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Uemura Y, Sakai Y, Tsutsumi YM, Kakuta N, Murakami C, Satomi S, Oyama T, Ohshita N, Takasago T, Hamada D, Sairyo K, Tanaka K. Postoperative nausea and vomiting following lower limb surgery :a comparison between single-injection intraarticular anesthesia and continuous epidural anesthesia. THE JOURNAL OF MEDICAL INVESTIGATION 2020; 66:303-307. [PMID: 31656294 DOI: 10.2152/jmi.66.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Study Objective : the incidence of postoperative nausea and vomiting (PONV) following single-injection intraarticular anesthesia was compared to that following continuous epidural anesthesia. Design : Prospective, double-blind, randomized study. Setting : University-affiliated teaching hospital. Patients : Forty-eight patients finally participated in this study, and each group contained twenty-four patients. Interventions : Patients scheduled to undergo lower limb surgery under general anesthesia were randomly allocated into two groups, to receive either single-injection intraarticular or continuous epidural anesthesia for postoperative analgesia. Measurements : The incidence and severity of PONV, complete response rates (i.e., no vomiting or rescue antiemetic use), and pain scores were recorded 2, 24, and 48 h postoperatively. Main results : No significant differences between groups were observed in the incidence and severity of PONV, rescue antiemetic use, or complete response rate at any of the time points, but only the use of rescue analgesics was significantly less in continuous epidural anesthesia group during the 2-24h postoperative period (P=0.04). Conclusion : While the use of single-injection intraarticular anesthesia following lower limb surgery did not prevent PONV more than continuous epidural anesthesia in this study, the intraarticular technique still provides greater simplicity, safety, and cost-effectiveness. J. Med. Invest. 66 : 303-307, August, 2019.
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Affiliation(s)
- Yuta Uemura
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
| | - Yoko Sakai
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
| | - Yasuo M Tsutsumi
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima JAPAN
| | - Nami Kakuta
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
| | - Chiaki Murakami
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
| | - Shiho Satomi
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
| | - Takuro Oyama
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
| | - Naohiro Ohshita
- Department of Anesthesiology, Osaka Dental University, Osaka JAPAN
| | - Tomoya Takasago
- Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, JAPAN
| | - Daisuke Hamada
- Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, JAPAN
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, JAPAN
| | - Katsuya Tanaka
- Department of Anesthesiology, Tokushima University, Tokushima JAPAN
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Kızılcık N, Özler T, Menda F, Uluçay Ç, Köner Ö, Altıntaş F. The effects of intra-articular levobupivacain versus levobupivacain plus magnesium sulfate on postoperative analgesia in patients undergoing arthroscopic meniscectomy: A prospective randomized controlled study. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:104-109. [PMID: 28314555 PMCID: PMC6197358 DOI: 10.1016/j.aott.2017.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/14/2016] [Accepted: 09/15/2016] [Indexed: 01/31/2023]
Abstract
Objective The aim of this study was to compared the effectiveness of intraarticular levobupivacain with levobupivacain and magnesium sulfate. Methods In this prospective randomized double blinded study, 96 patients (67 male, 29 female; age range: 18–65 years) with ASA (American Society of Anesthesiologist) score I and II, who had undergone arthroscopic meniscectomy operation, were divided to 3 groups that had postoperative analgesia with intra-articular saline injection (control group), levobupivacain injection (L group) or levobupivacain and magnesium sulfate injection (LM group). Patients were compared with postoperative VAS (Visual Analog Score) score during rest and activity, opioid analgesic need, non-opioid analgesic need and other medication needs. Results Postoperative VAS scores during rest and activation at early postoperative period were significantly lower at LM group when compared with L group and lower than control group at all time periods. Opioid analgesic need, non-opioid analgesic need and other medication needs for non-pain symptoms were lower at LM group when compared with L and control groups at all time periods. Conclusion Intraarticular magnesium sulfate plus Levobupivacain injection is a safe and effective method for post operative pain management after arthroscopic meniscectomy. Keywords: Intra-articular injection, Magnesium sulfate, Levobupivacain, Postoperative analgesia, Chondrocyte apoptosis, Pain management, Arthroscopic menisectomy Level of Evidence Level I, Therapeutic study
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Affiliation(s)
| | - Turhan Özler
- Yeditepe University Faculty of Medicine, Turkey.
| | - Ferdi Menda
- Yeditepe University Faculty of Medicine, Turkey
| | | | - Özge Köner
- Yeditepe University Faculty of Medicine, Turkey
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Zhou Y, Yang TB, Wei J, Zeng C, Li H, Yang T, Lei GH. Single-dose intra-articular ropivacaine after arthroscopic knee surgery decreases post-operative pain without increasing side effects: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2016; 24:1651-9. [PMID: 26049805 DOI: 10.1007/s00167-015-3656-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 05/19/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to appraise the efficacy and safety of single-dose intra-articular ropivacaine administered for pain relief after arthroscopic knee surgery. METHODS PubMed, Embase, and Cochrane Library databases were searched in October 2014 to identify randomized controlled trials of single-dose intra-articular ropivacaine for post-operative pain relief. Post-operative pain intensity, the amount of rescue analgesia required, and side effects including local anaesthetic toxicity were assessed. The relative risk (RR), the weighted mean difference (WMD), and their corresponding 95 % confidence intervals (CIs) were calculated. RESULTS Eight randomized controlled trials were included in the analysis. Statistically significant differences in the visual analogue scale for pain intensity value were observed during the immediate post-operative period (WMD -10.35, 95 % CI -17.12 to -3.59, p = 0.003) and the early post-operative period (WMD -11.90, 95 % CI -18.12 to -5.69, p = 0.0002), but not during the late post-operative period (WMD -2.89, 95 % CI -7.46 to 1.68, n.s.). There was no significant difference in the amount of rescue analgesia required (RR 0.76, 95 % CI 0.52-1.11, n.s.). Only two trials reported the incidence of drug-related side effects (including nausea and vomiting): the incidence in the ropivacaine groups was no higher than that in the control groups. Only one trial assessed local anaesthetic toxicity as an outcome, but it was not detected. CONCLUSIONS Single-dose intra-articular ropivacaine administered at the end of arthroscopic knee surgery provides effective pain relief in the immediate and early post-operative periods without increasing short-term side effects.
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Affiliation(s)
- Yang Zhou
- Department of Social Medicine, School of Public Health, Central South University, Changsha, 410008, Hunan Province, China.,Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Tu-Bao Yang
- Department of Social Medicine, School of Public Health, Central South University, Changsha, 410008, Hunan Province, China.,Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, 410008, Hunan Province, China
| | - Jie Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, 410008, Hunan Province, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan Province, China.
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Arti H, Arti S. The Effects of Intraarticular Opioids in pain relief after Arthroscopic Menisectomy: A Randomized Clinical Trial Study. Pak J Med Sci 2013; 29:625-8. [PMID: 24353591 PMCID: PMC3809271 DOI: 10.12669/pjms.292.2809] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 11/12/2012] [Accepted: 01/01/2013] [Indexed: 11/15/2022] Open
Abstract
Objective: Knee arthroscopy is a painful procedure which if untreated will cause intensive and prolonged pain that may prevent rehabilitation of patients. This study was designed to compare the analgesic effects of different opioids in the early post operative period in comparison to control group. Methodology: One hundred forty patients were prospectively assigned to four groups randomly. After arthroscopic menisectomy all patients received an intraarticular injection containing 9.5 ml bupivacaine 0.5% with 1:200000 epinephrine in a 10 ml syringe. The remainder of syringe was filled with one of the study solutions. Group I: 5mg methadone, group II: 5mg morphine, group III: 5 ml normal saline, group IV: 50 mg meperidine. At three stages in the ealy post operative period the need for analgesics was recorded. A statistical comparison was done afterwards. Results: In morphine group (group II), the analgesic usage in hospitalized and outpatients compared with other groups was significantly low(P<0.05). Conclusion: Morphine in comparison to meperidine or methadone is more beneficial in reducing pain or analgesic need when is added to bupivacain injection following arthroscopic menisectomy.
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Affiliation(s)
- Hamidreza Arti
- Hamidreza Arti, Associate Professor of Orthopaedic Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sara Arti
- Sara Arti, Ms. in Midwifery and Biostatistics, Vice Chancellery for Research, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
This paper is the thirty-fourth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2011 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration (Section 16); and immunological responses (Section 17).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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