Articles: analgesics.
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Randomized Controlled Trial
Preoperative Ultrasound-Guided Percutaneous Cryoneurolysis for the Treatment of Pain following Mastectomy: A Randomized, Participant- and Observer-Masked, Sham-Controlled Study.
Ultrasound-guided percutaneous cryoneurolysis is an analgesic technique in which a percutaneous probe is used to reversibly ablate a peripheral nerve(s) using exceptionally low temperature, and has yet to be evaluated with randomized, controlled trials. Pain after mastectomy can be difficult to treat, and the authors hypothesized that the severity of surgically related pain would be lower on postoperative day 2 with the addition of cryoanalgesia compared with patients receiving solely standard-of-care treatment. ⋯ Percutaneous cryoneurolysis markedly improved analgesia without systemic side effects or complications after mastectomy.
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Randomized Controlled Trial
Effect of Combined Epidural Morphine and Midazolam on Postoperative Pain in Patients Undergoing Major Abdominal Cancer Surgery.
The objective was to compare analgesic effect of combined epidural morphine-midazolam with either drug alone on postoperative pain in patients undergoing major abdominal cancer surgery. ⋯ Addition of midazolam to epidural morphine prolonged time of first analgesic request and decreased total analgesic consumption.
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Minerva anestesiologica · Nov 2022
Randomized Controlled TrialEfficacy of intravenous versus intraperitoneal lidocaine for postoperative analgesia in laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled trial.
Laparoscopic cholecystectomy (LC) has become the gold standard for gallbladder removal due to the low degree of invasiveness. However, postoperative pain still persists. Local anesthetics provide analgesia, reduce opioid consumption, and accelerate the return of bowel activity with a rare incidence of toxicity. However, it is still inconclusive to verify the more superior route of administration. This study aimed to compare the efficacy of intravenous lidocaine infusion, intraperitoneal lidocaine instillation, and placebo in reducing postoperative analgesia. ⋯ Intravenous lidocaine is superior to intraperitoneal lidocaine instillation and placebo in reducing postoperative analgesic requirement and visceral pain within the first six hours. Intravenous infusion is a simple and reliable method for reducing abdominal pain following laparoscopic cholecystectomy.
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Randomized Controlled Trial
Efficacy and safety of co-crystal of tramadol-celecoxib (CTC) in acute moderate-to-severe pain after abdominal hysterectomy: A randomized, double-blind, phase 3 trial (STARDOM2).
STARDOM2 is a randomized, double-blind, phase 3 trial evaluating the efficacy and safety of co-crystal of tramadol-celecoxib (CTC)-a first-in-class analgesic co-crystal comprising racemic tramadol hydrochloride and celecoxib in a supramolecular network that modifies their pharmacokinetic properties-for the management of acute postoperative pain (NCT03062644; EudraCT:2016-000593-38). ⋯ In the randomized, double-blind, phase 3 STARDOM2 trial-in acute moderate-to-severe pain after abdominal hysterectomy-the novel co-crystal of tramadol-celecoxib (CTC) 200 mg BID was superior to placebo and non-inferior to tramadol 100 mg QID. Although superiority to tramadol was not reached, CTC 200 mg BID exposed patients to lower cumulative opioid (tramadol) doses than tramadol (100 mg QID) alone, with fewer treatment-emergent adverse events. CTC 200 mg thus has a clinically relevant improved benefit/risk profile compared with tramadol alone.
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Randomized Controlled Trial
Postoperative analgesia of intraoperative nefopam in patients undergoing anterior cervical spine surgery: A prospective randomized controlled trial.
Nefopam is a non-opioid, non-nonsteroidal anti-imflammatory drug, analgesic drug that inhibits the reuptake of serotonin, norepinephrine, and dopamine. It is widely used as an adjuvant for pain. This study investigated whether the intraoperative, intravenous infusion of nefopam (20 mg) reduces postoperative morphine consumption, pain scores, and alleviates neuropathic pain in patients undergoing cervical spine surgery. ⋯ A single, intraoperative infusion of 20 mg of nefopam did not significantly reduce postoperative (24 hours) morphine consumption in patients undergoing anterior cervical spine surgery.