Background: Gastric cancer surgery is major surgery and often encountered in surgical. Objectives: To assess the efficacy and the side effect of postoperative patient \ufffd?controlled epidural analgesia (PCEA) with bupivacaine \ufffd?fentanyl after gastrectomy. Subjects and method:A prospective trial was conducted on 30 patients with gastrectomy because of cancer. Epidural catheter was inserted at level of D7-D9. Postoperative pain relief using PCEA with bupivacaine 0,125% - fentanyl 2\u03bcg/ml: 2ml bolus every 10 min, with basal infusion 2ml/h. VAS during normal tidal ventilation and following cough, the side effects were monitored during 48 hour period. Results: VAS decreased from 6,4 \xb1 1,4 to 2,6 \xb1 0,7, p<0,01 after 15 min. 90% patients had VAS under 2,5 after 1 hour and 100% reached VAS under 2,5 after 8 hours during normal tidal ventilation and following cough as well. Incidence of urinary retention, nausea and pruritus were 13,3; 3,3; and 3,3% respectively. Conclusion: PCEA provided a effective pain control after gastrectomy during normal tidal ventilation and following cough. The side effects remained unusual and minor.
Stomach Neoplasms/ surgery ; Bupivacaine ; Fentanyl ; Pain ; Postoperative/ prevention & ; control ;

OBJECTIVETo systematically evaluate the efficacy and safety of preoperative administration of cyclooxygenase-2 (COX-2) inhibitor on pain occurring with total knee arthroplasty (TKA).

METHODSWe electronically searched PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang data from inception to March 15, 2014 and manual searched journal of library collection to identify randomized controlled trials (RCTs) about preoperative administration of COX-2 inhibitor on pain occurring with TKA. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.1.0. Meta-analysis was performed by using RevMan 5.2 software.

RESULTSA total of 6 RCTs involving 228 patients were included. The results of meta-analyses showed that: (1) Efficacy: The visual analog scale (VAS) of post-operation at 12-hour (WMD = -0.60, 95% CI -0.83 to -0.37, P < 0.000 01) and 24-hour (WMD = -0.74, 95% CI -1.29 to - 0.19, P = 0.008) was decreased when COX-2 inhibitor was used before operation. And compared with control group, experimental group decreased the modified numerical pain rating scale (MNPRS) at 24-hour (WMD = -0.50, 95% CI -0.70 to -0.30, P < 0.000 01), 48-hour (WMD = -0.55,95% CI -0.65 to -0.45,P < 0.000 01) under quiescent conditions, and the same result at 24-hour (WMD = -0.82, 95% CI -1.26 to -0.38, P <0.000 01), 48-hour (WMD = -0.71, 95% CI -0.82 to -0.60, P < 0.000 01) under active conditions. The morphine consumption postoperatively were fewer in experimental group at the first day (WMD = - 1.35, 95% CI -1.92 to -0.79, P < 0.000 01) and the second day (WMD = -1.60, 95% CI -2.68 to -0.52, P = 0.004). (2) Safety: COX-2 inhibitor could lessen the incidence of postoperative pruritus (RR = 0.35, 95% CI 0.15 to 0.84, P = 0.02), but not statistically decrease of nausea and vomiting (RR = 0.83, 95% CI 0.54 to 1.28, P = 0.40) and exhaustion (RR = 0.63, 95% CI 0.05 to 7.67, P = 0.72).

CONCLUSIONThe current evidence indicated that preoperative administration of COX-2inhibitor can effectively improve the effect of postoperative analgesia, reduce the consumption of morphine and lessen the incidence of pruritus. Due to the limited quantity of the included studies and the evidence with limited strength,further high-quality RCTs are needed to verify the aforementioned conclusion.

Arthroplasty, Replacement, Knee ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; prevention & control ; Pruritus ; prevention & control

Adult ; Analgesia ; methods ; Female ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; metabolism ; prevention & control ; Stress Disorders, Post-Traumatic ; prevention & control

*Acupuncture Therapy ; Coronary Disease/*therapy ; Emergencies ; Immunity, Cellular ; Moxibustion ; Nervous System Physiology ; Pain, Postoperative/prevention & control ; Stomach Ulcer/prevention & control

Background: Nefopam a powerful painkiller has been put into clinical use since 1976, effects preemptive analgesia. Objectives: To assess the effect of presurgical IV Nefopam on postoperative pain after major upper abdomonal surgery. Subjects and method: A double-blind randomized controlled trial. 62 patients were divided into 2 groups: Nefopam (N, n = 31) and placebo group (PG, n = 31). Presurgical IV 20 mg Nefopam was used in N.PCA was used for both groups. Postoperative non-painful time (PNPT); VAS/48 hours at rest and on cough; IV Morphine rescue with PCA was measured during postsurgical 48 hour period.Results: PNPT was longer in N 42 \xb1 8,9 vs. 22 \xb1 4,8, p<0,01. Titration dose of morphine, Morphine consumption of first 24 hours, and of another 24 hours were lower in N 5,6 \xb1 1,7; 25,2 \xb1 4,9; 10,1 \xb1 3,6 mg vs. 7,1 \xb1 1,5; 30,1 \xb1 4,5; 13,3 \xb1 2,1, p<0,05 and < 0,01, respectively. VASs under tested conditions during first 16 hours were significant lower in N. Conclusion: Presurgical Nefopam had the effect of pre-emptive analgesia as evidence by a significant VAS decrease during the first 16 hours with lower Morphine consumption of 48 hours .
Nefopam/ administration & ; dosage ; Abdominal Cavity/surgery ; Pain ; Postoperative/ prevention & ; control ;

Excitatory Amino Acids ; secretion ; Humans ; Neurotransmitter Agents ; secretion ; Pain, Postoperative ; etiology ; metabolism ; prevention & control

Preemptive analgesia refers to the use of analgesics or regional nerve block in advance of nerve conduction changing or nerve remodeling caused by traumatic stimulation, so as to achieve better postoperative pain relief and to prevent postoperative pain hypersensitivity. Preemptive analgesia minimizes or prevents postoperative pain by reducing peripheral and central sensitization, which thereby limit the pain cascade. This paper briefly introduces the mechanism and methods of preemptive analgesia, as well as its application and research progress in the field of oral treatment. With the increased requirements for comfortable medical treatments and popularization of multimodal analgesia in pain management of oral surgery, preemptive analgesia will be more widely studied and applied in oral diagnosis and treatment.
Analgesia/methods* ; Analgesics/therapeutic use* ; Dental Care ; Humans ; Pain, Postoperative/prevention & control*

OBJECTIVES: To evaluate the efficacy of different ways of cocktail analgesic mixture injection on total knee arthroplasty (TKA). METHODS: A total of 50 patients with knee osteoarthritis treated by TKA from July to September 2018 were randomly divided into two groups (=25). The Group 1 underwent anterior intra-articular injection before prosthesis implanted while the Group 2 underwent posterior intra-articular injection before prosthesis implanted. Visual Analogue Scale (VAS) of all patients for pain during activity and at rest, maximal flexion degree of the knee at the 48th h and the 72th h after surgery, the time of raise leg, usage rate of patient-controlled analgesia (PCA), and complications were evaluated and analyzed. RESULTS: VAS for pain at rest of patients in the Group 1 was significantly less than that in the Group 2 at the 6th, 12th, and 24th h after surgery (all <0.05). Maximal flexion degree of the knee at the 48th h and the 72th h after surgery in the Group 1 was better than that in the Group 2 (both <0.05). The Group 1 costed less time than the Group 2 on the ability to perform an active straight leg raise (=0.027). CONCLUSIONS The anterior intra-articular cocktail analgesic mixture injection can strongly relieve the pain early after TKA, which can improve knee function and achieve painless rehabilitation in most patients, with safety.
Analgesics ; Arthroplasty, Replacement, Knee ; Humans ; Injections, Intra-Articular ; Osteoarthritis, Knee ; surgery ; Pain Measurement ; Pain, Postoperative ; prevention & control

OBJECTIVE: To compare the effects of bupivacaine, lidocaine and saline injections in alleviating post tonsillectomy pain. METHOD: We recruited 60 patients into the study. All subjects were randomly allocated into 3 groups. Group 1 received 0.9% sodium chloride (saline group), group 2 received 0.25% bupivacaine (bupivacaine group) and group 3 received 2% lidocaine (lidocaine group), infiltrated around each tonsil. Pain was evaluated with McGrath's face scale. RESULT: The postoperative pain scores at 2 and 6 hours were similar among the groups (P>0.05). The pain scores in the bupivacaine group were lower than those in the saline group at 12 h (P<0.05). The pain scores in the bupivacaine and lidocaine groups were significantly lower than those in the saline group from 18 to 24 hours until day 7 (P<0.05). There was no difference between the bupivacaine and lidocaine groups (P> 0.05). CONCLUSION Local infiltration of bupivacaine is a relatively and safe effective method and is equivalent to use of lidocaine for post tonsillectomy pain.
Analgesia ; methods ; Bupivacaine ; Child ; Child, Preschool ; Female ; Humans ; Lidocaine ; Male ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Snoring ; surgery ; Tonsillectomy

PURPOSE: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. METHOD: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. RESULTS: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. CONCLUSION: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.
Adult ; Aged ; Female ; Genital Diseases, Female/*nursing/pathology ; Humans ; Middle Aged ; Pain/nursing/*prevention & control ; Pain, Postoperative/nursing/*prevention & control ; *Patient Education as Topic ; Patient Satisfaction ; Preoperative Care/nursing