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2 results

  • Non-opioid analgesics and post-operative pain following transoral robotic surgery for oropharyngeal cancer

  • K M Van Abel, A B Sauer, S C Kruthiventi, T N Weingarten, D B Noel, D L Price, J L Kasperbauer, J R Janus, K D Olsen, E J Moore
  • Journal:
    The Journal of Laryngology & Otology / Volume 136 / Issue 6 / June 2022
    Published online by Cambridge University Press:
    10 January 2022, pp. 527-534
    Print publication:
    June 2022
  • Objective

    To investigate associations between multimodal analgesia and post-operative pain among patients undergoing transoral robotic surgery for oropharyngeal squamous cell carcinoma.

    Methods

    Records of patients who underwent surgery from 5 September 2012 to 30 November 2016 were abstracted. Associations were assessed using multivariable analysis.

    Results

    A total of 216 patients (mean age of 59.1 years, 89.4 per cent male) underwent transoral robotic surgery (92.6 per cent were human papilloma virus positive, 87.5 per cent had stage T1–T2 tumours, and 82.9 per cent had stage N0–N1 nodes). Gabapentin (n = 86) was not associated with a reduction in severe pain. Ibuprofen (n = 72) was administered less often in patients with severe pain. Gabapentin was not associated with increased post-operative sedation (p = 0.624) and ibuprofen was not associated with increased bleeding (p = 0.221). Post-operative opioid usage was not associated with surgical duration, pharyngotomy, bilateral neck dissections, tumour stage, tumour size, subsite or gabapentin.

    Conclusion

    Scheduled low-dose gabapentin was not associated with improved pain control or increased respiratory depression. Ibuprofen was not associated with an increased risk of bleeding and may be under-utilised.

  • Lack of peripheral analgesia mediated by intraplantar administration of neostigmine in carrageenan-injected rats

  • H. Bouaziz, M. E. Gentili, F. Girard, J. X. Mazoit, D. Benhamou, M. C. Laxenaire, D. Fletcher
  • Journal:
    European Journal of Anaesthesiology / Volume 18 / Issue 5 / May 2001
    Published online by Cambridge University Press:
    16 August 2006, pp. 303-305
    Print publication:
    May 2001

  • Background and objective The aim of the study was to test the peripheral analgesic action of neostigmine. Intraplantar administration of neostigmine was studied in carrageenan-injected rats.

    Methods After assessing baseline values (T0) for paw circumference and the paw withdrawal threshold on both hind paws, the right hind paw was injected with 0.2mL of 1% carrageenan and the left hind paw with 0.2mL of saline (0.9% NaCl). Two hours later (T1), both hindpaws were tested for inflammation (paw circumference) and for hyperalgesia (paw withdrawal threshold) and subsequently 20 mg of neostigmine was injected in the right hind paw. The paw withdrawal threshold was tested again 10 (T2), 20 (T3) and 60 min (T4) and paw circumference 60 min (T4) after neostigmine injection.

    Results Carrageenan injection in the right hindpaw was associated with a decrease in the paw withdrawal threshold reflecting mechanical hyperalgesia (P < 0.001) and an increase in paw circumference reflecting oedema (P < 0.001) in the right hind paw when compared with the left side from T1 to T4. Neostigmine had no effect on paw circumference and the paw withdrawal threshold at measuring points T2, T3 and T4 when compared with T1 in the right hindpaw. Conclusion Our results support the lack of peripheral analgesic effect of neostigmine.