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to placebo. Due to limited included data only a very low number of outcomes S.r.l.) 30 mg IV and group TMD n=32 tramadol (Tramadol Basi, Laboratórios
for the comparison with opioids could be pooled. Basi -S.A.)100 mg IV. The time of the first administration of both drugs was at
Our data provide ample evidence that DEX administration compared to pla- the time of skin closure and repeated every 8 hrs in first 24 hrs postoperatively.
cebo is an ef fective intervention for postoperative pain treatment. The most Morphine Sulphate 3-5 mg IV was used as a rescue analgesic. Analgesic ef-
common adverse ef fect was intraoperative bradycardia following DEX admin- ficacy was assessed using a visual analog scale VAS from 1-10, in 2(T0),4(T1),
istration. Thus caution might be warranted in patients with a higher risk for 6(T2),8(T3),12(T4),and 24 (T5)hours from the end of surgery. The side ef fects:
a stroke or myocardial infarction; this should be investigated in large trials nausea, vomiting, allergic reactions, itching, headache, disorientation were
focusing on safety issues of intraoperative DEX coadministration. Evidence assessed and recorded at T0, T1, T2,T3,T4 and T5.Patient satisfaction was
regarding the comparison of DEX with opioids is currently less clear and ren- assessed through Satisfaction Rating Scale -SRS (0=not satisfied,1=not very
ders further research. satisfied,2=quite satisfied, 3=satisfied,4=very satisfied).
Conclusion(s): Adults treated with intraoperative dexmedetomidine infusion Results and Discussion: There were no significant dif ferences between the
reported lower postoperative pain intensities, consumed less postoperative groups with respect to demographic data and duration of anesthesia. Good
opioids and showed less opioid-related adverse events compared to placebo. postoperative analgesia was recorded in both groups. There is no dif ference
between K RT and TRD groups in the pain scores measured, except at the
T1.VAS score (KTR vs. TRD) were (4.1vs 5.0, p=NS at T0, (2.8 vs. 5.9, p<
14AP6-10 0.05) at T1, (2.2 vs. 2.6, p=NS) at T2, (2.0 vs. 2.5, p=NS) at T3, (2.7 vs. 2.4,
Retrospective study comparing continuous preperitoneal p=NS) at T4, (1.1 vs. 1.2, p=NS) at T5.Only a 3 patients in TRD group at T3
versus epidural local anesthetics infusion for abdominal required morphine administration to achieve adequate analgesia.
Side ef fects were reported in 54% of patients of TRD group and in 8.0% of
surgery
patients of KTR group (p < 0.005). Treatment with ketorolac was considered
Polo Gil M., Zugasti O., Pavon A., Perez Bergara E., Baldeon E., Dufur M. satisfactory by patients average score with the SRS > 3 at T0, T1, T2, T3, T4,
Complejo Hospitalario de Navarra, Dept of Anaesthesiology, Pamplona, Spain and T5, whereas with tramadol SRS was >3 at T0, T1, and < 2 at T2, T3, T4,
and T5 (p< 0.05).
Background and Goal of Study: Pre-peritoneal catheters (PPC) for local an- Conclusion(s): Ketorolac and tramadol produced comparable ef fective post-
esthetic infusion have been associated with shorter length of stay (LOS)1. operative analgesia, but ketorolac showed significant advantage over trama-
We compare the analgesic ef ficacy and complications of PPC versus thoracic dol considering side ef fects.
epidural (TE) in midline laparotomy.
Materials and Methods: Age, gender, surgical procedure, emergency of
surgery, 24, 48 and 72 hours pain scores, supplementary analgesia, side- 14AP7-1
ef fects(nausea-vomiting and local anesthetics toxicity), complications (peri- Ef fect of oral pregabalin on opioid-induced hyperalgesia in
stalsis recovery, wound infection), and LOS of patients who underwent mid-
line laparotomy throughout one year were retrospectively reviewed.
patients undergoing laparo-endoscopic single-site urologic
Numeric rating scale (0-11) was utilized to measure pain. Pain scores were surgery
subsequently classified into severe (10-7), moderate (6-4), mild (3-1) and no Cheol L., Yoon-Kang S.
pain (0) categories. Wonk wang Universit y College of Medicine, Dept of Anaesthesiology & Pain
All the PPC elastomers delivered 5 ml h-1 0,375% levobupivacaine. TE elasto- Medicine, Iksan, Korea, Republic of
mers contained 0,125% levobupivacaine that was infused at a variable rate of
5-12 ml h-1. Intravenous paracetamol 1gr/6 h, and dexketoprophen, 50 gr/8h Background: Pregabalin is an antiepileptic drug that is ef fective for treating
were prescribed. Tramadol was administered on patient request. postoperative pain, neuropathic pain, anxiety, and hemodynamic instability.
Dif ferences in pain category frequencies were tested with Pearsons ᵡ2. T The aim of this study was to investigate the ef fect of a single preoperative
Student was used to work out dif ference in hospital LOS. dose of pregabalin in patients with opioid-induced hyperalgesia (OIH).
Results and Discussion: Two hundred twenty-seven laparotomies were re- Materials and Methods: Ninety ASA I-II patients undergoing laparoendo-
viewed. 50,7% patients received epidural, 28,6% intravenous PCA with mor- scopic single-site urologic surgery were randomly assigned to one of the fol-
phine, and 20,7% PPC. Infusion times for TE and PPC ranged from 24 to 96 lowing three groups that received either pregabalin or placebo 1 h before
hours. Urgent surgery was significantly more frequent in PPC group (45% vs anesthesia and an intraoperative remifentanil infusion. Group plL received
12,8%) The reasons to use PPCs were contraindication or technical impos- placebo and 0.05 µg/kg/min remifentanil, group plH received placebo and 0.3
sibility to place an epidural catheter in 70%, and laparoscopy conversion to µg/kg/min remifentanil, and group prH received 300 mg pregabalin plus 0.3
open surgery in 30% of the cases. µg/kg/min remifentanil. The primary endpoint was pain intensity upon move-
Both techniques showed similar ef fectiveness for postoperative pain man- ment 1, 6, 12, and 24 h af ter surgery. Secondary endpoints were the area
agement. Zero pain was more frequent in TE. No patient in either group had of hyperalgesia and mechanical hyperalgesia threshold 24 h af ter surgery,
severe pain 48 h af ter surgery, however tramadol was demanded 6% more time to first postoperative analgesic requirement, and cumulative postopera-
frequently by patients carrying PPC. tive volume of morphine administered via a patient-controlled analgesia (PCA)
Complication rate was similar in both groups (21,3% vs 26%). pump over 24 h.
LOS was longer in PPC group (15,8 vs 12,7 days). Results and Discussion: The time to first postoperative analgesic require-
Conclusion(s): PPC was an ef fective alternative analgesic approach for those ment in group plH was significantly shorter than that in group plL. The injected
patients in whom epidural catheter insertion is either impossible or contrain- PCA volume was significantly greater in group plH than that in the other two
dicated. A bigger sample size, enrolling a greater percentage of scheduled groups. Postoperative pain intensity in group plH was significantly greater
procedures would be needed to confirm the impact on LOS. than that in the other two groups at 6, 12, and 24 h af ter surgery. The me-
References: chanical hyperalgesia threshold and the area of hyperalgesia around the
1. Gross ME et al. Am J Surg 2011:202:765-770 surgical incision 24 h af ter surgery in group plH dif fered significantly from
those in the other two groups, which were not significantly dif ferent. Adverse
ef fects were comparable among groups. Taken together, pregabalin alone