Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective study was undertaken to compare the analgesic effect of intra-articular bupivacaine, morphine, or saline in the 24-hour period following cranial cruciate ligament repair in dogs. Thirty-six clinical patients with ruptured cranial cruciate ligaments were randomly assigned to one of three groups. After surgical stabilization, and before skin closure, an intra-articular injection was given; group one (n = 12) received 0.5% bupivacaine HCl at 0.5 mL/kg, group two (n = 12) received morphine at 0.1 mg/kg diluted with saline to a volume of 0.5 mL/kg, and group three (n = 12) received saline at 0.5 mL/kg. Heart rate, respiratory rate, mean arterial blood pressure, cumulative pain score, visual analog pain score, and pain threshold test on both stifles were recorded preoperatively and at 0 to 6 and 24 hours postoperatively. Surgeons and pain scoring investigators were unaware of the intra-articular medication given. Supplemental analgesia, if needed, was provided in the postoperative period according to subjective assessment of patient discomfort. Postoperative pain scores were lowest in the bupivacaine group and highest in the saline group. Pain threshold, measured by applying calibrated loads to the knee, was higher postoperatively in the bupivacaine group than in the saline group. Dogs in the morphine and bupivacaine groups required less supplemental analgesia than dogs in the saline group. The local provision of analgesia reduces the need for systemic drugs with potential side effects. Both intra-articular morphine and intra-articular bupivacaine provided better postoperative analgesia than intra-articular saline, with intra-articular bupivacaine showing the greatest effect.
 ...
PMID:Postoperative analgesia for stifle surgery: a comparison of intra-articular bupivacaine, morphine, or saline. 871 87

Postoperative pain management has dramatically improved with the advent of patient-controlled analgesia (PCA) delivery. The optimal PCA system would encompass several key characteristics, including consistent efficacy across a number of surgeries; safety of both the analgesic drug delivered and the delivery system; ease of setup, maintenance, and administration; patient comfort during analgesic delivery; avoidance of analgesic gaps; minimal invasiveness; and it would be associated with high patient satisfaction. Existing PCA modalities (using intravenous or epidural routes) encompass some of these characteristics (e.g., they have demonstrated efficacy across a number of surgeries); however, they are limited by the need for an indwelling catheter and the time and resources required for system setup and use. Device programming-related medication errors by hospital staff are an unfortunate risk, and could lead to significant harm. New PCA technologies are on the horizon that address some of the limitations to existing modalities; however, the added complexity of these newer systems are a concern, and their benefits and drawbacks remain to be assessed. These technologies include "smart" intravenous PCA infusion pumps to improve the safety of analgesic administration; needle-free options, such as the fentanyl HCl iontophoretic transdermal system for transdermal delivery; and a number of PCA devices for intranasal delivery, as well as several new options for patient-controlled regional analgesia. This review will discuss the benefits and drawbacks of both existing and emerging PCA modalities in the context of the ideal PCA system, and provide a critical evaluation of their use in postoperative settings.
 ...
PMID:Patient-controlled drug delivery for acute postoperative pain management: a review of current and emerging technologies. 1829 96

Postoperative pain is an important parameter in discharge and rehabilitation in daycase arthroscopic knee surgery. This study compared the efficacy of intraarticular application of lornoxicam, bupivacaine and placebo on postoperative pain after arthroscopic knee surgery. With the approval of the local ethics committee and informed consent of the patients, 90 patients (ASA score I-II), aged between 18-65 years undergoing arthroscopic meniscectomy were included in this randomized, blinded, prospective study and were divided into three groups (30 patients each): 8 mg lornoxicam was applied to Group L (GL), 50 mg bupivacaine to Group B (GB) and normal saline to Group S (GS) in 20 mL volume intraarticularly. Postoperative analgesia was maintained by intravenous tramadol-HCl 50 mg/h at the first 4 h and then paracetamol 500 mg plus codeine 7.5 mg preparation as needed. The numeric rating scale (NRS) values were evaluated at rest and at active-passive motion at 4, 12, 24 and 48 h, total analgesic consumption were recorded. There were statistically significant differences between GS and GL and GS and GB in term of tramadol consumption (p < 0.05 and p < 0.05). The analgesiconsumption of GL patients at the end of 48 h were lower than GB and GS (p < 0.001 and p < 0.05). The NRS values of GL were always lower than the other groups with statistical significance at certain times. We concluded that intraarticular lornoxicam provided better pain control than bupivacaine and saline in arthroscopic knee surgery.
 ...
PMID:[Comparison of analgesic activity of intraarticular lornoxicam, bupivacaine and saline after knee arthroscopy]. 1911 52

This randomized, active-controlled study evaluated the extent and duration of analgesia after administration of liposome bupivacaine (LB), a novel formulation of bupivacaine, compared with bupivacaine HCl given via local infiltration in excisional hemorrhoidectomy. One hundred patients were randomly assigned to receive a single dose of bupivacaine HCl 75 mg (0.25% with 1:200,000 epinephrine) or LB 66, 199, or 266 mg upon completion of hemorrhoidectomy. Postoperative pain intensity was assessed using a numeric rating scale at rest to calculate a cumulative pain score (area under the curve). Cumulative pain scores were significantly lower with LB at each study dose (P < 0.05) compared with bupivacaine HCl 72 hours after surgery. Post hoc analysis showed that mean total postoperative opioid consumption was statistically significantly lower for the LB 266-mg group compared with the bupivacaine HCl group during the 12- to 72-hour postoperative period (P = 0.019). Median time to first opioid use was 19 hours for LB 266 mg versus 8 hours for bupivacaine HCl (P = 0.005). Incidence of opioid-related adverse events was 4 per cent for LB 266 mg compared with 35 per cent for bupivacaine HCl (P = 0.007). Local infiltration with LB resulted in significantly reduced postsurgical pain compared with bupivacaine HCl in patients after hemorrhoidectomy surgery.
 ...
PMID:A double-blind, randomized, active-controlled study for post-hemorrhoidectomy pain management with liposome bupivacaine, a novel local analgesic formulation. 2254 31