Articles: postoperative-pain.
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Randomized Controlled Trial
Epidural analgesia versus oral morphine for postoperative pain management following video-assisted thoracic surgery: A randomised, controlled, double-blind trial.
The use of thoracic epidural analgesia for postoperative pain management in video-assisted thoracic surgery (VATS) is controversial. Still, the evidence on omitting it in favour of systemic opioids is inconclusive, and studies are small and non-blinded. ⋯ Epidural analgesia provided better pain relief after VATS than oral morphine. The between-group difference in rescue intravenous morphine consumption was statistically significant but clinically irrelevant.
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Randomized Controlled Trial
Duration of analgesia after forefoot surgery compared between an ankle and a sciatic nerve block at the popliteal crease: A randomised controlled single-blinded trial.
Forefoot surgery is associated with severe postoperative pain. Ankle and sciatic nerve blocks provide satisfactory postoperative analgesia after forefoot surgery, but little is known on their respective duration of analgesia. ⋯ Compared with the ankle block, the sciatic nerve block at the popliteal crease does not provide a longer duration of analgesia in patients undergoing forefoot surgery in the setting of multimodal analgesia.
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Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-mediated anti-inflammatory reflexes. To investigate this relationship, we conducted a study with 55 patients undergoing minimally invasive cardiothoracic surgery to evaluate whether cardiovagal baroreflex sensitivity (BRS) can predict postoperative pain. ⋯ These findings indicate that preoperative BRS can independently predict postoperative pain, which could serve as a modifiable criterion for optimizing postoperative pain management. PERSPECTIVE: This article shows that preoperative BRS predicts postoperative pain outcomes independently of the inflammatory response and pain sensitivity to noxious pressure stimulation. These results provide valuable insights into the role of baroreceptors in pain and suggest a helpful tool for improving postoperative pain management.
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Randomized Controlled Trial
Transcutaneous Electrical Nerve Stimulation Integrated into Pants for the Relief of Postoperative Pain in Hip Surgery Patients: A Randomized Trial.
The effect of transcutaneous electrical nerve stimulation (TENS) on pain and impression of change was assessed during a 2.5-hour intervention on the first postoperative days following hip surgery in a randomized, single-blinded, placebo-controlled trial involving 30 patients. ⋯ Mixed-frequency TENS integrated in pants could potentially be an interesting addition to the arsenal of treatments for multimodal analgesia following hip surgery. This trial is registered with NCT05678101.
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Randomized Controlled Trial
Effects of 4 mg and 8 mg Dexamethasone Added to Intrathecal Bupivacaine on Perioperative Analgesia Among Adult Orthopedic Patients at Sodo Christian Hospital: A Prospective Cohort Study.
Background: Several adjuvant drugs have been tried to prolong spinal anesthesia block. Currently, dexamethasone appears to be effective in extending the duration of sensory block and enhancing analgesia during surgery. It is unclear, however, whether administering dexamethasone at a dose of 8 mg offers any advantages over administering it at a dose of 4 mg. ⋯ In addition, there was no significant difference (p > 0.05) in postoperative analgesic use, initial analgesia rescue time, or pain severity, as measured by the Numerical Rating Scale (NRS). The addition of dexamethasone did not result in any issues, nor was there a statistically significant difference in the onset time between the two groups. Conclusion: Dexamethasone at a dose of 4 mg extends the duration of sensory, motor, and overall analgesia in a manner similar to that of 8 mg dexamethasone with comparable durations for both the initial analgesic request and overall analgesic use.