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Keywords Epidural analgesia after abdom...

Epidural analgesia after abdominal surgery

https://read.qxmd.com/read/37829781/correlation-of-pain-perception-and-fentanyl-consumption-after-major-abdominal-surgery-with-cgrp-4218t-c-polymorphism-a-prospective-interventional-study
#21
JOURNAL ARTICLE
H T Prashant, Kirti N Saxena, Seema Kapoor, Bharti Wadhwa, Sukhyanti Kerai, Prachi Gaba
BACKGROUND AND AIMS: Genetic polymorphisms contribute to patients' variability in pain perception and response to opioid treatment. The present study evaluated the association of calcitonin gene-related peptide (CGRP) 4218T/C polymorphisms with fentanyl consumption over 24 h postoperatively in patients after major abdominal surgery. METHODS: Eighty-five patients undergoing major abdominal surgery under general anaesthesia were recruited. For postoperative analgesia, epidural fentanyl and intravenous paracetamol were provided...
September 2023: Indian Journal of Anaesthesia
https://read.qxmd.com/read/37758623/therapeutic-efficacy-of-intravenous-lidocaine-infusion-compared-with-thoracic-epidural-analgesia-in-major-abdominal-surgery-a-noninferiority-randomised-clinical-trial
#22
RANDOMIZED CONTROLLED TRIAL
Fabian D Casas-Arroyave, Susana C Osorno-Upegui, Mario A Zamudio-Burbano
BACKGROUND: Open major abdominal surgery is one of the most risky surgical procedures for acute postoperative pain. Thoracic epidural analgesia (TEA) has been considered the standard analgesic approach. In different reports, lidocaine i.v. has been shown to have an analgesic efficacy comparable with TEA. We compared the analgesic efficacy of i.v. lidocaine with thoracic epidural analgesia using bupivacaine in patients undergoing major abdominal surgery. METHODS: In this noninferiority clinical trial, 210 patients were randomised to thoracic epidural bupivacaine with morphine or i...
November 2023: British Journal of Anaesthesia
https://read.qxmd.com/read/37741618/influence-of-regional-analgesia-on-self-reported-quality-of-sleep-after-gynecological-abdominal-surgery-a-secondary-analysis-of-a-randomized-trial
#23
JOURNAL ARTICLE
Ninnie Borendal Wodlin, Emelie Oliv, Preben Kjølhede, Lena Nilsson
OBJECTIVE: To determine whether intrathecal morphine analgesia (ITM) in abdominal surgery for presumed gynecological malignancy was associated with better self-reported sleep quality postoperatively compared with epidural analgesia (EDA), and to evaluate risk factors for bad sleep quality. METHODS: A secondary analysis of a randomized open controlled trial, comparing ITM and EDA as postoperative analgesia in 80 women undergoing laparotomy under general anesthesia in an ERAS framework...
September 21, 2023: Journal of Obstetrics and Gynaecology Canada: JOGC
https://read.qxmd.com/read/37693033/comparison-of-ultrasound-guided-transversus-abdominis-plane-block-and-caudal-epidural-block-for-postoperative-analgesia-in-paediatric-lower-abdominal-surgeries-a-randomised-controlled-trial
#24
JOURNAL ARTICLE
Vivek Ranjan, Swati Singh
BACKGROUND AND AIMS: Ultrasound-guided transversus abdominis plane (TAP) block is an effective technique for postoperative analgesia in lower abdominal surgeries. This study aims to compare the duration and efficacy of an ultrasound-guided TAP block with those of a caudal epidural for paediatric unilateral lower abdominal surgeries. METHODS: After ethical approval, sixty children aged 1 to 9 years were randomised into ultrasound-guided TAP block or caudal block with general anaesthesia for unilateral lower abdominal surgeries...
August 2023: Indian Journal of Anaesthesia
https://read.qxmd.com/read/37683972/comparative-efficacy-of-micropore-tm-surgical-dressing-tegaderm-tm-and-lockit-plus%C3%A2-for-lumbar-epidural-catheter-fixation-in-children-a-prospective-parallel-group-randomized-controlled-trial
#25
JOURNAL ARTICLE
D Anilakumari, D Singla, A Agarwal, R Kumari
BACKGROUND: Proper fixation of an epidural catheter is necessary for desired drug effect and to prevent catheter displacement. Different techniques have been used for epidural catheter fixation. The aim of the study was to compare the relative efficacy of MicroporeTM surgical dressing, TegadermTM , and Lockit plus® in preventing lumbar epidural catheter migration in children. METHODS: We studied 167 patients aged 5-16 years, for up to 48 hrs. after the elective abdominal or lower limb surgery...
September 6, 2023: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/37505418/effectiveness-of-preoperative-thoracic-epidural-testing-strategies-a-retrospective-comparison-of-three-commonly-used-testing-methods
#26
JOURNAL ARTICLE
Hermann Dos Santos Fernandes, Naveed Siddiqui, Sharon Peacock, Ezequiel Vidal, John Matelski, Bahar Entezari, Muhammad Khan, Yehoshua Gleicher
PURPOSE: Thoracic epidural analgesia (TEA) is a well stablished technique for pain management in major thoracic and abdominal surgeries; however, it has considerable failure rates. Local anesthetic (LA) administration and subsequent assessment of sensory block through physical examination (e.g., decreased temperature perception determined via an LA temperature dissociation test [LATDT]) has been the historical standard for evaluation of thoracic epidural placement. Nevertheless, newer methods to objectively evaluate successful placement have recently been developed, e...
July 28, 2023: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/37454895/utility-of-continuous-paravertebral-block-after-retroperitoneal-abdominal-aortic-aneurysm-repair
#27
JOURNAL ARTICLE
Cody B Jackson, Jamshed Desai, W Anthony Lee, Leslie A Renfro
BACKGROUND: Open abdominal aortic aneurysm (AAA) repairs can be associated with significant pain and morbidity. Previous studies have demonstrated utility of adjunctive epidural analgesia (EA) in addition to general anesthesia (GA) to reduce pain and blunt the maladaptive surgical stress response. However, EA may be complicated by epidural hematomas and severe hypotension. Recently, we started using continuous paravertebral block (PVB) for perioperative analgesia after retroperitoneal AAA repair...
July 15, 2023: Annals of Vascular Surgery
https://read.qxmd.com/read/37360747/erector-spinae-plane-esp-block-for-postoperative-pain-management-after-open-oncologic-abdominal-surgery
#28
RANDOMIZED CONTROLLED TRIAL
Michael Dubilet, Benjamin F Gruenbaum, Michael Semyonov, Shlomo Yaron Ishay, Anton Osyntsov, Michael Friger, Alexander Geftler, Alexander Zlotnik, Evgeni Brotfain
Patients undergoing abdominal oncologic surgical procedures require particular surgical and anesthesiologic considerations. Traditional pain management, such as opiate treatment, continuous epidural analgesia, and non-opioid drugs, may have serious side effects in this patient population. We evaluated erector spinae plane (ESP) blocks for postoperative pain management following elective oncologic abdominal surgeries. In this single-center, prospective, and randomized study, we recruited 100 patients who underwent elective oncological abdominal surgery between December 2020 and January 2022 at Soroka University Medical Center in Beer Sheva, Israel...
2023: Pain Research & Management
https://read.qxmd.com/read/37333708/comparison-of-median-and-paramedian-technique-of-thoracic-epidural-anaesthesia-in-patients-undergoing-laparotomy-under-combined-general-and-epidural-anaesthesia-a-prospective-observational-study
#29
JOURNAL ARTICLE
Priyanka Mudavath, Indira Gurajala, Prasad R Kaluvala, Padmaja Durga
BACKGROUND AND AIMS: Most studies have found that lumbar epidural catheterisation is technically easier with a paramedian than median approach. There is scant literature comparing the two approaches to the epidural space in the mid-thoracic spine. This study aims to compare the median versus paramedian approaches in the location of epidural space in the T7-9 region in patients undergoing laparotomy under combined general and epidural anaesthesia. METHODS: A prospective observational study was conducted after ethical approval and written informed consent on 70 patients undergoing major abdominal surgery...
May 2023: Indian Journal of Anaesthesia
https://read.qxmd.com/read/37321761/intrathecal-opioids-for-the-management-of-post-operative-pain
#30
REVIEW
Narinder Rawal
Intrathecal opioids are highly effective in the management of post-operative pain. The technique is simple with a very low risk of technical failure or complications, and it does not require additional training or expensive equipment such as ultrasound machines and, therefore, is widely practised around the world. The high-quality pain relief is not associated with sensory, motor or autonomic deficits. This study focuses on intrathecal morphine (ITM) which is the only US Food and Drug Administration-approved opioid for intrathecal administration and remains the most commonly used as well as extensively studied...
June 2023: Best Practice & Research. Clinical Anaesthesiology
https://read.qxmd.com/read/37221022/effect-of-rectus-sheath-anaesthesia-versus-thoracic-epidural-analgesia-on-postoperative-recovery-quality-after-elective-open-abdominal-surgery-in-a-french-regional-hospital-the-study-protocol-of-a-randomised-controlled-qor-rect-cath-trial
#31
JOURNAL ARTICLE
Thomas Maury, Arpiné Elnar, Sandra Marchionni, Romain Frisoni, Christophe Goetz, Antoine Bécret
INTRODUCTION: Enhanced recovery after surgery (ERAS) protocols increase patient well-being while significantly reducing mortality, costs and length-of-stay after surgery. A key component is multimodal analgesia that prevents postoperative pain and facilitates early refeeding and mobilisation. Thoracic epidural analgesia (TEA) was long the gold standard for locoregional anaesthesia in anterior abdominal wall surgery. However, newer wall-block techniques such as rectus-sheath block (RSB) may be preferable because they are less invasive and may provide equivalent analgesia with fewer side effects...
May 23, 2023: BMJ Open
https://read.qxmd.com/read/37200670/inadvertent-placement-of-thoracic-epidural-catheter-in-pleural-cavity-a-case-report-and-review-of-published-literature
#32
Sanaa Khan, Wajahat Nazir Ahmed, Asad Aleem, Saad Ur Rehman
Thoracic epidural placement is considered the gold standard for pain management for abdominal or thoracic surgery. It provides analgesia superior to that provided by opioids with a decreased risk of pulmonary complications. Insertion of a thoracic epidural catheter requires the knowledge and expertise of an anesthetist; epidural catheter insertion may be challenging especially when sited in the higher thoracic region, in patients with unusual neuraxial anatomy, patients unable to position adequately for insertion or morbidly obese patients...
April 2023: Curēus
https://read.qxmd.com/read/37168150/comparison-of-changes-in-chest-wall-mechanics-and-respiratory-timing-between-patient-controlled-epidural-analgesia-and-intravenous-patient-controlled-analgesia-after-laparoscopic-gastrectomy-a-randomized-controlled-trial
#33
JOURNAL ARTICLE
Masako Asada, Keiko Nobukuni, Jun Yoshino, Naoyuki Fujimura
BACKGROUND: Upper abdominal surgery is associated with postoperative diaphragmatic dysfunction. Whether patient-controlled epidural analgesia (PCEA) is superior to intravenous patient-controlled analgesia (IV-PCA) in preventing postoperative diaphragmatic dysfunction is still unclear in laparoscopic gastric surgery. METHODS: Sixteen patients undergoing laparoscopic gastrectomy randomly received either PCEA or IV-PCA. The primary outcomes were the change in chest wall mechanics and respiratory timing, measured by respiratory inductive plethysmography (Respitrace; Ambulatory Monitoring Inc...
April 2023: Curēus
https://read.qxmd.com/read/36958287/comparison-of-postoperative-analgesic-effects-of-thoracic-epidural-analgesia-and-rectus-sheath-block-in-laparoscopic-abdominal-surgery-a-randomized-controlled-noninferiority-trial
#34
JOURNAL ARTICLE
Yohei Owada, Yuya Murata, Yuto Hamaguchi, Kumiko Yamada, Shinichi Inomata, Koichi Ogawa, Yusuke Ohara, Yosihimasa Akashi, Tsuyoshi Enomoto, Kazushi Maruo, Makoto Tanaka, Tatsuya Oda
INTRODUCTION: In the Enhanced Recovery After Surgery program, abdominal wall blocks are strongly recommended as postoperative multimodal analgesia for laparoscopic abdominal surgery. The purpose of this study was to compare the efficacy of single-shot rectus sheath block (RSB) with that of thoracic epidural analgesia (TEA) as a method of multimodal analgesia in patients receiving conventional laparoscopic abdominal surgery. METHODS: A noninferiority comparison was performed...
March 23, 2023: Asian Journal of Endoscopic Surgery
https://read.qxmd.com/read/36923189/emergency-awake-abdominal-surgery-under-thoracic-epidural-anaesthesia-in-a-high-risk-patient-within-a-resource-limited-setting
#35
Johannes J Le Roux, Koji Wakabayashi, Zainub Jooma
Awake abdominal surgery is performed daily around the world for caesarean section surgery under lumbar subarachnoid anaesthesia and/or graded lumbar epidural anaesthesia. Reports of awake abdominal surgery under thoracic epidural anaesthesia (TEA) for patients with bowel obstruction are scarce, as this patient population is at high risk for pulmonary aspiration. In this report, we describe a case in which a graded TEA was successfully used as the sole anaesthetic technique in a patient with severe pulmonary disease undergoing an awake emergency laparotomy for bowel ischaemia for whom no postoperative intensive care monitoring was available...
February 2023: Curēus
https://read.qxmd.com/read/36599018/surface-landmarks-in-the-lateral-decubitus-position-are-unreliable-for-thoracic-epidural-catheter-placement-a-case-series
#36
JOURNAL ARTICLE
Sean W Dobson, Robert S Weller, James D Turner, Christopher M Lack, Daryl S Henshaw
Thoracic epidurals remain the optimal method for providing postoperative analgesia after complex open abdominal and thoracic surgeries. However, they can be challenging to both place and maintain, as evidenced by a failure rate that exceeds 30%.1 Proper identification of the epidural space and accurate placement of the catheter are critical in order to deliver effective postoperative analgesia and avoid failure.2,3 This case series investigated the difficulty in correctly identifying the proper vertebral level for thoracic epidural catheter procedures when performed in the lateral decubitus position...
December 1, 2022: A&A Practice
https://read.qxmd.com/read/36547262/posterior-quadratus-lumborum-block-versus-epidural-analgesia-for-postoperative-pain-management-after-open-radical-cystectomy-a-randomized-clinical-trial
#37
RANDOMIZED CONTROLLED TRIAL
Andrus Korgvee, Erik Veskimae, Heini Huhtala, Heikki Koskinen, Teuvo Tammela, Eija Junttila, Maija-Liisa Kalliomaki
BACKGROUND: In open abdominal surgery, continuous epidural analgesia is commonly used method for postoperative analgesia. However, ultrasound (US)-guided fascial plane blocks may be a reasonable alternative. METHODS: In this randomized controlled trial, we compared posterior quadratus lumborum block (QLB) with epidural analgesia for postoperative pain after open radical cystectomy (ORC). Adult patients aged 18-85 with bladder cancer (BC) scheduled for open RC were randomized in two groups...
March 2023: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/36446941/transverse-abdominis-plane-block-compared-with-patient-controlled-epidural-analgesia-following-abdominal-surgery-a-meta-analysis-and-trial-sequential-analysis
#38
JOURNAL ARTICLE
Young Hyun Jeong, Ji-Yoon Jung, Hyeyeon Cho, Hyun-Kyu Yoon, Seong-Mi Yang, Ho-Jin Lee, Won Ho Kim
Thoracic epidural analgesia (TEA) and transversus abdominis plane (TAP) block are used for pain control after abdominal surgery. Although there have been several meta-analyses comparing these two techniques, the conclusion was limited by a small number of studies and heterogeneity among studies. Our meta-analysis used the Medline, EMBASE, and Cochrane central library databases from their inception through September 2022. Randomized controlled trials (RCTs) comparing TEA and TAP block were included. The pre-specified primary outcome was the pain score at rest at 12 h postoperatively...
November 29, 2022: Scientific Reports
https://read.qxmd.com/read/36446689/effects-of-ultrasound-guided-caudal-epidural-and-transversus-abdominis-plane-block-on-postoperative-analgesia-in-pediatric-inguinal-hernia-repair-surgeries
#39
JOURNAL ARTICLE
Hacer Polat, Emre Şentürk, Meltem Savran Karadeniz, Emre Sertaç Bingül, Ebru Emre Demirel, Başak Erginel, Kamil Mehmet Tuğrul
INTRODUCTION: Ultrasound guided caudal epidural block (CEB) and transversus abdominis plane block (TAPB) are two techniques which are used for pain management after inguinal hernia surgeries (IHR). CEB is accepted as gold standard for lower abdominal surgeries while TAPB is more popular. OBJECTIVE: It is aimed to compare ultrasound guided CEB and TAPB for postoperative pain scores, additional analgesic requirement and chronic pain development in pediatric bilateral open IHR...
November 15, 2022: Journal of Pediatric Urology
https://read.qxmd.com/read/36381915/erector-spinae-plane-catheter-for-postoperative-thoracotomy-pain-in-a-patient-with-indwelling-spinal-cord-stimulators-a-case-report
#40
David T Cheng, Eldhose Abrahams, Aimee Pak
Analgesia after thoracotomy is challenging but important as inadequate pain control may result in early postoperative complications and a higher risk for post-thoracotomy pain syndrome. The authors report the successful utilization of an erector spinae plane (ESP) catheter for post-thoracotomy analgesia in a 40-year-old female with two dual-leaded spinal cord stimulators (SCS) in the cervical and thoracic levels. Although thoracic epidural analgesia is the current standard, epidural catheterization may present with obstructive, mechanical, or infectious concerns in patients with SCS...
October 2022: Curēus
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