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

Post-operative pain experience following apicectomy of a single maxillary anterior tooth was compared in two groups of patients having this treatment under local anaesthesia. Twenty patients received 3.6 ml of 2% lignocaine with 1:80,000 adrenaline and 23 patients the same volume of 1.5% etidocaine with 1:200,000 adrenaline, as the local anaesthetic agent. Although soft tissue anaesthesia lasted significantly longer when etidocaine with adrenaline was used, pain experience and analgesic intake did not differ between regimens. Lignocaine with adrenaline produced better operating conditions as haemorrhage control was more effective and the quality of operative anaesthesia was more satisfactory than with etidocaine and adrenaline. The use of etidocaine with adrenaline offered no advantages over lignocaine with adrenaline when administered as infiltration anaesthesia for apical surgery.
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PMID:The effect of two different local anaesthetic solutions on pain experience following apicectomy. 827 24

The use of local anaesthetic has been shown to reduce the incidence of pain after laparoscopic sterilisation and the need for opioid analgesia from day surgery. We investigated a technique in which a catheter is placed in the pouch of Douglas allowing repeated administration of local anaesthetic in the postoperative period. Forty patients were randomly allocated pre-operatively into one of two groups to receive in a double-blind manner either lignocaine 1% or normal saline. Pain was assessed using visual analogue and subjective scoring systems. Postoperative pain scores were significantly reduced (p < 0.05) after injection of lignocaine through the catheter. There were no complications related to the technique and no evidence of local anaesthetic toxicity. Lignocaine instilled into the Pouch of Douglas is an effective method for postoperative pain relief after laparoscopic sterilisation.
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PMID:Pouch of Douglas block for laparoscopic sterilisation. 1002 89

This paper reviews published data on welfare aspects of stag restraint and velvet antler removal, and prevention of antler growth. Several studies of physical restraint and handling demonstrate behavioural and physiological changes both during and after velvet antler removal. Interpretations vary as to whether the act of velvet antler removal imposes a welfare cost additional to that of handling and restraint alone. Chemical restraint presents immediate and delayed welfare risks to the animal. Surgical removal of velvet antler can be achieved without acute pain using a high dose rate of local anaesthetic applied as a ring block, rather than as regional nerve blocks, provided the wait time is adequate. However, there is evidence of less than optimum reproducibility. Lignocaine hydrochloride produces rapid analgesia of short duration, whilst bupivacaine has a delayed onset, but longer duration of analgesia. Mepivacaine has a rapid onset and intermediate duration of analgesia. Mixtures of long and short-acting local anaesthetics provide rapid onset and long duration of analgesia. Present methods for electronic analgesia are aversive and not sufficiently effective. The efficacy and possible aversiveness of compression techniques for inducing analgesia of antlers are currently under evaluation. Post-operative pain and the need for its control have been insufficiently researched. Post-operative sequelae are uncommon, but include clostridial infection. Antler growth in most stags can be prevented by rubber-band application to the growing pedicle, although behavioural changes after ring application suggest this practice may be painful. The procedures used for velvet antler removal, and whether practices are acceptable on the balance of welfare costs and benefits, should be reviewed on an ongoing basis as science, using an increasing range of techniques and measures, provides more data about the welfare implications of this practice.
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PMID:Welfare of farmed deer in New Zealand. 2. Velvet antler removal. 1603 77

Postoperative pain after laparoscopic cholecystectomy (LC) is generally less than open cholecystectomy; however, the postoperative shoulder and abdominal pain experienced by patients still causes preventable distress. Intraperitoneal irrigation of the diaphragmatic surface and gallbladder fossa using normal saline, bupivacaine, or lignocaine may effectively control visceral abdominal pain after an LC. Two hundred patients with similar demographics undergoing elective LC were randomized to one of four groups of 50 patients each, including Group A placebo control, Group B with isotonic saline irrigation, Group C with bupivacaine irrigation, and Group D with lignocaine irrigation. All patients received preperitoneal abdominal wall infiltration with 0.25 per cent bupivacaine to control parietal (somatic) abdominal pain. The visual analogue and verbal rating pain scores at 0, 4, 8, 12 and 24 hours for both shoulder and abdominal pain were recorded in a prospective double-blind fashion at four points during the first 24 postoperative hours. Analgesia requirements, vital signs, blood glucose, and incidence of nausea and vomiting were also recorded. Patients in each group demonstrated a significant difference in visual analogue and verbal rating pain scores and analgesic consumption when compared with controls. Lignocaine controlled pain significantly better than saline or bupivacaine. Bowel function recovery was similar in all patients, and there were no significant complications. We conclude that intraperitoneal irrigation with either saline, bupivacaine, or lignocaine can significantly reduce visceral abdominal pain after LC. Lignocaine was the most efficacious local anesthetic in this trial and has a high safety profile when used at recommended doses.
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PMID:Post-laparoscopic cholecystectomy pain: effects of intraperitoneal local anesthetics on pain control--a randomized prospective double-blinded placebo-controlled trial. 1837 82

Postoperative pain continues to be inadequately managed. While opioids remain the mainstay for postoperative analgesia, their use can be associated with adverse effects, including ileus, which can prolong hospital stay. A number of studies have investigated the use of perioperative intravenous lidocaine infusion for improving postoperative analgesia and enhancing recovery of bowel function. This systematic review was performed to determine the overall efficacy of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery in patients undergoing various surgical procedures. We searched the databases of MEDLINE, CINAHL and the Cochrane Library from 1966 to December 2009. We searched for randomized controlled comparisons of lidocaine infusion with placebo in the surgical setting and reporting on postoperative analgesia and other aspects of patient recovery from surgery. The quality of all included studies was assessed using the Modified Oxford Scale. Information on postoperative pain intensity and analgesic requirements was extracted from the trials and compared qualitatively. Other relevant data such as return of bowel function, length of hospital stay, intraoperative anaesthetic requirement and adverse effects were also compared. Sixteen trials were included. A total of 395 patients received intravenous lidocaine with 369 controls. In open and laparoscopic abdominal surgery, as well as in ambulatory surgery patients, intravenous perioperative infusion of lidocaine resulted in significant reductions in postoperative pain intensity and opioid consumption. Pain scores were reduced at rest and with cough or movement for up to 48 hours postoperatively. Opioid consumption was reduced by up to 85% in lidocaine-treated patients when compared with controls. Infusion of lidocaine also resulted in earlier return of bowel function, allowing for earlier rehabilitation and shorter duration of hospital stay. First flatus occurred up to 23 hours earlier, while first bowel movement occurred up to 28 hours earlier in the lidocaine-treated patients. Duration of hospital stay was reduced by an average of 1.1 days in the lidocaine-treated patients. Administration of intravenous lidocaine infusion did not result in toxicity or clinically significant adverse events. Lidocaine had no impact on postoperative analgesia in patients undergoing tonsillectomy, total hip arthroplasty or coronary artery bypass surgery. In conclusion, intravenous lidocaine infusion in the perioperative period is safe and has clear advantages in patients undergoing abdominal surgery. Patients receiving lidocaine infusion had lower pain scores, reduced postoperative analgesic requirements and decreased intraoperative anaesthetic requirements, as well as faster return of bowel function and decreased length of hospital stay. Further studies are needed to assess whether lidocaine has a beneficial effect in patients undergoing other types of surgery and to determine the optimum dose, timing and duration of infusion of lidocaine in this setting.
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PMID:Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. 2051 81