Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation
BACKGROUND: Spinal anaesthesia as an adjunct to general anaesthesia may reduce postoperative pain and opioid consumption after laparoscopic abdominoperineal rectal amputation. We designed a randomized double blinded pilot study with two objectives: 1) to explore potential benefits of spinal anaesthe...
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ftpubmed:oai:pubmedcentral.nih.gov:10239760 2023-07-02T03:33:11+02:00 Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation Antunes, Marisa Baumgärtel, Aleksander Gjessing, Petter Fosse Ytrebø, Lars Marius 2023-05-31 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239760/ http://www.ncbi.nlm.nih.gov/pubmed/37284327 https://doi.org/10.2147/JPR.S410019 en eng Dove http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239760/ http://www.ncbi.nlm.nih.gov/pubmed/37284327 http://dx.doi.org/10.2147/JPR.S410019 © 2023 Antunes et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). J Pain Res Case Series Text 2023 ftpubmed https://doi.org/10.2147/JPR.S410019 2023-06-11T00:47:07Z BACKGROUND: Spinal anaesthesia as an adjunct to general anaesthesia may reduce postoperative pain and opioid consumption after laparoscopic abdominoperineal rectal amputation. We designed a randomized double blinded pilot study with two objectives: 1) to explore potential benefits of spinal anaesthesia as an adjunct to general anaesthesia and 2) to provide power and sample size estimations for potential differences between the groups. Primary outcome measures were postoperative pain and oral morphine equivalent (OMEq) consumption. METHODS: Patients scheduled for elective laparoscopic abdominoperineal rectal amputation at the University Hospital of North Norway were randomised to spinal (n=5) or a sham spinal procedure (n=5). Numeric rating scale (NRS) and OMEq were monitored postoperatively for 72 h. RESULTS: Age, sex, body mass index, and ASA were not significantly different between the groups. During surgery, patients in the spinal group received less remifentanil (p=0.06). NRS was lower in the spinal group 1 hr after admittance to the post-anaesthesia care unit (PACU) (p=0.06) and on the first postoperative day at 8 AM (p=0.03). OMEq consumption in the PACU was lower in the spinal group (p=0.008), but no differences between the groups were detected after discharge to the ward. Sample size estimations revealed that eight patients in each group would be needed to study potential NRS differences after admission to the PACU and 23 patients in each group to study potential differences in OMEq consumption on day 1. CONCLUSION: Spinal anaesthesia as an adjunct to general anaesthesia reduces postoperative pain and opioid consumption after laparoscopic abdominoperineal rectal amputation. Data from the current study should be followed up by a sufficiently powered randomized controlled trial. CLINICAL TRIAL REGISTRATION: Trial registered at https://clinicaltrials.gov (NCT05406765). Text North Norway PubMed Central (PMC) Norway Journal of Pain Research Volume 16 1855 1865 |
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Case Series Antunes, Marisa Baumgärtel, Aleksander Gjessing, Petter Fosse Ytrebø, Lars Marius Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation |
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Case Series |
description |
BACKGROUND: Spinal anaesthesia as an adjunct to general anaesthesia may reduce postoperative pain and opioid consumption after laparoscopic abdominoperineal rectal amputation. We designed a randomized double blinded pilot study with two objectives: 1) to explore potential benefits of spinal anaesthesia as an adjunct to general anaesthesia and 2) to provide power and sample size estimations for potential differences between the groups. Primary outcome measures were postoperative pain and oral morphine equivalent (OMEq) consumption. METHODS: Patients scheduled for elective laparoscopic abdominoperineal rectal amputation at the University Hospital of North Norway were randomised to spinal (n=5) or a sham spinal procedure (n=5). Numeric rating scale (NRS) and OMEq were monitored postoperatively for 72 h. RESULTS: Age, sex, body mass index, and ASA were not significantly different between the groups. During surgery, patients in the spinal group received less remifentanil (p=0.06). NRS was lower in the spinal group 1 hr after admittance to the post-anaesthesia care unit (PACU) (p=0.06) and on the first postoperative day at 8 AM (p=0.03). OMEq consumption in the PACU was lower in the spinal group (p=0.008), but no differences between the groups were detected after discharge to the ward. Sample size estimations revealed that eight patients in each group would be needed to study potential NRS differences after admission to the PACU and 23 patients in each group to study potential differences in OMEq consumption on day 1. CONCLUSION: Spinal anaesthesia as an adjunct to general anaesthesia reduces postoperative pain and opioid consumption after laparoscopic abdominoperineal rectal amputation. Data from the current study should be followed up by a sufficiently powered randomized controlled trial. CLINICAL TRIAL REGISTRATION: Trial registered at https://clinicaltrials.gov (NCT05406765). |
format |
Text |
author |
Antunes, Marisa Baumgärtel, Aleksander Gjessing, Petter Fosse Ytrebø, Lars Marius |
author_facet |
Antunes, Marisa Baumgärtel, Aleksander Gjessing, Petter Fosse Ytrebø, Lars Marius |
author_sort |
Antunes, Marisa |
title |
Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation |
title_short |
Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation |
title_full |
Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation |
title_fullStr |
Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation |
title_full_unstemmed |
Spinal Anaesthesia as an Adjunct to General Anaesthesia for Laparoscopic Abdominoperineal Rectal Amputation |
title_sort |
spinal anaesthesia as an adjunct to general anaesthesia for laparoscopic abdominoperineal rectal amputation |
publisher |
Dove |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239760/ http://www.ncbi.nlm.nih.gov/pubmed/37284327 https://doi.org/10.2147/JPR.S410019 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_source |
J Pain Res |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239760/ http://www.ncbi.nlm.nih.gov/pubmed/37284327 http://dx.doi.org/10.2147/JPR.S410019 |
op_rights |
© 2023 Antunes et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
op_doi |
https://doi.org/10.2147/JPR.S410019 |
container_title |
Journal of Pain Research |
container_volume |
Volume 16 |
container_start_page |
1855 |
op_container_end_page |
1865 |
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1770273021494296576 |