Pain as a factor complicating recovery and discharge after ambulatory surgery.

Abstract:

UNLABELLED:Pain complicates the recovery process after ambulatory surgery. We surveyed 175 ambulatory surgery patients to determine pain severity, analgesic use, relationship of pain to duration of recovery, and the relative importance of various factors to predicting these outcomes. Multivariate regression analysis was used to determine unique contributions of predictor variables to outcome. Surgical procedures included knee arthroscopy (n = 50), hernia surgery (n = 25), pelvic laparoscopy (n = 25), transvaginal uterine surgery (n = 25), surgery for breast disease (n = 25), and plastic surgery (n = 25). Maximum pain (on a scale of 0-10) varied from 2.3 +/- 0.5 to 5.1 +/- 0.5 (mean +/- SE), depending on surgical procedure; 24% of patients had pain scores of > or =7, and 24% were delayed in Phase 1 recovery by pain. Pain scores were lower if local anesthetic or ketorolac was administered intraoperatively (22% and 26% respectively). Fentanyl dose during recovery correlated with maximum pain scores; fentanyl dose was 42% less if ketorolac was administered intraoperatively. In females, the recovery fentanyl dose increased in proportion to the intraoperative fentanyl dose. The maximum pain score was predictive of total recovery time (135, 172, and 212 min of recovery for maximum pain scores of 0-3, 4-6, and 7-10, respectively; P < 0.001). We conclude that improvements in pain therapy are warranted to improve patient comfort and to expedite recovery. IMPLICATIONS:Moderate to severe pain is common after ambulatory surgery and is a frequent cause of delayed discharge. Postoperative pain, opioid-related side effects, and time to discharge were less when nonsteroidal antiinflammatory drugs or local anesthetics were used intraoperatively to prevent pain before patient awakening.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Pavlin DJ,Chen C,Penaloza DA,Polissar NL,Buckley FP

doi

10.1097/00000539-200209000-00025

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

627-34, table of contents

issue

3

eissn

0003-2999

issn

1526-7598

journal_volume

95

pub_type

临床试验,杂志文章
  • Ketamine blocks currents through mammalian nicotinic acetylcholine receptor channels by interaction with both the open and the closed state.

    abstract::Single channel recordings have shown that ketamine (Ket) decreases the open time of the nicotinic acetylcholine receptor channel (nAChR). The present experiments on simultaneous openings of the nAChRs of mouse myotubes investigate the interaction of Ket with the open as well as with the closed state of the channels. T...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199610000-00031

    authors: Scheller M,Bufler J,Hertle I,Schneck HJ,Franke C,Kochs E

    更新日期:1996-10-01 00:00:00

  • Effects of alfentanil on isolated cardiac tissues of the rabbit.

    abstract::Alfentanil causes cardiac stimulation or depression in intact animals and in clinical practice; there is no information concerning its direct effects on the heart. Therefore, we studied the effects of alfentanil on isolated cardiac tissues from young adult rabbits. The right atrium with sinoatrial node (SA node) was b...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199009000-00009

    authors: Zhang CC,Su JY,Calkins D

    更新日期:1990-09-01 00:00:00

  • Relative performance of the level 1 and ranger pressure infusion devices.

    abstract:UNLABELLED:Pressure infusion devices are often used to administer fluids in the operating room, but they may rarely be associated with serious venous air embolism. We studied the performance of the Level 1 and the Ranger Pressure Infusor in the laboratory. The Ranger delivered less air and delivered fluid faster than t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000082492.38765.74

    authors: Eaton MP,Dhillon AK

    更新日期:2003-10-01 00:00:00

  • A secure method of nasotracheal tube fixation using an infant feeding tube.

    abstract::A well secured endotracheal tube is very essential for the safe conduct of anesthesia. In maxillofacial surgeries, providing secure fixation of the nasotracheal tube has always been a problem. We have used an infant feeding tube that goes around the nasal septum for the fixation of the nasal endotracheal tube. This me...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ANE.0000134801.87404.3F

    authors: Bhat VR,Venkateshwaran G

    更新日期:2004-11-01 00:00:00

  • High-dose hydromorphone (Dilaudid) for coronary artery bypass surgery.

    abstract::The hemodynamic effects of high-dose hydromorphone hydrochloride (H), 1.25 mg/kg, were investigated in 10 patients with normal ventricular function undergoing coronary artery bypass graft (CABG) surgery. One patient with unstable angina was excluded from the study because of hypotension and facial flushing after a 6-m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Welti RS,Moldenhauer CC,Hug CC Jr,Kaplan JA,Holbrook GW

    更新日期:1984-01-01 00:00:00

  • The effect of systemic zonisamide (Zonegran) on thermal hyperalgesia and mechanical allodynia in rats with an experimental mononeuropathy.

    abstract:UNLABELLED:We studied the ability of zonisamide (Zonegran) to relieve thermal hyperalgesia and/or mechanical allodynia in the chronic constriction injury model of neuropathic pain. Zonisamide (25, 50, or 100 mg/kg) or saline was administered in a blinded, randomized manner by intraperitoneal injection on postoperative ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000062652.66661.97

    authors: Hord AH,Denson DD,Chalfoun AG,Azevedo MI

    更新日期:2003-06-01 00:00:00

  • The efficiency of CO2 elimination during high-frequency jet ventilation for laryngeal microsurgery.

    abstract:UNLABELLED:For adequate and safe use of high-frequency jet ventilation (HFJV), reliable monitoring of the PCO2 status and course is necessary. Because of improved handling and performance, recently available transcutaneous PCO2 monitoring devices such as MicroGas 7650 (Kontron Instruments Medical Sensors, Basel, Switze...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199807000-00037

    authors: Biro P,Eyrich G,Rohling RG

    更新日期:1998-07-01 00:00:00

  • Misaligned Feeding May Aggravate Pain by Disruption of Sleep-Awake Rhythm.

    abstract:BACKGROUND:Increasing evidence suggests that patients with eating disorders are more likely to develop chronic pain. A misaligned diet has been reported to disrupt the sleep-awake rhythms. Combined with our previous investigation on circadian pain, we aimed to investigate the role of misaligned diet in the pain sensiti...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000002727

    authors: Xu F,Zhao X,Liu H,Shao X,Chu S,Gong X,Ma Z,Gu X

    更新日期:2018-07-01 00:00:00

  • Adding fentanyl 0.0002% to epidural bupivacaine 0.125% does not delay gastric emptying in laboring parturients.

    abstract::Previous studies have shown that bolus doses of fentanyl (50 and 100 micrograms) with epidural bupivacaine delay gastric emptying by up to 45 min. We studied the effect of the addition of small-dose fentanyl to epidural bupivacaine infusions on gastric emptying during labor. The acetaminophen absorption technique was ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199603000-00032

    authors: Zimmermann DL,Breen TW,Fick G

    更新日期:1996-03-01 00:00:00

  • The care of patients with phantom limb pain in a pain clinic.

    abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197711000-00019

    authors: Blankenbaker WL

    更新日期:1977-11-01 00:00:00

  • The Kepler intubation system.

    abstract::Our goal in this study was to develop a robotic intubation system and to conduct a feasibility pilot study on the use of a robotic intubation system for endotracheal intubations. The Kepler Intubation System was developed, consisting of a remote control center (joystick and intubation cockpit) linked to a standard vid...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182410cbf

    authors: Hemmerling TM,Wehbe M,Zaouter C,Taddei R,Morse J

    更新日期:2012-03-01 00:00:00

  • Postoperative analgesia at home after ambulatory hand surgery: a controlled comparison of tramadol, metamizol, and paracetamol.

    abstract::We compared in a prospective, randomized, double-blinded study the analgesic efficacy of three drugs in 120 ASA I and II patients scheduled to undergo ambulatory hand surgery with IV regional anesthesia. At discharge, oral analgesic tablets were prescribed as follows: tramadol 100 mg every 6 h, metamizol 1 g every 6 h...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200102000-00013

    authors: Rawal N,Allvin R,Amilon A,Ohlsson T,Hallén J

    更新日期:2001-02-01 00:00:00

  • Effects of sodium pentobarbital, ketamine, halothane, and chloralose on brainstem auditory evoked responses.

    abstract::A parametric study was performed in cats comparing the effects on the brainstem auditory evoked response of four anesthetic agents used either in the operating room or the laboratory: sodium pentobarbital, ketamine, halothane, and chloralose. Each anesthetic agent was administered to each of four cats in varying seque...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Cohen MS,Britt RH

    更新日期:1982-04-01 00:00:00

  • Transdermal scopolamine: an alternative to ondansetron and droperidol for the prevention of postoperative and postdischarge emetic symptoms.

    abstract:BACKGROUND:Given the controversy regarding the use of droperidol and the high cost of the 5-HT3 antagonists, a cost-effective alternative for routine use as a prophylactic antiemetic would be desirable. We designed two parallel, randomized, double-blind sham and placebo-controlled studies to compare the early and late ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000250364.91567.72

    authors: White PF,Tang J,Song D,Coleman JE,Wender RH,Ogunnaike B,Sloninsky A,Kapu R,Shah M,Webb T

    更新日期:2007-01-01 00:00:00

  • Anesthesia by n-alkanes not consistent with the Meyer-Overton hypothesis: determinations of the solubilities of alkanes in saline and various lipids.

    abstract::Because deviations from the Meyer-Overton rule may provide insights into the attributes of the anesthetic site of action, we characterized the solubility of the n-alkanes in various hydrophobic solvents (n-tetradecane, olive oil, n-octanol, and lecithin) as well as saline using variations on standard techniques. Incre...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199307000-00003

    authors: Taheri S,Laster MJ,Liu J,Eger EI 2nd,Halsey MJ,Koblin DD

    更新日期:1993-07-01 00:00:00

  • Analysis of 1478 Cases of Hypospadias Repair: The Incidence of Requiring Repeated Anesthetic Exposure as Well as Exploration of the Involvement of Trainees on Case Duration.

    abstract:BACKGROUND:Recently, there has been significant focus on the effects of anesthesia on the developing brain. Concern is heightened in children <3 years of age requiring lengthy and/or multiple anesthetics. Hypospadias correction is common in otherwise healthy children and may require both lengthy and repeated anesthetic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004596

    authors: Adler AC,Chandrakantan A,Sawires Y,Lee AD,Hart M,Koh CJ,Janzen NK,Austin PF,Andropoulos DB

    更新日期:2019-12-09 00:00:00

  • Hyperbaric bupivacaine for spinal anesthesia in cesarean section.

    abstract::The efficacy and safety of 0.5% hyperbaric bupivacaine (Sensorcaine, Astra) was evaluated in 22 patients undergoing elective cesarean section under spinal anesthesia. The dose varied from 7.5 to 10 mg, (depending on the patient's height) which was significantly lower than previously reported. Patients were placed in h...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Santos A,Pedersen H,Finster M,Edström H

    更新日期:1984-11-01 00:00:00

  • Pharmacokinetics and pharmacodynamics of edrophonium in elderly surgical patients.

    abstract::The effect of age (over 70 yr) on the pharmacokinetics and pharmacodynamics of edrophonium was evaluated in seven patients aged 76-87 yr and in seven patients aged 27-57 yr. When elderly patients were compared with younger controls, the elderly exhibited a statistically significant decreased plasma clearance (5.9 +/- ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199010000-00003

    authors: Matteo RS,Young WL,Ornstein E,Schwartz AE,Silverberg PA,Diaz J

    更新日期:1990-10-01 00:00:00

  • Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Total Knee Arthroplasty.

    abstract::Enhanced recovery after surgery (ERAS) has rapidly gained popularity in a variety of surgical subspecialities. A large body of literature suggests that ERAS leads to superior outcomes, improved patient satisfaction, reduced length of hospital stay, and cost benefits, without affecting rates of readmission after surger...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000003564

    authors: Soffin EM,Gibbons MM,Ko CY,Kates SL,Wick E,Cannesson M,Scott MJ,Wu CL

    更新日期:2019-03-01 00:00:00

  • A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): Part II. Population pharmacokinetic and pharmacodynamic modeling and simulation.

    abstract:BACKGROUND:A new benzodiazepine, remimazolam, which is rapidly metabolized by tissue esterases to an inactive metabolite, has been developed to permit a fast onset, a short, predictable duration of sedative action, and a more rapid recovery profile than currently available drugs. We report on modeling of the data and s...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e318241f68a

    authors: Wiltshire HR,Kilpatrick GJ,Tilbrook GS,Borkett KM

    更新日期:2012-08-01 00:00:00

  • The effects of heparin, protamine, and heparinase 1 on platelets in vitro using whole blood flow cytometry.

    abstract:UNLABELLED:The effects of heparinization and the reversal of heparin activity on platelet function after cardiopulmonary bypass have not been well defined. Flow cytometry has become a convenient and powerful technique for characterizing platelets. We examined the expression of a secretion marker (P-selectin) and an agg...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200004000-00007

    authors: Kozek-Langenecker SA,Mohammad SF,Masaki T,Kamerath C,Cheung AK

    更新日期:2000-04-01 00:00:00

  • Postoperative Myocardial Injury in Middle-Aged and Elderly Patients Following Curative Resection of Esophageal Cancer With Aggressive or Standard Body Temperature Management: A Randomized Controlled Trial.

    abstract:BACKGROUND:Risk of intraoperative hypothermia is relatively high in middle-aged and elderly patients undergoing curative resection of esophageal cancer, which may cause myocardial ischemia during the early postoperative period. The objective of this study was to compare aggressive or standard body temperature managemen...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000004022

    authors: Zhang Z,Xu M,Wu D,Zhang X,Wu J

    更新日期:2019-08-01 00:00:00

  • The effects of tramadol and morphine on immune responses and pain after surgery in cancer patients.

    abstract:UNLABELLED:There has been growing interest in determining the possible immune consequences of opioid administration for the management of postoperative pain. We studied the effects of morphine and tramadol on pain and immune function during the postoperative period in 30 patients undergoing abdominal surgery for uterin...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200006000-00028

    authors: Sacerdote P,Bianchi M,Gaspani L,Manfredi B,Maucione A,Terno G,Ammatuna M,Panerai AE

    更新日期:2000-06-01 00:00:00

  • Intrathecal adenosine analog administration reduces substance P in cerebrospinal fluid along with behavioral effects that suggest antinociception in rats.

    abstract:UNLABELLED:Adenosine and adenosine analogs induce analgesia in humans and presumed antinociception in animal models when administered both systemically and intrathecally. In the present investigation in rats, we studied the effects of intrathecally administered adenosine analogs, with or without systemic coadministrati...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199709000-00025

    authors: Sjölund KF,Sollevi A,Segerdahl M,Lundeberg T

    更新日期:1997-09-01 00:00:00

  • The Effect of Dexmedetomidine on Propofol Requirements During Anesthesia Administered by Bispectral Index-Guided Closed-Loop Anesthesia Delivery System: A Randomized Controlled Study.

    abstract:BACKGROUND:Dexmedetomidine, a selective α2-adrenergic agonist currently approved for continuous intensive care unit sedation, is being widely evaluated for its role as a potential anesthetic. The closed-loop anesthesia delivery system (CLADS) is a method to automatically administer propofol total intravenous anesthesia...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000003470

    authors: Dutta A,Sethi N,Sood J,Panday BC,Gupta M,Choudhary P,Puri GD

    更新日期:2019-07-01 00:00:00

  • Supraventricular arrhythmias in intensive care unit patients: short and long-term consequences.

    abstract:BACKGROUND:Supraventricular arrhythmias (SVA), including atrial fibrillation and flutter, are common in surgical and nonsurgical intensive care unit (ICU) patients. There is increased mortality among surgical ICU patients who develop new-onset atrial arrhythmias after noncardiac, non-thoracic surgery. We sought to dete...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000255759.41131.05

    authors: Goodman S,Shirov T,Weissman C

    更新日期:2007-04-01 00:00:00

  • Decreased insulin requirements with spinal cord stimulation in a patient with diabetes.

    abstract:UNLABELLED:We describe a case of type-2 diabetes mellitus with significant improvement in blood glucose control and significant decrease in insulin requirements after initiation of spinal cord stimulation. We believe that spinal cord stimulation may provide additional beneficial effects in patients with chronic pain an...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000102674.41527.1e

    authors: Kapural L,Hayek SM,Stanton-Hicks M,Mekhail N

    更新日期:2004-03-01 00:00:00

  • The effects of paracetamol and parecoxib on kidney function in elderly patients undergoing orthopedic surgery.

    abstract::The common adverse effects of traditional nonsteroidal antiinflammatory drugs on renal function include reductions in renal blood flow, glomerular filtration rate, and sodium and potassium excretion, mainly via inhibition of renal cyclooxygenase. We designed the present study to determine the effects of IV paracetamol...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000244324.87947.29

    authors: Koppert W,Frötsch K,Huzurudin N,Böswald W,Griessinger N,Weisbach V,Schmieder RE,Schüttler J

    更新日期:2006-11-01 00:00:00

  • The effect of amitriptyline, gabapentin, and carbamazepine on morphine-induced hypercarbia in rabbits.

    abstract:BACKGROUND:Severe exacerbation of chronic neuropathic pain often requires morphine in patients already treated with drugs such as tricyclic antidepressants, carbamazepine and gabapentin. However, it is unclear if a combination of these drugs intensifies the effects of morphine on the respiratory system and, if so, whet...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31817e6e53

    authors: Kozer E,Levichek Z,Hoshino N,Kapur B,Leombruno J,Taguchi N,Garcia-Bournissen F,Koren G,Ito S

    更新日期:2008-10-01 00:00:00

  • Single-injection percutaneous peribulbar anesthesia with a short needle as an alternative to the double-injection technique for cataract extraction.

    abstract:BACKGROUND:We evaluated the efficacy of a single-injection technique for percutaneous peribulbar anesthesia with a short needle as an alternative to the double-injection technique for cataract extraction. METHODS:We included 200 patients who underwent elective cataract surgery randomized into 2 equal groups. They rece...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3181c293bd

    authors: Ghali AM,Hafez A

    更新日期:2010-01-01 00:00:00