of operation (Table 1). The addition of buprenorphine elevated the sensory blockade by three segments both during spread and regression of anesthesia (Figs. 1, 2). Postoperative analgesia was better up to 8 h after injection (p less than 0.05), after 8 h pain levels were equal in test and control groups (Fig. 3). After buprenorphine patients became aware of pain sensation 13 h after injection; in the control group the pain-free interval lasted only 9 h (p greater than 0.05). There were no differences in the need for postoperative analgesics between both groups. The respiratory rate was lower during the whole period of observation (p less than 0.05). The mean values for PaCO2, pH and BE were similar in both groups (Fig. 4). PaO2 was elevated in the buprenorphine group. There was no essential alteration of blood pressure after buprenorphine. The pulse rate, however, was slightly diminished.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[O.15 mg Intrathecal buprenorphine applied for postoperative analgesia. A clinical double-blind study]. 311 38


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