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Costa GL, Spadola F, Di Pietro S, Nava V, Licata P, Giudice E, Leonardi F, Bruno F, Messina L, Macrì F, Macrì D, Ferrantelli V, Tabbì M, Interlandi C. Tramadol vs. Lidocaine Administered Intraperitoneally and in Incisional Lines for the Intraoperative and Postoperative Pain Management of Romifidine-Telazol-Anesthetized Swine Undergoing Umbilical Hernia Repair. Animals (Basel) 2023; 13:2905. [PMID: 37760305 PMCID: PMC10525986 DOI: 10.3390/ani13182905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of the study was to compare the analgesic efficacy of tramadol and lidocaine for local anesthesia during umbilical hernia repair in swine. The study was performed on 66 large white crossbred swine. The swine received a mixture of tiletamine/zolazepam at 5 mg/kg and romifidine at 80 µg/kg, administered intramuscularly. Then, they were divided into three groups (n = 22) that received different treatments with lidocaine at 4 mg/kg and tramadol at 4 mg/kg. The LL group received lidocaine both by infiltration of the surgical planes and intraperitoneally. The LT group received lidocaine by infiltration of the surgical planes and tramadol intraperitoneally. The TT group received tramadol both by infiltration of the surgical planes and intraperitoneally. In all groups, the infiltration of the surgical planes into the umbilical region involved both the skin and muscle planes. Heart rate, noninvasive arterial blood pressure, and respiratory frequency were recorded during surgery. The response to the surgical stimulus was evaluated using a cumulative pain scale (the cut-off point for rescue analgesia was set to 10). Postoperative pain was assessed using the UNESP-Botucatu pig composite acute pain scale (the cut-off point was set to 4). The trend of physiological variables was adequate for patients under anesthesia. No subject required intraoperative and postoperative rescue analgesia. Tramadol could therefore be used for pain management in livestock.
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Affiliation(s)
- Giovanna Lucrezia Costa
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Filippo Spadola
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Simona Di Pietro
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Vincenzo Nava
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Patrizia Licata
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Elisabetta Giudice
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Fabio Leonardi
- Department of Veterinary Science, University of Parma, Via del Taglio 10, 43126 Parma, Italy;
| | - Fabio Bruno
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Laura Messina
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Francesco Macrì
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Daniele Macrì
- Zooprophylactic Institute, Via Gino Marinuzzi 4, 90100 Palermo, Italy; (D.M.); (V.F.)
| | - Vincenzo Ferrantelli
- Zooprophylactic Institute, Via Gino Marinuzzi 4, 90100 Palermo, Italy; (D.M.); (V.F.)
| | - Marco Tabbì
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Claudia Interlandi
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
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Kim DE, Kang WJ, Choi JH, Yi JW, Park SW. The Effects of Perioperative Intravenous Lidocaine Injection on Postoperative Pain following Laparoscopic Cholecystectomy. Korean J Anesthesiol 2008. [DOI: 10.4097/kjae.2008.54.1.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Dae Eon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea
| | - Wha Ja Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea
| | - Jung Hyun Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea
| | - Jae Woo Yi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea
| | - Sung Wook Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea
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Abstract
Although significant improvement has been made in the treatment of pain in the postoperative period, many patients still experience unnecessary discomfort resulting in distress, higher morbidity and prolonged stay in hospital. The standard pillar of postoperative treatment of severe pain is the use of opioids. However, adverse reactions to opioids make their use unfavourable. A better understanding of the pathophysiology of pain has helped clinicians to a more balanced approach to postoperative pain treatment. The development of the multimodal approach to postoperative analgesia, with the use of different drugs acting via different routes to give good analgesia, with minimal side-effects, represents a major development in the treatment of postoperative pain. Early, aggressive mobilisation and feeding must follow in order to restore normal conditions quickly. Alternatives to opioids should be used as extensively as possible. Local anaesthesia, used as regional blocks or as wound infiltration, is most beneficial. Paracetamol has good basic analgesic properties, and should probably be used in dosages higher than recommended today. The combination with a NSAID results in better and longer-lasting analgesia. The intravenous form propacetamol will increase the possibilities of its use. The new concept of selective COX-2 inhibiting NSAIDs will result in analgesic and anti-inflammatory drugs with fewer side-effects. The well-known inexpensive group of corticosteroids have good analgesic and anti-emetic properties, and are especially interesting to use in patients who do not tolerate NSAIDs. The alpha2-receptor agonists like clonidine, when administered epidurally or intrathecally, are useful adjuncts, but their adverse effects on sedation and hypotension limit their use. NMDA-receptor antagonists are of limited value in the postoperative period. Adenosine and neostigimine are still on a research level but may lead to new, clinically useful analgesic drugs. In the future, cannabinoids, cholecystokinin-receptor antagonists and neurokinin-1 antagonists may become important analgesic drugs.
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Affiliation(s)
- V Dahl
- Department of Anaesthesia, Baerum Hospital, Norway.
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Elhakim M, Elkott M, Ali NM, Tahoun HM. Intraperitoneal lidocaine for postoperative pain after laparoscopy. Acta Anaesthesiol Scand 2000; 44:280-4. [PMID: 10714840 DOI: 10.1034/j.1399-6576.2000.440310.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND A controversy exists over the effectiveness and clinical value of intraperitoneal local anaesthetics for treating pain after laparoscopic cholecystectomy. The use of intraperitoneal lidocaine was evaluated in this study. METHODS At the end of surgery, 200 ml saline containing 200 mg lidocaine, or the same volume of saline, were randomly splashed under the right diaphragmatic surface in 50 patients in a double-blind manner. Postoperative shoulder and abdominal pain intensity were recorded on a numeric grading scale and a visual analogue scale, respectively. Analgesic consumption was also recorded. Respiratory function tests were compared before and after surgery. Side effects and recovery variables were assessed by the nurses at 2-h intervals. RESULTS The incidence, severity and duration of shoulder pain were reduced from 40% of patients scoring 3.9+/-0.2 for duration of 17.9+/-0.2 h in the control group to 12% scoring 2.5+/-0.5 for duration of 1.6+/-0.01 h in the lidocaine group. Lidocaine treated patients had significantly less abdominal postoperative pain immediately on return to the ward and during the first postoperative day (P<0.05). "No pain on deep inspiration" was reported by 72% of patients in the lidocaine group immediately on return to the ward compared to 8% of those in the control group. Analgesic consumption for 24 h after surgery was significantly less in the lidocaine group (P<0.05). There were no significant differences in respiratory function tests, recovery variables or incidence of side effects between the two groups. CONCLUSION Intraperitoneal lidocaine is simple to use and results in a long-lasting reduction of pain after a single administration.
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Affiliation(s)
- M Elhakim
- Department of Anaesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
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Estèbe JP. [Locoregional intravenous anesthesia]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1999; 18:663-73. [PMID: 10464534 DOI: 10.1016/s0750-7658(99)80154-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyse current data on intravenous regional anaesthesia (IVRA), its benefits and drawbacks. DATA SOURCES Articles were obtained from a Medline search using the following search terms: 'intravenous regional anaesthesia', alone or combined with 'local anaesthetic agents', 'toxicity'. STUDY SELECTION Following articles in English and in French have been selected: main articles, original articles, update and review articles, letters to the editor and recent editorials. DATA EXTRACTION Physiopathological and pharmacological data were extracted for involved mechanisms and means for improving this technique. DATA SYNTHESIS IVRA is a reliable and efficient technique with a lower cost than general anaesthesia and well adapted for limb surgery in the ambulatory patient. Depending on the site of the surgical field, the pneumatic tourniquet is set either on the arm, forearm or wrist for the upper limb or thigh, calf or ankle for the lower limb. When set in periphery, less local anaesthetic agent is required. A wide tourniquet requires a lower inflation pressure than a double cuff tourniquet. A single cuff is as efficient as a dual cuff if shape, size and inflating pressure are appropriate. The limb occlusion pressure (LOP) is the minimal pressure required to occlude blood flow. It is assessed with either a pulse oximeter or Doppler for determination of the lowest cuff inflating pressure. The cuff is inflated to 50 mmHg above LOP. Oozing in the surgical field can be decreased by the re-exsanguination technique. Currently, lidocaine is the only local anaesthetic released in France for IVRA. Addition of a muscle relaxant, a NSAID or clonidine allows the dose of local anaesthetic agent to be decreased and improves postoperative analgesia.
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Affiliation(s)
- J P Estèbe
- Service d'anesthésie-réanimation 2, CHRU de Rennes, Hôpital Hôtel-Dieu, France
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