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2 results

  • Assessment of early post-operative pain following septorhinoplasty

  • P Szychta, B Antoszewski
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 11 / November 2010
    Published online by Cambridge University Press:
    06 July 2010, pp. 1194-1199
    Print publication:
    November 2010
  • Objective:

    To evaluate pain incidence and intensity in patients undergoing septorhinoplasty, and to assess analgesic treatment effectiveness, in the first 7 days after surgery.

    Design:

    Prospective outcomes analysis using visual analogue scale assessment of pain intensity in the first 7 post-operative days.

    Subjects:

    Fifty-seven patients were enrolled in the study, 29 women and 28 men, aged 18 to 51 years. All were treated for post-traumatic deformity of the external nose and/or nasal septum, with either septorhinoplasty or septoplasty.

    Results:

    In the first 3 days after septorhinoplasty, patients' mean visual analogue scale pain score exceeded the range denoting ‘analgesic success’, and showed considerable exacerbation in the evening. Patients' pain decreased to a mean score of 15.4 one hour after administration of a nonsteroidal anti-inflammatory drug (metamizole).

    Conclusion:

    Analgesia is recommended for all patients in the first 3 days after septorhinoplasty, especially in the early evening.

  • 19 - Anaesthesia for major abdominal and urological surgery

    • By Paul Myles, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia, Kate Leslie, Department of Anaesthesia and Pain Management, Royal Melbourne Hospital and Department of Pharmacology, University of Melbourne, Melbourne, Australia
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book:
    Evidence-based Anaesthesia and Intensive Care
    Published online:
    05 September 2009
    Print publication:
    09 October 2006, pp 223-246

  • Summary

    This chapter describes many evidence-based interventions relevant to anaesthesia for abdominal surgery. The two most common analgesic therapies after abdominal surgery are patient controlled analgesia (PCA) and epidural analgesia. It has been suggested that a strategy of targeting tissue oxygen delivery, so-called "optimisation" or "goal-directed" therapy, can improve postoperative outcome. Patients undergoing major abdominal surgery are particularly at risk of hypothermia, because of the potential for significant heat loss. There is substantial evidence in the literature that maintenance of normothermia during major abdominal surgery may lead to improved outcomes. Major abdominal surgery patients, in particular cancer patients, are at relatively high risk of deep venous thrombosis (DVT) and pulmonary embolism. There is a large amount of evidence derived from randomised trials and meta-analyses of trials in abdominal surgical practice to guide anaesthetic practice.