Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain
Multimodal analgesia can improve perioperative analgesia but knowledge of combination protocols is still incomplete. This study was designed to evaluate whether the combination of sciatic nerve blockade (SNB) and intravenous alfentanil (IVA) is more effective than either single treatment in relievin...
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| Format: | Article |
| Language: | English |
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Elsevier
2012-02-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664612000162 |
| _version_ | 1818426746432651264 |
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| author | Yeong-Ray Wen Chih-Peng Lin Ming-Dar Tsai Jui-Yuan Chen Chih-Chun Ma Wei-Zen Sun Chia-Chuan Wang |
| author_facet | Yeong-Ray Wen Chih-Peng Lin Ming-Dar Tsai Jui-Yuan Chen Chih-Chun Ma Wei-Zen Sun Chia-Chuan Wang |
| author_sort | Yeong-Ray Wen |
| collection | DOAJ |
| description | Multimodal analgesia can improve perioperative analgesia but knowledge of combination protocols is still incomplete. This study was designed to evaluate whether the combination of sciatic nerve blockade (SNB) and intravenous alfentanil (IVA) is more effective than either single treatment in relieving postoperative pain in rats.
Methods: In a plantar incision model, withdrawal thresholds were evaluated by von Frey test before incision as baselines and for 7 days after incision. The animals were randomly allocated into various groups to receive SNB with 1% or 2% lidocaine, IVA of 50 or 150 μg/kg, or combined treatments (SNB 1% + 50 μg/kg IVA or SNB 2% + 150 μg/kg IVA) before incision. The results were compared with those of sham procedures—i.e., injections of peri-sciatic or intravenous saline, or a combination of both.
Results: Plantar incision caused postoperative allodynia for 3 days. SNB with 2% lidocaine reduced allodynia at 1 hour, 3 hours, day 1, and day 2, but not at postoperative 5 hours or days 3–7, whereas 150 μg/kg IVA produced short analgesia for only 3 hours after surgery. Neither low-dose SNB nor low-dose IVA had a significant effect. When high-dose SNB and high-dose IVA were combined, a strong antiallodynic effect was shown in an additive manner. No synergism was evidently displayed by the combination.
Conclusion: Our results indicated that in an incisional pain model, multimodal analgesia is superior to single or no pretreatment; however, the combination of multimodal analgesic treatments should be individually discerned depending on nociceptive types and analgesic mechanisms. |
| first_indexed | 2024-12-14T14:34:44Z |
| format | Article |
| id | doaj.art-1113faa938084f049b2343ca89e1c2f7 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-14T14:34:44Z |
| publishDate | 2012-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-1113faa938084f049b2343ca89e1c2f72022-12-21T22:57:42ZengElsevierJournal of the Formosan Medical Association0929-66462012-02-01111210110810.1016/j.jfma.2011.02.001Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative painYeong-Ray Wen0Chih-Peng Lin1Ming-Dar Tsai2Jui-Yuan Chen3Chih-Chun Ma4Wei-Zen Sun5Chia-Chuan Wang6School of Medicine, China Medical University, Taichung, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, TaiwanDepartment of Neurosurgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDepartment of Anesthesiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDepartment of Anesthesiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, TaiwanSchool of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanMultimodal analgesia can improve perioperative analgesia but knowledge of combination protocols is still incomplete. This study was designed to evaluate whether the combination of sciatic nerve blockade (SNB) and intravenous alfentanil (IVA) is more effective than either single treatment in relieving postoperative pain in rats. Methods: In a plantar incision model, withdrawal thresholds were evaluated by von Frey test before incision as baselines and for 7 days after incision. The animals were randomly allocated into various groups to receive SNB with 1% or 2% lidocaine, IVA of 50 or 150 μg/kg, or combined treatments (SNB 1% + 50 μg/kg IVA or SNB 2% + 150 μg/kg IVA) before incision. The results were compared with those of sham procedures—i.e., injections of peri-sciatic or intravenous saline, or a combination of both. Results: Plantar incision caused postoperative allodynia for 3 days. SNB with 2% lidocaine reduced allodynia at 1 hour, 3 hours, day 1, and day 2, but not at postoperative 5 hours or days 3–7, whereas 150 μg/kg IVA produced short analgesia for only 3 hours after surgery. Neither low-dose SNB nor low-dose IVA had a significant effect. When high-dose SNB and high-dose IVA were combined, a strong antiallodynic effect was shown in an additive manner. No synergism was evidently displayed by the combination. Conclusion: Our results indicated that in an incisional pain model, multimodal analgesia is superior to single or no pretreatment; however, the combination of multimodal analgesic treatments should be individually discerned depending on nociceptive types and analgesic mechanisms.http://www.sciencedirect.com/science/article/pii/S0929664612000162alfentanilmultimodal analgesiaplantar incisionpostoperative painsciatic nerve blockade |
| spellingShingle | Yeong-Ray Wen Chih-Peng Lin Ming-Dar Tsai Jui-Yuan Chen Chih-Chun Ma Wei-Zen Sun Chia-Chuan Wang Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain Journal of the Formosan Medical Association alfentanil multimodal analgesia plantar incision postoperative pain sciatic nerve blockade |
| title | Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain |
| title_full | Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain |
| title_fullStr | Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain |
| title_full_unstemmed | Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain |
| title_short | Combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain |
| title_sort | combination of nerve blockade and intravenous alfentanil is better than single treatment in relieving postoperative pain |
| topic | alfentanil multimodal analgesia plantar incision postoperative pain sciatic nerve blockade |
| url | http://www.sciencedirect.com/science/article/pii/S0929664612000162 |
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