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Intranasal pain

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https://www.readbyqxmd.com/read/29440808/intranasal-ketamine-for-the-management-of-incidental-pain-during-wound-dressing-in-cancer-patients-a-pilot-study
#1
Nivedita Page, Vivek Nirabhawane
Introduction: Cancer wounds need regular dressing; else they develop infection, foul odor, and in extreme cases, maggots. Patients resist dressing due to the severe incidental pain during dressing. Intranasal ketamine was tried as an analgesic to reduce this incidental pain. Materials and Methods: Twenty patients with wounds requiring regular dressing were selected; these patients had a basal pain score of 4/10 and incidental pain score of 7/10 during four consecutive dressings...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29409869/the-role-of-hippocampal-brain-derived-neurotrophic-factor-in-age-related-differences-in-neuropathic-pain-behavior-in-rats
#2
Hiroki Tateiwa, Takashi Kawano, Atsushi Nishigaki, Daiki Yamanaka, Bun Aoyama, Marie Shigematsu-Locatelli, Satoru Eguchi, Fabricio M Locatelli, Masataka Yokoyama
AIMS: This study was aimed to explore the contribution of central brain-derived neurotrophic factor (BDNF) in the neuropathic pain pathogenesis using an aged rodent model. MAIN METHODS: Adult and aged rats were randomly assigned to either a sciatic nerve ligation (SNL) group or a control skin sham surgery group. Sensory behavioral testing were performed on the day before surgery and on the 3rd, 7th, 14th, and 21st days after surgery, followed by measurement of BDNF protein levels in different brain regions...
January 31, 2018: Life Sciences
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#3
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29392071/comparison-of-early-period-results-of-nasal-splint-and-merocel-nasal-packs-in-septoplasty
#4
Fatih Bingöl, Ali Budak, Eda Şimşek, Korhan Kılıç, Buket Özel Bingöl
Objective: Several types of nasal packs are used postoperatively in septoplasty. In this study, we compared two commonly used nasal packing materials, the intranasal septal splint with airway and Merocel tampon, in terms of pain, bleeding, nasal obstruction, eating difficulties, discomfort in sleep, and pain and bleeding during removal of packing in the early period. Methods: The study group included 60 patients undergoing septoplasty. Patients were divided into two groups (n=30 in each group)...
September 2017: Turkish Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29371045/pediatric-emergency-department-triage-based-pain-guideline-utilizing-intranasal-fentanyl-effect-of-implementation
#5
Kristin Schoolman-Anderson, Roni D Lane, Jeff E Schunk, Nancy Mecham, Richard Thomas, Kathleen Adelgais
BACKGROUND: Pain management guidelines in the emergency department (ED) may reduce time to analgesia administration (TTA). Intranasal fentanyl (INF) is a safe and effective alternative to intravenous opiates. The effect of an ED pain management guideline providing standing orders for nurse-initiated administration of intranasal fentanyl (INF) is not known. The objective of this study was to determine the impact of a pediatric ED triage-based pain protocol utilizing intranasal fentanyl (INF) on time to analgesia administration (TTA) and patient and parent satisfaction...
January 16, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29368961/human-abuse-potential-studies-of-abuse-deterrent-opioids-lessons-from-oral-and-intranasal-studies-with-morphine-abuse-deterrent-extended-release-injection-molded-tablets
#6
Lynn R Webster, Eugene R Viscusi, Colville Brown, Jeffrey M Dayno
BACKGROUND: The development and use of abuse-deterrent (AD) opioids is part of a multifaceted strategy to reduce misuse, abuse, and diversion, while maintaining access for patients with severe pain who may benefit from their analgesic efficacy. Morphine AD, extended-release (ER), injection-molded tablets (morphine-ADER-IMT; ARYMO® ER; Egalet US Inc, Wayne, PA) is approved by the FDA as an AD opioid. As part of the characterization of AD opioids, assessments of their human abuse potential (HAP) are required...
January 25, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29364490/intranasal-drug-administration-for-procedural-sedation-in-children-admitted-to-pediatric-emergency-room
#7
C Fantacci, G C Fabrizio, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: Pain relief is a very important aspect in Pediatrician's clinical practice. It is often thought that young children, particularly infants, do not perceive as much pain as adults because of their immature nervous system and that untreated pain would not have adverse long-term consequences. Instead, it has been demonstrated that infants and children experience pain in a similar manner to adults. Many factors, particularly emotional factors, can increase the child's pain perception...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29350840/a-phase-3-trial-of-mometasone-furoate-sinus-implants-for-chronic-sinusitis-with-recurrent-nasal-polyps
#8
Robert C Kern, J Pablo Stolovitzky, Stacey L Silvers, Ameet Singh, Jivianne T Lee, David M Yen, Alfred M C Iloreta, Francis P J Langford, Boris Karanfilov, Keith E Matheny, James W Stambaugh, Anna K Gawlicka
BACKGROUND: Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent polyposis after sinus surgery by delivering 1350 μg of mometasone furoate (MF) directly to the ethmoid sinus mucosa over approximately 90 days. METHODS: A randomized, sham-controlled, double-blind trial was undertaken in 300 adults with refractory chronic rhinosinusitis with NPs (CRSwNP), who were candidates for repeat surgery...
January 19, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29335480/novel-analgesic-effects-of-melanin-concentrating-hormone-on-persistent-neuropathic-and-inflammatory-pain-in-mice
#9
Jae-Hwan Jang, Ji-Yeun Park, Ju-Young Oh, Sun-Jeong Bae, Hyunchul Jang, Songhee Jeon, Jongpil Kim, Hi-Joon Park
The melanin-concentrating hormone (MCH) is a peptidergic neuromodulator synthesized by neurons in the lateral hypothalamus and zona incerta. MCHergic neurons project throughout the central nervous system, indicating the involvements of many physiological functions, but the role in pain has yet to be determined. In this study, we found that pMCH-/- mice showed lower baseline pain thresholds to mechanical and thermal stimuli than did pMCH+/+ mice, and the time to reach the maximum hyperalgesic response was also significantly earlier in both inflammatory and neuropathic pain...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29287863/demonstration-of-analgesic-effect-of-intranasal-ketamine-and-intranasal-fentanyl-for-postoperative-pain-after-pediatric-tonsillectomy
#10
RANDOMIZED CONTROLLED TRIAL
Alper Yenigun, Sinan Yilmaz, Remzi Dogan, Seda Sezen Goktas, Muhittin Calim, Orhan Ozturan
OBJECTIVE: Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children. MATERIAL AND METHOD: This randomized-controlled study was conducted to evaluate the effects of intranasal ketamine and intranasal fentanyl in children undergoing tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29283946/rhinogenic-contact-point-headache-surgical-treatment-versus-medical-treatment
#11
Ignazio La Mantia, Calogero Grillo, Claudio Andaloro
Rhinogenic contact point headache (RCPH) is a headache syndrome secondary to mucosal contact points in the sinonasal cavities, in the absence of inflammatory signs, hyperplastic mucosa, purulent discharge, sinonasal polyps, or masses. It may result from pressure on the nasal mucosa due to anatomic variations among which the septal deviation, septal spur, and concha bullosa, are the most commonly observed. In recent years, RCPH has remained a subject of controversy regarding both its pathogenesis and treatment...
December 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29280484/intranasal-tissue-necrosis-associated-with-opioid-abuse-case-report-and-systematic-review
#12
REVIEW
Danielle A Morrison, Sarah K Wise, John M DelGaudio, Naweed I Chowdhury, Joshua M Levy
OBJECTIVE: Opioid abuse is a common disorder affecting over 2 million Americans. Intranasal tissue necrosis is a previously described sequela of nasal opioid inhalation, with a similar presentation to invasive fungal rhinosinusitis (IFRS). The goal of this case report and systematic review is to evaluate the evidence supporting this uncommon disease, with qualitative analysis of the presentation, management and treatment outcomes. DATA SOURCES: MEDLINE, EMBASE, Google Scholar, Scopus, and Web of Science...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29239753/the-use-of-intranasal-analgesia-for-acute-pain-control-in-the-emergency-department-a-literature-review
#13
REVIEW
Billy Sin, Jennifer Wiafe, Christine Ciaramella, Luis Valdez, Sergey M Motov
BACKGROUND: Traditional routes for administration of pain medications include oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes are not feasible, the intranasal (IN) route may be considered. The objectives of this evidence-based review were: to review the literature which compared the safety and efficacy of IN analgesia to traditional routes and to determine if IN analgesia should be considered over traditional routes for acute pain control in the ED. METHODS: The MEDLINE and EMBASE databases from July 1970 to July 2017 were searched...
February 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29236279/the-maxillary-nerve-block-for-in-office-hybrid-balloon-sinus-dilation-procedures-a-preliminary-study
#14
Gary J Nishioka
Transitioning of rhinologic procedures from the operating room to the office setting in selected patients is a rising trend. An effective pain-control, patient-preparation protocol is essential, especially with advanced in-office rhinologic procedures such as hybrid balloon sinus dilation (BSD), in which other procedures such as ethmoidectomy, turbinate reduction, and other procedures are concomitantly performed. A regimen using oral sedation, topical tetracaine gel, topical tetracaine/epinephrine-soaked cottonoid packs, and intranasal local infiltrative anesthesia can vary significantly in effectiveness and be suboptimal at times (as determined by using treated patients as historical controls)...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29201961/intranasal-lidocaine-for-primary-headache-management-in-emergency-department-a-clinical-trial
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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