ABSTRACT
Background: Adhesions are bands of scar tissue that form between organs. In the abdomen, they form after an abdominal surgery or after a bout of intra-abdominal infection [i.e., pelvic inflammatory disease, diverticulitis]. More than 95% of patients who undergo abdominal surgery develop adhesions; these are nearly inevitably part of the body's healing process. Though most adhesions are asymptomatic, some can cause bowel obstructions, infertility, and chronic pain
Objectives: Concerning whether patients with chronic pelvic pain benefit from laparoscopic adhesiolysis or whether any appearing advantage is a placebo effect
Materials and Methods: This review was conducted using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1990, through October 31, 2017
Results: The spectrum of treatments for a small-bowel obstruction ranges from conservative management with bowel rest to surgical intervention, sometimes involving bowel resection. The caveat with regard to surgical treatment is that while surgery may be required to release symptomatic adhesions, postoperative reformation of these adhesions is common. Debate continues as to whether laparoscopic adhesiolysis yields added benefit in terms of decreasing postoperative adhesion reformation; however, promising results have been obtained with Open approach
Conclusion: Laparotomy with open adhesiolysis has been the treatment of choice for acute complete bowel obstructions. Patients who have partial obstructions, with some enteric contents traversing the obstruction, might similarly require surgery if nonoperative measures fail
ABSTRACT
Background: Proper postoperative pain management, which can be advanced using a multimodal approach, results in pain relief with minimal side effects. Newer recovery protocols, along with minimally invasive surgeries add to the better management of post-operative complication. Many factors play a role in failure of proper postoperative pain management, which mainly include insufficient education, fear of complications associated with analgesic drugs, poor pain assessment and inadequate staffing
Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE from January 1987 to March 2017. The following search terms were used: post-operative pain mechanism, post-operative pain management, non-opioid pain management
Aim of the work: In this study we aimed to understand the mechanism and the management of post-operative pain, along with shining some light upon the recent advances
Conclusion: Various combinations and modalities of pain management exist, and their use depends largely on the case, the patients, and their perception of pain. Enhanced recovery protocols have significantly improved perioperative and postoperative pain management, making the decrease in opioids need a priority