Remifentanil for abdominal surgery is associated with unexpectedly unfavorable outcomes

Insufficient perioperative pain treatment is known as a highly predictive risk factor for the development of chronic postoperative pain. Remifentanil is an ultrashort-acting opioid that provides quick and efficient analgesia but is associated with the induction of opioid-induced hyperalgesia. Despite these well-known characteristics, this substance is being increasingly used in anesthesia and in a variety of medical fields, such as intensive-care medicine and obstetrics. The aim of our study was to reveal whether remifentanil influences postoperative pain, the requirement for postoperative analgesics, and requirement of antiemetics (as indirect indicator of postoperative nausea and vomiting), as well as the effects on time to extubation and length of stay in the postanesthesia care unit in daily clinical routine. From an electronic medical records database of 55,693 anesthesias, we analyzed data from all patients receiving intraabdominal surgery (visceral, gynecological, and urological) under general anesthesia or combined general-epidural anesthesia by propensity score matching. The administration of remifentanil was associated with higher postoperative pain scores despite a higher requirement of postoperative analgesics. Additional epidural analgesia was not able to avoid this finding. The intraoperative use of remifentanil is associated with a deterioration of pain levels and postoperative analgesic requirement, wherefore the potential benefit of this substance seems to be...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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Improved patient outcomes and satisfaction associated with enhanced recovery after surgery protocols have increasingly replaced traditional peri-operative anesthesia care. Fast-track surgery pathways have been extensively validated in patients undergoing hysterectomies, yet impact on fertility-sparing laparoscopic gynecologic operations, particularly those addressing chronic pain conditions, has not been examined.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Original Research: Gynecology Source Type: research
Authors: Casale M, Costantino A, Sabatino L, Luchena A, Moffa A, Cassano M, Rinaldi V, Baptista PM Abstract OBJECTIVE: This paper aims to report our experience with a minimally invasive surgical procedure for the treatment of chronic rhinosinusitis with nasal polyps, performed in a day-surgery setting under local anaesthesia. METHODS: A retrospective study of 30 patients with chronic rhinosinusitis with nasal polyps was conducted. Sino-Nasal Outcome Test 22 and modified Lund-Kennedy scores were collected. Intra- and post-operative pain was evaluated using a 10-point visual analogue scale. RESULTS: The mean ...
Source: Journal of Laryngology and Otology - Category: ENT & OMF Tags: J Laryngol Otol Source Type: research
Conditions:   Failed Back Surgery Syndrome;   Pain, Chronic Intervention:   Other: local anesthetic injection Sponsor:   Haydarpasa Numune Training and Research Hospital Not yet recruiting
Source: - Category: Research Source Type: clinical trials
ConclusionESP Block did not prove to be an effective technique for postoperative analgesia of open cholecystectomy, at the doses performed in this study, having required more use of rescue opioid, and without differences in NPS. More comprehensive studies are required to assess the efficacy of ESP block for the visceral and abdominal somatic component, considering the specific blockade level.ResumoJustificativa e objetivoO Bloqueio do Plano do Músculo Eretor da Espinha (ESP Block) é um bloqueio relativamente novo, inicialmente descrito para analgesia de dor torácica crônica, porém já...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
Conclusions Open label placebos might play a role in multimodal analgesic concepts.Editor ’s PerspectiveWhat We Already Know about This TopicPlacebo treatments even if known to the patient to be placebo, so-called “open label placebo,” may be effective in reducing chronic painThe effects of the extent of placebo education are poorly understoodWhat This Article Tells Us That Is NewUsing a well-characterized electrical pain sensitization model in human volunteers, the effects of short versus detailed placebo educational protocols were measuredOpen label placebo treatment reduced pain sensitization in the vo...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Abstract Chronic pain is a highly prevalent and complex health problem that is associated with a heavy symptom burden, substantial economic and social impact, and also, very few highly effective treatments. This review examines evidence for the efficacy and safety of magnesium in chronic pain. The previously published protocol for this review was registered in International Prospective Register of Systematic Reviews (PROSPERO), MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched until September 2018. We included randomized controlled trials (RCTs) comparing magnesi...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
CONCLUSION: Our findings suggest that Pulsed RF neurotomy of the genicular nerves is an efficient and safe treatment method for patients with chronic knee osteoarthritis. PMID: 32030698 [PubMed - in process]
Source: Agri Dergisi - Category: Anesthesiology Tags: Agri Source Type: research
Publication date: Available online 7 February 2020Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Nuno Sá Malheiro, Nuno Ricardo Afonso, Diamantino Pereira, Belinda Oliveira, Carmélia Ferreira, Ana Cristina CunhaAbstractIntroductionPainful shoulder syndrome is a frequent condition among the elderly and an important cause of functional disability. As the conservative is not always effective, ultrasound guided suprascapular nerve blockade presents as an important alternative treatment.ObjectiveTo evaluate the efficacy and safety of the use of 0.25% levobupivacaine and 40 mg of tri...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
No abstract available
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Correspondence Source Type: research
Chronic low back pain conditions are highly prevalent and constitute the leading cause of disability worldwide. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the US Food and Drug Administration and the American Pain Society (APS), have combined to create the ACTTION-APS Pain Taxonomy (AAPT). The AAPT initiative convened a working group to develop diagnostic criteria for chronic low back pain. The working group identified three distinct low back pain conditions which result in a vast public health burden across the lifespan.
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
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