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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 20919

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Dr. Mirosław Czuczwar

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Guest Editor

2nd Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-081 Lublin, Poland
Interests: perioperative medicine; intensive care medicine; pharmacology; fluid therapy; nutrition
Special Issues, Collections and Topics in MDPI journals

Dr. Paweł Piwowarczyk

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Co-Guest Editor

Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-093 Lublin, Poland
Interests: intensive care; clinical nutrition; the pharmacokinetics of antibiotics; extra corporeal membrane oxygenation
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Dr. Kazimierz Widenka

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Co-Guest Editor

Medical College, Rzeszów University, 35-310 Rzeszów, Poland.
Interests: minimally invasive cardiac surgery; ERAS protocol in cardiac surgery; acute postoperative pain; postoperative chronic pain prevention

Dr. Michał Borys

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Co-Guest Editor

Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-093 Lublin, Poland
Interests: acute postoperative pain; postoperative chronic pain prevention; regional anesthesia; obstetric anesthesia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are a multi-disciplinary team of anesthesiologists and surgeons devoted to delivering patient-focused care. We aim to launch a Special Issue on Postoperative Pain Treatment and Prevention in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of health sciences and public health. For detailed information about the journal, please refer to the journal website (https://www.mdpi.com/journal/ijerph).

Over 200 million major surgeries are performed annually worldwide. Even though the World Health Organization proclaimed pain relief and management as a fundamental human right, many patients experience moderate or severe pain in the postoperative period. According to different variables (e.g., type of surgery, pain measurement tool, time of assessment, and patient sex and age), acute postoperative pain may be categorized as moderate or severe in approximately 60% to 80% of cases. A significant number of patients are also likely to suffer from chronic postsurgical pain, which is one of the most common complications following surgery, with increasing evidence of both its prevalence and intensity. Surprisingly, the introduction of new analgesic techniques and drugs and the implementation of national guidelines for pain management did not significantly influence inadequately treated pain, both acute and chronic postoperative. This Special Issue aims to present the latest findings on the epidemiology, pathophysiology, diagnostics, management, and prevention of perioperative pain. We are also open to any other subject area related to acute and chronic pain in the perioperative setting. The listed keywords suggest just a few of the many possibilities.

Dr. Mirosław Czuczwar
Dr. Michał Borys
Dr. Kazimierz Widenka
Dr. Paweł Piwowarczyk
Guest Editors

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

postoperative pain management
analgesia
analgesics
multimodal analgesia
chronic postsurgical pain
opioids
regional anesthesia
enhanced recovery after surgery pathway
neuropathic pain

Published Papers (8 papers)

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Research

10 pages, 988 KiB

Open AccessArticle

Effect of Bilateral Quadratus Lumborum Block Type I on Patient Satisfaction and Incidence of Chronic Postsurgical Pain Following Cesarean Section-A Randomized Controlled Trial

by Marcin Mieszkowski, Marek Janiak, Michał Borys, Paweł Radkowski, Marta Mieszkowska, Yauheni Zhalniarovich and Dariusz Onichimowski

Int. J. Environ. Res. Public Health 2021, 18(17), 9138; https://doi.org/10.3390/ijerph18179138 - 30 Aug 2021

Cited by 4 | Viewed by 2079

Abstract

Background: Quadratus lumborum block (QLB) provides a reduction in pain scores and opioid consumption after cesarean section (CS). Intrathecal morphine (ITM) is still considered as the gold standard of acute postoperative pain therapy, but it does have some significant side effects. The aim of this clinical study was to evaluate whether performing the quadratus lumborum block type I in patients undergoing CS would be associated with an increased satisfaction of pain therapy and a decreased incidence of chronic postsurgical pain (CPSP). Methods: Sixty patients scheduled for elective CS were enrolled. All patients received spinal anesthesia and were randomly allocated to either the QLB group (received bilateral quadratus lumborum block type I with the use of 24 m mL 0.375% ropivacaine) or the control group (received no block). The level of satisfaction was evaluated using a three-step scale and the answers provided in a questionnaire regarding the patients’ satisfaction with the method of postoperative pain treatment in the first 48 h. After a 6-month period, all patients were interviewed to evaluate the incidence and possible severity of CPSP. Results: Satisfaction scores were significantly lower in the QLB group than in the control group (p = 0.0000). There were no significant differences between the QLB and control groups regarding the occurrence of chronic postsurgical pain after 6 months following CS (p = 0.102). No statistical differences between the groups were recorded when we compared the results of the questionnaire after a period of 48 h from CS (the number of participants were limited in number). Conclusions: QLB type I is an analgetic option that increased the satisfaction of parturients with pain therapy after CS compared to patients who did not receive the block, and there is a tendency for a lower incidence of CPSP. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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11 pages, 1494 KiB

Open AccessArticle

Comparison of Postoperative Pain and Adverse Effects between Variable-Rate Feedback Infusion and Conventional Fixed-Rate Basal Infusion Modes of Patient-Controlled Epidural Analgesia following Open Gastrectomy: A Randomized Controlled Trial

by Yoo Kyung Jang, Na Young Kim, Jeong Soo Lee, Hye Jung Shin, Hyoung Gyun Kim, Suk Woo Lee, Jae Chul Koh and Young Chul Yoo

Int. J. Environ. Res. Public Health 2021, 18(16), 8777; https://doi.org/10.3390/ijerph18168777 - 19 Aug 2021

Cited by 2 | Viewed by 2127

Abstract

Patient-controlled epidural analgesia is widely used to control postoperative pain following major intra-abdominal surgeries. However, determining the optimal infusion dose that can produce effective analgesia while reducing side effects remains a task to be solved. Postoperative pain and adverse effects between variable-rate feedback infusion (VFIM group, n = 36) and conventional fixed-rate basal infusion (CFIM group, n = 36) of fentanyl/ropivacaine-based patient-controlled epidural analgesia were evaluated. In the CFIM group, the basal infusion rate was fixed (5 mL/h), whereas, in the VFIM group, the basal infusion rate was increased by 0.5 mL/h each time a bolus dose was administered and decreased by 0.3 mL/h when a bolus dose was not administered for 2 h. Patients in the VFIM group experienced significantly less pain at one to six hours after surgery than those in the CFIM group. Further, the number of patients who suffered from postoperative nausea was significantly lower in the VFIM group than in the CFIM group until six hours after surgery. The variable-rate feedback infusion mode of patient-controlled epidural analgesia may provide better analgesia accompanied with significantly less nausea in the early postoperative period than the conventional fixed-rate basal infusion mode following open gastrectomy. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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10 pages, 2942 KiB

Open AccessArticle

The Effectiveness of Transversus Abdominis Plane and Quadratus Lumborum Blocks in Acute Postoperative Pain Following Cesarean Section—A Randomized, Single-Blind, Controlled Trial

by Michał Borys, Beata Potręć-Studzińska, Paweł Kutnik, Justyna Sysiak-Sławecka, Elżbieta Rypulak, Tomasz Gęca, Anna Kwaśniewska, Mirosław Czuczwar and Paweł Piwowarczyk

Int. J. Environ. Res. Public Health 2021, 18(13), 7034; https://doi.org/10.3390/ijerph18137034 - 30 Jun 2021

Cited by 3 | Viewed by 2398

Abstract

Acute pain intensity related to cesarean section (CS) may be extensive and is often underestimated. This may influence mothers’ quality of life and their children’s development. Regional analgesia techniques that include transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have proven their efficacy in the postoperative period after CS. Although several randomized controlled studies and one meta-analysis have investigated the utility of TAPB and QLB in the reduction of acute and chronic pain after CS, only one study directly compared both types of regional blocks and revealed superiority of QLB over TAPB. Our study aimed to reevaluate the effectiveness of transversus TAPB and QLB in controlling acute postoperative pain after CS. We recruited 197 women with singleton pregnancies undergoing CS under spinal anesthesia. The patients were randomized to receive either TAPB or QLB after CS. The acute postoperative pain was evaluated using the visual analog scale (VAS) at 2, 4, 8, 12 and 24 h after the operation. No significant difference in acute postoperative pain intensity between the groups was found. The patients who received TAPB had a higher demand for supplemental morphine injections (p < 0.039). In our study, none of the evaluated regional blocks demonstrated an advantage over the other regarding acute postoperative pain management. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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12 pages, 3362 KiB

Open AccessArticle

Incidence of Suture-Method Catheter Dislocation with Femoral Nerve Block and Femoral Triangle Block after Total Knee Arthroplasty

by Bulat Tuyakov, Mateusz Kruszewski, Lidia Glinka, Oksana Klonowska, Michal Borys, Pawel Piwowarczyk and Dariusz Onichimowski

Int. J. Environ. Res. Public Health 2021, 18(13), 6687; https://doi.org/10.3390/ijerph18136687 - 22 Jun 2021

Cited by 2 | Viewed by 1879

Abstract

Catheter dislocation with continuous peripheral nerve blocks represents a major problem in clinical settings. There is a range of factors affecting the incidence of catheter dislocation, including catheter type. This study aimed to assess the incidence of suture-method catheter (SMC) dislocation 24 h after total knee arthroplasty (TKA), with continuous femoral nerve block (CFNB) and continuous femoral triangle block (CFTB), respectively. In the prospective randomized trial, 40 patients qualified for TKA with SMC and were divided into two groups, those who received CFNB (Group 1, n = 20) and those who received CFTB (Group 2, n = 20). After 24 h, the degree of catheter displacement (cm), pain intensity (NRS) and opioid consumption (mg) was assessed. The catheter dislocation rates were found to be 15% in Group 1 versus 5% in Group 2, with the catheter dislocated by 0.83 cm (SD = ±0.87) and 0.43 cm (SD = ±0.67), respectively. There were no differences in NRS score (p = 0.86) or opioid consumption (p = 0.16) between the groups. In each case, a displaced catheter was successfully repositioned by pulling, which clinically resulted in a lower NRS score. The results of the study suggest that CFTB with SMC may be used after TKA with a good effect, as it is associated with low catheter dislocation rates and an adequate analgesic effect. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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12 pages, 1507 KiB

Open AccessArticle

Effectiveness of Fascia Iliaca Compartment Block after Elective Total Hip Replacement: A Prospective, Randomized, Controlled Study

by Wojciech Gola, Szymon Bialka, Aleksander J. Owczarek and Hanna Misiolek

Int. J. Environ. Res. Public Health 2021, 18(9), 4891; https://doi.org/10.3390/ijerph18094891 - 4 May 2021

Cited by 11 | Viewed by 2865

Abstract

Objective: An assessment of the feasibility of fascia iliaca compartment block (FICB) combined with nonopioid analgesics and patient controlled analgesia (PCA), oxycodone, in the perioperative anaesthetic management for elective total hip replacement (THR). Design: A randomised, single-center, open-label study. Setting: A single hospital. The study was conducted from October 2018 to May 2019. Participants: In total, 109 patients were scheduled for elective total hip replacement. Interventions: Postoperative FICB with 0.375% ropivacaine in conjunction with nonopioid analgesics (paracetamol, metamizole, and pregabalin) and oxycodone as rescue analgesia. Measurements: Pain intensity was measured using the Numeric Pain Rating Scale (NRS) at rest and during rehabilitation, the total dose of postoperative oxycodone required, the occurrence of opioid-related adverse events, patient hospitalisation time, and level of satisfaction. Follow-up period: 48 h. Main Results: A total of 109 patients were randomised into two groups and, of these, 9 were subsequently excluded from the analysis (three conversions to general anaesthesia, two failures to perform FICB, four failures to use the PCA pump). Patients in the FICB group received standard intravenous analgesia with FICB, and those in the control group were managed with standard intravenous analgesia only. Pain level measured with NRS was significantly lower at rest and during rehabilitation in the FICB group. Oxycodone use in the first 48 h was significantly higher in the control group (p < 0.001); additionally, the time to the first dose of rescue analgesia was significantly shorter (p < 0.001). In the control group, there was a higher rate of side effects and a significantly longer hospitalisation time (p < 0.001). Similarly, higher satisfaction with the applied analgesic treatment was noted in the FICB group. Conclusions: FICB in elective THR treatments is an effective form of analgesia, which reduces the need for opioids, the number of complications, the length of hospitalisation, and which ensures a high level of patient satisfaction with the analgesic treatment used. Trial registration: ClinicalTrials.gov No. NCT04690647. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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18 pages, 1343 KiB

Open AccessArticle

Association of Gender, Painkiller Use, and Experienced Pain with Pain-Related Fear and Anxiety among University Students According to the Fear of Pain Questionnaire-9

by Paweł Piwowarczyk, Agnieszka Kaczmarska, Paweł Kutnik, Aleksandra Hap, Joanna Chajec, Urszula Myśliwiec, Mirosław Czuczwar and Michał Borys

Int. J. Environ. Res. Public Health 2021, 18(8), 4098; https://doi.org/10.3390/ijerph18084098 - 13 Apr 2021

Cited by 3 | Viewed by 2255

Abstract

Anxiety and fear are determinants of acute and chronic pain. Effectively measuring fear associated with pain is critical for identifying individuals’ vulnerable to pain. This study aimed to assess fear of pain among students and evaluate factors associated with pain-related fear. We used the Fear of Pain Questionnaire-9 to measure this fear. We searched for factors associated with fear of pain: gender, size of the city where the subjects lived, subject of academic study, year of study, the greatest extent of experienced pain, frequency of painkiller use, presence of chronic or mental illness, and past hospitalization. We enrolled 717 participants. Median fear of minor pain was 5 (4–7) fear of medical pain 7 (5–9), fear of severe pain 10 (8–12), and overall fear of pain 22 (19–26). Fear of pain was associated with gender, frequency of painkiller use, and previously experienced pain intensity. We found a correlation between the greatest pain the participant can remember and fear of minor pain (r = 0.112), fear of medical pain (r = 0.116), and overall fear of pain (r = 0.133). Participants studying medicine had the lowest fear of minor pain while stomatology students had the lowest fear of medical pain. As students advanced in their studies, their fear of medical pain lowered. Addressing fear of pain according to sex of the patient, frequency of painkiller use, and greatest extent of experienced pain could ameliorate medical training and improve the quality of pain management in patients. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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10 pages, 2321 KiB

Open AccessArticle

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

by Piotr Bryniarski, Szymon Bialka, Michal Kepinski, Anna Szelka-Urbanczyk, Andrzej Paradysz and Hanna Misiolek

Int. J. Environ. Res. Public Health 2021, 18(7), 3625; https://doi.org/10.3390/ijerph18073625 - 31 Mar 2021

Cited by 8 | Viewed by 2799

Abstract

Erector spinae plane block was recently introduced as an alternative to postoperative analgesia in surgical procedures including thoracoscopies and mastectomies. There are no clinical trials regarding erector spinae plane block in percutaneous nephrolithotomy. The aim of our study was to test the efficacy and safety of erector spinae plane block after percutaneous nephrolithotomy. We analyzed 68 patients, 34 of whom received erector spinae plane block. The average visual analogue scale score 24 h postoperatively was the primary endpoint. The secondary endpoints were nalbuphine consumption and the need for rescue analgesia. Safety measures included the mean arterial pressure, Ramsey scale score, and rate of nausea and vomiting. The visual analogue scale, blood pressure, and Ramsey scale were assessed simultaneously at 1, 2, 4, 6, 12, and 24 h postoperatively. The average visual analogue scale was 2.9 and 3 (p = 0.65) in groups 1 (experimental) and 2 (control), respectively. The visual analogue scale after 1 h postoperatively was significantly lower in the erector spinae plane block group (2.3 vs. 3.3; p = 0.01). The average nalbuphine consumption was the same in both groups (46 mL vs. 47.2 mL, p = 0.69). The need for rescue analgesia was insignificantly different in both groups (group 1, 29.4; group 2, 26.4%; p = 1). The mean arterial pressure was similar in both groups postoperatively (91.8 vs. 92.5 mmHg; p = 0.63). The rate of nausea and vomiting was insignificantly different between the groups (group 1, 17.6%; group 2, 14.7%; p = 1). The median Ramsey scale in all the measurements was two. Erector spinae plane block is an effective pain treatment after percutaneous nephrolithotomy but only for a very short postoperative period. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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12 pages, 3519 KiB

Open AccessArticle

Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study

by Michał Borys, Aleksandra Zamaro, Beata Horeczy, Ewa Gęszka, Marek Janiak, Piotr Węgrzyn, Mirosław Czuczwar and Paweł Piwowarczyk

Int. J. Environ. Res. Public Health 2021, 18(7), 3500; https://doi.org/10.3390/ijerph18073500 - 28 Mar 2021

Cited by 14 | Viewed by 2971

Abstract

Background: Severe postoperative pain is a significant problem after cesarean sections. Methods: This study was a randomized, controlled trial of 105 patients conducted in two hospitals. All patients were anesthetized spinally for elective cesarean section. Each participant was randomly allocated to one of three study groups: the quadratus lumborum block (QLB) group, the transversus abdominis plane block (TAPB) group, or the control (CON) group. The primary outcome of this study determined acute pain intensity on the visual analog scale (VAS). The secondary outcomes determined morphine consumption and chronic pain evaluation according to the Neuropathic Pain Symptom Inventory (NPSI) after hospital discharge. Results: At rest, the pain intensity was significantly higher in the CON group than in the QLB and TAPB groups at hours two and eight. Upon activity, the pain in the control subjects was more severe than in the QLB and TAPB groups in three and two of five measurements, respectively. Moreover, morphine consumption was significantly lower in the QLB (9 (5–10)) and TAPB (10 (6–14)) groups than in the CON (16 (11–19)) group. Persistent postoperative pain was significantly lower in the QLB group than in the CON group at months one and six following hospital discharge. Conclusions: Both the QLB and TAPB can improve pain management after cesarean delivery. Moreover, the QLB might reduce the severity of persistent postoperative pain months after cesarean section. Full article

(This article belongs to the Special Issue Postoperative Pain Treatment and Prevention)

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