الفهرس 
Pathophysiology of PainOnly 14 pages are availabe for public view
Abstract
Poorly controlled acute pain after surgery is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain.
The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses.
In order to blunt the autonomic and somatic reflex responses to pain and to enhance subsequent restoration of the function of different body-organs as breathing, coughing, and moving easily, together with resumption of oral feeding, and early hospital discharge.
Many studies have been carried out trying to find a solution for these dilemma thus different pain modalities as local infiltration of the surgical field, systemic analgesia (narcotics and non-narcotics), neuro-axial blocks, and nerve blocks shined out, however each has shown its side effect which limits its use to specific cases.
The aim of this study is to compare Supraclavicular Brachial plexus nerve block to patient controlled analgesia for postoperative pain management in forearm surgeries. Therefore, we performed a randomized study to compare the efficacy of Supraclavicular Brachial plexus nerve block with that of patient controlled analgesia.
The study was conducted on 64 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 32 patients each:
group 1: consisting of patients received ultrasound guided supraclavicular brachial plexus nerve block.
group 2: consisting of patients received patient controlled analgesia (PCA).
The two groups were adequately monitored and assessed intra- and post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia and total consumption of it in the 1st 24 postoperative hours, postoperative nausea and vomiting. Demographic data and post operative hemodynamics were also assessed.
The results of the study revealed that there is significant difference between supraclvicular brachial plexus block and patient controlled analgesia regarding the postoperative analgesia after forearm surgery.