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morphin epidural

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https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#1
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27878902/a-retrospective-comparison-of-intrathecal-morphine-and-epidural-hydromorphone-for-analgesia-following-posterior-spinal-fusion-in-adolescents-with-idiopathic-scoliosis
#2
Rebecca A Hong, Kathleen M Gibbons, G Ying Li, Ashlee Holman, Terri Voepel-Lewis
BACKGROUND: Posterior spinal fusion to correct idiopathic scoliosis is associated with severe postoperative pain. Intrathecal morphine is commonly used for analgesia after adolescent posterior spinal fusion; however, anticipating and managing the increase in pain scores after resolution of analgesic effect of intrathecal morphine analgesia is challenging. In 2014, we developed a clinical protocol detailing both the administration of intrathecal morphine intraoperatively and the transition to routine, scheduled oral analgesics at 18 h postoperatively...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27871585/optimal-epidural-analgesia-for-patients-diagnosed-as-having-gynecologic-cancer-undergoing-interstitial-brachytherapy
#3
Ashley K Amsbaugh, Mark J Amsbaugh, Moataz N El-Ghamry, Brian M Derhake
STUDY OBJECTIVE: To determine the optimal epidural analgesia for patients receiving interstitial brachytherapy (ISBT) for gynecologic cancers. DESIGN: Retrospective analysis. SETTING: Operating room and hospital ward. PATIENTS: Seventy-three patients diagnosed as having gynecologic cancer and undergoing ISBT. INTERVENTIONS: Twelve patients received ropivacaine alone, 14 patients received ropivacaine with fentanyl, and 45 patients received ropivacaine with hydromorphone by epidural infusion...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871549/a-multicenter-study-of-the-analgesic-effects-of-epidural-chloroprocaine-after-lower-limb-orthopedic-surgery
#4
Hongwei Xu, Huiping Li, Yunxia Zuo, Baxian Yang, Yuke Tian, Qulian Guo, Jianguo Xu, Chaoran Wu
STUDY OBJECTIVE: To investigate the effects and optimal concentration of chloroprocaine for epidural analgesia after lower limb orthopedic surgery. DESIGN: Prospective, randomized, observational, multicenter clinical study. SETTING: Operating room, postoperative recovery area, university hospital. PATIENTS: One hundred and twenty patients from 4 hospitals were enrolled and randomized into 5 groups after lower limb orthopedic surgery under epidural anesthesia with lidocaine...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#5
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27792112/patient-controlled-intermittent-epidural-bolus-versus-epidural-infusion-for-posterior-spinal-fusion-after-adolescent-idiopathic-scoliosis-prospective-randomized-double-blinded-study
#6
Mehmet Ali Erdogan, Ulku Ozgul, Muharrem Uçar, Mehmet Fatih Korkmaz, Mustafa Said Aydogan, Ahmet Selim Ozkan, Cemil Çolak, Mahmut Durmuş
STUDY DESIGN: A prospective randomized double-blinded study. OBJECTIVE: To compare the efficacy and side effects of patient-controlled intermittent bolus epidural analgesia (PCIEA) and patient-controlled continuous epidural analgesia (PCCEA) for postoperative pain control in adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Epidural analgesia is an accepted efficacious and safe procedure for postoperative pain management in scoliosis surgery...
October 25, 2016: Spine
https://www.readbyqxmd.com/read/27718435/suspected-total-spinal-in-patient-having-emergent-caesarean-section-a-case-report-and-literature-review
#7
H Virgin, E Oddby, J G Jakobsson
INTRODUCTION: Epidural analgesia is commonly used for management of pain during childbirth. Need for emergent Caesarean section e.g. because of signs of foetal distress or lack of progress is however not an uncommon event. In females having an established epidural; general anaesthesia, top-up of the epidural or putting a spinal are all possible options. Dosing of the spinal anaesthesia in females having epidural is a matter of discussion. PRESENTATION OF CASE: We describe a healthy 32 years, 0 para mother in gestation week 36 having labour epidural analgesia but due to foetal distress scheduled for an emergent Caesarean section category 2 that developed upper extremity weakness and respiratory depression after administration of standard dose high density bupivacaine/morphine/fentanyl intrathecal anaesthesia...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27703394/survey-of-pain-specialists-regarding-conversion-of-high-dose-intravenous-to-neuraxial-opioids
#8
Andrew W Gorlin, David M Rosenfeld, Jillian Maloney, Christopher S Wie, Johnathan McGarvey, Terrence L Trentman
The conversion of high-dose intravenous (IV) opioids to an equianalgesic epidural (EP) or intrathecal (IT) dose is a common clinical dilemma for which there is little evidence to guide practice. Expert opinion varies, though a 100 IV:10:EP:1 IT conversion ratio is commonly cited in the literature, especially for morphine. In this study, the authors surveyed 724 pain specialists to elucidate the ratios that respondents apply to convert high-dose IV morphine, hydromorphone, and fentanyl to both EP and IT routes...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27677086/-comparison-of-ultrasound-guided-femoral-and-sciatic-nerve-block-versus-epidural-anaesthesia-for-orthopaedic-surgery-in-dogs
#9
Mareike Arnholz, Stephan Hungerbühler, Clarissa Weil, Alexandra F Schütter, Karl Rohn, Julia Tünsmeyer, Sabine B R Kästner
OBJECTIVE: Comparison of ultrasound-guided femoral and sciatic nerve block versus epidural anaesthesia with bupivacaine and morphine for orthopaedic surgery of the pelvic limb in dogs with respect to analgesic effectiveness, clinical utility and side effects. MATERIAL AND METHODS: The study included 22 dogs (American Society of Anesthesiologists, ASA grades I and II) undergoing orthopaedic surgery distal to the mid-femoral bone. The study was designed as a randomized, prospective, blinded clinical trial...
September 27, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/27625476/hepatic-resection-is-associated-with-reduced-postoperative-opioid-requirement
#10
Caitlyn Rose Moss, Julia Christine Caldwell, Babatunde Afilaka, Khaled Iskandarani, Vernon Michael Chinchilli, Patrick McQuillan, Amanda Beth Cooper, Niraj Gusani, Dmitri Bezinover
BACKGROUND AND AIMS: Postoperative pain can significantly affect surgical outcomes. As opioid metabolism is liver-dependent, any reduction in hepatic volume can lead to increased opioid concentrations in the blood. The hypothesis of this retrospective study was that patients undergoing open hepatic resection would require less opioid for pain management than those undergoing open pancreaticoduodenectomy. MATERIAL AND METHODS: Data from 79 adult patients who underwent open liver resection and eighty patients who underwent open pancreaticoduodenectomy at our medical center between January 01, 2010 and June 30, 2013 were analyzed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27622453/effect-of-parecoxib-as-an-adjunct-to-patient-controlled-epidural-analgesia-after-abdominal-hysterectomy-a-multicenter-randomized-placebo-controlled-trial
#11
Wei-Feng Liu, Hai-Hua Shu, Guo-Dong Zhao, Shu-Ling Peng, Jin-Fang Xiao, Guan-Rong Zhang, Ke-Xuan Liu, Wen-Qi Huang
OBJECTIVE: This multicenter, randomized, placebo-controlled study evaluated the efficacy and side effects of parecoxib during patient-controlled epidural analgesia (PCEA) after abdominal hysterectomy. METHODS: A total of 240 patients who were scheduled for elective abdominal hysterectomy under combined spinal-epidural anesthesia received PCEA plus postoperative intravenous parecoxib 40 mg or saline every 12 h for 48 h after an initial preoperative dose of parecoxib 40 mg or saline...
2016: PloS One
https://www.readbyqxmd.com/read/27621865/randomized-trial-of-epidural-vs-subcutaneous-catheters-for-managing-pain-after-modified-nuss-in-adults
#12
Dawn E Jaroszewski, M'hamed Temkit, MennatAllah M Ewais, Todd C Luckritz, Joshua D Stearns, Ryan C Craner, Brantley D Gaitan, Harish Ramakrishna, Christopher A Thunberg, Ricardo A Weis, Kelly M Myers, Marianne V Merritt, David M Rosenfeld
BACKGROUND: Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults. Managing adult patients' pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q)...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27597428/comparison-of-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-for-analgesia-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#13
Sylvia H Wilson, Bethany J Wolf, Abdalrahman A Algendy, Clark Sealy, Harry A Demos, Julie R McSwain
BACKGROUND: Total hip arthroplasty (THA) is associated with significant postoperative pain. Both lumbar epidurals and lumbar plexus nerve blocks have been described for postoperative pain control, but it is unclear if one technique is more beneficial. METHODS: Using electronic medical records, a randomly selected, cohort of 58 patients with lumbar epidurals were compared with 58 patients with lumbar plexus nerve blocks following primary THA. The primary end point was 48-hour postoperative opiate consumption...
August 10, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27575452/continuous-epidural-versus-wound-infusion-plus-single-morphine-bolus-as-postoperative-analgesia-in-open-abdominal-aortic-aneurysm-repair-a-randomized-non-inferiority-trial
#14
Lorenzo Ball, Giulia Pellerano, Laura Corsi, Nadia Giudici, Anna Pellegrino, Daniela Cannata, Gregorio Santori, Domenico Palombo, Paolo Pelosi, Angelo Gratarola
BACKGROUND: We compared a bundle of interventions including wound infiltration and continuous infusion with local anaesthetics plus a single morphine bolus (CWI-M) with continuous epidural infusion (CEI) as postoperative analgesia. METHODS: Fifty-one adults undergoing open abdominal aortic aneurysm repair were randomised in this non-inferiority open-label trial. In the CEI group, patients received thoracic epidural levobupivacaine 0.12% plus sufentanil 0.4 g·ml-1 infusion for 48h...
August 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27574464/managing-anesthesia-for-cesarean-section-in-obese-patients-current-perspectives
#15
REVIEW
Agnes M Lamon, Ashraf S Habib
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27559433/opioid-sparing-effect-of-selective-cyclooxygenase-2-inhibitors-on-surgical-outcomes-after-open-colorectal-surgery-within-an-enhanced-recovery-after-surgery-protocol
#16
Varut Lohsiriwat
AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2 (COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery. METHODS: Patients undergoing open colorectal resection within an enhanced recovery after surgery protocol from 2011 to 2015 were reviewed. Patients with combined general anesthesia and epidural anesthesia, and those with acute colonic obstruction or perforation were excluded. Patients receiving selective COX-2 inhibitor were compared with well-matched individuals without such a drug...
July 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27510834/a-review-of-anesthetic-techniques-and-outcomes-following-minimally-invasive-repair-of-pectus-excavatum-nuss-procedure
#17
Geoff Frawley, Jacinta Frawley, Joe Crameri
BACKGROUND: Pectus excavatum (PE) is the most common congenital chest wall deformity, occurring in 1 : 1000 children with a male to female ratio of 4 : 1. Several procedures have been described to manage this deformity, including cartilage resection with sternal osteotomy (the Ravitch procedure) and a minimally invasive repair technique (the Nuss procedure). While initially described as a nonthoracoscopic technique, the current surgical approach of the Royal Childrens Hospital involves thoracoscopic assistance...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27476402/anaesthetic-management-of-two-bengal-tiger-i-panthera-tigris-tigris-i-cubs-for-fracture-repair
#18
Gareth E Zeiler, Eva Rioja, Charlie Boucher, Adrian S W Tordiffe
This case series describes the anaesthetic management of two sibling Bengal tiger (Panthera tigris tigris) cubs that were found to have spontaneous femur fractures due to severe nutritional secondary hyperparathyroidism. Both cubs received a combination of medetomidine (25 µg/kg) and ketamine (4 mg/kg) intramuscularly and were maintained with isoflurane in oxygen. An epidural injection of morphine (0.1 mg/kg) and ropivacaine (1.6 mg/kg) was administered to both tigers, which allowed a low end-tidal isoflurane concentration to be maintained throughout the femur fracture reduction operations...
2013: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/27443464/comparative-outcomes-and-perioperative-complications-of-robotic-vs-open-cystoplasty-and-complex-reconstructions
#19
Andrew J Cohen, Katie Brodie, Prithvi Murthy, Duncan T Wilcox, Mohan S Gundeti
OBJECTIVE: To compare perioperative and surgical outcomes in a two center, two surgeon open vs. robotic augmentation ileocystoplasty (AI). METHODS: We reviewed patients undergoing AI open vs. robotically between 2008 and 2014 at two centers. We compared the groups' preoperative characteristics, perioperative outcomes, complications, and interim functional outcomes. RESULTS: The cohort consisted of 17 and 15 patients with median follow up 45 and 46 months, in open and robotic groups respectively...
July 18, 2016: Urology
https://www.readbyqxmd.com/read/27366488/investigation-of-effects-of-epidural-anaesthesia-combined-with-general-anaesthesia-on-the-stress-response-in-patients-undergoing-hip-and-knee-arthroplasty
#20
Yeliz Sağlık, Dilek Yazıcıoğlu, Osman Çiçekler, Haluk Gümüş
OBJECTIVE: To investigate the effects of general anaesthesia and general+epidural anaesthesia on the stress response which was evaluated with the adrenocorticotrophic hormone (ACTH), cortisol, insulin, and glucose levels and the haemodynamic parameters. METHODS: Forty two, American Society of Anesthesiologists physiologic status I-II, patients undergoing hip and knee arthroplasty were randomized into two groups; general anaesthesia (Group G) and general anaesthesia+epidural anaesthesia (Group E)...
June 2015: Turkish Journal of Anaesthesiology and Reanimation
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