Articles: pain-management-methods.
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Acta medica Iranica · Feb 2017
Randomized Controlled TrialVapocoolant Spray Effectiveness on Arterial Puncture Pain: A Randomized Controlled Clinical Trial.
Arterial blood gas (ABG) sampling is a painful procedure with no perfect technique for quelling the discomfort. An ideal local anesthesia should be rapid, easy to learn, inexpensive, and noninvasive. This study was aimed to compare pain levels from ABG sampling performed with vapocoolant spray in comparison to placebo. ⋯ This study showed that while the spray exerts more application pain, the number of attempts required for ABG sampling was not significantly lower in group A compared with group B (1.38±0.54 vs. 1.53±0.68; P=0.372). Vapocoolant spray was not effective in ABG pain reduction, had milder application pain compared to placebo (P<0.05), but did not reduce sampling attempts. At present, this spray cannot be recommended for arterial puncture anesthesia, and further study on different timing is necessary.
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Randomized Controlled Trial Comparative Study
Comparison of ropivacaine with and without fentanyl vs bupivacaine with fentanyl for postoperative epidural analgesia in bilateral total knee replacement surgery.
Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.1% with/without fentanyl 2.5 μg/mL vs plain bupivacaine 0.0625% with fentanyl 2.5 μg/mL in patients undergoing bilateral TKR. ⋯ After bilateral TKR, ropivacaine-fentanyl combination administered through a PCEA system resulted in "superior" analgesic efficacy, that is, pain relief without motor blockade, than "ropivacaine alone" (lesser pain relief) and bupivacaine-fentanyl (pain relief but with attendant motor blockade). Overall, the addition of fentanyl to epidural local anesthetic returned favorable postoperative analgesia profile and patient satisfaction with minor incidence of opioid-related side effects.
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Rev Esp Anestesiol Reanim · Feb 2017
Randomized Controlled Trial Comparative StudyEffectiveness and safety of continuous ultrasound-guided femoral nerve block versus epidural analgesia after total knee arthroplasty.
Total knee arthroplasty is associated with severe postoperative pain. The aim of this study was to compare continuous ultrasound-guided femoral nerve block with continuous epidural analgesia, both with low concentrations of local anaesthetic after total knee arthroplasty. ⋯ Continuous ultrasound-guided femoral nerve block provides analgesia and morphine consumption similar to epidural analgesia, with the same level of satisfaction, but with a lower rate of side effects after total knee arthroplasty.
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Randomized Controlled Trial
Ultrasound-guided transversus abdominis plane block for postoperative analgesia in living liver donors: A prospective, randomized, double-blinded clinical trial.
Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block on postoperative analgesia and opioid consumption in living liver donors in whom a right "J" abdominal incision was used. ⋯ The TAP block reduced 24-h postoperative morphine consumption and contributed to analgesia in living liver donors who underwent upper abdominal wall incisions.
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Randomized Controlled Trial
Anesthesia management with ultrasound-guided thoracic paravertebral block for donor nephrectomy: A prospective randomized study.
To determine the efficacy of ultrasound-guided thoracic paravertebral block intraoperatively and 24 hours postoperatively in patients undergoing donor nephrectomy. ⋯ Continuous thoracic paravertebral block provides good intraoperative stability with a low anesthetic requirement and reduces postoperative morphine consumption for up to 24 hours. Ultrasound guided technique enhanced the safety of TPVB and provides analgesia without major complications.