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Author: Anton Krige
Publisher: Springer
ISBN: 3319944827
Category : Medical
Languages : en
Pages : 272
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Book Description
This book presents current evidence in an Enhanced Recovery Programme context, and provides a common sense approach to using the array of available analgesia techniques appropriately in major abdominal surgery. Current pain relief options are discussed, many of which have been described only in the last ten years. Topics covered range from the now widespread use of portable ultrasound machines to an appreciation of the value of some older drugs in a new context. Analgesia for Major Abdominal Surgery is aimed at anesthetists, acute pain teams, and acute pain nurses, as well as colorectal, hepatobiliary, urological and gynecological surgeons.
Author: Anton Krige
Publisher: Springer
ISBN: 3319944827
Category : Medical
Languages : en
Pages : 272
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Book Description
This book presents current evidence in an Enhanced Recovery Programme context, and provides a common sense approach to using the array of available analgesia techniques appropriately in major abdominal surgery. Current pain relief options are discussed, many of which have been described only in the last ten years. Topics covered range from the now widespread use of portable ultrasound machines to an appreciation of the value of some older drugs in a new context. Analgesia for Major Abdominal Surgery is aimed at anesthetists, acute pain teams, and acute pain nurses, as well as colorectal, hepatobiliary, urological and gynecological surgeons.
Author: Charles Vacanti
Publisher: Cambridge University Press
ISBN: 1139498401
Category : Medical
Languages : en
Pages : 1191
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Book Description
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
Author: Danilo Canzio
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
BACKGROUND The use of loco-regional anesthesia aims at providing an adequate intra- and/or post-operative pain management for a broad spectrum of surgical interventions which historically have relayed on the use of opiod drugs. On this fashion, the aim of our study is to prove that the use of bilateral continuous subcostal TAP block, in a multimodal opiod-sparing analgesic approach, provides a successful post-operative pain management for major abdominal surgical interventions. We adopted the NRS score as a reference and u2264 6 as an acceptable response. METHODS We enrolled (16) patients undergoing major abdominal surgery. A primer infusion of 1gr paracetamol + 30 mg ketoralac was administered 30 minutes prior to the end of the intervention. Moreover, in the immediate post-operative period, via US guidance, a 20 ml bolus of 0.5% levobupivacaine was administered bilaterally. Then, a permanent catheter was placed on both sides with a 2ml/h infusion of 0.5% levobupivacaine (20 ml in 28 ml of 0.9% NaCl). RESULTS In the 30-minutes post-operative period, the NRS score was u2264 4 for all of our patients. Then u2264 3 in the 6, 12 and 24-hour post-operative period. None of our patients requested any supplementary analgesics. CONCLUSIONS The major drawback of this study is the small size of our sample. Further studies might encourage the spread of this procedure as a new gold-standard for laparoscopic interventions (e.g. right hemicolectomy and laparocele) and its non-inferiority to epidural analgesia, the current gold-standard for laparotomic surgeries (especially left hemicolectomy).
Author: Iulia Cindea
Publisher:
ISBN:
Category : Medicine
Languages : en
Pages :
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Book Description
The Impact of Epidural Analgesia on Postoperative Outcome After Major Abdominal Surgery.
Author: Fiona Duncan
Publisher:
ISBN:
Category :
Languages : en
Pages : 318
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Book Description
Author: Gérard Mick
Publisher: Springer Science & Business Media
ISBN: 3319043226
Category : Medical
Languages : en
Pages : 175
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Book Description
Primum non nocere... The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic... It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela? This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book.
Author: F. Michael Ferrante
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 720
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Book Description
Author: NIkolaos Pentilas
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
EFFICACY OF MULTIMODAL ANALGESIA WITH INTRATHECAL MORPHINE IN MAJOR ABDOMINAL SURGERY Background and Goal of Study:Patients undergoing major abdominal surgery present a challenging postoperative pain management problem. Adequate pain management influence recovery and outcome after major abdominal surgery. Epidural delivered analgesia remains the mainstay for pain management. However there is growing evidence in literature for alternative techniques in pain management, particular in the setting of ERAS protocols. The goal of this study is to evaluate retrospectively the efficacy of a multimodal approach in pain management in major abdominal surgery based on intrathecal injection of morphine Materials and Methods:Patients (n=117) undergoing major abdominal surgery were enrolled in this study. Types of surgery were, 60 colectomies , 20 pancreatectomies, 12 total gastrectomies , 5 radical nefrectomies , 15 hepatectomies and 5 cases of abdominal masses . All patients had multimodal analgesia consists of 1)an intrathecal injection of 0.5mg of morphine with 35-50u03bcg clonidine and 5 ml of water saline 2) wound infiltration with high volume bupivacaine 0.5%+0,5mg Adrenaline+8mg Dexamethazone 3) continuous intravenous infusion with morphine 0.5-0.9 mg/h . All patients had general balanced anesthesia consists of propofol/remifentanyl and desflurane . For all patients, VAS at rest and at coughing, time for first analgesic request, incidence of nausea, vomiting, pruritus, sedation and respiratory depression were assessed. Results and Discussion: All patients were extubated in theatre and were discharged from the intermediate care unit within 12-24 hours. VAS score at rest was 0-2 for all patients during the first 24 hours, up to 3 for the next 24 hours and up to 5 for the third day. For the VAS score on coughing results were 2-3, 4-5, 5-6 respectively. Time to first analgesic request (VASu22654) was 36-48 hours (tramadol 50-100mg IV). Incidence of nausea, vomiting and pruritus were 10%, 4%, 0% respectively. No patient sedation or respiratory depression occurred. Current literature supports that alternative anaesthetic techniques may be beneficial as part of multimodal analgesia. In this study intrathecal injection of morphine provide adequate postoperative analgesia as part of a complete multimodal pain management protocol.Conclusion(s):Intrathecal morphine as part of a complete multimodal pain management protocol can be an effective alternative for pain management in major abdominal surgery allowing individualized tailoring of analgesia to the patients thus facilitating recovery. References:M. Hu00fcbner at al , Intrathecal analgesia and restrictive perioperative fluid management within enhanced recovery pathway : hemodynamic implications. Journal of the American College of Surgeons Vol 216 (6):1124-1134 (2013).
Author: Víctor M. Whizar-Lugo
Publisher: BoD – Books on Demand
ISBN: 1837686017
Category : Medical
Languages : en
Pages : 218
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Book Description
Currently, two-thirds of patients undergoing surgery experience acute postoperative pain (POP), which increases the possibility of immediate postoperative complications and facilitates the development of chronic POP. Post-surgical pain does not have a useful biological function, so it must be prevented, avoided, and/or eliminated. The objective of the rational management of acute pain after surgery is to facilitate the rapid recovery of patients with a prompt integration into their usual preoperative activities. The global crisis of opioid abuse has forced us to use other analgesic drugs as well as regional analgesia techniques that are part of effective multimodal analgesia. The non-pharmacological approach has also gained importance in the comprehensive management of acute POP. This book reviews advances in the understanding, management, and complications of POP.
Author: Viorel Gherghina
Publisher:
ISBN:
Category : Medicine
Languages : en
Pages :
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Book Description
Patient-Controlled Analgesia After Major Abdominal Surgery in the Elderly Patient.
