Postoperative Pain Management in Gynecologic Surgery: Evaluating the Role of Multimodal Anesthesia
Authors/Creators
- 1. Assistant Professor Department of Obstetrics and Gynaecology, GMC Rajouri, India
- 2. Assistant Professor Department of Obstetrics and Gynaecology GMC Jammu, India
- 3. Assistant Professor, Department of Anaesthesia, GMC Jammu, India
- 4. Assistant Professor, Department of Blood Transfusion Medicine, GMC and AH Rajouri, Jammu and Kashmir, India
- 5. Assistant Professor, Department of Anaesthesia, SKIMS, India
Description
Background: Effective postoperative pain management is crucial in gynecologic surgery to enhance patient recovery and satisfaction. Multimodal anesthesia uses a combination of analgesic techniques to improve pain relief, reduce opioid use, and speed up recovery. Objectives: To evaluate the effectiveness of multimodal anesthesia in reducing pain, opioid consumption, and adverse effects in patients undergoing gynecologic surgeries. Methods: A prospective study was conducted with 100 patients undergoing elective gynecologic surgeries. Patients were divided into two groups: one receiving multimodal anesthesia and the other receiving traditional opioid-based analgesia. Data on pain scores, opioid use, adverse effects, and recovery milestones were collected. Results: Patients in the multimodal group experienced significantly lower pain scores, reduced opioid use, and fewer side effects compared to the traditional analgesia group. Conclusion: Multimodal anesthesia provides superior pain control, minimizes opioid requirements, and enhances recovery, making it a preferable approach for managing postoperative pain in gynecologic surgeries.
Abstract (English)
Background: Effective postoperative pain management is crucial in gynecologic surgery to enhance patient recovery and satisfaction. Multimodal anesthesia uses a combination of analgesic techniques to improve pain relief, reduce opioid use, and speed up recovery. Objectives: To evaluate the effectiveness of multimodal anesthesia in reducing pain, opioid consumption, and adverse effects in patients undergoing gynecologic surgeries. Methods: A prospective study was conducted with 100 patients undergoing elective gynecologic surgeries. Patients were divided into two groups: one receiving multimodal anesthesia and the other receiving traditional opioid-based analgesia. Data on pain scores, opioid use, adverse effects, and recovery milestones were collected. Results: Patients in the multimodal group experienced significantly lower pain scores, reduced opioid use, and fewer side effects compared to the traditional analgesia group. Conclusion: Multimodal anesthesia provides superior pain control, minimizes opioid requirements, and enhances recovery, making it a preferable approach for managing postoperative pain in gynecologic surgeries.
Files
IJPCR,Vol16,Issue10,Article64.pdf
Files
(315.9 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:728c0300e676abc4d5795696defcac50
|
315.9 kB | Preview Download |
Additional details
Dates
- Accepted
-
2024-09-26
Software
- Repository URL
- http://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue10,Article64.pdf
- Development Status
- Active
References
- 1. Wong M, Morris S, Wang K, Simpson K. Managing Postoperative Pain after Minimally Invasive Gynecologic Surgery in the Era of the Opioid Epidemic. J Minim Invasive Gynecol. 2018 Nov-Dec; 25(7):1165-1178. doi: 10.10 16/j.jmig.2017.09.016. Epub 2017 Sep 28. PMID: 28964926. 2. Munro A, Sjaus A, George RB. Anesthesia and analgesia for gynecological surgery. Curr Opin Anaesthesiol. 2018 Jun; 31(3):274-279. doi: 10.1097/ACO.0000000000000584. PMID: 29474216. 3. Kalogera E, Bakkum-Gamez JN, Jankowski CJ, Trabuco E, Lovely JK, Dhanorker S, Grubbs PL, Weaver AL, Haas LR, Borah BJ, Bursiek AA, Walsh MT, Cliby WA, Dowdy SC. Enhanced recovery in gynecologic surgery. Obstet Gynecol. 2013 Aug; 122(2 Pt 1):319-328. doi: 10.1097/AOG.0b013e31829 aa780. PMID: 23969801; PMCID: PMC3913 481. 4. Ren Y, Sun D, Pei L, Liu X, Liu Y, Liu H. A Full Enhanced Recovery after Surgery Program in Gynecologic Laparoscopic Procedures: A Randomized Controlled Trial. J Minim Invasive Gynecol. 2021 Sep; 28(9):1610- 1617.e6. doi: 10.1016/j.jmig.2021.01.024. Epub 2021 Mar 4. PMID: 33676007. 5. Ferrari F, Forte S, Sbalzer N, Zizioli V, Mauri M, Maggi C, Sartori E, Odicino F. Validation of an enhanced recovery after surgery protocol in gynecologic surgery: an Italian randomized study. Am J Obstet Gynecol. 2020 Oct; 223(4):543.e1-543.e14. doi: 10.1016/j.ajog.2020.07.003. Epub 2020 Jul 8. PMID: 32652064. 6. Ismail S, Mistry AA, Siddiqui AS, Aziz A, Zuberi NF. The analgesic efficacy of ultrasound-guided transversus abdominis plane block vs. local anesthetic infiltration technique in major gynecologic surgery: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2023 Oct-Dec; 39(4):557-564. doi: 10.4103/ joacp.joacp_78_22. Epub 2022 Aug 31. PMID: 38269169; PMCID: PMC10805223. 7. Bayaliieva AZh, Khusainova II, Berdnikova EA, Garipova GH. [BALANCED MULTIMODAL ANALGESIA IN GYNECOLOGIC ONCOLOGY]. Anesteziol Reanimatol. 2016 Mar-Apr; 61(2):121-3. Russian. PMID: 27468502. 8. Hawkins R, Evans M, Hammond S, Hartopp R, Evans E. Placenta accreta spectrum disorders - Peri-operative management: The role of the anaesthetist. Best Pract Res Clin Obstet Gynaecol. 2021 Apr; 72:38-51. doi: 10.1016/ j.bpobgyn.2020.08.003. Epub 2020 Aug 13. PMID: 32888811. 9. Ladanyi C, Sticco P, Blevins M, Boyd S, Gutmann D, Holcombe J, Mohling S. Efficacy and Safety of a Surgeon-Performed LaparoscopicGuided, 4-point Transversus Abdominis Plane Block: A retrospective review. J Minim Invasive Gynecol. 2021 Jan; 28(1):124-130. doi: 10.1016/j.jmig.2020.06.012. Epub 2020 Jun 17. PMID: 32562766. 10. Modesitt SC, Sarosiek BM, Trowbridge ER, Redick DL, Shah PM, Thiele RH, Tiouririne M, Hedrick TL. Enhanced Recovery Implementation in Major Gynecologic Surgeries: Effect of Care Standardization. Obstet Gynecol. 2016 Sep; 128(3):457-66. doi: 10.1097/AOG. 0000000000001555. PMID: 27500337. 11. Kim SR, Laframboise S, Nelson G, McCluskey SA, Avery L, Kujbid N, Zia A, Bernardini MQ, Ferguson SE, May T, Hogen L, Cybulska P, Bouchard-Fortier G. Implementation of a restrictive opioid prescription protocol after minimally invasive gynecologic oncology surgery. Int J Gynecol Cancer. 2021 Dec; 31(12):1584-1588. doi: 10.1136/ijgc-20 21-002968. Epub 2021 Nov 8. PMID: 34750198. 12. Gasanova I, Grant E, Way M, Rosero EB, Joshi GP. Ultrasound-guided transversus abdominal plane block with multimodal analgesia for pain management after total abdominal hysterectomy. Arch Gynecol Obstet. 2013 Jul; 288(1):105-11. doi: 10.1007/s00404-012-269 8-3. Epub 2013 Jan 6. PMID: 23291970. 13. DI Filippo A, Capezzuoli T, Fambrini M, Cariti G, Orlandi G, Vannucci G, Borracci T, DI Nallo L, Mazzella M, Petraglia F. Enhanced recovery after gynecological surgery: comparison between intrathecal and intravenous morphine multimodal analgesia. Minerva Obstet Gynecol. 2023 Apr; 75(2):145-149. doi: 10.23736/S2724-606X.21.04961-7. Epub 2021 Dec 1. PMID: 34851074. 14. Moizo E, Berti M, Marchetti C, Deni F, Albertin A, Muzzolon F, Antonino A. Acute Pain Service and multimodal therapy for postsurgical pain control: evaluation of protocol efficacy. Minerva Anestesiol. 2004 Nov; 70(11):779-87. English, Italian. PMID: 15699914. 15. Griffiths JD, Middle JV, Barron FA, Grant SJ, Popham PA, Royse CF. Transversus abdominis plane block does not provide additionalbenefit to multimodal analgesia in gynecological cancer surgery. Anesth Analg. 2010 Sep; 111(3):797-801. doi: 10.1213/ANE.0b013e318 1e53517. Epub 2010 Jun 14. PMID: 20547822. 16. Moon HY, Baek CW, Choi GJ, Shin HY, Kang H, Jung YH, Woo YC, Kim JY, Park SG. Palonosetron and aprepitant for the prevention of postoperative nausea and vomiting in patients indicated for laparoscopic gynaecologic surgery: a double-blind randomised trial. BMC Anesthesiol. 2014 Aug 10; 14:68. doi: 10.1186/1471-2253-14-68. PMID: 25165427; PMCID: PMC4146452.