ABSTRACT
Varicocelectomy is a common operation in urology associated with considerable postoperative pain. The aim of this prospective, randomized, double-blind study was to investigate whether a combination of general anesthesia and bilateral nerve stimulator guided paravertebral nerve blocks could provide better postoperative pain relief compared to general anesthesia in combination with placebo paravertebral nerve block. Sixty patients scheduled for varicocelectomy were randomized prospectively. Thirty patients each in either the active group [general anaesthesia combined with nerve stimulator guided bilateral paravertebral block] or the control group [general anaesthesia combined with normal saline nerve stimulator guided bilateral paravertebral block]. Postoperative pain was assessed by visual analogue scale scores at predetermined time intervals. The active group was found to have better postoperative pain-relief [p < 0.005], reduced need for analgesics [p < 0.05], and also a more rapid return to normal activities [p < 0.001] compared to control group. Higher surgeon and patient satisfaction [p < 0.001] were noted in the active group compared to the control group. Preoperative paravertebral blockade combined with general anesthesia showed significantly reduced postoperative pain scores and analgesic consumption, earlier return to normal activity and was associated with better patient and surgeon satisfaction during varicocelectomy surgery
ABSTRACT
Breast cancer surgery is frequently associated with postoperative nausea, vomiting, pain and painful restricted movement. It is well established that thoracic paravertebral block with or without general anesthesia provides better postoperative analgesia and reduces the risk of nausea and vomiting after breast surgery as well as the incidence of chronic pain. Paravertebral block improves the quality of recovery after breast cancer surgery and provides the patient with the option of ambulatory discharge
Subject(s)
Humans , Female , Analgesia/methods , Anesthesia, Local , Anesthesia, Conduction , Anesthetics, Local , Postoperative Nausea and Vomiting , PainABSTRACT
Goal of the study: Lumbar micro discectomy surgery is already performed under spinal anesthesia [SA] in many institutions. The aim of this study is to compare the quality of analgesia and recovery after SA when compared to general anesthesia [GA] after lumbar microdiscectomy surgery. methods: Following light sedation, SA is performed with the patient in the left lateral decubitus position, one to two levels above the herniated disc level. Isobaric 0.5% bupivacaine 3-3.5 ml was injected intrathecally followed by wound infiltration with 15 ml of bupivacaine with 1/200 000 epinephrine prior to surgical incision. Despite randomization, we found significantly more females in the GA group. Pain scores at 4 and 8h postoperatively were lower in SA group as well as total analgesic consumption during the first 24 h. Postoperative recovery including time to drinking, eating and walking were more rapid after SA when compared to GA. During the postoperative period, the incidence of urinary retention was comparable between groups but the occurrence of postoperative nausea and vomiting was significantly higher in the GA group. Moreover, the overall patient's and surgeon's satisfaction were significantly better in the SA group. SA associated to wound infiltration using bupivacaine is an interesting alternative to general anesthesia for outpatient lumbar microdiscectomy surgery