Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery
<i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might b...
Ausführliche Beschreibung
Autor*in: |
Michał Jan Stasiowski [verfasserIn] Aleksandra Pluta [verfasserIn] Anita Lyssek-Boroń [verfasserIn] Magdalena Kawka [verfasserIn] Lech Krawczyk [verfasserIn] Ewa Niewiadomska [verfasserIn] Dariusz Dobrowolski [verfasserIn] Robert Rejdak [verfasserIn] Seweryn Król [verfasserIn] Jakub Żak [verfasserIn] Izabela Szumera [verfasserIn] Anna Missir [verfasserIn] Przemysław Jałowiecki [verfasserIn] Beniamin Oskar Grabarek [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2021 |
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Übergeordnetes Werk: |
In: Medicina - MDPI AG, 2016, 57(2021), 3, p 262 |
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Übergeordnetes Werk: |
volume:57 ; year:2021 ; number:3, p 262 |
Links: |
Link aufrufen |
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DOI / URN: |
10.3390/medicina57030262 |
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Katalog-ID: |
DOAJ018506984 |
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520 | |a <i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. | ||
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10.3390/medicina57030262 doi (DE-627)DOAJ018506984 (DE-599)DOAJef04fa4268a64d9cb664691084ae50f3 DE-627 ger DE-627 rakwb eng R5-920 Michał Jan Stasiowski verfasserin aut Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. vitreoretinal surgery general anaesthesia peribulbar block topical anaesthesia surgical pleth index Medicine (General) Aleksandra Pluta verfasserin aut Anita Lyssek-Boroń verfasserin aut Magdalena Kawka verfasserin aut Lech Krawczyk verfasserin aut Ewa Niewiadomska verfasserin aut Dariusz Dobrowolski verfasserin aut Robert Rejdak verfasserin aut Seweryn Król verfasserin aut Jakub Żak verfasserin aut Izabela Szumera verfasserin aut Anna Missir verfasserin aut Przemysław Jałowiecki verfasserin aut Beniamin Oskar Grabarek verfasserin aut In Medicina MDPI AG, 2016 57(2021), 3, p 262 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:3, p 262 https://doi.org/10.3390/medicina57030262 kostenfrei https://doaj.org/article/ef04fa4268a64d9cb664691084ae50f3 kostenfrei https://www.mdpi.com/1648-9144/57/3/262 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 3, p 262 |
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10.3390/medicina57030262 doi (DE-627)DOAJ018506984 (DE-599)DOAJef04fa4268a64d9cb664691084ae50f3 DE-627 ger DE-627 rakwb eng R5-920 Michał Jan Stasiowski verfasserin aut Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. vitreoretinal surgery general anaesthesia peribulbar block topical anaesthesia surgical pleth index Medicine (General) Aleksandra Pluta verfasserin aut Anita Lyssek-Boroń verfasserin aut Magdalena Kawka verfasserin aut Lech Krawczyk verfasserin aut Ewa Niewiadomska verfasserin aut Dariusz Dobrowolski verfasserin aut Robert Rejdak verfasserin aut Seweryn Król verfasserin aut Jakub Żak verfasserin aut Izabela Szumera verfasserin aut Anna Missir verfasserin aut Przemysław Jałowiecki verfasserin aut Beniamin Oskar Grabarek verfasserin aut In Medicina MDPI AG, 2016 57(2021), 3, p 262 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:3, p 262 https://doi.org/10.3390/medicina57030262 kostenfrei https://doaj.org/article/ef04fa4268a64d9cb664691084ae50f3 kostenfrei https://www.mdpi.com/1648-9144/57/3/262 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 3, p 262 |
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10.3390/medicina57030262 doi (DE-627)DOAJ018506984 (DE-599)DOAJef04fa4268a64d9cb664691084ae50f3 DE-627 ger DE-627 rakwb eng R5-920 Michał Jan Stasiowski verfasserin aut Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. vitreoretinal surgery general anaesthesia peribulbar block topical anaesthesia surgical pleth index Medicine (General) Aleksandra Pluta verfasserin aut Anita Lyssek-Boroń verfasserin aut Magdalena Kawka verfasserin aut Lech Krawczyk verfasserin aut Ewa Niewiadomska verfasserin aut Dariusz Dobrowolski verfasserin aut Robert Rejdak verfasserin aut Seweryn Król verfasserin aut Jakub Żak verfasserin aut Izabela Szumera verfasserin aut Anna Missir verfasserin aut Przemysław Jałowiecki verfasserin aut Beniamin Oskar Grabarek verfasserin aut In Medicina MDPI AG, 2016 57(2021), 3, p 262 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:3, p 262 https://doi.org/10.3390/medicina57030262 kostenfrei https://doaj.org/article/ef04fa4268a64d9cb664691084ae50f3 kostenfrei https://www.mdpi.com/1648-9144/57/3/262 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 3, p 262 |
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10.3390/medicina57030262 doi (DE-627)DOAJ018506984 (DE-599)DOAJef04fa4268a64d9cb664691084ae50f3 DE-627 ger DE-627 rakwb eng R5-920 Michał Jan Stasiowski verfasserin aut Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. vitreoretinal surgery general anaesthesia peribulbar block topical anaesthesia surgical pleth index Medicine (General) Aleksandra Pluta verfasserin aut Anita Lyssek-Boroń verfasserin aut Magdalena Kawka verfasserin aut Lech Krawczyk verfasserin aut Ewa Niewiadomska verfasserin aut Dariusz Dobrowolski verfasserin aut Robert Rejdak verfasserin aut Seweryn Król verfasserin aut Jakub Żak verfasserin aut Izabela Szumera verfasserin aut Anna Missir verfasserin aut Przemysław Jałowiecki verfasserin aut Beniamin Oskar Grabarek verfasserin aut In Medicina MDPI AG, 2016 57(2021), 3, p 262 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:3, p 262 https://doi.org/10.3390/medicina57030262 kostenfrei https://doaj.org/article/ef04fa4268a64d9cb664691084ae50f3 kostenfrei https://www.mdpi.com/1648-9144/57/3/262 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 3, p 262 |
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10.3390/medicina57030262 doi (DE-627)DOAJ018506984 (DE-599)DOAJef04fa4268a64d9cb664691084ae50f3 DE-627 ger DE-627 rakwb eng R5-920 Michał Jan Stasiowski verfasserin aut Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. vitreoretinal surgery general anaesthesia peribulbar block topical anaesthesia surgical pleth index Medicine (General) Aleksandra Pluta verfasserin aut Anita Lyssek-Boroń verfasserin aut Magdalena Kawka verfasserin aut Lech Krawczyk verfasserin aut Ewa Niewiadomska verfasserin aut Dariusz Dobrowolski verfasserin aut Robert Rejdak verfasserin aut Seweryn Król verfasserin aut Jakub Żak verfasserin aut Izabela Szumera verfasserin aut Anna Missir verfasserin aut Przemysław Jałowiecki verfasserin aut Beniamin Oskar Grabarek verfasserin aut In Medicina MDPI AG, 2016 57(2021), 3, p 262 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:3, p 262 https://doi.org/10.3390/medicina57030262 kostenfrei https://doaj.org/article/ef04fa4268a64d9cb664691084ae50f3 kostenfrei https://www.mdpi.com/1648-9144/57/3/262 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 3, p 262 |
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Michał Jan Stasiowski Aleksandra Pluta Anita Lyssek-Boroń Magdalena Kawka Lech Krawczyk Ewa Niewiadomska Dariusz Dobrowolski Robert Rejdak Seweryn Król Jakub Żak Izabela Szumera Anna Missir Przemysław Jałowiecki Beniamin Oskar Grabarek |
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Michał Jan Stasiowski |
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preventive analgesia, hemodynamic stability, and pain in vitreoretinal surgery |
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Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery |
abstract |
<i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. |
abstractGer |
<i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. |
abstract_unstemmed |
<i<Background and Objectives:</i< Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. <i<Materials and Methods:</i< We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (<i<p</i< < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). <i<Results:</i< Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (<i<p</i< < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. <i<Conclusions:</i< SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS. |
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Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery |
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