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Intranasal pain

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https://www.readbyqxmd.com/read/29201961/intranasal-lidocaine-for-primary-headache-management-in-emergency-department-a-clinical-trial
#1
Hassan Barzegari, Hassan Motamed, Behrad Ziapour, Majid Hajimohammadi, Mina Kadkhodazadeh
Introduction: Most of the headache cases only require pain management in emergency department (ED). The present study aimed to evaluate the efficacy of intranasal lidocaine in this regard. Method: In this clinical trial, adult patients with primary headache were randomly treated with 7.5 mg intravenous (IV) chlorpromazine and 1 ml intranasal lidocaine 2% (treatment) or normal saline 0.9% (placebo), and were compared 5, 15, and 30 minutes later regarding success rate using SPSS 21...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29200141/effects-of-the-introduction-of-intranasal-fentanyl-on-reduction-of-pain-severity-score-in-children-an-interrupted-time-series-analysis
#2
Bill Lord, Paul A Jennings, Karen Smith
OBJECTIVES: Children are at risk of inadequate analgesia due to paramedics' inexperience in assessing children and challenges in administering analgesics when the patient is distressed and uncooperative. This study reports on the outcome of a change to practice guidelines that added intranasal fentanyl and intramuscular morphine within a large statewide ambulance service. METHODS: This retrospective study included patients younger than 15 years treated by paramedics between January 2008 and December 2011...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29200140/evaluating-the-implementation-barriers-of-an-intranasal-fentanyl-pain-pathway-for-pediatric-long-bone-fractures
#3
Tamara Arnautovic, Kathryn Sommese, Paul C Mullan, Steven Barron Frazier, Turaj Vazifedan, Dana Erikson Ramirez
OBJECTIVES: This study aimed to assess physician comfort, knowledge, and implementation barriers regarding the use of intranasal fentanyl (INF) for pain management in patients with long-bone fractures in a pediatric emergency department (ED) with an INF pain pathway. METHODS: A retrospective chart review was conducted of patients, 3 to 21 years old, in our ED with an International Classification of Diseases-9th Revision code for a long-bone fracture from September 1, 2013, to August 31, 2015...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29191784/nanoparticulate-peptide-delivery-exclusively-to-the-brain-produces-tolerance-free-analgesia
#4
Lisa Godfrey, Antonio Iannitelli, Natalie L Garrett, Julian Moger, Ian Imbert, Tamara King, Frank Porreca, Ramesh Soundararajan, Aikaterini Lalatsa, Andreas G Schätzlein, Ijeoma F Uchegbu
The delivery of peptide drugs to the brain is challenging, principally due to the blood brain barrier and the low metabolic stability of peptides. Exclusive delivery to the brain with no peripheral exposure has hitherto not been demonstrated with brain quantification data. Here we show that polymer nanoparticles encapsulating leucine5-enkephalin hydrochloride (LENK) are able to transport LENK exclusively to the brain via the intranasal route, with no peripheral exposure and nanoparticle localisation is observed within the brain parenchyma...
November 27, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29174282/intranasal-dexmedetomidine-in-termination-of-first-trimester-pregnancy-of-suction-evacuation
#5
Hang Shi, Duo Yang, Jie Liu
BACKGROUND AND AIM: Deep sedation without intubation for termination of first trimester pregnancy of suction evacuation entails use of sedatives such as propofol or a combination of propofol and sulfentanil, with unwanted complications. Dexmedetomidine is an α2-adrenoreceptor agonist which provides sedation, anxiolysis and analgesia, without any of the complications associated with the popular sedatives. METHODS: A total number of 90 patients were randomized to three groups: 1...
September 24, 2017: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/29169696/efficacy-and-feasibility-of-opioids-for-burn-analgesia-an-evidence-based-qualitative-review-of-randomized-controlled-trials
#6
REVIEW
Chao Yang, Xiao-Min Xu, Guang-Zhao He
Opioids are commonly used for burn analgesia, but no comprehensive reviews have been published on such use. We aimed to assess the literature regarding the effectiveness and side effects of opioids both in adult and pediatric burn patients. We conducted a systematic search of the PubMed, Embase, Cochrane, and Web of Science databases. Information on study characteristics, results, and interventions was extracted. The review identified nine studies that satisfied the inclusion criteria. Burn sizes of patients ranged from 1% to 62% of the body...
November 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29153730/effect-of-a-combination-of-intranasal-ketorolac-and-nitrous-oxide-on-the-success-of-the-inferior-alveolar-nerve-block-in-patients-with-symptomatic-irreversible-pulpitis-a-prospective-randomized-double-blind-study
#7
Daniel Stentz, Melissa Drum, Al Reader, John Nusstein, Sara Fowler, Mike Beck
INTRODUCTION: Previous studies in patients with irreversible pulpitis have reported increased success of the inferior alveolar nerve block (IANB) using premedication with ketorolac. Preemptive nitrous oxide administration has also shown an increase in the success of the IANB. Recently, ketorolac has been made available for intranasal delivery. Perhaps combining ketorolac and nitrous oxide would increase success. Therefore, the purpose of this prospective, randomized, double-blind study was to determine the effect of a combination of intranasal ketorolac and nitrous oxide/oxygen on the anesthetic success of the IANB in patients presenting with symptomatic irreversible pulpitis...
November 15, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/29112108/nitrous-oxide-70-for-procedural-analgosedation-in-a-pediatric-emergency-department-with-or-without-intranasal-fentanyl-analgesic-efficacy-and-adverse-events-if-combined-with-intranasal-fentanyl
#8
Michelle Seiler, Markus A Landolt, Georg Staubli
OBJECTIVES: Nitrous oxide 70% (N20 70%) is an excellent medication for procedural analgosedation in a pediatric emergency department. However, its analgesic efficacy remains uncertain for painful procedures; therefore, a combination with intranasal fentanyl (INF), an opioid, was suggested. This study aimed at observing and assessing the analgesic efficacy and rate of adverse events using N20 70% with and without INF. METHODS: Children who received N20 70% in a tertiary children's hospital emergency department from January 1, 2014 to June 30, 2015 were included in this observational study with prospective data collection...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29094889/chronic-rhinosinusitis
#9
Ahmad R Sedaghat
Chronic rhinosinusitis is an inflammatory disease of the paranasal sinuses that occurs in 1% to 5% of the U.S. POPULATION: It may significantly decrease quality of life. Chronic rhinosinusitis is defined by the presence of at least two out of four cardinal symptoms (i.e., facial pain/pressure, hyposmia/anosmia, nasal drainage, and nasal obstruction) for at least 12 consecutive weeks, in addition to objective evidence. Objective evidence of chronic rhinosinusitis may be obtained on physical examination (anterior rhinoscopy, endoscopy) or radiography, preferably from sinus computed tomography...
October 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/29094347/generalized-pain-sensitization-and-endogenous-oxytocin-in-individuals-with-symptoms-of-migraine-a-cross-sectional-study
#10
Dokyoung S You, Rachel Haney, Sergiu Albu, Mary W Meagher
OBJECTIVE: The current study examined pain and neurogenic inflammation responses to topical capsaicin during the interictal period (between headache) and their relationship with plasma oxytocin in individuals with migraine. BACKGROUND: Individuals with migraine can experience generalized (extracephalic) hyperalgesia, which can persist even between headache attacks. Elevated levels of plasma and cerebrospinal fluid oxytocin have been observed during migraine attacks, oxytocin levels being positively associated with the intensity of migraine symptoms...
November 2, 2017: Headache
https://www.readbyqxmd.com/read/29066928/assessment-and-treatment-of-breakthrough-cancer-pain-from-theory-to-clinical-practice
#11
REVIEW
Renato Vellucci, Rocco Domenico Mediati, Silvia Gasperoni, Massimo Mammucari, Franco Marinangeli, Patrizia Romualdi
Breakthrough cancer pain (BTcP) is a common condition in oncological patients. However, its management is still suboptimal. Improved knowledge of BTcP and its management in clinical practice may have immediate importance for all physicians involved in the supportive care of cancer patients. This review critically discusses the most important concepts for the correct diagnosis of BTcP and presents some intriguing cases of the management of this condition in clinical practice. Overall, the most appropriate therapeutic choice appears to be a rapid-onset opioid (ROO), and in particular, the nasal route of administration is the quickest and most convenient mode of administration for the management of BTcP, especially when the patient needs rapid resolution of pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29055680/oxytocin-increases-attention-to-the-eyes-and-selectively-enhances-self-reported-affective-empathy-for-fear
#12
Kelly Hubble, Katie Daughters, Antony S R Manstead, Aled Rees, Anita Thapar, Stephanie H M van Goozen
Oxytocin (OXT) has previously been implicated in a range of prosocial behaviors such as trust and emotion recognition. Nevertheless, recent studies have questioned the evidence for this link. In addition, there has been relatively little conclusive research on the effect of OXT on empathic ability and such studies as there are have not examined the mechanisms through which OXT might affect empathy, or whether OXT selectively facilitates empathy for specific emotions. In the current study, we used eye-tracking to assess attention to socially relevant information while participants viewed dynamic, empathy-inducing video clips, in which protagonists expressed sadness, happiness, pain or fear...
October 18, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/29028747/nervous-system-delivery-of-antilysophosphatidic-acid-antibody-by-nasal-application-attenuates-mechanical-allodynia-after-traumatic-brain-injury-in-rats
#13
Andreas Eisenried, Anders C N Meidahl, Michael Klukinov, Alexander Z Tzabazis, Roger A Sabbadini, J David Clark, David C Yeomans
Lysophosphatidic acid (LPA) is a bioactive lipid that impacts neurological outcomes after neurotrauma by inhibiting neuroregeneration, promoting inflammation, and contributing to behavioral deficits. Blocking LPA signaling with a novel anti-LPA monoclonal antibody (mAb) is neuroprotective after traumatic brain injury (TBI) if given to injured animals whose blood-brain barrier (BBB) has been compromised. It is hypothesized that the anti-LPA mAb could improve chronic pain initiated by TBI. However, poor brain penetration after systemic application of the antibody makes access to the central nervous system (CNS) problematic in situations where the BBB is intact...
November 2017: Pain
https://www.readbyqxmd.com/read/28967529/intranasal-fentanyl-and-quality-of-pediatric-acute-care
#14
Kathleen M Adelgais, Alison Brent, Joseph Wathen, Suhong Tong, Derrek Massanari, Sara Deakyne, Marion R Sills
BACKGROUND: Changes in the manner in which medications can be delivered can have significant effects on the quality of care in the acute care setting. OBJECTIVE: The objective of this study was to evaluate the change in three Institute of Medicine quality indicators (timeliness, safety, and effectiveness) in the pediatric emergency department (ED) after the introduction of the Mucosal Atomizer Device Nasal™ (MADn) for opioid analgesia. METHODS: This was a retrospective review of patients receiving opioid analgesia for certain conditions over a 5-year period...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28963465/the-oxytocinergic-system-modulates-sadistic-context-dependent-empathy-in-humans
#15
Siyang Luo, Yiyi Zhu, Ying Xu, Qianting Kong
The oxytocinergic system is crucial for sociality and well-being and is associated with empathy. It is suggested that the oxytocinergic system exerts context- and person-dependent effects. We examined how sexual sadistic contexts influenced the effects of the oxytocinergic system on empathic-related behaviors and brain activity in healthy adults. Combining genetic neuroimaging, pharmacological techniques and a psychological paradigm of empathy, we recorded EEG neural responses in female OXTR rs53756 G/G and A/A carriers and measured subjective empathic ratings after intranasal administration of oxytocin/placebo in healthy male adults during the perception of painful facial expressions in sadistic/general social contexts...
September 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28955676/a-rare-cause-of-intranasal-mass-bilateral-ectopic-nasal-teeth
#16
Hasan-Emre Koçak, Kadir Özdamar, Bekir Bilgi, Harun Acıpayam
INTRODUCTION: Ectopic teeth occur in a wide variety of sites, including the maxillary sinus, mandibular condyle, coronoid process, orbital, and nasal cavities. Reported symptoms and signs associated with nasal teeth include facial pain, external nasal deformities, foul-smelling rhinorrhea, recurrent epistaxis, and oronasal fistula. Ectopic teeth occurring bilaterally in the nasal cavity is very very rare. CASE REPORT: A bilateral intranasal ectopic teeth case, which is asymptomatic on the right side and symptomatic on the left side, is presented...
September 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28951235/intranasally-administered-igf-1-inhibits-spreading-depression-in-vivo
#17
Yelena Y Grinberg, Lois A Zitzow, Richard P Kraig
Spreading depression (SD) is a wave of cellular depolarization that travels slowly through susceptible gray matter brain areas. SD is the most likely cause of migraine aura and perhaps migraine pain, and is a well-accepted animal model of migraine. Identification of therapeutics that can prevent SD may have clinical relevance toward migraine treatment. Here we show that insulin-like growth factor-1 (IGF-1) significantly inhibited neocortical SD in vivo after intranasal delivery to rats. A single dose of IGF-1 inhibited SD within an hour, and continued to protect for at least seven days thereafter...
December 15, 2017: Brain Research
https://www.readbyqxmd.com/read/28942578/intranasal-sumatriptan-for-acute-migraine-attacks-a-systematic-review-and-meta-analysis
#18
Amr Menshawy, Hussien Ahmed, Ammar Ismail, Abdelrahman Ibrahim Abushouk, Esraa Ghanem, Ravikishore Pallanti, Ahmed Negida
We performed this systematic review and meta-analysis to evaluate the tolerability and efficacy of intranasal sumatriptan, a selective serotonin agonist, compared to placebo or other migraine therapeutics for the treatment of acute migraine attacks. We searched PubMed, SCOPUS, Embase, and Cochrane CENTRAL for relevant randomized controlled trials (RCTs). Data were extracted from eligible studies and pooled as risk ratios (RR), using RevMan software. We performed subgroup and meta-regression analyses for different doses and treatment endpoints...
September 23, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28934076/delayed-urinary-symptoms-induced-by-ketamine
#19
María Robles-Martínez, Alfonso C Abad, Violeta Pérez-Rodríguez, Elena Ros-Cucurull, Abderraman Esojo, Carlos Roncero
One of the side-effects of ketamine abuse is genito-urinary damage. This report describes a case of a former ketamine user who presented with urinary symptoms associated with ketamine years after stopping consumption. This was a 26-year-old male with a history of ketamine abuse. He started treatment for alcohol dependence at age 19. He smoked marijuana daily and denied any other drug use. During the follow-up, urinary symptoms were evidenced (dysuria, frequency, urgency, incontinence, nocturia, hematuria, and suprapubic pain)...
September 21, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#20
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVES: We compared the tolerability and efficacy of intranasal subdissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger noninferiority trial that could investigate the potential opioid-sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared 1 mg/kg intranasal ketamine to 1.5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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