Background: Our institution’s traditional pain management strategy after shoulder arthroplasty has involved the utilization of postoperative patient-controlled narcotic analgesia. More recently, we have implemented a protocol (TLC) that utilizes a multimodal approach. The purpose of this study was to determine whether this change has improved pain control and decreased narcotic utilization. ...

BACKGROUND Acupuncture has potential value in producing analgesia in the postoperative period, but previous trials have inconsistent results. We aimed to study the effect of electroacupuncture on pain and nausea and the requirement for postoperative analgesia via patient-controlled analgesia. METHOD 107 patients who were undergoing abdominal hysterectomy or laparascopic cholecystectomy were r...

Background: Caudal anaesthesia is the most common regional technique for regional anaesthesia in pediatrics. However, many adjuvants are now used to prolong its analgesic effect. In this study we investigate the addition of dexmedetomidine to bupivacaine in caudal analgesia for major abdominopelvic surgeries in pediatrics. Methods: Sixty children ASA I or II, males and females, aged 6 months to...

BACKGROUND The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect. METHODS A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assesse...

BACKGROUND Dexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy. METHODS A total of 60 ...

conclusions a single preoperative oral dose of pregabalin, acetaminophen, dextromethorphan, and naproxen one hour before surgery is an effective method for reducing postoperative pain and morphine consumption in patients undergoing radical neck dissection. background preemptive analgesia may be considered as a method not only to alleviate postoperative pain but also to decrease analgesic consum...

BACKGROUND AND OBJECTIVES Clinical effects and the potential synergism between clonidine, an alpha2-adrenergic agonist, and ropivacaine have not been studied in patients undergoing epidural anesthesia. This research aimed at clinically evaluating clonidine associated to ropivacaine for epidural anesthesia. METHODS Participated in this double-blind study 60 patients of both genders who were di...

Clonidine has been shown to prolong sensory analgesia when given as an adjunct to peripheral nerve blocks but has not been evaluated when given in conjunction with a femoral-sciatic nerve block. The purpose of this investigation was to determine whether the addition of clonidine to a femoral-sciatic nerve block would prolong the duration of sensory analgesia in groups of patients undergoing ant...

The purpose of this study was to determine if intrathecal fentanyl speeds the onset and prolongs the duration of sensory and motor block, prolongs the duration of postoperative analgesia, or increases the incidence of adverse effects in patients undergoing spinal anesthesia for outpatient knee arthroscopy. Fifty patients were randomized to receive 12 mg of hyperbaric bupivacaine 0.75% with 25 m...

An appropriate post operative analgesia after thoracotomies is mandatory to improve the patient's outcome, reduce complications rate, morbidity, hospital cost and length of stay. In this paper we review the evidences regarding the use of paravertebral block for thoracic surgery. In particular we examine the effect of paravertebral block compared to the other technique in four major issues: anal...