Objectives: Postoperative analgesia technique varies depending on the operation, patient, anesthetist, and circumstances. PCA (patient controlled analgesia) is an effective way of supporting postoperative analgesia. In this study, we aimed to present the efficacy and safety of our postoperative PCA treatment and the patient profile along with the requirements, preferences and decision-making process.
Methods: We discuss herein the PCA protocols of our clinic, the overall distribution of operations for which PCA was applied and the principles by which a pain team works.
Results: The operations for which PCA was applied included knee prosthesis, cesarean section, hip prosthesis, lower extremity trauma surgery, painless delivery, gastrointestinal surgery, multiple trauma surgery, thoracotomy, hysterectomy, laminectomy, and urogenital surgery. Postoperative PCA alone was successful in 89% of the patients, and with the supplemental analgesic agent, it was successful in an additional 6% of the patients, thus achieving a total success rate of 95%.
Conclusion: We believe the epidural and intravenous PCA protocols applied in our clinic for postoperative analgesia are effective and safe.
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Multimodal analgesia and anesthesia have become the gold standard in total joint arthroplasty to reduce postoperative pain and opioid consumption and minimize complications associated with opioid use. There are several elements in an effective multimodal protocol, including oral medications, periarticular injection, regional nerve blocks, and spinal and general anesthesia. Many nonopioid medications are often used, such as acetaminophen and NSAIDs.
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December 2024
The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
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Department of Anesthesiology, Henan Provincial Chest Hospital & Chest Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Introduction: Chronic post-thoracotomy pain (CPTP) is a persistent and disabling condition affecting a significant proportion of patients after thoracotomy and posing a challenge for clinicians, despite advances in surgical and pain management strategies. Esketamine, the S-enantiomer of ketamine, has emerged as a promising therapeutic agent for various pain conditions, with evidence for its effectiveness in alleviating acute and chronic pain. This systematic review and meta-analysis will be conducted to assess the efficacy of esketamine in treating CPTP, and evaluate its effectiveness in reducing pain intensity, improving functional outcomes, and reducing opioid consumption, as well as its adverse effects.
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Dr Md Khairul Kabir Khan, Junior Consultant, Department of Anaesthesiology and Intensive Care Unit, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
Different additives have been used to improve the duration and quality of analgesia of the local anaesthetic used in the single-dose caudal block technique, such as opioids, epinephrine, clonidine, neostigmine, etc. Dexmedetomidine is a potent and a highly selective α2-adrenergic agonist having a sympatholytic, sedative, and analgesic effect and has been described as a safe and effective additive in many anaesthetic and analgesic techniques. Another agent is Fentanyl, a lipophilic opioid, is added frequently to local anaesthetics which least likely to cause respiratory depression when given extradurally, because of its high lipid solubility.
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Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Background: The combination of esketamine and propofol has become a common choice for total intravenous anesthesia in hysteroscopic procedures. However, the optimal effective dose has not yet been determined. The aim of this study was to determine the median effective dose (ED) and 95% effective dose (ED) of esketamine compounded with propofol for painless hysteroscopy.
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