Tag Archives: analgesia

Effect of Caffeine on Pain Management

DOI: 10.2478/amma-2020-0030

Caffeine is a widely consumed substance, as its main intake reasons are its memory and concentration enhancing properties. Beside these well-known effects, there has been put forward a hypothesis that caffeine consumption along with antinociceptive medication can potentiate the analgesic effect of this class of drugs. Our aim was to point out the importance of this particular potentiator effect by selecting and analyzing all papers on this topic written in English from the Medline database, published until the present moment. We observed that caffeine can represent a significant aid for certain patients in matters of pain management, by both reducing the pain killer doses and by increasing life quality.

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Anaesthesia and Postoperative Analgesia Performed by Insertion of a Perineural Catheter at the Brachial Plexus Site – Case Series

DOI: 10.1515/amma-2015-0055

Postoperative pain management is of major importance and the existence of a device that ensures a good analgesia in the immediate postoperative period and also removes the side effects of the systemic drugs, is becoming a necessity.
Objectives: The goal was to obtain a good quality anaesthesia and also a good postoperative analgesia by inserting a perineural catheter at the brachial plexus site.
Material and method: This study included adult patients who underwent brachial plexus anaesthesia through a perineural catheter inserted at the brachial plexus site. The perineural catheter was introduced by ultrasound guidance with neurostimulation control. After insertion, a quantity of a anaesthetic admixture of 0.4mg/kg is administered. The anaesthetic admixture contained Ropivacaine and Lidocaine, equimolar concentration of 0.5% In the postoperative period, the analgesia was ensured trough the already installed catheter. The analgesic mixture contained Ropivacaine and Lidocaine, equivalent concentrations of 0, 25%. The administration rate was 5 ml every 4 hours, starting 6 hours postoperatively.
Results: The anaesthesia, obtained through the perineural catheter, was a good quality anaesthesia ensuring both, good sensory and motor block. The feedback regarding postoperative analgesia was positive, this type of pain management being efficient and without the systemic drug side effects. This approach of brachial plexus block was accepted easily by the patients and was rated as a very satisfactory method.
Conclusions: The insertion of a perineural catheter for anaesthesia and postoperative analgesia represents a safe and efficient method of achieving both analgesia and anaesthesia.

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Continuous Local Analgesia in Postoperative Treatment of Large Incisional Hernias – Preliminary Results

DOI: 10.1515/amma-2015-0019

Background: The incisional hernias are frequent complications after laparotomy. Extended subcutaneous tissue dissection is often necessary for the treatment of large incisional hernias, and this procedure is frequently followed by a high intensity pain in the postoperative period. The aim of this study was to assess the postoperative patient comfort without using major analgesics.
Material and method: we present the preliminary results of an ongoing study from Surgery Clinic 1 of Emergency Clinical County Hospital of Târgu Mures, University of Medicine and Pharmacy Târgu Mures. The study comprises in the intraoperative insertion of a subcutaneous catheter (Pajunk InfiltraLong) placed on lay, through which we administered continuously Ropivacaine 0,5%.
Results: Ten patients have been included in the study by now. For 5 of the patients the wound infiltration was started with 7 ml/h in the first 6 postoperative hours, after which the rate decreased to 5 ml/h until the end of the 72 hours, when the catheter was removed. For 2 patients the wound infiltration was started with 10ml/h in the first 6 postoperative hours, after which the rate decreased to 7 ml/h in the first day, followed by 5 ml/h for the next two days. Two patients needed a minor analgesic in the immediate postoperative period and one patient needed major analgesia in the first 24 hours.
Conclusions: By using this method, postoperative analgesia can be achieved without using major systemic analgesics and a superior patient comfort can be achieved simply by adjusting the infusion rate

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