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intrathecal morphine

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https://www.readbyqxmd.com/read/29315129/relative-contributions-of-adductor-canal-block-and-intrathecal-morphine-to-analgesia-and-functional-recovery-after-total-knee-arthroplasty-a-randomized-controlled-trial
#1
Abhijit Biswas, Anahi Perlas, Meela Ghosh, KiJinn Chin, Ahtsham Niazi, Barjind Pandher, Vincent Chan
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia may enhance early rehabilitation after orthopedic surgery. This randomized double-blind trial investigates the relative contributions of adductor canal block and low-dose intrathecal morphine (ITM) to postoperative analgesia and functional recovery after total knee arthroplasty. METHODS: Two-hundred one patients undergoing elective unilateral total knee arthroplasty under spinal anesthesia were randomized to 3 groups...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29312839/safety-and-efficacy-of-the-use-of-intrathecal-morphine-for-spinal-three-column-osteotomy
#2
Jason R Audlin, Swamy Kurra, William Lavelle, Richard A Tallarico, Mike H Sun, Nathaniel R Ordway, Elizabeth A Demers Lavelle
Introduction The use of intrathecal morphine has the potential to help alleviate the pain that patients experience undergoing spinal surgeries. Complications can cause immobilization, which can lead to vascular thrombosis and ileus. Studies have shown epidural analgesia significantly lowered postoperative pain scores in scoliosis surgeries. Intrathecal anesthesia has been shown to have good pain control over the initial 24-hour postoperative period. Purpose Determine if intrathecal morphine would reduce postoperative pain with minimal side effects...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#3
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29284849/comparison-of-the-efficacy-and-safety-of-morphine-and-fentanyl-as-adjuvants-to-bupivacaine-in-providing-operative-anesthesia-and-postoperative-analgesia-in-subumblical-surgeries-using-combined-spinal-epidural-technique
#4
Owais Mushtaq Shah, Kharat Mohammad Bhat
Introduction: The combined spinal epidural (CSE) technique involves intentional subarachnoid blockade and epidural catheter placement during the same procedure to combine their individual best features, to reduce the total drug dosage and avoid their respective disadvantages. The addition of opioids to local anesthetics (bupivacaine) for CSE anesthesia (CSEA) is increasingly common to enhance the block. Neuraxial fentanyl is more potent and has shorter duration of action than morphine which provides prolonged anesthesia and analgesia, however at the cost of increased incidence of adverse effects like delayed respiratory depression...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284510/the-napressim-trial-the-use-of-low-dose-prophylactic-naloxone-infusion-to-prevent-respiratory-depression-with-intrathecally-administered-morphine-in-elective-hepatobiliary-surgery-a-study-protocol-and-statistical-analysis-plan-for-a-randomised-controlled-trial
#5
David Cosgrave, Marie Galligan, Era Soukhin, Victoria McMullan, Siobhan McGuinness, Anand Puttappa, Niamh Conlon, John Boylan, Rabia Hussain, Peter Doran, Alistair Nichol
BACKGROUND: Intrathecally administered morphine is effective as part of a postoperative analgesia regimen following major hepatopancreaticobiliary surgery. However, the potential for postoperative respiratory depression at the doses required for effective analgesia currently limits its clinical use. The use of a low-dose, prophylactic naloxone infusion following intrathecally administered morphine may significantly reduce postoperative respiratory depression. The NAPRESSIM trial aims to answer this question...
December 29, 2017: Trials
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#6
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#7
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29138593/intrathecal-pain-management-a-team-based-approach
#8
REVIEW
Jeremy A Adler, Neona M Lotz
Objective: Physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs) provide professional services on pain management teams. This review provides an overview of the practical management of chronic pain with intrathecal (IT) therapy using an interprofessional approach (eg, physicians and other health care professionals), with a focus on the contributions of PAs, NPs, and RNs. Methods: Narrative review based on literature searches of the Medline database and treatment guidelines on the use of IT therapy in the management of patients with chronic pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29123622/retrospective-analysis-of-the-financial-break-even-point-for-intrathecal-morphine-pump-use-in-korea
#9
Eun Kyoung Kim, Ji Yeon Shin, Anyela Marcela Castañeda, Seung Jae Lee, Hyun Kyu Yoon, Yong Chul Kim, Jee Youn Moon
Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29042318/mechanisms-of-%C3%AE-opioid-receptor-inhibition-of-nmda-receptor-induced-substance-p-release-in-the-rat-spinal-cord
#10
Wenling Chen, Helena S Ennes, James A McRoberts, Juan Carlos Marvizón
The interaction between NMDA receptors and μ-opioid receptors in primary afferent terminals was studied by using NMDA to induce substance P release, measured as neurokinin 1 receptor internalization. In rat spinal cord slices, the μ-opioid receptor agonists morphine, DAMGO and endomorphin-2 inhibited NMDA-induced substance P release, whereas the antagonist CTAP right-shifted the concentration response of DAMGO. In vivo, substance P release induced by intrathecal NMDA after priming with BDNF was inhibited by DAMGO...
October 16, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29027773/perioperative-pain-management-in-cardiac-surgery-a-systematic-review
#11
Elena Bignami, Alberto Castella, Vincenzo Pota, Francesco Saglietti, Antonio Scognamiglio, Cinzia Trumello, Maria C Pace, Massimo Allegri
BACKGROUND: Every year, more than 1.5 million patients, who undergo cardiac surgery worldwide, are exposed to a series of factors that can trigger acute postoperative pain associated with hemodynamic instability, respiratory complications, and psychological disorders. Through an evaluation of literature data about postoperative pain in cardiac surgery we define unmet needs and potential objectives for future research on this often underestimated problem. METHODS: Following PRISMA Guidelines, a systematic literature search was carried out by two independent researchers on Scopus, CINAHL, the Cochrane Library, and PubMed using the keywords: [(perioperative OR postoperative) analgesia AND "cardiac surgery"]...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29016893/efficacy-safety-and-feasibility-of-the-morphine-microdose-method-in-community-based-clinics
#12
Denise M Wilkes, Susan J Orillosa, Erik C Hustak, Courtney G Williams, Gulshan R Doulatram, Daneshvari R Solanki, Eduardo A Garcia, Li-Yen M Huang
Objectives: The goal of this study was to assess the success of the morphine microdose method in a community pain clinic setting by monitoring follow-up frequency, dose escalation, and monotherapy/polytherapy ratio. The morphine microdose method involves a pretrial reduction or elimination of systemic opioids followed by a period of abstinence. Intrathecal (IT) morphine is then started at doses of less than 0.2 mg per day. Systemic opioid abstinence is then continued after pump implant and IT morphine monotherapy...
June 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28993160/inhibition-of-morphine-tolerance-by-mrgc-receptor-via-modulation-of-interleukin-1%C3%AE-and-matrix-metalloproteinase-9-in-dorsal-root-ganglia-in-rats
#13
Yue Zhang, Kai Wang, Minyan Lin, Qi Li, Yanguo Hong
Opiate tolerance is a critical issue in pain management. Previous studies show that activation of Mas-related gene (Mrg) C receptor can modulate the development of morphine tolerance. This study was designed to investigate the underlying mechanism(s). Intrathecal (i.t.) administration of morphine (20µg) increased the expression of interleukin-1β (IL-1β) and matrix metalloproteinase-9 (MMP-9) in small- and medium-sized neurons in dorsal root ganglia (DRG). Co-administration of bovine adrenal medulla 8-22 (BAM8-22), a selective MrgC receptor agonist, via i...
October 6, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28991118/truncated-%C3%AE-opioid-receptors-with-6-transmembrane-domains-are-essential-for-opioid-analgesia
#14
Zhigang Lu, Jin Xu, Mingming Xu, Grace C Rossi, Susruta Majumdar, Gavril W Pasternak, Ying-Xian Pan
BACKGROUND: Most clinical opioids act through μ-opioid receptors. They effectively relieve pain but are limited by side effects, such as constipation, respiratory depression, dependence, and addiction. Many efforts have been made toward developing potent analgesics that lack side effects. Three-iodobenzoyl-6β-naltrexamide (IBNtxA) is a novel class of opioid active against thermal, inflammatory, and neuropathic pain, without respiratory depression, physical dependence, and reward behavior...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28975565/inhibition-of-%C3%AE-ark1-ameliorates-morphine-induced-tolerance-and-hyperalgesia-via-modulating-the-activity-of-spinal-nmda-receptors
#15
Xue Zhang, Shaorui Chen, Hong Chen, Huilin Pan, Yilin Zhao
Our previous study has proposed that increased presynaptic NMDARs activities play pivotal roles in the development of opioid tolerance and hyperalgesia, and blocking spinal NMDARs attenuates chronic morphine-induced synaptic plasticity and behavior. However, the cellular signaling mechanisms remain to be investigated. The aim of this research was to address the role of β-ARK1 in opioid analgesia. Opioid tolerance and hyperalgesia was induced by daily systemic morphine injections in rats for eight consecutive days...
October 3, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28964640/a-prospective-study-of-post-cesarean-delivery-hypoxia-after-spinal-anesthesia-with-intrathecal-morphine-150%C3%AE-g
#16
Karim S Ladha, Rie Kato, Lawrence C Tsen, Brian T Bateman, Toshiyuki Okutomi
INTRODUCTION: Delayed respiratory depression is a feared complication of intrathecal morphine in patients undergoing cesarean delivery. The incidence, timing and risk factors for hypoxia in this population are not known. METHODS: Patients undergoing cesarean delivery under spinal anesthesia at a tertiary care center from October 2012 to March 2016 were included in the study. The Berlin sleep apnea Questionnaire was completed before surgery. Oxygen saturation was recorded every second for 24hours after the initiation of spinal anesthesia...
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28961489/spinal-ccl1-ccr8-signaling-interplay-as-a-potential-therapeutic-target-evidence-from-a-mouse-diabetic-neuropathy-model
#17
Magdalena Zychowska, Ewelina Rojewska, Anna Piotrowska, Grzegorz Kreiner, Irena Nalepa, Joanna Mika
BACKGROUND: Chemokine signaling has been implicated in the pathogenesis of diabetic neuropathy; however, the involvement of the chemokine CC motif ligand 1 (CCL1)-chemokine CC motif receptor 8 (CCR8) interaction remains unknown. The goal of this study was to examine the role of CCL1-CCR8 signaling interplay in the development of hypersensitivity and in opioid effectiveness in diabetic neuropathy. METHODS: Primary glial cell cultures and a streptozotocin (STZ; 200mg/kg, intraperitoneal)-induced mouse model of diabetic neuropathy were used...
September 25, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28950244/severe-side-effects-from-intrathecal-morphine-for-chronic-pain-after-repeated-failed-spinal-operations
#18
Bård Lundeland, Lars Janerås, Gunnvald Kvarstein
No abstract text is available yet for this article.
September 23, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28948894/minimally-invasive-technique-for-intrathecal-administration-of-morphine-in-rats-practicality-and-antinociceptive-properties
#19
Aurelie Anic Thomas, Johann Detilleux, Charlotte Friederike Sandersen, Paul Andrew Flecknell
The intrathecal (IT) route of administration represents a means to reduce the dose of morphine administered for analgesia, potentially minimizing interactions between opioid effects and experimental outcomes. Perceived technical difficulty, and previously described invasive methods, may limit its use. This report describes a minimally invasive technique for IT administration of morphine by direct transcutaneous lumbosacral puncture in rats; and assesses antinociceptive properties of morphine in anaesthetized rats...
October 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28939014/novel-endomorphin-analogs-are-more-potent-and-longer-lasting-analgesics-in-neuropathic-postoperative-inflammatory-and-visceral-pain-relative-to-morphine
#20
Amy K Feehan, Jenny Morgenweck, Xing Zhang, Ariel Amgott-Kwan, James E Zadina
Activation of the mu-opioid receptor provides the gold standard for pain relief, but a majority of opioids used clinically have adverse effects that have contributed to an epidemic of overdose deaths. We recently characterized mu-opioid receptor selective endomorphin (EM) analogs that provide potent antinociception with reduction or absence of a number of side effects of traditionally prescribed opioids including abuse liability, respiratory depression, motor impairment, tolerance, and inflammation [91]. The current study explores the effectiveness of these EM analogs relative to morphine in four major pain models by both intrathecal and intravenous administration in male, Sprague-Dawley rats and male CD-1 mice...
September 19, 2017: Journal of Pain: Official Journal of the American Pain Society
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