Successful ambulatory surgery is dependent on analgesia that is effective, has minimal adverse effects, and can be safely managed by the patient at home after discharge. A number of studies have identified that the provision of effective postoperative analgesia is inadequate for a significant proportion of patients. The following discussion details the current available analgesic options for am...

The objective of this study was to determine if the addition of 1% tetracaine to 0.25% bupivacaine prolonged the duration of postoperative analgesia of supraclavicular brachial plexus nerve blockade for patients undergoing ambulatory shoulder surgery. We conducted a prospective, double-blinded, randomized controlled clinical study at an ambulatory surgery center utilizing ultrasound- and nerve ...

BACKGROUND The transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing midline abdominal wall incisions. We evaluated its analgesic efficacy over the first 48 postoperative hours after cesarean delivery performed through a Pfannensteil incision, in a randomized controlled, double-blind, clinical trial. METHODS Fifty women unde...

We reviewed our experience to compare the effectiveness of epidural analgesia and total intravenous analgesia on postoperative pain control in patients undergoing endovascular abdominal aortic aneurysm repair. Records of 32 patients during a 2-year period were retrospectively investigated. TIVA group (n = 18) received total intravenous anesthesia, and EA group (n = 14) received epidural anesthe...

OBJECTIVE Pain after total knee arthroplasty (TKA) is severe, thus adequate pain control can be a challenge. Intrathecal morphine (ITM) provides excellent postoperative analgesia for TKA, but may have side effects. Femoral nerve block (FNB) also has been used for postoperative analgesia in TKA. We examined postoperative analgesia efficacy and side effects of ITM combined with single shot femora...

Patients with pain after operation received morphine hydrochloride intrathecally in doses of 0.02 mg kg-1 (n = 30) and 0.2 mg kg-1 (n = 30). The high-dose group showed slightly longer-lasting and more potent analgesia than the low-dose group. Sedation, decreases in heart rate and systolic arterial pressure, oliguria, nausea and urinary retention were more frequent in the high-dose group. Two pa...

·T WO factors have increased interest in ketamine for postoperative analgesia. The first was the discovery of the N-Methyl-D-aspartate (NMDA) receptor and its role in central pain processing and spinal cord neural plasticity.1 Ketamine is one of two clinically useful NMDA receptor antagonists available (the other is dextromethorphan). Ketarnine binds non-competitively to the PCI, (phencyclidine...

Background: Magnesium has antinociceptive effects in animal and human models of pain. Magnesium has been used as an adjuvant by various routes, including intravenous, intrathecal and epidural in different dosage regimens. Forty patients undergoing Total Knee Replacement surgery were enrolled to receive either fentanyl (Group F) or fentanyl plus magnesium sulphate (Group FM) post operatively for...

Mechanisms of postoperative sleep architecture disturbances and sleep-disordered breathing are uncertain. The authors hypothesised that patients undergoing surgery under regional anaesthesia without opioids used for analgesia would experience lesser changes in these parameters than operated general with per- opioids. After ethical approval informed consent, total hip replacement were included a...

PURPOSE The optimal management of postoperative pain using multimodal analgesia is a key component of Enhanced Recovery After Surgery (ERAS). Pain has adverse clinical implications on postoperative recovery, including prolonging the time to recovery milestones and length of hospital stay. Moreover, the ubiquity of opioids in postoperative analgesic regimens results in adverse effects, such as s...