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- Gupta, Anil, et al.
(författare)
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Postoperative pain after abdominal hysterectomy : A double-blind comparison between placebo and local anesthetic infused intraperitoneally
- 2004
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Ingår i: Anesthesia and Analgesia. - 0003-2999 .- 1526-7598. ; 99:4, s. 1173-1179
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Tidskriftsartikel (refereegranskat)abstract
- Abdominal hysterectomy is associated with moderate to severe postoperative pain. We randomly divided 40 patients (ASA status I-II) undergoing elective abdominal hysterectomy into 2 groups: group P received an infusion of normal saline 5 mL/h via a catheter placed intraperitoneally at the end of surgery, and group L received 0.25% levobupivacaine 12.5 mg/h (5 mL/h). Ketobemidone was administered IV via a patient-controlled analgesia pump as a rescue analgesic in all patients. The catheter was removed after 24 h. Incisional pain, deep pain, and pain on coughing were assessed 1, 2, 3, 4, 8, 16, and 24 h after surgery by using a visual analog scale. Ketobemidone consumption during 0-72 h was recorded. Time to sit, walk, eat, and drink; home discharge; and plasma concentrations of levobupivacaine were also determined. Pain at the incision site, deep pain, and pain on coughing were all significantly less in group L compared with group P at 1-2 h after surgery. After 4 h, the mean visual analog scale pain scores at rest and during coughing remained <3 cm during most time periods. Total ketobemidone consumption during 4-24 h was significantly less in group L compared with group P (mean, 19 versus 31 mg, respectively). A less frequent incidence of postoperative nausea, but not vomiting, was also found during 4-24 h in group L compared with group P (P < 0.025). Total and free plasma concentrations of levobupivacaine were small. We conclude that levobupivacaine used as an infusion intraperitoneally after elective abdominal hysterectomy has significant opioid-sparing effects.
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| 2. |
- Kimme, Peter, 1961-, et al.
(författare)
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High incidence of pruritus after large doses of hydroxyethyl starch (HES) infusions
- 2001
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 45:6, s. 686-689
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are several studies indicating a correlation between treatment with hydroxyethyl starch (HES) and pruritus. In order to see whether there is a possible dose–response relationship between HES and pruritus, we retrospectively studied 50 patients who had received HES in varying doses (cumulative dose 500–19500 ml) as hemodilution therapy after subarachnoid hemorrhage.Methods: Of 50 consecutive patients, 6 were excluded due to severe neurological sequelae. A questionnaire was sent to the remaining 44 patients at 6 months (5–12 months) median (range) after the end of HES treatment.Results: We received answers from 37 patients, of whom 54% reported pruritus. On average pruritus lasted for 15 weeks. There was significantly more pruritus in patients who received more than 5000 ml of HES versus those who received less than 5000 ml (P=0.023). Pruritus had a delayed onset and appeared as pruritic crises lasting for 2–30 min. It had a patchy distribution in most patients and no predilected locations. In 4 patients (20%) the pruritus lasted longer than 21 weeks.Conclusion: Our study indicates that there is a dose-dependency for the incidence of HES-induced pruritus, and that in some cases the pruritus may be severe and long-lasting.
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