Pain management and analgesia

Evaluation of early postoperative intravenous opioid rescue as a novel quality measure in patients who receive thoracic epidural analgesia: a retrospective cohort analysis and prospective performance improvement intervention

In this study, we explored the utility of intravenous opioid rescue analgesia in the post anesthesia care unit (PACU-OpResc) as a single marker of thoracic epidural analgesia (TEA) failure and evaluated the re...

Authors: Nadav Levy, Peter Santer, Liana Zucco, Sarah Nabel, Galina Korsunsky and Satya Krishna Ramachandran

Lidocaine coinfusion alleviates vascular pain induced by hypertonic saline infusion: a randomized, placebo-controlled trial

Hypertonic saline solution has been frequently utilized in clinical practice. However, due to the nonphysiological osmolality, hypertonic saline infusion usually induces local vascular pain. We conducted this ...

Authors: Zhiping Song, Shibiao Chen, Yang Zhang, Xiaoyun Shi, Na Zhao and Zhengyu Liao

Analgesic efficacy of postoperative bilateral, ultrasound-guided, posterior transversus abdominis plane block for laparoscopic colorectal cancer surgery: a randomized, prospective, controlled study

We assessed whether a postoperative bilateral, ultrasound-guided, posterior transversus abdominis plane (TAP) block could reduce 24 h rescue tramadol requirement compared with placebo in patients undergoing el...

Authors: Yang Zhao, Han-Ying Zhang, Zong-Yi Yuan, Yi Han, Yi-Rong Chen, Qi-lin Liu and Tao Zhu

Bilateral posterior Quadratus Lumborum block for pain relief after cesarean delivery: a randomized controlled trial

Achieving optimal analgesia with few side effects is the goal of pain management after cesarean delivery. Intrathecal (IT) morphine is the current standard but ultrasound-guided quadratus lumborum block (QLB) ...

Authors: Pawinee Pangthipampai, Sukanya Dejarkom, Suppachai Poolsuppasit, Choopong Luansritisakul and Suwida Tangchittam

Effect of ultrasound-guided transversus abdominis plane block with rectus sheath block on patients undergoing laparoscopy-assisted radical resection of rectal cancer: a randomized, double-blind, placebo-controlled trial

Many patients complain of pain following laparoscopic surgery. Clinicians have used ultrasound-guided posterior transversus abdominis plane block (TAPB) and rectus sheath block (RSB) for multimodal analgesia a...

Authors: Min Liang, Xia Xv, Chunguang Ren, Yongxing Yao and Xiujuan Gao

Characterization of self-anticipated pain score prior to elective surgery - a prospective observational study

Current principles of postoperative pain management are primarily based on the types and extent of surgical intervention. This clinical study measured patient’s self-anticipated pain score before surgery, and ...

Authors: Wei-Shu Chang, Yi-Ting Hsieh, Moa-Chu Chen, Shu-Ching Chang, Tzu-Shan Chen, Yun-Chi Chang, Yu-Chuan Tsai and Chen-Fuh Lam

Letter to the editor: Reply

Authors: Jung-Woo Shim and Min Suk Chae

The effect of perineural dexamethasone on rebound pain after ropivacaine single-injection nerve block: a randomized controlled trial

Rebound pain after a single-shot nerve block challenges the real benefit of this technique. We aimed to investigate whether perineural dexamethasone addition decreased the incidence of rebound pain after a sin...

Authors: Jie Fang, Yuncen Shi, Fang Du, Zhanggang Xue, Jing Cang, Changhong Miao and Xiaoguang Zhang

Cut-off points between pain intensities of the postoperative pain using receiver operating characteristic (ROC) curves

Pain assessment and management are important in postoperative circumstances as overdosing of opioids can induce respiratory depression and critical consequences. We aimed this study to check the reliability of...

Authors: Sooyoung Cho, Youn Jin Kim, Minjin Lee, Jae Hee Woo and Hyun Jung Lee

Evaluate construct validity of the Revised American Pain Society Patient Outcome Questionnaire in gynecological postoperative patients using confirmatory factor analysis

The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) evaluates the patient-reported quality of pain management in adults. A validated APS-POQ-R is pivotal to guide effective pain managem...

Authors: Sook Hui Chaw, Yoke Lin Lo, Jia Yin Lee, Jia Wing Wong, Wan Aizat Wan Zakaria, Shairil Rahayu Ruslan, Wei Keang Tan and Ina Ismiarti Shariffuddin

The analgesic efficacy of ultrasound-guided transversus abdominis plane (TAP) block combined with oral multimodal analgesia in comparison with oral multimodal analgesia after caesarean delivery: a randomized controlled trial

The transversus abdominis plane (TAP) block is used increasingly in parturients after caesarean delivery. This is a randomized controlled trial to evaluate the effectiveness of bilateral single-shot of TAP blo...

Authors: Yang Yu, Shenshan Gao, Vivian Man-ying Yuen, Siu-Wai Choi and Xuebing Xu

The comparison of efficacy and complications of coblation and radiofrequency thermocoagulation for V2/V3 idiopathic trigeminal neuralgia: a retrospective cohort study of 292 cases

Coblation is a novel technique in respect of treating idiopathic trigeminal neuralgia. We aimed to identify the efficacy and complications between radiofrequency thermocoagulation (RFT) and coblation for V2/V3...

Authors: Chenhui Wang, Zhi Dou, Mengwei Yan, Yuanzhang Tang, Rui Zhao, Yujie Han and Jiaxiang Ni

Effects of intravenous lidocaine, dexmedetomidine, and their combination on IL-1, IL-6 and TNF-α in patients undergoing laparoscopic hysterectomy: a prospective, randomized controlled trial

Surgical-related inflammatory responses have negative effects on postoperative recovery. Intravenous (IV) lidocaine and dexmedetomidine inhibits the inflammatory response. We investigated whether the co-admini...

Authors: Siqi Xu, Shenghong Hu, Xia Ju, Yuanhai Li, Qing Li and Shengbin Wang

Comparison of analgesic efficacy between rectus sheath blockade, intrathecal morphine with bupivacaine, and intravenous patient-controlled analgesia in patients undergoing robot-assisted laparoscopic prostatectomy: a prospective, observational clinical study

We explored the analgesic outcomes on postoperative day (POD) 1 in patients undergoing robot-assisted laparoscopic prostatectomy (RALP) who received intravenous patient-controlled analgesia (IV-PCA), rectus sh...

Authors: Jung-Woo Shim, Yun Jeong Cho, Minhee Kim, Sang Hyun Hong, Hyong Woo Moon, Sung Hoo Hong and Min Suk Chae

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently u...

Authors: Pasquale Sansone, Luca Gregorio Giaccari, Mario Faenza, Pasquale Di Costanzo, Sara Izzo, Caterina Aurilio, Francesco Coppolino, Maria Beatrice Passavanti, Vincenzo Pota and Maria Caterina Pace

Wound infiltration with ropivacaine as an adjuvant to patient controlled analgesia for transforaminal lumbar interbody fusion: a retrospective study

Surgical procedure usually causes serious postoperative pain and poor postoperative pain management negatively affects quality of life, function and recovery time. We aimed to investigate the role of wound inf...

Authors: Kunpeng Li, Changbin Ji, Dawei Luo, Hongyong Feng, Keshi Yang and Hui Xu

Postoperative analgesic efficacy of ear acupuncture in patients undergoing abdominal hysterectomy: a randomized controlled trial

Numerous studies have revealed that acupuncture can increase the somatic pain threshold. Electro-acupuncture (EA) can help pain-relieving with minimal physiologic disturbance. Various painful disorders, as wel...

Authors: Hamdy A. Hendawy and Mohamed E. Abuelnaga

Efficacy of non-opioid analgesics to control postoperative pain: a network meta-analysis

The aim of this network meta-analysis (NMA) was to evaluate the safety and efficacy of intravenous (IV) Meloxicam 30 mg (MIV), an investigational non-steroidal anti-inflammatory drug (NSAID), and certain other...

Authors: John A. Carter, Libby K. Black, Dolly Sharma, Tarun Bhagnani and Jonathan S. Jahr

Continuous block at the proximal end of the adductor canal provides better analgesia compared to that at the middle of the canal after total knee arthroplasty: a randomized, double-blind, controlled trial

The optimal position for continuous adductor canal block (ACB) for analgesia after total knee anthroplasty (TKA) remians controversial, mainly due to high variability in the localization of the the adductor ca...

Authors: Yuda Fei, Xulei Cui, Shaohui Chen, Huiming Peng, Bin Feng, Wenwei Qian, Jin Lin, Xisheng Weng and Yuguang Huang

Ropivacaine infiltration analgesia of the drainage exit site enhanced analgesic effects after breast Cancer surgery: a randomized controlled trial

Postoperative pain after breast cancer surgery remains a major challenge in patient care. Local infiltration analgesia is a standard analgesic technique used for pain relief after surgery. Its application in p...

Authors: Baona Wang, Tao Yan, Xiangyi Kong, Li Sun, Hui Zheng and Guohua Zhang

Ultrasound-guided ilioinguinal-iliohypogastric block (ILIHB) or perifocal wound infiltration (PWI) in children: a prospective randomized comparison of analgesia quality, a pilot study

Ilioinguinal-iliohypogastric block (ILIHB) is a well-established procedure for postoperative analgesia after open inguinal surgery in children. This procedure is effective and safe, especially when ultrasound ...

Authors: Bjoern Grosse, Stefan Eberbach, Hans O. Pinnschmidt, Deirdre Vincent, Martin Schmidt-Niemann and Konrad Reinshagen

Analgesic efficacy of ultrasound guided paravertebral block in percutaneous nephrolithotomy patients: a randomized controlled clinical study

Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study wa...

Authors: Ferda Yaman and Devrim Tuglu

Necrotizing fasciitis caused by the treatment of chronic non-specific back pain

Chronic back pain is a multifactorial disease that occurs particularly in adults and has many negative effects on the quality of daily life. Therapeutic strategies are often multimodal and designed for a long-...

Authors: Lilit Floether, Michael Bucher, Ralf Benndorf and Anna-Maria Burgdorff

Antinociceptive effects of magnesium sulfate for monitored anesthesia care during hysteroscopy: a randomized controlled study

Opioids are the most effective antinociceptive agents, they have undesirable side effects such as respiratory depressant and postoperative nausea and vomiting. The purpose of the study was to evaluate the anti...

Authors: Peng-fei Gao, Jing-yan Lin, Shun Wang, Yun-feng Zhang, Guo-qiang Wang, Qi Xu and Xiao Guo

How does intraarticular dexmedetomidine injection effect articular cartilage and synovium? An animal study

Intraarticular injections are widely used to provide pain relief after arthroscopic procedures and minimize the use of opioids. Dexmedetomidine has been proven to potentiate pain relief and postpone the demand...

Authors: Başak Akça, Aysun Ankay Yılbaş, Filiz Üzümcügil, Berkem Büyükakkuş, Elham Bahador Zırh, Dilara Zeybek and Fatma Sarıcaoğlu

The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial

In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty.

Authors: Muzaffer Gencer and Ayşe Yeşim Göçmen

Differential rates of intravascular uptake and pain perception during lumbosacral epidural injection among adults using a 22-gauge needle versus 25-gauge needle: a randomized clinical trial

Inadvertent intravascular injection has been suggested as the most probable mechanism behind serious neurological complications during transforaminal epidural steroid injections. Authors believe a smaller gaug...

Authors: Robin Raju, Michael Mehnert, David Stolzenberg, Jeremy Simon, Theodore Conliffe and Jeffrey Gehret

Retrospective study of quadratus lumborum block for postoperative analgesia in patients undergoing percutaneous nephrolithotomy

The postoperative analgesic effect of transmuscular quadratus lumborum block (QLB-TM) in patients following lower abdominal surgeries has been identified; however, the efficacy of QLB using the lateral approac...

Authors: Luning Chen, Jingjing Ji, Yali Tian, Qing Sun, Xuefeng Qiu, Xiaogong Li and Bingbing Li

Sufentanil postoperative analgesia reduce the increase of T helper 17 (Th17) cells and FoxP3⁺ regulatory T (Treg) cells in rat hepatocellular carcinoma surgical model: A randomised animal study

Surgery-related pain and opioids might exacerbate immune defenses in immunocompromised cancer patients which might affect postoperativd overall survival. Sufentanil is a good postoperative pain control drug,th...

Authors: Yanhua Peng, Jinfeng Yang, Duo Guo, Chumei Zheng, Huiping Sun, Qinya Zhang, Shuangfa Zou, Yanping Zhang, Ke Luo and Keith A. Candiotti

Ketorolac tromethamine pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

To observe the effect of pretreatment with ketorolac tromethamine on sufentanil-induced cough in general anesthesia patients.

Authors: Zhen Tian, Bei Hu, Min Miao, Lulu Zhang, Lin Wang and Bin Chen

Pain management after ambulatory surgery: a prospective, multicenter, randomized, double-blinded parallel controlled trial comparing nalbuphine and tramadol

Postoperative pain in ambulatory surgery is a multifactorial issue affecting patient satisfaction, time of discharge, and rehospitalization. This study evaluated the efficacy and safety of nalbuphine for the t...

Authors: Yu-jiao Guan, Lai Wei, Qin Liao, Qi-wu Fang, Nong He, Chong-fang Han, Chang-hong Miao, Gang-jian Luo, Han-bing Wang, Hao Cheng, Qu-lian Guo and Zhi-gang Cheng

The impact of ultrasound-guided bilateral rectus sheath block in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy — a retrospective study

Rectus sheath block (RSB) is known to attenuate postoperative pain and reduce perioperative opioid consumption. Thus, a retrospective study was performed to examine the effects of bilateral rectus sheath block...

Authors: Shaoheng Wang, Pengfei Liu, Teng Gao, Lei Guan and Tianzuo Li

Comparison of preemptive paracetamol, paracetamol-diclofenac & paracetamol-tramadol combination on postoperative pain after elective abdominal surgery under general anesthesia, Ethiopia: a randomized control trial study, 2018

In the practice of postoperative pain management, pain is still poorly managed in low resource setting where the practice of epidural and opioid free analgesia is impractical. There has been a recent trend of ...

Authors: Zemedu Aweke, Fetene Seyoum, Tewoderos Shitemaw and Derartu Neme Doba

Effectiveness of wound infusion of 0.2% ropivacaine by patient control analgesia pump after minithoracotomy aortic valve replacement: a randomized, double-blind, placebo-controlled trial

Local anesthetic wound infusion has become an invaluable technique in multimodal analgesia. The effectiveness of wound infusion of 0.2% ropivacaine delivered by patient controlled analgesia (PCA) pump has not ...

Authors: Gordan Mijovski, Matej Podbregar, Juš Kšela, Matej Jenko and Maja Šoštarič

Objective validation of YouTube™ educational videos for the instruction of regional anesthesia nerve blocks: a novel approach

YouTube™ (“YouTube”) is often used as an educational tool to instruct anesthesia providers on regional anesthesia nerve blocks. However, there is no current objective standard to assess the educational quality...

Authors: George L. Tewfik, Adam N. Work, Steven M. Shulman and Patrick Discepola

A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain

We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodied in a novel algor...

Authors: Ban Leong Sng, Daryl Jian’an Tan, Chin Wen Tan, Nian-Lin Reena Han, Rehena Sultana and Alex Tiong Heng Sia

Effect of caudal ketamine on minimum local anesthetic concentration of ropivacaine in children: a prospective randomized trial

Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. However, the effect of caudal ketamine on the minimum local anesthetic concentration (MLA...

Authors: Huai-Zhen Wang, Ling-Yu Wang, Hui-Hong Liang, Yan-Ting Fan, Xing-Rong Song and Ying-Jun She

Comparison of intrathecal morphine with continuous patient-controlled epidural anesthesia versus intrathecal morphine alone for post-cesarean section analgesia: a randomized controlled trial

Several neuraxial techniques have demonstrated effective post-cesarean section analgesia. According to previous reports, it is likely that patient-controlled epidural analgesia (PCEA) without opioids is inferi...

Authors: Izumi Sato, Hajime Iwasaki, Sarah Kyuragi Luthe, Takafumi Iida and Hirotsugu Kanda

The effect of intraoperative lidocaine infusion on opioid consumption and pain after totally extraperitoneal laparoscopic inguinal hernioplasty: a randomized controlled trial

As a component of multimodal analgesia, the administration of systemic lidocaine is a well-known technique. We aimed to evaluate the efficacy of lidocaine infusion on postoperative pain-related outcomes in pat...

Authors: Anup Ghimire, Asish Subedi, Balkrishna Bhattarai and Birendra Prasad Sah

Infraclavicular nerve block reduces postoperative pain after distal radial fracture fixation: a randomized controlled trial

It is unclear whether regional anesthesia with infraclavicular nerve block or general anesthesia provides better postoperative analgesia after distal radial fracture fixation, especially when combined with reg...

Authors: Stanley S. Wong, Wing S. Chan, Christian Fang, Chi W. Chan, Tak W. Lau, Frankie Leung and Chi W. Cheung

The effect of transversus abdominis plane block on the chronic pain after colorectal surgery: a retrospective cohort study

Chronic postsurgical pain (CPSP) is common and would reduce the quality of life of patients. Transversus abdominal plane (TAP) block has been widely used in lower abdominal surgery and many researches demonstr...

Authors: Zi-Ye Pan, Zhong-Hua Hu, Fan Zhang, Wen-Xiu Xie, Yong-Zhong Tang and Qin Liao

Retrospective evaluation of pain in patients with coccydynia who underwent impar ganglion block

We aimed to evaluate pain scores one year after impar ganglion block in patients with coccydynia who did not benefit from conservative treatment.

Authors: Ozlem Sagir, Hafize Fisun Demir, Fatih Ugun and Bulent Atik

Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review

We systematically reviewed the evidence on the efficacy and safety of dorsal root ganglion (DRG) targeted pulsed radiofrequency (PRF) versus any comparator for treatment of non-neuropathic pain.

Authors: Ivana Vuka, Svjetlana Došenović, Tihana Marciuš, Lejla Ferhatović Hamzić, Katarina Vučić, Damir Sapunar and Livia Puljak

Effects of transversus abdominis plane block versus quadratus lumborum block on postoperative analgesia: a meta-analysis of randomized controlled trials

Trunk block technique has been used in postoperative analgesia for patients undergoing surgery, specifically, transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have been proved effect...

Authors: Yanqing Wang, Xiaojia Wang and Kexian Zhang

The effect of ultrasound-guided erector spinae plane block on postsurgical pain: a meta-analysis of randomized controlled trials

The effect of erector spinae plane block has been evaluated by clinical trials leading to a diversity of results. The main objective of the current investigation is to compare the analgesic efficacy of erector...

Authors: Mark C. Kendall, Lucas Alves, Lauren L. Traill and Gildasio S. De Oliveira

Interscalene brachial plexus block for surgical repair of clavicle fracture: a matched case-controlled study

Innervation of the clavicle is complex and debated, with scarce data on the analgesic and clinical impact of regional anaesthesia after surgical repair of clavicle fracture.

Authors: Magnus Olofsson, Patrick Taffé, Kyle Robert Kirkham, Frédéric Vauclair, Bénédict Morin and Eric Albrecht

The efficacy of Antipyretic Analgesics administration intravenously for Preventing Rocuronium-Associated Pain/Withdrawal Response: a systematic review and meta-analysis

Rocuronium-associated injection pain/withdrawal response (RAIPWR) was non-ideal but occurred frequently when injection intravenously during anesthesia induction. Many studies had reported that pretreating with...

Authors: Jia Wang, Yu Cui, Bin Liu and Jianfeng Chen

The erector spinae plane block causes only cutaneous sensory loss on ipsilateral posterior thorax: a prospective observational volunteer study

Ultrasound-guided erector spine plane (ESP) block is widely used in perioperative analgesia for back, chest and abdominal surgery. The extent and distribution of this block remain controversial. This study was...

Authors: Jingxiong Zhang, Yuting He, Shi Wang, Zhengjie Chen, Yu Zhang, Yuan Gao, Quanguang Wang, Yun Xia, Thomas J. Papadimos and Riyong Zhou

Application of preoperative assessment of pain induced by venous cannulation in predicting postoperative pain in patients under laparoscopic nephrectomy: a prospective observational study

Postoperative pain is the most prominent concern among surgical patients. It has previously been reported that venous cannulation-induced pain (VCP) can be used to predict postoperative pain after laparoscopic...

Authors: Fei Peng, Yanshuang Li, Yanqiu Ai, Jianjun Yang and Yanping Wang

Ultrasound-guided erector spinae plane block for postoperative analgesia: a meta-analysis of randomized controlled trials

Ultrasound-guided Erector Spinae Plane Block (ESPB) has been increasingly applied in patients for postoperative analgesia. Its effectiveness remain uncertain. This meta-analysis aimed to determine the clinical...

Authors: Jiao Huang and Jing-Chen Liu