Articles: analgesics.
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Randomized Controlled Trial
Paracetamol did not improve the analgesic efficacy with regional block after video assisted thoracoscopic surgery: a randomized controlled trial.
Various analgesic techniques have been applied, the pain after video assisted thoracic surgery (VATS) is still challenging for anesthesiologists. Paracetamol provide analgesic efficacy in many surgeries. However, clinical evidence in the lung surgery with regional block remain limited. This monocentric double-blind randomized controlled trial investigates the efficacy of paracetamol after VATS with regional block. ⋯ The analgesic efficacy of one gram of paracetamol with ESPB and ICNB after VATS was not proven. Thus, caution should be exercised when prescribing paracetamol for pain control during VATS.
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Acta Anaesthesiol Scand · Jan 2025
Randomized Controlled TrialEffect of intraoperative methadone in robot-assisted cystectomy on postoperative opioid requirements: A randomized clinical trial.
Postoperative pain management is a challenge after robot-assisted cystectomy (RAC). Methadone has a long duration of action, and we therefore hypothesized that a single dose of intraoperative methadone would reduce postoperative opioid requirements and pain intensity in bladder cancer patients undergoing RAC. ⋯ A single dose of intraoperative methadone does not reduce postoperative opioid requirements compared with a single dose of morphine in bladder cancer patients undergoing RAC.
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Randomized Controlled Trial Comparative Study
Comparison of Ultrasound-Guided Single-Injection Erector Spinae Plane Block, Retrolaminar Block and Paravertebral Block for Postoperative Analgesia in Single-Incision Video-Assisted Thoracoscopic Surgery: A Three-Arm, Double-Blind, Randomized Controlled Non-Inferiority Trial.
Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS). ⋯ ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety.
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Randomized Controlled Trial
Predictors of subacute postoperative pain after total knee arthroplasty: A secondary analysis of two randomized trials.
Methods for identifying high-pain responders undergoing total knee arthroplasty remain important to improve individualized pain management. This study aimed at evaluating pre- and perioperative predictors of pain on Days 2-7 after total knee arthroplasty. ⋯ This study investigated factors associated with pain after total knee arthroplasty beyond the immediate postoperative period. The analysis revealed significant associations between preoperative pain levels and, particularly, pain 24 h postoperatively, with subsequent subacute pain the following week. These findings can assist in identifying patients who would benefit from enhanced, individualized analgesic interventions to facilitate postoperative recovery.
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Randomized Controlled Trial
Oral ketamine for acute postoperative analgesia (OKAPA) trial: A randomized controlled, single center pilot study.
Although opioids represent the mainstay of treating surgical pain, their use is associated with significant side effects. There is an urgent need to find new pain relievers with safer side effect profiles. One drug that has been receiving increasing attention is ketamine. By using the oral route of administration, ketamine could potentially be used by patients in a less resource-intensive manner with similar efficacy. This study aims to examine the role of oral ketamine in improving recovery after major spine surgery. ⋯ This pilot study demonstrated that low dose oral ketamine can be safely used as an adjunct in postoperative pain treatment to help reduce opioid consumption after major spine surgery.