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Local anaesthesia adjuvant

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https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#1
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29491513/advances-in-regional-anaesthesia-a-review-of-current-practice-newer-techniques-and-outcomes
#2
REVIEW
Christopher Wahal, Amanda Kumar, Srinivas Pyati
Advances in ultrasound guided regional anaesthesia and introduction of newer long acting local anaesthetics have given clinicians an opportunity to apply novel approaches to block peripheral nerves with ease. Consequently, improvements in outcomes such as quality of analgesia, early rehabilitation and patient satisfaction have been observed. In this article we will review some of the newer regional anaesthetic techniques, long acting local anaesthetics and adjuvants, and discuss evidence for key outcomes such as cancer recurrence and safety with ultrasound guidance...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29479931/dexmedetomidine-as-an-adjunct-for-caudal-anaesthesia-and-analgesia-in-children-a-review
#3
Mehdi Trifa, Dmitry Tumin, Joseph D Tobias
BACKGROUND: The aim of this review was to evaluate the current evidence regarding the use of dexmedetomidine as an adjuvant to local anaesthetic agents (LAA) for caudal blockade anaesthesia and analgesia in children. METHODS: A literature search was performed of the Medline, Embase, and CINAHL databases using the keywords "dexmedetomidine" and "caudal". We included all studies that used caudal dexmedetomidine as an adjuvant to a LAA in children, excluding case reports, reviews, expert opinions, and animal studies...
February 22, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29453466/effects-of-intrathecal-dexmedetomidine-as-an-adjuvant-to-hyperbaric-bupivacaine-for-spinal-anaesthesia-in-adults-undergoing-elective-infra-umbilical-surgery
#4
Binod Gautam, Sujata Niroula, Mona Sharma, Sushila Moktan Lama
INTRODUCTION: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. METHODS: In this randomized double-blind study 38 patients were allocated into each of two groups...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29319604/the-european-society-of-regional-anaesthesia-and-pain-therapy-american-society-of-regional-anesthesia-and-pain-medicine-recommendations-on-local-anesthetics-and-adjuvants-dosage-in-pediatric-regional-anesthesia
#5
Santhanam Suresh, Claude Ecoffey, Adrian Bosenberg, Per-Anne Lonnqvist, Gildasio S de Oliveira, Oscar de Leon Casasola, José de Andrés, Giorgio Ivani
BACKGROUND AND OBJECTIVES: Dosage of local anesthetics (LAs) used for regional anesthesia in children is not well determined. In order to evaluate and come to a consensus regarding some of these controversial topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a Joint Committee Practice Advisory on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. METHODS: Representatives from both ASRA and ESRA composed the joint committee practice advisory...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29283170/perioperative-events-influence-cancer-recurrence-risk-after-surgery
#6
REVIEW
Jonathan G Hiller, Nicholas J Perry, George Poulogiannis, Bernhard Riedel, Erica K Sloan
Surgery is a mainstay treatment for patients with solid tumours. However, despite surgical resection with a curative intent and numerous advances in the effectiveness of (neo)adjuvant therapies, metastatic disease remains common and carries a high risk of mortality. The biological perturbations that accompany the surgical stress response and the pharmacological effects of anaesthetic drugs, paradoxically, might also promote disease recurrence or the progression of metastatic disease. When cancer cells persist after surgery, either locally or at undiagnosed distant sites, neuroendocrine, immune, and metabolic pathways activated in response to surgery and/or anaesthesia might promote their survival and proliferation...
April 2018: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#7
REVIEW
Carolyne Pehora, Annabel Me Pearson, Alka Kaushal, Mark W Crawford, Bradley Johnston
BACKGROUND: Peripheral nerve block (infiltration of local anaesthetic around a nerve) is used for anaesthesia or analgesia. A limitation to its use for postoperative analgesia is that the analgesic effect lasts only a few hours, after which moderate to severe pain at the surgical site may result in the need for alternative analgesic therapy. Several adjuvants have been used to prolong the analgesic duration of peripheral nerve block, including perineural or intravenous dexamethasone. OBJECTIVES: To evaluate the comparative efficacy and safety of perineural dexamethasone versus placebo, intravenous dexamethasone versus placebo, and perineural dexamethasone versus intravenous dexamethasone when added to peripheral nerve block for postoperative pain control in people undergoing surgery...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28893017/a-comparative-study-of-analgesic-effect-of-intrathecal-nalbuphine-and-fentanyl-as-adjuvant-in-lower-limb-orthopaedic-surgery
#8
Shagufta Naaz, Usha Shukla, Swati Srivastava, Erum Ozair, Adil Asghar
INTRODUCTION: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. AIM: The study aims to compare the analgesic efficacy of fentanyl with that of two doses of nalbuphine when used with injection bupivacaine heavy in spinal anaesthesia. MATERIALS AND METHODS: A randomised, double blinded, prospective study on 90 patients of ASA I and II undergoing lower limb orthopaedic surgery under subarachnoid block was done...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28794523/safety-monitoring-of-local-anaesthetic-drugs-from-the-perspective-of-pharmacovigilance-programme-of-india
#9
Pramod Kumar, Ismeet Kaur, Vivekanandan Kalaiselvan, Abhishank Singh
Pharmacovigilance Programme of India (PvPI) was established to promote patient safety by the Ministry of Health and Family Welfare, Government of India in July 2010. It covers various medical hospitals/institutes and National Health Programmes across the country. India is coordinating with various national and international programmes to be a part of international drug monitoring and to monitor the risk-benefit profile of medicines. At present, India has contributed more than 200,000 adverse drug reactions (ADRs) to the database and can draw signals for regulatory decisions...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28208976/dexamethasone-as-an-adjuvant-to-bupivacaine-in-supraclavicular-brachial-plexus-block-in-paediatrics-for-post-operative-analgesia
#10
Karl Sa Ribeiro, Anjali Ollapally, Julie Misquith
INTRODUCTION: Sensory blockade of the brachial plexus with local anaesthetics for perioperative analgesia leads to stable haemodynamics intraoperatively, smoother emergence from general anaesthesia and decreased need for supplemental analgesics or suppositories in the Post-operative period. However, increasing the duration of local anaesthetic action is often desirable because it prolongs surgical anaesthesia and analgesia. Various studies in adults prove that steroids increase the duration of action of local anaesthetics when used as adjuncts...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27938537/uncommon-localizations-of-hydatid-cyst-review-of-the-literature
#11
REVIEW
G Salamone, L Licari, B Randisi, N Falco, R Tutino, A Vaglica, R Gullo, C Porello, G Cocorullo, G Gulotta
INTRODUCTION: Hydatid disease is an endemic anthropozoonosis with usual localization in liver and lungs. Rarely it localizes in uncommon sites as spleen, skeleton, kidney, brain, cardiac muscle, peritoneum, sub cutis. Complications of uncommon localizations are the same that for usual ones. MATERIAL AND METHODS: Review of the literature on rare and atypical localization of hydatid cysts in soft tissues. Key-words used on Pub-Med [(echinococ OR hydatid) AND (soft tissue OR subcutaneous OR cutaneous)] without time limit...
July 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27746540/effect-of-intravenous-dexmedetomidine-on-spinal-anaesthesia-with-0-5-hyperbaric-bupivacaine-in-lower-abdominal-surgeries-a-prospective-randomized-control-study
#12
Madhavi Unmesh Santpur, Govind Marutrao Kahalekar, Nowreen Saraf, Aparna Losari
BACKGROUND: Regional anesthesia is the preferred technique for most of lower abdominal and lower limb surgeries. For decades, lignocaine had been the local anesthetic of choice for spinal anesthesia. Recent studies show that intravenous clonidine and dexmedetomidine can prolong the duration of the spinal anesthesia. Dexmedetomidine is a more suitable adjuvant compared to clonidine due to its more selective α2A receptor agonist activity. AIM: The study was undertaken to evaluate the effects of intravenous administration of dexmedetomidine on spinal anesthesia with 0...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27629425/hyperbaric-versus-isobaric-bupivacaine-for-spinal-anaesthesia-for-caesarean-section
#13
REVIEW
Ban Leong Sng, Fahad Javaid Siddiqui, Wan Ling Leong, Pryseley N Assam, Edwin Sy Chan, Kelvin H Tan, Alex T Sia
BACKGROUND: Bupivacaine is an amide local anaesthetic used in hyperbaric and isobaric forms. These are administered intrathecally into the spine to provide regional anaesthesia for caesarean section. Several trials have compared hyperbaric and isobaric bupivacaine but none have conclusively shown the benefit of either. This review was first published in 2013 and updated in 2016. OBJECTIVES: Our objectives were to:1. Determine the effectiveness of hyperbaric bupivacaine compared to isobaric bupivacaine for spinal anaesthesia in women undergoing caesarean section;2...
September 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27358643/a-randomised-controlled-trial-comparing-the-effect-of-adjuvant-intrathecal-2-mg-midazolam-to-20-micrograms-fentanyl-on-postoperative-pain-for-patients-undergoing-lower-limb-orthopaedic-surgery-under-spinal-anaesthesia
#14
RANDOMIZED CONTROLLED TRIAL
Francis Codero, Mung'ayi Vitalis, Sharif Thikra
BACKGROUND: Intrathecal adjuvants are added to local anaesthetics to improve the quality of neuraxial blockade and prolong the duration of analgesia during spinal anaesthesia. Used intrathecally, fentanyl improves the quality of spinal blockade as compared to plain bupivacaine and confers a short duration of post-operative analgesia. Intrathecal midazolam as an adjuvant has been used and shown to improve the quality of spinal anaesthesia and prolong the duration of post-operative analgesia...
March 2016: African Health Sciences
https://www.readbyqxmd.com/read/27330198/comparative-evaluation-of-intrathecal-morphine-and-intrathecal-dexmedetomidine-in-patients-undergoing-gynaecological-surgeries-under-spinal-anaesthesia-a-prospective-randomised-double-blind-study
#15
Pranjali Kurhekar, S Madan Kumar, D Sampath
BACKGROUND AND AIMS: Inrathecal opioids like morphine added to local anaesthetic agents have been found to be effective in achieving prolonged post-operative analgesia. Intrathecal dexmedetomidine may be devoid of undesirable side effects related to morphine and hence, this study was designed to evaluate analgesic efficacy, haemodynamic stability and adverse effects of both these adjuvants in patients undergoing gynaecological surgeries. METHODS: This was a prospective, randomised, double blind study involving 25 patients in each group...
June 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27190921/comparative-efficacy-of-intrathecal-bupivacaine-alone-and-combination-of-bupivacaine-with-clonidine-in-spinal-anaesthesia
#16
Ajay Wahi, Amanjot K Singh, Kartik Syal, Ajay Sood, Jyoti Pathania
INTRODUCTION: Clonidine is an α2 agonist agent that has been used as an adjuvant to local anaesthetics in regional anaesthesia. AIM: This study compared two combinations of bupivacaine and clonidine with bupivacaine alone for surgeries below the level of umbilicus in spinal anaesthesia. MATERIALS AND METHODS: We conducted a randomized double blind study on 90 patients of ASA I and ASA II aged 20-60 years, 30 in each group, undergoing surgery below the level of umbilicus in spinal anaesthesia...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26658200/regional-anaesthesia-and-analgesia-relationship-to-cancer-recurrence-and-survival
#17
REVIEW
T Tedore
Cancer treatment is associated with significant morbidity and mortality. Surgery is a mainstay of treatment for many tumours, and anaesthetists care for cancer patients on a daily basis. Surgery itself induces a stress response and inhibits the immune system, and cancer surgery is associated with the release of tumour cells systemically. Preclinical and clinical studies suggest that the anaesthetics and adjuvants given in the perioperative period can affect cancer recurrence and survival, perhaps tipping the balance in some instances to determine whether cancer progresses or regresses...
December 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26137339/extramedullary-plasmacytoma-of-the-larynx-treated-by-a-surgical-endoscopic-approach-and-radiotherapy
#18
Massimiliano Pino, Filippo Farri, Pietro Garofalo, Fausto Taranto, Andrea Toso, Paolo Aluffi
Extramedullary plasmacytoma (EMP) is a rare variant of plasma cell myeloma that affects soft tissues. The head and neck region are the most affected sites, although others have also been described. Herein we report an uncommon case of EMP of the larynx in a 65-year-old male who presented with a history of progressive dysphonia and hoarseness. Laryngeal fiberscopy evidenced a reddish pedicled voluminous mass in the left false cords and ventricle. Microscopic suspension laryngoscopy was performed under general anaesthesia and a 4 W Acublade CO2 Laser was used for transoral resection of the lesion...
2015: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/26082203/a-randomised-controlled-trial-of-intravenous-dexamethasone-combined-with-interscalene-brachial-plexus-blockade-for-shoulder-surgery
#19
RANDOMIZED CONTROLLED TRIAL
M Desmet, B Vanneste, M Reynvoet, J Van Cauwelaert, L Verhelst, H Pottel, C Missant, M Van de Velde
We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre-operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded outcomes for 48 h. The median (IQR [range]) time to first postoperative analgesic request after saline was 12.2 (11.0-14.1 [1.8-48]) h, which was extended by intravenous dexamethasone 2...
October 2015: Anaesthesia
https://www.readbyqxmd.com/read/26057879/speed-spinal-anesthesia-revisited-new-drugs-and-their-clinical-effects
#20
REVIEW
Hinnerk Wulf, Karl Hampl, Thorsten Steinfeldt
PURPOSE OF REVIEW: Spinal anesthesia (SPA) has not been popular for day-case surgery because of prolonged neurologic blockade with long-acting local anesthetics such as bupivacaine, thereby delaying discharge. Although the intermediate duration of action of lidocaine and mepivacaine appears to be more suitable for day-case surgery, their use is not deemed appropriate by many because of a high incidence of transient neurologic symptoms (TNSs). The present review summarizes recent clinical data on the intrathecal use of alternative local anesthetics and adjuvants that may offer valuable alternatives to general anesthesia in day-case surgery...
October 2013: Current Opinion in Anaesthesiology
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