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sedation analgesia

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https://www.readbyqxmd.com/read/29136716/-the-impact-of-goal-directed-analgesia-on-mechanical-ventilated-patients-s-outcomes-in-intensive-care-unit-a-clinical-observational-study
#1
Q D Li, X Y Wan, Y L Zhang, S W Li, L L Han, W W Li, H Y Shi
To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit.A total of 126 patients who needed mechanical ventilation were recruited.With a method of before and after paired comparison, they were divided into two group: (1) analgesia with empirical administration or control group; (2) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from (368...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29132572/secondary-gains-advances-in-neurotrauma-management
#2
REVIEW
Brit Long, Alex Koyfman
Neurotrauma is a leading cause of death and is associated with many secondary injuries. A balance of mean arterial pressure (MAP) and intracranial pressure (ICP) is required to ensure adequate cerebral blood flow and cerebral perfusion pressure. Evaluation and management in the emergency department entails initial stabilization and resuscitation while assessing neurologic status. ICP management follows a tiered approach. Intubation requires consideration of preoxygenation, head of bed elevation, first pass success, and adequate analgesia and sedation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132458/-efficacy-of-analgesic-and-sedative-treatments-in-children-with-mechanical-ventilation-in-the-pediatric-intensive-care-unit
#3
Xiao-Fang Cai, Fu-Rong Zhang, Long Zhang, Ji-Min Sun, Wen-Bin Li
OBJECTIVE: To compare the efficacy and safety of different analgesic and sedative treatments in children with mechanical ventilation in the pediatric intensive care unit (PICU). METHODS: Eighty children with mechanical ventilation in the PICU who needed analgesic and sedative treatments were equally and randomly divided into midazolam group and remifentanil+midazolam group. The sedative and analgesic effects were assessed using the Ramsay Scale and the Face, Legs, Activity, Cry and Consolability (FLACC) Scale...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29129149/anaesthetic-and-cardiorespiratory-effects-of-ketamine-plus-dexmedetomidine-for-chemical-restraint-in-black-capuchin-monkeys-sapajus-nigritus
#4
J A B Chagas, L C P Santos, J R Silva Filho, C Bondan
AIMS: To evaluate the quality of anaesthesia and cardiorespiratory effects of ketamine and two doses of dexmedetomidine in captive black capuchin monkeys (Sapajus nigritus) undergoing routine clinical examination. METHODS: Twenty-four animals undergoing routine clinical examination were enrolled in the study. Animals were briefly physically restrained and examined to ensure no obvious illness was present and that they were healthy. Monkeys were randomly allocated to two groups (n=12 per group) and then treated with a combination of I/M 7...
November 12, 2017: New Zealand Veterinary Journal
https://www.readbyqxmd.com/read/29125398/the-management-of-peri-and-postprocedural-pain-in-interventional-radiology-a-narrative-review
#5
Jeremy N Cashman, Lenny Ng
Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Nevertheless, a variety of more or less complex protocols exist for intraprocedural sedation and for peri- and postprocedural analgesia...
November 10, 2017: Pain Management
https://www.readbyqxmd.com/read/29121531/decreased-pain-tolerance-before-surgery-and-increased-postoperative-narcotic-requirements-in-abstinent-tobacco-smokers
#6
Ling Shen, Kai Wei, Qianbo Chen, Haibo Qiu, Yong Tao, Qiang Yao, Jinchao Song, Chengjian Li, Liang Zhao, Yantao Liu, Zhijie Lu
INTRODUCTION: The clinical influence of smoking cessation on pain tolerance before surgery and postoperative pain perception is not fully understood. This clinical study investigated the effect of smoking cessation on pain threshold during the perioperative period in patients undergoing hepatic resection. METHODS: We enrolled 148 male patients (68 non-smokers and 80 abstinent smokers) who underwent hepatic resection and received postoperative patient-controlled intravenous analgesia...
October 28, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/29121287/analgesia-nociception-index-for-the-assessment-of-pain-in-critically-ill-patients-a-diagnostic-accuracy-study
#7
G Chanques, T Tarri, A Ride, A Prades, A De Jong, J Carr, N Molinari, S Jaber
Background: Behavioural pain tools are used in Intensive Care Unit (ICU) patients unable to self-report their pain-intensity but need sustained efforts to educate and train the ICU team because of the subjective nature of these clinical tools. This study measured the validity and performance of an electrophysiological monitoring tool based on the spectral analysis of heart rate variability, the Analgesia Nociception Index (ANI) which varies from 0 (minimal parasympathetic tone, maximal stress-response and pain) to 100 (maximal parasympathetic tone, minimal stress-response and pain)...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#8
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29114415/effect-of-low-dose-remifentanil-on-postoperative-pain-relief-and-heart-rate-variability-in-post-anaesthesia-care-unit
#9
Shynma Uchida, Yuji Kadoi, Shigeru Saito
Objective: Several reports have shown the negligible adverse effects of low-dose remifentanil on the autonomic nervous system. We propose that the administration of low-dose remifentanil would be beneficial without adverse respiratory and hemodynamic effects. This study aimed to examine the effects of low-dose remifentanil on postoperative pain relief and heart rate variability (HRV) after surgery. Methods: In total, 20 patients, who underwent breast cancer surgery, were analysed for HRV in the post-anaesthesia care unit (PACU)...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29114414/comparison-between-the-two-injection-technique-and-the-four-injection-technique-in-axillary-brachial-plexus-block-with-articaine
#10
Aysun Ertikin, Güldeniz Argun, Mesut Mısırlıoğlu, Murat Aydın, Murat Arıkan, Nihal Kadıoğulları
Objective: In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Methods: Sixty patients were randomly divided into two groups...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#11
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29108407/periprocedural-analgesic-efficacy-of-a-single-pre-emptive-administration-of-propacetamol-in-catheter-ablation-for-atrial-fibrillation-a-randomized-controlled-trial
#12
Sung Yeon Ham, Jong-Wook Song, Jae-Kwang Shim, Woo Kyung Lee, Hee-Jung Kim, Young-Lan Kwak
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed. METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29101958/interventional-pulmonology
#13
REVIEW
David M DiBardino, Andrew R Haas, Richard C Month
Bronchoscopy presents a unique challenge and need for collaboration between anesthesia providers and bronchoscopists. The approach to topical anesthesia, analgesia, and sedation must be customized based on complexity, duration, and setting. The bronchoscopy team must work together in each phase of the procedure to ensure patient safety and allow completion of a quality bronchoscopy. Airway access may change depending on the type of procedure planned and must be discussed before each case. Intraprocedural difficulties with ventilation, airway pressure, and sedation may arise that must be addressed together...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29097325/efficacy-and-safety-of-different-doses-of-dezocine-for-preemptive-analgesia-in-gynecological-laparoscopic-surgeries-a-prospective-double-blind-and-randomized-controlled-clinical-trial
#14
Meiyan Zhou, Liwei Wang, Congyou Wu, Li Yan, Rongguo Wang, Bin Sun, Jianhua Wang
BACKGROUND: The incidence of reproductive system tumors in Chinese females is increasing year by year, with the trend of younger onset ages. Laparoscopic surgery has been recognized by the majority of medical staff and patients, but the postoperative pain still exists. Therefore, it has become the focus of attention of medical workers to take effective analgesia measures to alleviate postoperative pain as well as to improve the degree of comfort and satisfaction for the patients. OBJECTIVES: The research objective was to study the effect of different doses of dezocine preemptive analgesia on the safety and the pain post laparoscopic surgeries, in order to explore the best dose of dezocine for postoperative analgesia in gynecological laparoscopic surgeries...
October 30, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29073928/safety-of-tubal-ligation-by-minilaparotomy-provided-by-clinical-officers-versus-assistant-medical-officers-study-protocol-for-a-noninferiority-randomized-controlled-trial-in-tanzanian-women
#15
Mark A Barone, Zuhura Mbuguni, Japhet Ominde Achola, Carmela Cordero, Joseph Kanama, Projestine S Muganyizi, Jamilla Mwanga, Caitlin Shannon, Leopold Tibyehabwa
BACKGROUND: Female sterilization by tubal ligation is a safe, extremely effective, and permanent way to limit childbearing. It is the most popular modern contraceptive method worldwide. The simplest way to provide tubal ligation is by a procedure called minilaparotomy, generally performed with the client under local anesthesia with systemic sedation and analgesia. In Tanzania, unmet need for family planning is high and has declined little in the past decade. Access to tubal ligation is limited throughout the country, in large part because of a lack of trained providers...
October 26, 2017: Trials
https://www.readbyqxmd.com/read/29072063/conscious-sedation-during-cryoballoon-ablation-of-atrial-fibrillation-the-feasibility-and-safety-study
#16
Dawid Miśkowiec, Jarosław D Kasprzak, Paulina Wejner-Mik, Ewa Szymczyk, Haval D Qawoq, Paweł Życiński, Tomasz Wcisło, Piotr Pagórek, Karolina Kupczyńska, Piotr Lipiec
BACKGROUND: Cryoballoon ablation for atrial fibrillation (cryoAF) is relatively simple, cost-effective and easy procedure. However, general anesthesia during this procedure may have negative impact on patients mortality and morbidity, as well as procedure costs. AIM: We sought to assess the feasibility and safety of conscious sedation during cryoAF. METHODS: Patients (pts) with paroxysmal or persistent, drug-refractory AF who underwent a first procedure of cryoAF were included in our single-center, retrospective study...
October 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29063727/nurse-driven-analgesia-and-sedation-in-pediatric-patients-with-univentricular-hearts-requiring-extracorporeal-life-support-after-first-stage-palliation-surgery-a-pilot-study
#17
Jörg Michel, Michael Hofbeck, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Walter Jost, Christian Schlensak, Matthias Kumpf, Gunnar Blumenstock, Felix Neunhoeffer
BACKGROUND: Few data are available regarding requirements of sedation and analgesia in children during extracorporeal life support. AIMS: The aim of this study was to evaluate if children with functionally univentricular hearts on extracorporeal life support after first-stage palliation surgery have higher requirement of analgesics and sedatives compared with children without extracorporeal life support using a goal-directed nurse-driven analgesia and sedation protocol...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29061282/analgesic-efficacy-of-laparoscopic-guided-transverse-abdominis-plane-block-using-liposomal-bupivacaine-in-bariatric-surgery
#18
Avinash Bhakta, Owen Glotzer, Ashar Ata, Marcel Tafen, Steven C Stain, Paul T Singh
BACKGROUND: Postoperative pain management is a major contributor to recovery and discharge in bariatric surgery. Local anesthetic agents are of particular interest: they're non-sedating and may reduce postoperative pain and hospital length of stay (LOS). DESIGN: Researchers queried the Bariatric Surgery Service Database for patients undergoing laparoscopic weight loss surgery from January 2012-December 2014. Patients were divided between those who did and did not receive liposomal bupivacaine intra-operatively...
September 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29052286/high-risk-respiratory-patients-experiences-of-bronchoscopy-with-conscious-sedation-and-analgesia-a-qualitative-study
#19
Catherine Saxon, Paul Fulbrook, Kwun Fong, Chantal F Ski
AIM: To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation. BACKGROUND: Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as 'conscious sedation', this facilitates depression of the patient's consciousness without causing respiratory compromise. Previously, studies have investigated patient experience using quantitative methods...
October 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29051890/considerations-for-pediatric-burn-sedation-and-analgesia
#20
REVIEW
Alice Fagin, Tina L Palmieri
Burn patients experience anxiety and pain in the course of their injury, treatment, and recovery. Hence, treatment of anxiety and pain is paramount after burn injury. Children, in particular, pose challenges in anxiety and pain management due to their unique physiologic, psychologic, and anatomic status. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination...
2017: Burns and trauma
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