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Prospective study of postoperative analgesia with or without epidural anesthesia in laparoscopic colectomy

ABSTRACT: Primary outcome(s): Visual Analog Scale (VAS) pain score 7 days after surgery

DISEASE(S): Colorectal Cancer

PROVIDER: 2655490 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Efficacy of lidocaine infusion with hydromorphone pumps on postoperative pain and gastrointestinal function recovery after laparoscopic colorectal surgery:a prospective, randomized, double-blind controlled trial

Project description:Interventions: Group A:Experimental group:Continuous intravenous injection of lidocaine;Group B: Control group:The same volume of normal saline will be administered during anesthesia and the postoperative PCA device Primary outcome(s): visual analog scale (VAS) score Study Design: Parallel

| 105691 | ecrin-mdr-crc

Epidural Analgesic Therapy (EAT) versus IntraVenous patient-controlled Analgesia (IVA)

Project description:Study hypothesis: Randomised trial conducted in order to quantify the concrete validity and limitations of intravenous patient-controlled analgesia therapy (IVA) versus epidural analgesic therapy (EAT) in "Fast Track" treatment of patients submitted to video laparoscopic left hemicolectomy. Primary outcome(s): Pain control, measured with the Visual Analogue Scale (VAS) at day 0,1 and 2

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Comparing epidural surgical anesthesia and spinal anesthesia following epidural labor analgesia for intrapartum cesarean section: a prospective randomized controlled trial.

Project description:The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS.Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h. In the ESA group (n = 163), ESA was performed with 17 ml of 2% lidocaine mixed with 100 µg fentanyl, 1 : 200,000 epinephrine, and 2 mEq bicarbonate. In the SA group (n = 160), SA was induced with 10 mg of 0.5% hyperbaric bupivacaine and 15 µg fentanyl. We investigated the failure rate of achieving pain-free surgery and the incidence of complications between the two groups.The failure rate of achieving pain-free surgery was higher in the ESA group than the SA group (15.3% vs. 2.5%, P < 0.001). There was no statistical difference between the two groups in the rate of conversion to general anesthesia; however, the rate of analgesic requirement was higher in the ESA group than in the SA group (12.9% vs. 1.3%, P < 0.001). The incidence of high block, nausea, vomiting, hypotension, and shivering and Apgar scores were comparable between the two groups.SA after ELA can lower the failure rate of pain-free surgery during intrapartum CS compared to ESA after ELA.

| S-EPMC5548943 | biostudies-other

Precision Pain Management for Major Abdominal Surgery in Colorectal Surgery

Project description:The primary objectives of this study are to evaluate the potential for preoperative pharmacogenomics (PGx) testing to positively influence postoperative opioid use through visual analog scale (VAS) guided administration of narcotic equivalent and lower pain scores as measured by OBAS in patients undergoing major abdominal surgery.

| 2267603 | ecrin-mdr-crc

A randomized comparison of epidural, dural puncture epidural, and combined spinal-epidural without intrathecal opioids for labor analgesia.

Project description:Background and aimsDural puncture epidural (DPE) has been shown to improve labor analgesia over epidural (EPL), with fewer side effects than a combined spinal-epidural (CSE). However, there is some debate regarding the superiority of DPE over EPL and CSE. Therefore, we aimed to compare the effects of EPL, DPE, and CSE without intrathecal opioids on the epidural local anesthetic (LA) consumption and occurrence of side effects in early labor.Material and methodsWe randomly assigned parturient to one of the 3 groups; EPL, DPE, or CSE. EPL and DPE groups received a 10 mL loading dose of 0.1% bupivacaine with fentanyl 2 μg/mL. CSE group received intrathecal 2.5 mg bupivacaine (without opioids). Labor analgesia was maintained in all patients via patient-controlled epidural analgesia (PCEA). The primary outcome was the mean hourly consumption of epidural LA.ResultsThe mean hourly consumption of epidural LA anesthetic was significantly lower in CSE (9.55 mL), compared with the EPL (11 mL), and DPE (10.5 mL), P < 0.01; but no significant difference was seen between EPL and DPE. Compared with EPL and DPE, CSE achieved faster time to complete analgesia defined as a numeric rating pain scale (NRPS) ≤1 and sensory block, lower NRPS in the first hour and higher frequencies of complete analgesia. There were no differences between groups in terms of physician top-up boluses, the occurrence of side-effects, mode of delivery, Apgar scores, and maternal satisfaction.ConclusionCompared with EPL and DPE, CSE without intrathecal opioids, had a less epidural LA consumption, faster onset of analgesia, with no difference in the incidence of side effects.Trial registrationThis study was registered at www.clinicaltrials.gov (NCT03980951).

| S-EPMC8289667 | biostudies-literature

Effects of ultrasound-guided quadratus lumborum block on perioperative pain control and outcome in laparoscopic radical resection of colorectal cancer

Project description:Interventions: Control group:patient control intravenous analgesia;Experimental group 1:Combination of ultrasound-guided anterior quadratus lumborum block 2mg/kg and patient control intravenous analgesia;Experimental group 2:Combination of ultrasound-guided anterior quadratus lumborum block 3mg/kg and patient control intravenous analgesia Primary outcome(s): visual analog scale, VAS Study Design: Parallel

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Gene Expression Profile of Pulpitis

Project description:This study was aimed to identify the genetic contributors to pulpal pain and inflammation. Inflamed pulps were collected from patients diagnosed with irreversible pulpitis (n=6). Normal pulps from teeth extracted for various reasons served as controls (n=6). Pain level was assessed using a visual analog scale (VAS). Genome-wide microarray analysis was performed using Affymetrix GeneTitan Multichannel Instrument. The difference in gene expression levels were determined by the Significance Analysis of Microarray program using a false discovery rate (q-value) of 5%. Genes involved in immune response, cytokine-cytokine receptor interaction and signaling, integrin cell surface interactions, and others were expressed at relatively higher levels in the pulpitis group. Moreover, several genes known to modulate pain and inflammation showed differential expression in asymptomatic and mild pain patients compared to those with moderate to severe pain(>30mm on VAS). This exploratory study provides a molecular basis for the clinical diagnosis of pulpitis. With an enhanced understanding of pulpal inflammation, future studies on treatment and management of pulpitis and on pain associated with it can have a biological reference to bridge treatment strategies with pulpal biology.

2016-02-03 | GSE77459 | GEO

Preoperative Gabapentin Administration Improves Postoperative Analgesia in Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer

Project description:Interventions: two groups: gabapentin Primary outcome(s): Visual Analogue Scale/Score;Opioid consumption;nausea and vomitting Study Design: Parallel

| 2683570 | ecrin-mdr-crc

Epidural analgesia for adults undergoing cardiac surgery with or without cardiopulmonary bypass.

Project description: Not available

| S-EPMC6396869 | biostudies-literature

Evaluation of Malva Sylvestris. formulation on Radiation proctitis

Project description:Intervention 1: In the intervention group patient should use sachet of Malva, 12 mg in 3 dosage that should brewed in boiled water, from first day of radiation until end of that.(each pocket is 4 g). Intervention 2: All patients in control group take powder of placebo which is designed for this study in 4 mg packets in three dosages a day orally with a glass of hot water.;Prevention;Placebo;In the intervention group patient should use sachet of Malva, 12 mg in 3 dosage that should brewed in boiled water, from first day of radiation until end of that.(each pocket is 4 g);All patients in control group take powder of placebo which is designed for this study in 4 mg packets in three dosages a day orally with a glass of hot water. Primary outcome(s): Anal Burning. Timepoint: Every 3 weeks. Method of measurement: visual analog scale 0-10.;Diarrhea. Timepoint: every 3 week. Method of measurement: visual analog scale 0-10.;Fecal incontinence. Timepoint: every 3 weeks. Method of measurement: visual analog scale.;Fecal urgency. Timepoint: every 3 weeks. Method of measurement: visual analog scale.;Anal bleeding. Timepoint: every 3 weeks. Method of measurement: visual analog scale.;Excretion of mucous. Timepoint: every 3 weeks. Method of measurement: visual analog scale. Study Design: Randomization: Randomized, Blinding: Triple blinded, Placebo: Used, Assignment: Parallel, Purpose: Prevention.

| 2479569 | ecrin-mdr-crc

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