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subcutaneous analgesia

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https://www.readbyqxmd.com/read/28536837/controlled-sedation-with-midazolam-and-analgesia-with-nalbuphine-to-alleviate-pain-in-patients-undergoing-subcutaneous-implantable-cardioverter-defibrillator-implantation
#1
Michaël Peyrol, Jérémie Barraud, Jennifer Cautela, Baptiste Maille, Marc Laine, Laurent Bonello, Franck Thuny, Franck Paganelli, Frédéric Franceschi, Linda Koutbi, Samuel Levy
PURPOSE: Subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD to prevent sudden cardiac death. Subcutaneous ICD implantation frequently requires general anesthesia because of procedure nociceptive steps during creation of a large device pocket and lead tunneling. This study aims to determine if a strategy of operator-guided controlled sedation with midazolam and analgesia with nalbuphine is effective in alleviating pain during S-ICD implantation...
May 23, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28527646/high-dose-amino-acid-administration-achieves-an-anabolic-response-in-type-2-diabetic-patients-that-is-independent-of-glycaemic-control-a-randomized-clinical-trial
#2
Chelsia Gillis, Patricia S Roque, Jürgen Bläss, Albert Urwyler, Harald Schepperle, Guido Kunz, Thomas Peters, Thomas Schricker, Linda Wykes, Andrea Kopp Lugli
BACKGROUND & AIMS: Surgical stress provokes protein catabolism and hyperglycaemia that is enhanced in patients with type 2 diabetes (T2DM), and increases perioperative morbidity. This study hypothesized that perioperative administration of high dose intravenous (IV) amino acids (AA) will augment protein balance in T2DM patients receiving tight plasma glucose control via continuous IV insulin compared to standard plasma glucose control via subcutaneous (SC) insulin sliding scale. METHODS: Eighteen patients with well-controlled T2DM (HbA1C% < 7...
May 3, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28509770/tumescent-anaesthesia-its-applications-and-well-tolerated-use-in-the-out-of-operating-room-setting
#3
Natalie F Holt
PURPOSE OF REVIEW: Tumescent anaesthesia is a method of administering dilute local anaesthetic into the subcutaneous tissue. Many anaesthesiologists are unfamiliar with the technique, its applications and potential risks. RECENT FINDINGS: The maximum safe dose of lidocaine with epinephrine in tumescent anaesthesia for liposuction is probably between 35 and 55 mg/kg. Without liposuction, the maximum dose of lidocaine with epinephrine should be no more than 28 mg/kg...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28502631/a-brain-targeted-ampakine-compound-protects-against-opioid-induced-respiratory-depression
#4
Wei Dai, Dian Xiao, Xiang Gao, Xin-Bo Zhou, Tong-Yu Fang, Zheng Yong, Rui-Bin Su
The use of opioid drugs for pain relief can induce life-threatening respiratory depression. Although naloxone effectively counteracts opioid-induced respiratory depression, it diminishes the efficacy of analgesia. Our studies indicate that ampakines, in particular, a brain-targeted compound XD-8-17C, are able to reverse respiratory depression without affecting analgesia at relatively low doses. Mice and rats were subcutaneously or intravenously injected with the opioid agonist TH-030418 to induce moderate or severe respiratory depression...
May 11, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28484316/the-effect-of-peritubal-infiltration-with-bupivacaine-and-morphine-on-postoperative-analgesia-in-patients-undergoing-percutaneous-nephrolithotomy
#5
Isra Karaduman, Derya Karasu, Canan Yilmaz, Sedat Oner, Hilal Erdem Solak, Gulsen Korfali
Objective. We aimed to investigate the effect of peritubal local anesthetic and opioid infiltration on pain scores and analgesic consumption in patients who underwent percutaneous nephrolithotomy. Material and Methods. Patients aged between 18 and 65 years and ASA I-III were included in this double-blind, randomized study. The patients were divided into two groups. All patients underwent spinoepidural anesthesia. 20 mL of 0.25 percent bupivacaine + 5 mg morphine (0.5 mL), in Group P (n = 66), infiltrated the renal capsule, perinephric fat, muscles, subcutaneous tissue, and skin under fluoroscopy...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28435535/opioid-receptor-activity-and-analgesic-potency-of-dpdpe-peptide-analogues-containing-a-xylene-bridge
#6
Azzurra Stefanucci, Ettore Novellino, Sako Mirzaie, Giorgia Macedonio, Stefano Pieretti, Paola Minosi, Edina Szűcs, Anna I Erdei, Ferenc Zádor, Sándor Benyhe, Adriano Mollica
d-Pen(2),d-Pen(5) enkephalin (DPDPE) is one of the most selective synthetic peptide agonists targeting the δ-opioid receptor. Three cyclic analogues of DPDPE containing a xylene bridge in place of disulfide bond have been synthesized and fully characterized as opioid receptors agonists. The in vitro activity was investigated showing a good affinity of 7a-c for μ- and δ-receptors. In vivo biological assays revealed that 7b is the most potent analogue with the ability to maintain high level of analgesia from 15 to 60 min following intracerebroventricular (i...
April 13, 2017: ACS Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28416162/pharmacokinetics-of-buprenorphine-following-constant-rate-infusion-for-postoperative-analgesia-in-dogs-undergoing-ovariectomy
#7
Andrea Barbarossa, Julie Rambaldi, Massimo Giunti, Anna Zaghini, Marco Cunto, Daniele Zambelli, Simond Valgimigli, Francesco Santoro, Noemi Romagnoli
OBJECTIVE: To investigate the pharmacokinetics of buprenorphine and its main active metabolite, norbuprenorphine, after administration of an intravenous loading dose followed by constant rate infusion (CRI) in dogs. STUDY DESIGN: Prospective, clinical study. ANIMALS: A total of seven healthy dogs undergoing elective ovariectomy. METHODS: Buprenorphine was administered as a loading dose (intravenous bolus of 15 μg kg(-1)) followed by CRI (2...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#8
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN: A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised controlled trial. This phase of the study examined breastfeeding intention and experience from the first hour of birth to 6 weeks postpartum. Medical records were audited and women were contacted at 6 weeks postpartum to complete a telephone questionnaire...
April 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28375661/pain-management-of-malignant-psoas-syndrome-under-epidural-analgesia-during-palliative-radiotherapy
#9
Takayo Ota, Masaru Makihara, Hiroshi Tsukuda, Ryuji Kajikawa, Masayuki Inamori, Nozomi Miyatake, Noriko Tanaka, Masahiro Tokunaga, Yoshikazu Hasegawa, Takuhito Tada, Masahiro Fukuoka
Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. The authors report a case of severe back pain caused by metastasis to the psoas muscle of advanced gastric cancer in a patient who underwent palliative radiotherapy under epidural analgesia...
April 4, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28374466/post-operative-pain-relief-using-local-infiltration-analgesia-during-open-abdominal-hysterectomy-a-randomized-double-blind-study
#10
J M Hayden, J Oras, O I Karlsson, K G Olausson, S-E Thörn, A Gupta
BACKGROUND: Post-operative pain is common and often severe after open abdominal hysterectomy, and analgesic consumption high. This study assessed the efficacy of local infiltration analgesia (LIA) injected systematically into different tissues during surgery compared with saline on post-operative pain and analgesia. METHODS: Fifty-nine patients were randomized to Group LIA (n = 29) consisting of 156 ml of a mixture of 0.2% ropivacaine + 30 mg ketorolac + 0.5 mg (5 ml) adrenaline, where the drugs were injected systematically in the operating site, around the proximal vagina, the ligaments, in the fascia and subcutaneously, or to saline and intravenous ketorolac, Group C (Control, n = 28), in a double-blind study...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28343071/analgesia-effect-of-baicalein-against-ntg-induced-migraine-in-rats
#11
Xiao-Fan Zhang, Wen-Jun Zhang, Cui-Lan Dong, Wan-Li Hu, Yu-Yao Sun, Yarigui Bao, Chun-Feng Zhang, Chang-Run Guo, Chong-Zhi Wang, Chun-Su Yuan
BACKGROUND: Migraine is a complex nervous system disease characterized by typical throbbing and unilateral headache, which causes severe healthy and social issues worldwide. The purpose of this study was to investigate the effect of baicalein (BAI) on the treatment of migraine. MATERIAL AND METHODS: Twenty-four rats were randomly divided equally into four groups, including a blank group, model group, positive group (ibuprofen tablets 82mg/kg), and BAI group (60mg/kg)...
June 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28316849/spontaneous-pneumomediastinum-in-labor
#12
Mohamed Adnane Berdai, Said Benlamkadem, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman's syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman's syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28302576/adolescent-chronic-escalating-morphine-administration-induces-long-lasting-changes-in-tolerance-and-dependence-to-morphine-in-rats
#13
Hamed Salmanzadeh, Hossein Azizi, Saeed Semnanian
Adolescence is a gradual period of transition from childhood to adulthood. It is considered as a sensitive developmental time point that long lasting changes occur in the brain. The present study examined adolescent chronic escalating morphine administration on morphine tolerance and dependence in adulthood. Adolescent male Wistar rats (30days old) were administered increasing doses of morphine (2.5 to 25mg/kg, s.c.) every 12h, for 10days. Control rats received saline according to the same protocol. Thereafter, during adulthood (65-75days old), tolerance to antinociceptive effect of morphine was induced by subcutaneous injection of 3mg/kg morphine, once a day for 7days...
March 14, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28217437/spontaneous-pneumomediastinum-in-a-healthy-young-female-a-case-report-and-literature-review
#14
Ahmed Dirweesh, Chikezie Alvarez, Muhammad Khan, Donald Christmas
Spontaneous pneumomediastinum (SPM) is an uncommon finding in young adults presenting usually without any comorbidities or an underlying pathology. It is most commonly due to alveolar rupture in the setting of an inciting event such an underlying asthma, barotrauma, valsalva maneuver, or esophageal rupture. Individuals can have varying presentations, from chest pain, dyspnea and dysphagia, to anxiety, weakness, or facial and neck swelling. The majority of patients have subcutaneous emphysema on examination and can have abnormal laboratory findings such as an elevated C-reactive proteins and leukocytosis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28138164/comparison-of-preventive-analgesia-techniques-in-circumcision-cases-dorsal-penile-nerve-block-caudal-block-or-subcutaneous-morphine
#15
Ebru Canakci, Ozgur Yagan, Nilay Tas, Tugce Mutlu, Abdullah Cirakoglu, Erdal Benli
OBJECTIVE: To compare 3 different techniques of preventive analgesia before circumcision operations in male children between 6-12 years of age. Our objective was to investigate the duration and quality of postoperative analgesia in patients, who were subject to caudal block technique, dorsal penile nerve block or who were administered subcutaneous morphine. METHODS: The prospective, randomised, single-blind study was conducted at Ordu University Training and Research Hospital, Ordu, Turkey, from January 1 to June 30, 2015, and comprised boys aged 6-12 years, who were scheduled to undergo circumcision operation...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28120158/pharmacokinetic-profile-and-tolerability-of-liposomal-bupivacaine-following-a-repeated-dose-via-local-subcutaneous-infiltration-in-healthy-volunteers
#16
David Rice, Justin W Heil, Lukasz Biernat
BACKGROUND: Liposomal bupivacaine is indicated for administration into the surgical site to produce post-surgical analgesia. OBJECTIVES: The objectives of this study were to characterize the pharmacokinetic and safety profiles of liposomal bupivacaine following a repeated dose in healthy volunteers. METHODS: Healthy adults were assigned to receive liposomal bupivacaine via subcutaneous infiltration in a single 266 mg dose (cohort 1) or in two 266 mg doses, with the second dose given immediately, 24, 48, or 72 h after the first dose (cohorts 2-5)...
March 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28118835/pilot-evaluation-of-a-novel-unilateral-onychectomy-model-and-efficacy-of-an-extended-release-buprenorphine-product
#17
RANDOMIZED CONTROLLED TRIAL
Masataka Enomoto, Patricia D Kigin, David Bledsoe, Robyn Slone, Jonathan Hash, Charles E Smith, B Duncan X Lascelles
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs), transdermal fentanyl patches, and transmucosal buprenorphine are probably the most commonly used options for providing post-operative analgesia in the early at-home period. However, these require daily administration or are associated with abuse concerns. One of the significant unmet needs in veterinary surgery and pain management is for longer acting opioids for cats to effectively bridge the gap between the in-hospital and at-home recovery periods...
January 24, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28115866/serratus-anterior-plane-block-for-hybrid-transthoracic-esophagectomy-a-pilot-study
#18
Cinzia Barbera, Pamela Milito, Michele Punturieri, Emanuele Asti, Luigi Bonavina
BACKGROUND: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. OBJECTIVES: Since the anatomic space involved in the SAP block corresponds to the area exposed by the surgeon during right posterolateral thoracotomy, we investigated the feasibility of a "surgically guided" continuous SAP block as an alternative to TEA in selected esophagectomy patients...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28113021/fentanyl-sublingual-tablets-versus-subcutaneous-morphine-for-the-management-of-severe-cancer-pain-episodes-in-patients-receiving-opioid-treatment-a-double-blind-randomized-noninferiority-trial
#19
Ernesto Zecca, Cinzia Brunelli, Fabio Centurioni, Andrea Manzoni, Alessandra Pigni, Augusto Caraceni
Purpose Fentanyl sublingual tablets (FST) are a potentially useful alternative to parenteral opioids such as subcutaneous morphine (SCM) to treat severe cancer pain episodes. No direct comparison between FST and SCM is available. The aim of this study was to test noninferiority of FST versus SCM during the first 30 min postadministration. Methods Patients receiving stable opioid therapy and experiencing a severe pain episode were randomly assigned to either 100 µg FST or 5 mg SCM in a double-blind, double-dummy trial...
March 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28079662/recognition-of-a-thoracic-epidural-hematoma-in-the-setting-of-transient-paralysis-a-case-report
#20
Beth VanderWielen, Lindsay Rubenstein, Marc Shnider, Cindy Ku, Jason Wakakuwa
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use...
January 11, 2017: A & A Case Reports
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