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

A study was carried out to compare the effectiveness of nasal splints (in preventing intranasal adhesions) with the morbidity associated with their use in nasal surgery. One hundred and ten patients undergoing a routine nasal operation were randomly allocated into two equal groups, one with splints and the other without. Post-operative pain and discomfort was assessed by a visual analogue scale at 48 hours and a week following surgery when either nasal suction (non-splinted group) or removal of splints was carried out. All patients were examined after six weeks for development of adhesions. Results showed that there was no significant difference in the incidence of adhesions between the splinted and non-splinted patient groups. However, the patients with splints had significantly more pain and nasal discomfort when assessed one week after surgery. It is concluded that the morbidity associated with nasal splints does not justify their use in routine nasal surgery if the aim is to prevent nasal adhesions, but they may still be indicated for enhancing the stability of the septum following septoplasty.
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PMID:Nasal splints, revisited. 1074 47

The study was carried out in 75 children aged 6-12 years with the physical status ASA I. The operations were performed on the lymphadenoid throat ring in a one-day setting. Awakening after anesthesia was evaluated by the following parameters: time between the end of intervention and extubation of the trachea, opening the eyes when asked, transportation from the operation room into the ward, and first dialogue with the doctor. A system of evaluating the level of recovery of respiration, motor activity, and consciousness by Aldret and Kroulik's score was used for objective assessment of the data. Postoperative pain and discomfort were evaluated using Hannallah's score in all age groups. The most rapid recovery of muscle tone, defense reflexes, and higher functions of the brain was observed in the patients anesthesized with propofol; adequate doses of narcotic analgetics during short-term interventions ensured satisfactory analgesia and psychological condition during the immediate postoperative period.
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PMID:[Clinical picture of awakening after general anesthesia with midazolam, propofol, ketamine and fluothane in children treated at one-day ambulatory facility]. 1133 15

We studied the analgesic efficacy of tramadol 2 mg kg(-1) for post-operative analgesia after day-case adenoidectomy in children aged 1-3 yr. Eighty children were allocated randomly to receive tramadol 2 mg kg(-1) i.v. or placebo immediately after induction of anaesthesia. Anaesthesia was induced with alfentanil 10 microg kg(-1) and propofol 4 mg kg(-1) followed by mivacurium 0.2 mg kg(-1) for tracheal intubation. Anaesthesia was continued with sevoflurane in nitrous oxide and oxygen. All children were given ibuprofen rectally at approximately 10 mg kg(-1) before the start of surgery. Post-operative pain and recovery assessments were performed by a nurse blinded to the analgesic treatment using the Aldrete recovery score, the pain/discomfort scale and measurement of recovery times. Rescue medication (pethidine in increments of 5 mg i.v.) was administered according to the pain scores. A post-operative questionnaire was used to evaluate the need for analgesia at home up to 24 h after operation. Rescue analgesic at home was rectal or oral ibuprofen 125 mg. Children in the tramadol group required fewer pethidine doses than those in the placebo group (P = 0.014). Forty-five per cent of children receiving tramadol did not require post-operative analgesia at all compared with 15% of children receiving placebo (P = 0.003). Recovery times and the incidence of adverse effects were similar in the two groups in the recovery room and at home. The requirement for rectal ibuprofen at home did not differ between groups.
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PMID:Analgesic efficacy of tramadol 2 mg kg(-1) for paediatric day-case adenoidectomy. 1157 36

The purpose of this prospective study was to evaluate the incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. Data were examined from 627 teeth that had necrotic pulps or required retreatment. Information was obtained for each patient treated with regard to presence of preoperative pain. Occurrence of periradicular bone destruction detected by radiographs was also recorded. The operators consisted of undergraduate students, who were in their first year of clinical training. Root canals were instrumented and then medicated with a calcium hydroxide/camphorated paramonochlorophenol paste. No systemic medication was prescribed. Approximately 1 week after the initial appointment, patients were asked about the occurrence of postoperative pain and the level of discomfort was rated as no pain, mild pain, moderate pain, or severe pain. Data were statistically analyzed using the Chi-square test. Mild pain occurred in 10% of the cases, moderate in 3.3%, and severe (flare-up) in 1.9%. Postoperative pain was significantly associated with the treatment of previously symptomatic teeth without periradicular lesions (p < 0.01). No other correlations were detected between the occurrence of postoperative discomfort and other clinical conditions. There was also no difference regarding the incidence of postoperative pain between treatment and retreatment (p > 0.01). The intracanal procedures used in this study to control root canal infections showed a small incidence of postoperative pain, particularly flare-ups, even performed by inexperienced undergraduate dental students.
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PMID:Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. 1206 29

We performed a prospective study to evaluate the feasibility of performing endoscopic total extraperitoneal repair of groin hernia (TEP) under epidural anesthesia in selected patients considered to be at high risk or unfit for general anesthesia. Fifty-eight endoscopic total extraperitoneal hernia repairs were performed in 36 patients between January 1997 and December 1999 under epidural anesthesia since they were considered a high risk or unfit for general anesthesia. All patients received intramuscular diclofenac sodium for preemptive analgesia. Intraoperatively, all were sedated with intravenous midazolam and fentanyl. Endoscopic TEP repair was successful under epidural anesthesia in 33 of 36 patients. In the remaining three patients, the procedure had to be converted to Lichtenstein's repair due to shoulder discomfort experienced by the patients as a result of pneumoperitoneum, which was produced by incidental peritoneal tears during extraperitoneal dissection. Intraoperatively, one patient had bleeding from the inferior epigastric artery, which was controlled with clipping of the artery. The mean operative time was 48 minutes (range, 28-72 minutes) in the TEP group and 94 minutes (range, 84-102 minutes) in the converted group. All the patients received an epidural top-up dose at the end of surgery for postoperative analgesia. All patients were ambulatory the same day. Postoperative pain was assessed by a visual analogue scale (VAS). The mean pain score was 1.2 (+/- 0.8) on discharge in the TEP group. During follow-up, seven patients developed scrotal swelling with cord induration, which was treated conservatively with scrotal support and analgesics. In all patients, resolution was observed within 6 weeks. One patient was detected to have a recurrence 4 months after surgery. Endoscopic TEP repair under epidural anesthesia appears to be safe, technically feasible, and an acceptable alternative in patients who are at high risk or unfit for general anesthesia.
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PMID:Extraperitoneal endoscopic groin hernia repair under epidural anesthesia. 1281 3

The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54) or infrared coagulation (N = 46). Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years). The mean duration of disease was 17.5 months (range 12 to 34 months). The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale). Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059). The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03), but also had a higher recurrence or failure rate (P = 0.03). Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.
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PMID:Infrared coagulation versus rubber band ligation in early stage hemorrhoids. 1450 78

Traditional surgery for snoring often leads to intolerable postoperative pain. A new surgical treatment, radiofrequency volumetric tissue reduction (RVTR) of the soft palate, was carried out and its effect and safety in the management of snoring were evaluated. Thirty-two patients received a single treatment of RVTR with a mean follow-up period of 4.5 months. All patients were assessed by a questionnaire using the Snore Outcomes Survey (SOS) and the Epworth Sleepiness Scale (ESS). Postoperative pain, speech and swallowing disturbances were also evaluated. The postoperative scores of SOS and ESS all significantly improved (p<0.05). Postoperative pain, speech and swallowing disturbances were all mild 1-3 days after treatment. With the success of treatment defined as a postoperative snoring index (SI) of <3 or a reduction of the SI by >5 points by the visual analogue scale, the success rate was 81.3% in patients with a respiratory disturbance index (RDI) of <20, and 50% in those with an RDI of >20. We conclude that RVTR of the soft palate is an effective treatment for snoring, resulting in only mild postoperative discomfort. A patient whose RDI was <20 had a higher success rate with a single RVTR treatment.
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PMID:Efficacy of radiofrequency volumetric tissue reduction of the soft palate in the treatment of snoring. 1468 65

Using mesh or a synthetic prosthesis during tension-free inguinal hernia repair has been shown to be safe and effective. We compared the final outcome in treating inguinal hernia in 45 patients using three different prosthetic materials: 15 patients underwent tension-free inguinal hernia repair using Prolene (polypropylene) mesh, 15 using Vypro (polyglactin and polypropylene) mesh, and 15 with Surgisis-a new bioactive material derived from porcine small intestinal submucosa. The aim of this study was to evaluate the safety and efficacy of tension-free inguinal repair using Surgisis, comparing it with conventional prosthetic materials. From January 2003 to December 2003, 45 male patients underwent Lichtenstein inguinal hernia repair. Median follow-up was 12 months, with a range of 1-16 months. Each patient underwent ultrasound evaluation of the inguinal region 1 month after surgery. All the procedures were completed under local anesthesia. There were no intraoperative complications, and all patients were discharged home the same day of surgery. No recurrent hernias and wound infections were observed in our post-operative follow-up period. Postoperative pain (visual analog score) and discomfort were lower in patients with Surgisis mesh. There was no statistically significant difference between the groups in terms of overall early and late complications; however, there was a tendency toward a higher incidence of pain and discomfort in Vypro and Prolene group. The median time to full recovery was significantly shorter in the Surgisis group. Surgisis mesh seems to be a promising new prosthetic material for hernia repair. Long-term follow-up is necessary to confirm these preliminary results.
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PMID:Comparison of three different mesh materials in tension-free inguinal hernia repair: prolene versus Vypro versus surgisis. 1646 43

Postoperative agitation is a common problem after sevoflurane anesthesia in children. In the present study, we evaluated if tropisetron or clonidine could reduce the incidence of postoperative agitation after day case adenoidectomy in small children. We included 75 unpremedicated children aged 1-7 yr who were randomly assigned to receive either placebo, tropisetron (0.1 mg/kg) or clonidine (1.5 microg/kg) after anesthesia induction. Anesthesia was induced and maintained with sevoflurane. Patients also received alfentanil (20 microg/kg) and diclofenac (1 mg/kg). Postoperative pain was treated with IV oxycodone (0.05 mg/kg). Time to achieve discharge criteria was recorded. Modified pain/discomfort scale was used assess the postoperative behavior. The incidence of postoperative agitation was significantly less (32%, 8/25 patients) in the tropisetron group compared with placebo (62%, 16/26 patients), P < 0.05). Clonidine could not prevent agitation (incidence 54%, 13/24). No adverse effects were noted during the study. Discharge times were similar between the groups (between 80 and 99 min on average). In conclusion, tropisetron 0.1 mg/kg significantly reduced the incidence of postoperative agitation after sevoflurane anesthesia. Clonidine 1.5 microg/kg did not differ from placebo with respect to postoperative agitation.
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PMID:The prevention of emergence agitation with tropisetron or clonidine after sevoflurane anesthesia in small children undergoing adenoidectomy. 1663 14

Nowadays different surgical techniques are available for the treatment of haemorrhoids even if a general, international consensus is still lacking. The authors, through a personal interpretation of haemorrhoids based on the PATE 2000 Sorrento classification, report on a comparative trial of haemorrhoidectomy by the transfixed stitches technique versus an open surgical technique (Milligan-Morgan). Particular attention was devoted in this prospective randomised trial to analysing the early postoperative side effects (bleeding, urinary retention), the time taken to return to active life and wound healing. Patients with grade III-IV haemorrhoids were enrolled in our study and divided into two groups: one treated by the transfixed stitches technique and the other by the Milligan-Morgan procedure. The main outcome measures such as analgesic use during the first week, early side effects, wound healing and the time taken to return to active life were evaluated. Patients were followed for 6 months after surgery. A total of 160 patients were enrolled, 80 in each group. The pain score after surgery was significantly lower in the transfixed stitches group than in the Milligan-Morgan group (p < 0.01). 30% of the transfixed stitches patients took analgesics in comparison with 90% of the Milligan-Morgan patients (p < 0.01). Postoperative pain after the start of bowel movements in the transfixed stitches group was lower than in the Milligan-Morgan group. Wound healing was immediate in the transfixed stitches patients and was obtained after one month in the open surgery group. Haemorrhoidectomy by the transfixed stitches technique is more advantageous in comparison with the Milligan-Morgan procedure because of its lesser discomfort for the patient, earlier wound healing, milder side effects, shorter surgical time and earlier return to active life.
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PMID:[Transfixed stitches technique versus open haemorrhoidectomy. Results of a randomised trial]. 1750 Jan 80


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