Articles: postoperative.
-
Reg Anesth Pain Med · Nov 2021
Randomized Controlled TrialPostoperative pain reduction by pre-emptive N-acetylcysteine: an exploratory randomized controlled clinical trial.
A new potential target for multimodal pain management is the group-II metabotropic glutamate receptor subtypes, which can be activated by N-acetylcysteine. We investigated whether pre-emptive administration of N-acetylcysteine leads to a reduction in postoperative pain after laparoscopic inguinal hernia repair. ⋯ Without finding important differences between N-acetylcysteine and placebo group in pain scores postoperatively, but with a high percentage of bothersome side effects for the N-acetylcysteine group, we would not recommend the use of pre-emptive intravenous N-acetylcysteine to reduce postoperative pain in laparoscopic inguinal hernia repair patients based on this study.
-
Reg Anesth Pain Med · Oct 2021
Randomized Controlled TrialRandomized comparison between pericapsular nerve group (PENG) block and suprainguinal fascia iliaca block for total hip arthroplasty.
This randomized trial compared ultrasound-guided pericapsular nerve group block and suprainguinal fascia iliaca block in patients undergoing primary total hip arthroplasty. We selected the postoperative incidence of quadriceps motor block (defined as paresis or paralysis of knee extension) at 6 hours as the primary outcome. We hypothesized that, compared with suprainguinal fascia iliaca block, pericapsular nerve group block would decrease its occurrence from 70% to 20%. ⋯ For primary total hip arthroplasty, pericapsular nerve group block results in better preservation of motor function than suprainguinal fascia iliaca block. Additional investigation is required to elucidate the optimal local anesthetic volume for motor-sparing pericapsular nerve group block and to compare the latter with alternate motor-sparing strategies such as periarticular local anesthetic infiltration.
-
Acta Anaesthesiol Scand · Oct 2021
Randomized Controlled TrialPhrenic nerve block on severe post-hepatectomy shoulder pain: A randomized, double-blind, placebo-controlled, pilot study.
Severe shoulder pain occurs frequently after surgery close to the diaphragm, potentially caused by referred pain via the ipsilateral phrenic nerve. We aimed to assess the analgesic effect of an ultrasound-guided phrenic nerve block on moderate to severe right-sided shoulder pain after open partial hepatectomy. ⋯ Postoperative phrenic nerve block significantly reduced severe post-hepatectomy shoulder pain. Larger studies are warranted to confirm the lack of clinically relevant block-related impairment of respiratory function.
-
Reg Anesth Pain Med · Oct 2021
Randomized Controlled TrialUltrasound-guided genicular nerve blocks following total knee arthroplasty: a randomized, double-blind, placebo-controlled trial.
Local anesthetic blockade of the genicular nerves, known targets of radiofrequency ablative techniques for knee pain, has not previously been studied in a randomized controlled trial evaluating acute pain after knee arthroplasty. We hypothesized that genicular nerve blockade added to an existing block regimen in total knee arthroplasty would result in a reduction in 24 hours opioid consumption. ⋯ Genicular nerve blockade was associated with a reduction in opioid consumption at 24 hours in primary total knee arthroplasty patients.
-
Reg Anesth Pain Med · Sep 2021
Randomized Controlled TrialIs preoperative genicular radiofrequency ablation effective for reducing pain following total knee arthroplasty? A pilot randomized clinical trial.
Although total knee arthroplasty (TKA) is an effective treatment for severe knee osteoarthritis (OA), a subset of patients experience significant postoperative pain and dissatisfaction. Several clinical trials support the analgesic benefits of genicular nerve radiofrequency ablation (GN-RFA) for non-operative knee OA, but only one prior trial has examined the effects of this intervention given preoperatively on postoperative outcomes following TKA, showing no analgesic benefit of cooled GN-RFA. The current study evaluated whether conventional thermal GN-RFA performed preoperatively resulted in significant improvements in pain and function following TKA. ⋯ Conventional GN-RFA of the superior lateral, superior medial, and inferior medial genicular nerves when performed prior to TKA did not provide clinically significant pain relief or improvement in functional status at 2 or 6 weeks postoperatively.