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At least 19 recordsLinked to original sources
PubMed1978

Postoperative pain in ophthalmology.

A survey of 100 consecutive patients suggests that, overall, ophthalmic surgery is not as painful postoperatively as general surgery. Cataracts are largely painless. Retinal detachments may sometimes give rise to postoperative pain like that in general surgery, but the numbers available are not yet sufficient for statistical analysis. Routine postoperative analgesia for encirclement procedures in retinal detachment patients should be considered for at least the first 18 hours after operation.

Cataract Extraction↗
PubMed1977

Efficacy and tolerance of Flunixin (SCH 14714) in the treatment of postoperative pain, with observations on the methodology of postoperative pain studies.

A new anti-inflammatory, antipyretic and analgesic drug 2(2'-methyl-3'-trifluoromethylanilino)-nicotinic acid (Flunixin, Sch 14714) was compared with aspirin and a placebo in a double-blind study of pain after four different types of operation. Sch 14714 proved to be superior to the two other drugs after herniorraphy and venous surgery of the leg. The frequency of adverse effects after this drug was, at most. 1.2% which did not differ from the side-effect rates of aspirin or placebo. The second and third days after operation yielded a very high rate of optimal pain relief scores resulting in poor discrimination. Thus cross-over studies seem to be superfluous in the study of pain-relieving drugs in the period following surgery. The patients' rather low demand of analgesic drugs indicated that more stringent enrollment criteria should be adhered to. It was also shown that radical venous surgery constituted a good model for pain studies.

Aniline Compounds↗
PubMed1977

The pharmacological management of postoperative pain.

The physiology and pharmacological management of postoperative pain are briefly discussed. Although narcotic analgesics are still the mainstay in the management of postoperative pain the judicious use of non-narcotic analgesics, anticholinergics, tranquillizers and soporifics as well as the administration of local anaesthetic agents could contribute greatly to the alleviation of postoperative pain and discomfort. Certain regimens for intravenous medication are outlined and strong emphasis is placed on the fact that postoperative pain relief is the duty of the doctor and not that of unskilled nursing staff.

Analgesics↗
PubMed2024

Associations between (pharmaco-)genetic markers and postoperative pain after inguinal hernia repair - a prospective study protocol.

BACKGROUND: Postoperative pain is a common complication following surgery, with severity and duration varying between patients. Chronic postoperative pain after inguinal hernia surgery has an incidence rate of approximately 10%. Risk factors for acute and chronic pain following hernia surgery include age, sex, psychosocial factors, and demographic background. Additionally, genetic polymorphisms in enzymes involved in pain mechanisms, as well as the metabolism of analgesics might influence pain perception, pain development, and response to pain medications. Key enzymes include the catechol-o-methyltransferase (COMT), the µ-opioid receptor 1 (OPRM1), and the cytochrome P450 2D6 (CYP2D6). CYP2D6 plays a crucial role in metabolizing analgesics such as tramadol, codeine, and oxycodone. It is also suspected to be involved in the synthesis of catecholamines and endogenous morphines suggesting a potential role in pathophysiology of pain. We hypothesize that the CYP2D6 activity influences the development of postoperative pain after hernia surgery. METHODS: This study is a prospective, observational, multicenter association study investigating adult patients scheduled for inguinal hernia surgery using a robotic-assisted (rTAPP) approach. Patients are enrolled during the preoperative surgical consultation. A buccal swab is collected for genetic testing at this time. Pain at the site of the hernia is assessed using the validated EuraHSQoL score preoperatively and at 2, 4, and 6 weeks postoperatively. Additionally, information on co-medication and details of the surgery will be collected. The planned number of participants is 350 patients. The primary objective is to analyze the association between different genotype-predicted CYP2D6 phenotypes and patient-reported pain intensity 6 weeks after surgery. Secondary objectives include the association between further genetic variants, such as the COMT rs4680 and OPRM1 rs1799971 genotype, and pain severity. Additionally, the potential of pharmacogenetic panel testing to optimize analgesic therapy in hernia surgery patients will be explored. DISCUSSION: The findings of this study are expected to provide valuable insights into identifying patients at higher risk for postoperative pain before surgery. This knowledge could pave the way for tailored interventions during and after surgery for these specific patients. TRIAL REGISTRATION: Deutsches Register Klinischer Studien https://www.drks.de/DRKS00034796 Registered on August 07, 2024.

Genetic Association Studies↗
PubMed1976

A comparison of tilidine hydrochloride and morphine in the treatment of postoperative pain.

Intramuscular injections of 10 mg morphine or 100 mg tilidine hydrochloride were administered in a double-blind fashion and in random order to 40 patients after minor surgical operations. The therapeutic effect of each analgesic was assessed by comparing the severity of pain immediately postoperatively with that 1, 2, 3 and 4 hours after injection of the relevant analgesic. Tilidine and morphine relieved pain to a similar degree. Within the limits of the protocol followed, morphine appeared superior to tilidine in some tests. No major side-effects occurred.

Adult↗
PubMed2026

Effect of transcutaneous auricular vagus nerve stimulation on postoperative pain in patients undergoing thoracoscopic partial lung resection: a randomized, double-blind, controlled clinical trial.

BACKGROUND: Postoperative pain after thoracic surgery remains common and challenging. Transcutaneous auricular vagus nerve stimulation (taVNS) is a noninvasive neuromodulation technique with potential analgesic effects. This study aimed to evaluate the efficacy and safety of taVNS for postoperative pain management in patients undergoing thoracoscopic partial lung resection. METHODS: Adults undergoing thoracoscopic partial lung resection were randomized to active or sham taVNS. The primary outcome was cough pain intensity at 48h post-surgery, assessed by Numeric Rating Scale (NRS). Secondary outcomes included cough pain at 24h and 72h, resting pain, moderate-to-severe pain incidence,&#xa0;opioid consumption, quality of recovery, postoperative pulmonary complications , chest tube duration, hospital stay, postoperative nausea/vomiting, and adverse events. RESULTS: Among 119 analyzed patients (active n&#x2009;=&#x2009;60, sham n&#x2009;=&#x2009;59), active taVNS reduced cough pain scores at 24h, 48h, and 72h postoperatively, as well as resting pain (p < 0.05). It also lowered the incidence of moderate-to-severe cough pain at 24h and 48h, reduced cumulative postoperative opioid use at 24h and 72h, and decreased rescue analgesia on postoperative day 3 (p < 0.05). Active taVNS was associated with a lower incidence of postoperative pneumothorax (p < 0.05). No serious adverse events occurred. CONCLUSION: Perioperative taVNS was associated with a modest analgesic benefit and reduced postoperative opioid requirements after thoracoscopic partial lung resection. The observed reduction in postoperative pneumothorax requires cautious interpretation, and further multicenter trials are needed to determine its clinical utility.

Humans↗
PubMed1978

Evaluation of preoperative ibuprofen for postoperative pain after removal of third molars.

An evaluation of the analgesic effects of preoperatively administered ibuprofen on prospective pain after the surgical removal of impacted third molar was undertaken in 100 patients in a double-blind parallel treatment trial. The pretreatment with ibuprofen delayed the mean time of onset of postoperative pain more than 100 minutes, as compared to pretreatment with placebo. The severity of pain initially experienced postoperatively was less in the pretreated group. There was no detectable interaction between the pretreatment and the analgesics administered postoperatively. The results of this study suggest that it is possible to delay the onset and lessen the severity of postoperative pain by preoperative administration of a nonsteroidal, antiinflammatory analgesic, such as ibuprofen.

Adolescent↗
PubMed1979

Continuous narcotic infusions for relief of postoperative pain.

Relief of acute pain after surgery or trauma is still inadequate in many centres, most patients being treated with intermittent intramuscular injections of narcotic analgesics. Over the past three years continuous intravenous narcotic infusions have been used at this hospital to treat postoperative pain; recently a system has been devised whereby an hourly dose is given and the dispenser recharged every hour. The method used is cheap and reliable, and signs of overdosage may be easily checked by nursing staff. Side effects rarely occur. Fifty patients who had received intravenous infusions after undergoing major abdominal surgery were sent a questionnaire to assess postoperative pain, and the results were compared with those from 50 matched controls who had received intramuscular injections. Of those who replied, only four patients who had received the infusion had found the pain distressing compared with 13 controls. Continuous narcotic infusions are most effective in relieving postoperative pain and may be given cheaply and reliably.

Abdomen↗
PubMed1976

Postoperative pain.

Explore the source record for details and available documents.

Analgesics, Opioid↗
PubMed1979

Diflunisal, a new analgesic, in the treatment of postoperative pain following removal of impacted mandibular third molars.

Diflunisal, 5-(2', 4'-difluorophenyl) -salicylic acid, has been shown in animal and human studies to possess pronounced analgesic and anti-inflammatory effects. The objective of the present investigation wa to compare the analgesic effect and safety of three doses of 500 mg diflunisal, given orally over 36 h, with placebo in the treatment of pain following surgical removal of impacted mandibular third molars. A total of 60 patients, 30 patients in each treatment group, participated in this double-blind, completely randomized study. The treatment groups were compared for demographic data, disease-related variables and pretreatment severity of pain. According to both the investigator's and the patient's overall evaluation of treatment efficacy on postoperative pain, diflunisal was significantly better than placebo (P less than 0.0001). Clinical adverse reactions were reported by seven patients (25%) in the diflunisal group compared to three patients (11%) in the control group. In two instances the adverse reactions were rated by the investigator to have been "unacceptable". The overall conclusion of this study is that diflunisal, compared to placebo, is a highly effective and well-tolerated analgesic in the treatment of postoperative pain following surgical removal of impacted mandibular third molars.

Administration, Oral↗
PubMed1979

A pharmacokinetic approach to postoperative pain: continuous infusion of pethidine.

In an attempt to improve postoperative pain management an intravenous infusion of pethidine was designed to provide stable therapeutic blood concentrations. Ten female patients undergoing elective abdominal hysterectomy were studied. After commencement of the infusion, blood pethidine concentrations increased rapidly and exceeded 0.46 microgram/ml after four hours. The mean steady-state concentration of 0.67 microgram/ml was reached by twenty-four hours. This infusion regimen resulted in the abolition of severe pain after three hours and analgesia continued for the duration of the two day study. Significant blood concentrations of the metabolite norpethidine were found although clinically no toxic effects were observed. Side effects of pethidine were infrequent. Controlled continuous intravenous infusion of pethidine produced stable blood concentrations and provided excellent pain control.

Adult↗
PubMed1979

Measurement and control of postoperative pain.

Continuous intravenous infusion of morphine in a dosage varied according to the changing needs of the patient is proposed as an ideal method of controlling postoperative pain and reducing postoperative respiratory complications. An original technique for the measurement of pain is described which, when used in conjunction with measurement of serum levels of free morphine, has demonstrated the superiority of this method of pain control. Preoperative psychological tests are considered as possible predictors of pain experienced after operation, and extra counselling is suggested for patients indicated to be at risk.

Counseling↗
PubMed2026

Effects of erector spinae plane block on postoperative pain in patients undergoing implant-based breast reconstruction for breast cancer: a randomized controlled trial.

BACKGROUND: Implant-based breast reconstruction after mastectomy causes acute pain. OBJECTIVE: To determine whether a single-shot T5 erector spinae plane block (ESPB) reduces postoperative pain. DESIGN: Single-center, RCT with allocation concealment; blinded assessors and statisticians. SETTING: Tertiary cancer center in China. PATIENTS: 100 adults scheduled for radical mastectomy with implant reconstruction were randomized (1:1); follow-up complete. INTERVENTION: Before induction, ESPB was given under ultrasound guidance at T5 with 30 mL of 0.375% ropivacaine plus dexmedetomidine 1 &#x3bc;g/kg; controls received no block. Standardized general anesthesia and postoperative PCA for both groups. MAIN OUTCOME MEASURES: Resting NRS at 6 h (MCID=1). Secondary outcomes were opioid consumption, quality of recovery, and PONV. RESULTS: ESPB did not significantly reduce resting pain at 6 h at the median (&#x3c4; =0.50; adjusted difference -0.9; p = 0.08). At the upper tail, pain intensity was lower (&#x3c4; = 0.75; -1.8; p <0.01). Repeated measures provided additional time-point information, improving estimation precision and test sensitivity. ESPB get lower pain scores at 6, 12, and 24 hours (all p <0.01). But, the 95% CI includes the MCID, the clinical benefit remains uncertain. Opioid use decreased at 24 h (-13.5 mg; p <0.01) and 48 h (-6.6 mg; p <0.01). Quality of recovery improved at 24 h (difference 5 points; p <0.01), but not later. No differences were observed in intraoperative hemodynamics or PONV. CONCLUSIONS: Single-shot T5 ESPB with perineural dexmedetomidine may reduce postoperative pain and opioid requirements and improve early recovery. Further large trials are warranted. Clinical relevance remains to be confirmed. TRIAL REGISTRATION: ClinicalTrials.gov NCT06143020.

Humans↗
PubMed1978

Postoperative pain and transcutaneous electrical nerve stimulation. A model to critique literature and develop documentation schema.

Since transcutaneous electrical nerve stimulation has become an established noninvasive modality in pain management, one successful clinical application has been in treating acute postoperative pain. Current clinical literature in this area is critiqued. In addition, considerations for documenting a comprehensive, systematic method of implementing and evaluating transcutaneous electrical nerve stimulation for any painful condition are suggested.

Electric Stimulation Therapy↗
PubMed2026

Clinical effectiveness of transversus abdominis plane block versus local anaesthesia wound infiltration for postoperative pain relief after laparoscopic appendicectomy in children: A multicentre, double-blind, randomised, controlled phase III trial.

BACKGROUND: Postoperative pain relief after laparoscopic appendicectomy in children provided by transversus abdominis plane (TAP) block and local anaesthesia wound infiltration (LAWI) of trocar insertion sites has never been compared. OBJECTIVE: To investigate whether TAP block could decrease postoperative opioid requirements after laparoscopic appendicectomy in children compared with LAWI. DESIGN: Multicentre, double-blind, phase III randomised trial. SETTING: Two tertiary paediatric surgery centres. PATIENTS: Children aged 3 to 15&#x200a;years admitted for laparoscopic appendicectomy. MAIN OUTCOME MEASURES: The primary outcome was the total dose of nalbuphine delivered within 24&#x200a;h after surgery. Secondary outcomes were the Face Legs Activity Cry Consolability (FLACC) scale values at 1, 2, 6, 12 and 24&#x200a;h, the time from levobupivacaine injection to the first dose of nalbuphine, and the time from the end of surgery to the first mobilisation. Patients received either ultrasound-guided TAP block (TAP group) or LAWI of trocar insertion sites (infiltration group) with 0.6&#x200a;ml&#x200a;kg -1 of levobupivacaine 2.5&#x200a;mg&#x200a;ml -1 , combined with standardised systemic multimodal analgesia including paracetamol, ketoprofen, phloroglucinol and nalbuphine. RESULTS: Forty-six and 50 patients were analysed in the TAP and infiltration groups, respectively [age: 10 [7 to 12] versus 10 [8 to 12] years; females: 16 (35%) versus 25 (50%); duration of surgery: 71 [64 to 90] versus 69 [56 to 89] min]. The primary outcome (total nalbuphine dose) was 0.2 [0.0 to 0.2] and 0.2 [0.0 to 0.2] mg&#x200a;kg -1 in the TAP and infiltration groups, respectively ( P &#x200a;=&#x200a;0.95). FLACC scale values did not significantly differ between the two groups ( P &#x200a;=&#x200a;0.78). Time to the first dose of nalbuphine or to first mobilisation was not significantly different between groups ( P value for log-rank test&#x200a;=&#x200a;0.095 and 0.18, respectively). CONCLUSION: TAP block does not appear to provide a greater opioid-sparing effect than LAWI of trocar insertion sites after laparoscopic appendicectomy in children, when combined with systemic multimodal analgesia including nonsteroidal anti-inflammatory drugs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04969133.

Humans↗
PubMed1975

The interaction of tilidine and pethidine in postoperative pain.

The mode of interaction between the new, non-narcotic analgesic tilidine and pethidine was studied in the treatment of postoperative pain. The potency ratio 3:1 (pethidine:tilidine) found previously was used in the comparison. Thus 0.25 mg/kg of pethidine with 0.75 mg/kg of tilidine and 0.5 mg/kg of pethidine with 1.5 mg/kg of tilidine were compared with 0.5 mg/kg and with 1.0 mg/kg of pethidine. These drug combinations proved to be equipotent with the pethidine dosages used. Consequently the mode of interaction seemed to be additive synergism. The onset of action was slightly faster with pethidine, but the duration of action was longer with pethidine-tilidine combinations. Respiratory depression and sedation were less evident after pethidine-tilidine combinations than after equianalgesic doses of pethidine. Circulatory effects were similar in all groups. No statistical difference in other side effects could be demonstrated between the groups.

Adolescent↗