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Effects Of Transversus Abdominis Plane Block And Intrathecal Morphine On Postoperative Pain Control For Patients Under Going Laparaoscopic Hand Assisted Colorectal Surgery
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Book Synopsis Effects of Transversus Abdominis Plane Block and Intrathecal Morphine on Postoperative Pain Control for Patients Under Going Laparaoscopic Hand Assisted Colorectal Surgery by : Ronald T. Donaldson
Download or read book Effects of Transversus Abdominis Plane Block and Intrathecal Morphine on Postoperative Pain Control for Patients Under Going Laparaoscopic Hand Assisted Colorectal Surgery written by Ronald T. Donaldson and published by . This book was released on 2014 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Effect of Continuous Bilateral Transversus Abdominis Plane Block on Opioid Consumption After Laparoscopic Colorectal Surgery by : Teal Hickey
Download or read book The Effect of Continuous Bilateral Transversus Abdominis Plane Block on Opioid Consumption After Laparoscopic Colorectal Surgery written by Teal Hickey and published by . This book was released on 2017 with total page 59 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Introduction: Perioperative pain management and attenuation of the sympathetic stress response is important in achieving positive patient outcomes. Opioids have been at the frontlines of analgesia plans. The untoward side effects of opioids lead practitioners to explore alternative analgesia methods with strategies including use of multimodal pain management, NSAIDs, and peripheral and neuraxial nerve blockade. While single injection bilateral transversus abdominis plane (TAP) blocks prove efficacious in pain management and opioid reduction, there is little evidence on the use of continuous TAP blocks. The purpose of this study is to explore the effects of continuous bilateral TAP blocks on opioid consumption after laparoscopic colorectal surgery. Methods: IRB approval was obtained for a retrospective chart analysis of elective laparoscopic colorectal procedures in a single medical center. All cases received intrathecal narcotics preoperatively. The experimental group received continuous bilateral TAP blocks placed before emergence and continued through postoperative day (POD) 2 while the control group did not. Thirty-four charts were reviewed. Demographics including age, sex, BMI, and ASA classification were collected and analyzed. The dependent variable, perioperative opioid consumption, was collected and analyzed. Secondary outcome measures, including length of stay, readmission, and complications (ileus and respiratory depression), were collected and analyzed. Results: Using a one-tailed t-test, statistical analysis was conducted to establish the significance of the data. Demographic analysis yielded no statistical significance between the control and experimental groups. No statistical significance was found in total morphine equivalents consumed during POD 1 or POD 2. There was no statistical difference in the length of stay, readmission rate, or rate of complications. There was significantly less opioid consumption in the experimental group in the post anesthesia care unit (p = 0.049), during POD zero (p = 0.006), and when comparing total opioid use from surgery through POD two (p = 0.031). Discussion: The use of continuous bilateral TAP blocks has been demonstrated to be an opioid reducing analgesic tool that is effective in patients recovering from laparoscopic colorectal surgery. When added to an enhanced recovery after surgery protocol, we believe that continuous bilateral TAP blocks will serve as an opioid sparing technique that will provide analgesia while allowing patients to return to normal physiological function as quickly as possible. We project that this will translate to fewer complications, a shorter length of stay, greater patient satisfaction, and fewer readmissions. Several theories warrant exploration as to why this study failed to show a significant decrease in opioid use during POD 1 and POD 2 despite the overall decrease in opioid consumption"--Page i.
Book Synopsis INTRATHECAL MORPHINE AND ABDOMINAL WALL BLOCKS REDUCE ANALGESIC CONSUMPTION AND POSTOPERATIVE NAUSEA AND VOMITING (PONV) IN ROBOTIC-ASSISTED LAPAROSCOPIC PROSTATECTOMY (RALP) by : Luca Aiello
Download or read book INTRATHECAL MORPHINE AND ABDOMINAL WALL BLOCKS REDUCE ANALGESIC CONSUMPTION AND POSTOPERATIVE NAUSEA AND VOMITING (PONV) IN ROBOTIC-ASSISTED LAPAROSCOPIC PROSTATECTOMY (RALP) written by Luca Aiello and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and aims: RALP is an increasingly emerging surgical approach for treating prostatic cancer.Patients treatedwith US-TAP block (TAPb) and rectus sheath blocks showed reduction in perioperative opioids administration andpostoperative pain(1).Moreover analgesic effects of intrathecal morphine (IM) was described as its capacity in decreasingdetrusor contractility and minctional urgency(2).Aim of this study was evaluate intra- and post-operative analgesic efficacy ofIM administration coupled to TAPb in RALP.Methods: 55 ASA Iu2013III patients were enrolled;all patients were under general anesthesia with US-TAPb (groupA,25patients) and 30patients received IM and TAPb and rectus sheath blocks (group B).Levobupivacaine 7,5mg andSulphate Morphine 100mcg in 3ml of hydrosaline 0.9%,were used for subarachnoidal injections.All patients receivedpostoperative multimodal analgesia with Paracetamol 3g/die iv.Ketoprofen and Tramadol were used as rescue drugs.Results:No complications were recorded.Intra- and post-operative drugs consumptions are shown in Tab 1.Results: her vital signs were stable during surgery.The patient experienced very good analgesia and described NRS painscore 0-2 up to 18 hours after ESPb.After 18hours and only once in the next 12 hours,the patient requested u201con demandu201dpain medication (Paracetamol 1 gr).The patient experienced no nausea or vomiting, and she was easily mobilized.Conclusions: In our experience,a single IM injection at low dose coupled Levobupivacaine combined with and rectussheath blocks abdominal wall blocks is safe,well tollerated,provide intraoperative lower opioid requirements,ensurepostoperative analgesia and reduce postoperative nausea and vomiting.REFERENCES:1) Ultrasound-guided transversus abdominis plane block (US- TAPb) for robot-assisted radical prostatectomy:a novel u20184-pointu2019 techniqueresults of a prospective,randomized study.Dal Moro F et al. Journal of Robotic Surgery https://doi.org/10.1007/s11701-018-0858-62) Intrathecal morphine for postoperative pain control following robot-assisted prostatectomy:a prospective randomized trial.Junyeol Bae etal J Anesth 2017;31:565u2013571.
Book Synopsis Acute Pain Management by : Pamela E. Macintyre
Download or read book Acute Pain Management written by Pamela E. Macintyre and published by CRC Press. This book was released on 2014-12-04 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt: Highly Commended, BMA Medical Book Awards 2015Comprehensive acute pain management no longer means only caring for patients with pain resulting from postoperative and trauma-related causes-it now includes managing patients with acute pain arising from a wide variety of conditions. Acute Pain Management: A Practical Guide provides health professional
Book Synopsis INTRATHECAL MORPHINE WITH OR WITHOUT TAP BLOCK FOR IMPROVED POSTOPERATIVE PAIN RELIEF IN MAJOR ELECTIVE LAPAROSCOPIC UROLOGICAL SURGERY. by :
Download or read book INTRATHECAL MORPHINE WITH OR WITHOUT TAP BLOCK FOR IMPROVED POSTOPERATIVE PAIN RELIEF IN MAJOR ELECTIVE LAPAROSCOPIC UROLOGICAL SURGERY. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Adequate postoperative pain relief is key to early recovery. The use of intrathecal morphine (IT morphine) in addition to a general anaesthetic has become increasingly common practice. The use of a Transversus Abdominal Plane block (TAP block) administered under direct vision by the surgeon is also thought to improve postoperative pain relief and reduce opiate requirement.The aim of our study was to determine if the addition of a TAP block did indeed improve postoperative outcomes.We did a retrospective review of all major elective laparoscopic urological surgeries dating as far back as December 2014. We looked at all the procedures in which IT morphine was administered at the time of induction of anaesthesia. The patients were divided in to two groups: Those who received IT Morphine with a TAP Block or IT Morphine alone. The primary outcome was to compare VAS pain scores and use of IV PCA Morphine/Fentanyl.The patients who received IT morphine alone had lower pain scores and less use of IV PCA morphine than the patients who received IT morphine with TAP block (P=0.00124 and P=0.04036).Our study demonstrates that the addition of a TAP block does not add any benefit in terms of postoperative VAS pain scores or use of IV PCA morphine. However, it does lead to a reduction in the use of other postoperative analgesics, particularly Oramorph.
Book Synopsis Enhanced Recovery After Surgery by : Olle Ljungqvist
Download or read book Enhanced Recovery After Surgery written by Olle Ljungqvist and published by Springer Nature. This book was released on 2020-03-30 with total page 654 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.
Book Synopsis Acute Pain Management by : Pamela E. Macintyre
Download or read book Acute Pain Management written by Pamela E. Macintyre and published by . This book was released on 2010-01-01 with total page 491 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :Ronnie Ann Rosenthal Publisher :Springer Science & Business Media ISBN 13 :1441969993 Total Pages :1364 pages Book Rating :4.4/5 (419 download)
Book Synopsis Principles and Practice of Geriatric Surgery by : Ronnie Ann Rosenthal
Download or read book Principles and Practice of Geriatric Surgery written by Ronnie Ann Rosenthal and published by Springer Science & Business Media. This book was released on 2011-07-12 with total page 1364 pages. Available in PDF, EPUB and Kindle. Book excerpt: "In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be "geriatric surgeons," but to assemble a comprehensive account that will allow "all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients." This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field." NEJM Book Review
Book Synopsis Acute Pain Management by : Raymond S. Sinatra
Download or read book Acute Pain Management written by Raymond S. Sinatra and published by Cambridge University Press. This book was released on 2009-04-27 with total page 729 pages. Available in PDF, EPUB and Kindle. Book excerpt: This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.
Book Synopsis The Effect of Transverses Abdominis Plane Block Combined with Intravenous Analgesia on Perioperative Analgesia and Recovery in Abdominal Colorectal Surgery Patients by : Liang Zhang
Download or read book The Effect of Transverses Abdominis Plane Block Combined with Intravenous Analgesia on Perioperative Analgesia and Recovery in Abdominal Colorectal Surgery Patients written by Liang Zhang and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Objective: To assess the efficacy of preoperative transversus abdominis plane block(TAPB) on perioperative analgesic effect and recovery in patients with abdominal colorectal surgery.Methods: 80 patients scheduled to undergoing abdominal colorectal surgery were randomly divided into two group ( group P and group R), with 40 cases in each group, Ultrasound-guided TAP block was practiced after general anesthesia in Group R with 0.375% Ropivacaine,Capacity of 0.3 ml/kg per side, and not give processing to patients in group P , sevoflurane concentration was maintained at 0% to 2% Intraoperative.Entropy indexwere maintained 40-60 intraoperatively, and keep SPI u2264 50,sufentanil was added 0.1ug/kg per time according to SPI .two groups were implemented PCIA after surgery uff0e The sevoflurane usage in the traoperative and sufentanil usage in the perioperative, postoperative VAS score at five time points , adverse reactions u3001 ambulation and length of hospital stay and patients' satisfaction of two groups wereanalyzed. Results: Compared with group P uff0c The usage of sufentanil in traoperative and 2hu30016h after surgery of Group R was significantly lower than that of group P ,the time to gastrointestinal function recovery and patients'first ambulation of Group R was in advance uff0c and insufficient analgesia cases are lesser than Group P(p
Book Synopsis Efficacy Of Bilateral Dual Transversus Abdominis Plane (TAP) Block For Postoperative Analgesia After Open Abdominal Aortic Aneurysm (AAA) Surgery by :
Download or read book Efficacy Of Bilateral Dual Transversus Abdominis Plane (TAP) Block For Postoperative Analgesia After Open Abdominal Aortic Aneurysm (AAA) Surgery written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Goal of Study: Patients scheduled for abdominal aortic aneurysm (AAA) surgery carry a high risk of cardiac, renal or respiratory comorbidities. The post-operative pain control is essential in this population. Transversus abdominis plane (TAP) block has been described as an effective technique to reduce postoperative pain and morphine consumption after gynecologic and lower abdominal surgery but not in open AAA surgery.The aim of this study was to demonstrate the postoperative analgesic efficacy of bilateral dual TAP block by reducing the amount of morphine consumption during the first 24 hours postoperative.Materials and Methods: This randomized, double-blind, controlled, prospective trial approved by the local ethics committee enrolled 60 adult patients with AAA or Leriche syndrome scheduled for an aortic surgery through midline laparotomy. Patients were randomized to receive bilateral dual TAP block using 4 x 10 mL of 0.375% ropivacaine (= 150 mg) (TAP group = 30 patients) or not (CONTROL group = 30 patients). Anaesthetic technique (Remifentanil, Sevoflurane) and postoperative analgesia were standardized. All patients received IV morphine via a morphine patient-controlled analgesia device and IV paracetamol every 6 hours for postoperative analgesia. Postoperative assessments were conducted every hour for the first 48 hours after surgery. Postoperatively pain scores at rest and with movement, total morphine consumption and opioid related side effects were recorded. The primary outcome of the study was total morphine (mg) consumption at 24 hours postoperatively.Results and Discussion: Both groups were comparable as to gender, age, body mass index (BMI), creatinine clearance and ASA physical status. Nine patients (64,3%) in the TAP group had a BMI > 30 kg/m2 and 5 (35,7%) in the CONTROL group. Total morphine consumption at 24 hours was 35,5 mg (+/- 24,2) in the TAP group and 33,3 mg (+/- 19,5) in the CONTROL group (P=0,71). Total morphine consumption at 48 hours was also similar in both groups (58,4 +/- 39 mg vs 60 +/- 35 mg, P=0,85). This non-significant result could be explained by the fact that the dose of ropivacaine wasnu2019t sufficient.Conclusion(s): In our study, bilateral dual TAP block performed in open AAA surgery doesnu2019t show a reduction of morphine consumption during the first 24 hours postoperative. A study with different doses of ropivacaine in this type of surgery could be interesting and refine this work.
Book Synopsis 5 - Ultrasound-guided Bilateral Erector Spinae Plane Block Versus Intrathecal Morphine for Analgesia in Living Donors for Liver Transplantation: A Randomized Non-inferiority Trial by :
Download or read book 5 - Ultrasound-guided Bilateral Erector Spinae Plane Block Versus Intrathecal Morphine for Analgesia in Living Donors for Liver Transplantation: A Randomized Non-inferiority Trial written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Preoperative ITM administration is an effective analgesic method in living donor hepatectomy, but is associated with adverse effects, including postoperative nausea, vomiting, and pruritus. The ESP block has been shown to provide effective postoperative analgesia after various laparoscopic abdominal surgeries. We therefore sought to determine the analgesic effects of ESP block in living liver donors undergoing laparoscopic right hepatectomy. We hypothesized that it would provide noninferior postoperative analgesia compared to ITM and reduce postoperative nausea/vomiting and pruritus.Methods: Fifty-four patients scheduled for pure laparoscopic right donor hepatectomy were randomly assigned to one of two groups: an ESP group (n=27) and an ITM group (n=27). Patients in the ESP group received preoperative bilateral single-injection ESP blocks at the level of the T8 transverse process with an injection of 20 mL 0.5% ropivacaine with 5mcg/mL epinephrine on each side). Patients in the ITM group received a preoperative intrathecal injection of 400 u00b5g morphine sulfate. The primary outcome was the pain score at rest 24 hours after surgery as assessed by an 11-point numeric rating scale. The predetermined noninferiority limit was 1. Incidences of postoperative nausea/vomiting and pruritus were assessed.Results: The mean resting pain score 24 hours after surgery was 2.5u00b11.0 in the ESP group and 1.3u00b11.1 in the ITM group (p
Book Synopsis Essentials of Anesthesia for Infants and Neonates by : Mary Ellen McCann
Download or read book Essentials of Anesthesia for Infants and Neonates written by Mary Ellen McCann and published by Cambridge University Press. This book was released on 2018-02-22 with total page 465 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical, comprehensive guide to the special needs of infants and neonates undergoing anesthesia.
Book Synopsis Essentials of Interventional Cancer Pain Management by : Amitabh Gulati
Download or read book Essentials of Interventional Cancer Pain Management written by Amitabh Gulati and published by Springer. This book was released on 2018-12-28 with total page 510 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text provides a comprehensive review and expertise on various interventional cancer pain procedures. The first part of the text addresses the lack of consistency seen in the literature regarding interventional treatment options for specific cancer pain syndromes. Initially, it discusses primary cancer and treatment-related cancer pain syndromes that physicians may encounter when managing cancer patients. The implementation of paradigms that can be used in treating specific groups of cancer such as breast cancer, follows. The remainder of the text delves into a more common approach to addressing interventional cancer pain medicine. After discussing interventional options that are commonly employed by physicians, the text investigates how surgeons may address some of the more severe pain syndromes, and covers the most important interventional available for our patients, intrathecal drug delivery. Chapters also cover radiologic options in targeted neurolysis and ablative techniques, specifically for bone metastasis, rehabilitation to address patients’ quality of life and function, and integrative and psychological therapies. Essentials of Interventional Cancer Pain Management globally assesses and addresses patients’ needs throughout the cancer journey. Written by experts in the field, and packed with copious tables, figures, and flow charts, this book is a must-have for pain physicians, residents, and fellows.
Download or read book Acute Pain written by Lesley Bromley and published by Oxford University Press. This book was released on 2010-06-03 with total page 205 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text covers the fundamentals of pain, the pharmacology of drugs used, and summarises the current evidence base for the management of acute pain. It provides practical direct clinical applications and strategies for the management of specific medical conditions in patient groups such as the elderly
Book Synopsis Critical Care Sedation by : Angelo Raffaele De Gaudio
Download or read book Critical Care Sedation written by Angelo Raffaele De Gaudio and published by Springer. This book was released on 2018-01-23 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive guide to delivering analgesia and sedation to critically ill patients for professionals and caregivers being involved in the management of these patients. It discusses and explains in detail the advantages and limitations of each drug and device using clear flowcharts, diagrams and tables. Furthermore, it explores the new drugs and – above all – new sedation delivery systems, particularly those for administering volatile anesthetics on ICUs. This book is a valuable and practical resource for anesthesists, intensivists and emergency physicians interested in sedation.
Book Synopsis Post-Anesthesia Care by : James W. Heitz
Download or read book Post-Anesthesia Care written by James W. Heitz and published by Cambridge University Press. This book was released on 2016-08-22 with total page 389 pages. Available in PDF, EPUB and Kindle. Book excerpt: The initial hours after surgery are a critical time in the care of the surgical patient. Familiarity with the clinical presentation of perioperative complications is important to achieving optimal outcomes. By taking an approach to complications based upon signs and symptoms seen in the early post-operative period among adult patients undergoing non-cardiac surgery, this book aids the practitioner in the clinical management of surgical patients during the often turbulent hours after surgery. After a brief introduction to PACU organization, this manual discusses the common and most serious symptoms encountered in the post-operative patient, giving guidance on diagnosis of the underlying disorder and the treatment options available. The book also includes chapters dedicated to subspecialty patients, including patients requiring post-operative mechanical ventilation, pediatric patients, patients with implantable cardiac devices, morbidly obese patients and the complex pain patient. This practical manual is essential reading for all practitioners working in the PACU environment.
