Efficacy of Local Anesthetic With Dexamethasone on the Quality of Recovery Following Total Extraperitoneal Bilateral Inguinal Hernia Repair: A Randomized Clinical Trial.

Importance: Quality of recovery (directly associated with patient satisfaction) is an important clinical outcome measurement and a surrogate of anesthetic/surgical care quality.

Objectives: To compare the efficacy of a transversus abdominis plane (TAP) block with dexamethasone sodium phosphate and preperitoneal instillation of local anesthetic (PILA) with dexamethasone vs control on postoperative quality of recovery following a bilateral total extraperitoneal inguinal hernia repair (TEP-IHR) (>24 hours). Secondary objectives included efficacy of this technique on postoperative opioid use, nausea and vomiting, and pain scores.

Neurolytic transversus abdominis plane block in the palliative treatment of intractable abdominal wall pain.

A 45 year old man with metastatic colon cancer presented with uncontrollable abdominal wall pain. Transversus abdominis plane (TAP) block with ropivacaine and methylprednisolone was performed with excellent pain relief, which allowed a significant weaning of the patient's opioid requirements. A second TAP block was performed with a 33% ethanol solution (ethanol and ropivacaine) with excellent pain relief.

The safety and efficacy of intrathecal opioid analgesia for acute postoperative pain: seven years' experience with 5969 surgical patients at Indiana University Hospital.

Unlabelled: To assess the efficacy of the analgesic technique and the incidence of complications, we prospectively evaluated patients who received intrathecal opioid analgesia (ITOA) to manage postsurgical pain. Daily quality assurance data were collected on the first postoperative day and tabulated for 5969 adult patients who had received ITOA for major urologic, orthopedic, general/ vascular, thoracic, and nonobstetrical gynecologic surgery. A scale of 1-10 was used to quantify each patient's satisfaction with analgesia.

Intravenous ketorolac and subarachnoid opioid analgesia in the management of acute postoperative pain.

Background And Objectives: Ketorolac is a parenteral nonsteroidal anti-inflammatory drug that provides analgesia through a peripheral mechanism. The purpose of this study was to evaluate whether the scheduled administration of intravenous ketorolac improves the analgesia provided by subarachnoid opioids after surgery.

Methods: Patients undergoing major urologic surgery were enrolled in a randomized, placebo-controlled, double-blinded study and received one of two analgesic regimens.