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Pain analgesia

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https://www.readbyqxmd.com/read/29791710/postoperative-pain-and-analgesia-is-there-a-genetic-basis-to-the-opioid-crisis
#1
Randa K Elmallah, Prem N Ramkumar, Anton Khlopas, Rathika R Ramkumar, Morad Chughtai, Nipun Sodhi, Assem A Sultan, Michael A Mont
BACKGROUND: Multiple factors have been implicated in determining why certain patients have increased postoperative pain, with the potential to develop chronic pain. The purpose of this study was to: 1) identify and describe genes that affect postoperative pain perception and control; 2) address modifiable risk factors that result in epigenetic altered responses to pain; and 3) characterize differences in pain sensitivity and thresholds between opioid-naïve and opioid-dependent patients...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791238/low-dose-ketamine-infusion-for-adjunct-management-during-vaso-occlusive-episodes-in-adults-with-sickle-cell-disease-a-case-series
#2
Nicole Palm, Catherine Floroff, Tanna B Hassig, Alice Boylan, Julie Kanter
The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs)...
May 23, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29790354/-opioids-and-new-trends-in-pain-therapy
#3
Jan Lejčko
Opioids are well known for their ability to reduce the perception of pain without a loss of consciousness. However, the influence of opioids on organism is very complex. Clinical pharmacology of currently available opioid analgesics is determined by three major factors - their opioid receptor properties, pharmacokinetic properties and genetic polymorphism in the opiate receptor and cytochrome P450 isoform. In acute severe pain are opioids very efficient. Long-term experience with opioid analgesia in patients with cancer pain has shown high favorable risk/benefit ratio...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29789638/human-carbonic-anhydrase-8-aav8-gene-therapy-inhibits-nerve-growth-factor-signaling-producing-prolonged-analgesia-and-anti-hyperalgesia-in-mice
#4
Gerald Z Zhuang, Udita Upadhyay, Xiaoying Tong, Yuan Kang, Diana M Erasso, Eugene S Fu, Konstantinos D Sarantopoulos, Eden R Martin, Tim Wiltshire, Luda Diatchenko, Shad B Smith, William Maixner, Roy C Levitt
Carbonic anhydrase-8 (Car8; murine gene symbol) is an allosteric inhibitor of inositol trisphosphate receptor-1 (ITPR1), which regulates neuronal intracellular calcium release. We previously reported that wild-type Car8 overexpression corrects the baseline allodynia and hyperalgesia associated with calcium dysregulation in the waddle (wdl) mouse due to a 19 bp deletion in exon 8 of the Car8 gene. In this report, we provide preliminary evidence that overexpression of the human wild-type ortholog of Car8 (CA8 WT ), but not the reported CA8 S100P loss-of-function mutation (CA8 MT ), inhibits nerve growth factor (NGF)-induced phosphorylation of ITPR1, TrkA (NGF high-affinity receptor), and ITPR1-mediated cytoplasmic free calcium release in vitro...
April 24, 2018: Gene Therapy
https://www.readbyqxmd.com/read/29789137/serratus-intercostal-interfascial-block-as-an-opioid-saving-strategy-in-supra-umbilical-open-surgery
#5
M T Fernández Martín, S López Álvarez, M A Pérez Herrero
INTRODUCTION: The administration of local anaesthetic in the serratus-intercostal space provides adequate analgesia in non-reconstructive breast surgery. The aim of this study was to evaluate whether the blockage of the last intercostal nerves (T7-T11) can lead to opioid savings in supra-umbilical open surgery procedures. MATERIAL AND METHODS: A prospective observational study was conducted on patients undergoing open supra-umbilical surgery under general anaesthesia and with a serratus-intercostal plane block [modified Blocking the bRanches of IntercostaL nerves in the Middle Axillary line (BRILMA)] as an associated analgesic strategy...
May 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29789038/pain-management-practices-surrounding-lumbar-punctures-in-children-a-survey-of-canadian-emergency-physicians
#6
Naveen Poonai, Victoria Brzozowski, Antonia S Stang, Amy L Drendel, Philippe Boisclair, Michael Miller, Stuart Harman, Samina Ali
CLINICIAN'S CAPSULE What is known about the topic? Few physicians adhere to recommendations surrounding analgesia for pediatric lumbar punctures (LPs). What did this study ask? How willing are emergency physicians to provide analgesia for pediatric LPs? What did this study find? Compared to older children, the willingness to provide analgesia was suboptimal in a young infant. Why does this study matter to clinicians? Knowledge translation should focus on dispelling misconceptions and emphasize the importance of analgesia for young infants undergoing LPs...
May 23, 2018: CJEM
https://www.readbyqxmd.com/read/29788532/the-effect-of-adding-magnesium-sulfate-to-epidural-bupivacaine-and-morphine-on-post-thoracotomy-pain-management-a-randomized-double-blind-clinical-trial
#7
Behrooz Farzanegan, Mahdi Zangi, Kimia Saeedi, Ali Khalili, Mehdi Rajabi, Alireza Jahangirifard, Habib Emami, Amir Ali Mahboobipour, Shadi Baniasadi
Post-thoracotomy pain is very severe and may cause pulmonary complications. Thoracic epidural analgesia can greatly decrease the pain experience and its consequences. However, finding new methods to decrease the amount of administered opioids is an important issue of research. We aimed to evaluate the effect of adding epidural magnesium sulfate to bupivacaine and morphine on pain control and the amount of opioid consumption after thoracotomy. Eighty patients undergoing thoracotomy at a tertiary cardiothoracic referral centre were enrolled in a randomized, double-blind trial...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29787611/evaluation-of-anaesthetic-protocols-for-laboratory-adult-zebrafish-danio-rerio
#8
Tânia Martins, Enoque Diniz, Luís M Félix, Luís Antunes
In the last decades, the use of zebrafish (Danio rerio) in biomedical research has increased. Anaesthesia is daily used in fish during experimental procedures to avoid discomfort, stress or pain. Also, fish welfare and the reliability of results can be compromised if an unsuitable anaesthetic protocol is used. Therefore, we aimed to refine anaesthetic protocols to be used in adult zebrafish by evaluating the efficacy of different anaesthetics, used alone or in combination. For that, zebrafish were randomly assigned to 8 different groups: 100 μg/mLMS-222 (MS); 0...
2018: PloS One
https://www.readbyqxmd.com/read/29785136/psychological-factors-as-predictors-of-early-postoperative-pain-after-open-nephrectomy
#9
Ana Mimic, Carsten Bantel, Jelena Jovicic, Branko Mimic, Darija Kisic-Tepavcevic, Otas Durutovic, Nebojsa Ladjevic
Purpose: There is an increasing interest in the identification of predictors for individual responses to analgesics and surgical pain. In this study, we aimed to determine psychological factors that might contribute to this response. We hence investigated patients undergoing a standardized surgical intervention (open nephrectomy). Patients and methods: Between May 2014 and April 2015, we conducted a prospective observational cohort study. The following psychological tests were administered preoperatively: Mini-Mental State Examination, Amsterdam Preoperative Anxiety and Information Scale (APAIS), Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Pain Catastrophizing Scale...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29784500/utility-of-percutaneous-catheters-for-local-anaesthetics-infusion-for-postoperative-pain-control-in-lumbar-arthrodesis-a-prospective-cohort-study
#10
F J Ortega-García, I García-Del-Pino, I Auñon-Martín, A J Carrascosa-Fernández
OBJECTIVE: To evaluate whether postoperative continuous wound infiltration of levobupivacaine through two submuscular catheters connected to two elastomeric pumps after lumbar instrumented arthrodesis is more effective than intravenous patient-controlled analgesia. MATERIAL AND METHODS: An observational, prospective cohorts study was carried out. The visual analogue scale, the need for additional rescue analgesia and the onset of adverse effects were recorded. RESULTS: Pain records measured with visual analogue scale scale were significantly lower in the 48hours postoperative record at rest (p=...
May 18, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29784431/-continuous-quadratus-lumborum-type-ii-block-in-partial-nephrectomy
#11
Rita Graça, Pilar Miguelez, José Miguel Cardoso, Miguel Sá, Joana Brandão, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Quadratus lumborum block was first described in 2007 and currently there are descriptions of its achievement through four different injection points. This blockage provides abdominal wall and visceral analgesia, and one of its mechanisms is the dispersion of the local anesthetic into the paravertebral space. We describe the performance of a continuous quadratus lumborum type II block for postoperative analgesia in a partial nephrectomy. CASE REPORT: A 64-year-old woman, scheduled for partial left laparoscopic nephrectomy...
May 18, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29784076/analgesic-efficacy-and-hematologic-effects-of-robenacoxib-in-mice
#12
Jennifer A Beninson, Jennifer L Lofgren, Patrick A Lester, Madeline M Hileman, Daniel J Berkowitz, Daniel D Myers
NSAID analgesics may confound models that require inflammation to mimic disease development in humans. This effect presents a challenge for veterinary staff and investigators, because surgery is often necessary to create mouse models of disease and NSAID are first-line analgesics used to treat postoperative pain. We evaluated robenacoxib, a NSAID highly selective for cyclooxygenase 2, in a carrageenan paw edema (CPE) assay and surgical model of venous thrombosis (VT). We generated a mouse-specific dose-response curve by using the CPE assay for robenacoxib doses of 3...
May 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29782641/the-analgesic-efficacy-and-pharmacokinetics-of-epidural-oxycodone-after-gynaecologic-laparotomy-a-randomised-double-blind-double-dummy-comparison-with-intravenous-administration
#13
Panu Piirainen, Hannu Kokki, Heidi Hautajärvi, Veli-Pekka Ranta, Merja Kokki
AIM: To compare the analgesic efficacy of epidural and i.v. oxycodone at the same dose. METHODS: In this randomised, double-blind, double-dummy clinical trial 30 women, aged 24-67 years, undergoing elective gynaecologic laparotomy were administrated either i.v. saline and epidural oxycodone 0.1 mg·kg-1 (EPI-group; n=15) or i.v. oxycodone 0.1 mg·kg-1 and epidural saline (IV-group; n=15). For multimodal analgesia patients received i.v. paracetamol and dexketoprofen, and a triple-mixture epidural infusion after the first four postoperative hours...
May 21, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29782453/a-robust-approach-to-implementing-fascia-iliaca-compartment-nerve-blocks-in-hip-fracture-patients
#14
Mark G Williams, Zachary Jeffery, Henry W Corner, John Charity, Marina Quantick, Natalie Sartin
BACKGROUND: A clear imperative exists to optimize the preoperative pain management of hip fracture patients. Increasingly, fascia iliaca compartment blocks (FICBs) are being effectively utilized as an adjunct to oral analgesia in the emergency department. PURPOSE: We investigated the feasibility, safety, and delivery rate when junior doctors and specialist nurses are trained in FICBs delivery, alongside the introduction of a step-by-step proforma. METHODS: We conducted a retrospective study of hip fractures patients presenting preinterventions (n = 138) between October and December 2014 and postinterventions (n = 246) between April and August 2015...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#15
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#16
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781876/postpartum-pain-management
#17
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
May 17, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29781846/preperitoneal-or-subcutaneous-wound-catheters-as-alternative-for-epidural-analgesia-in-abdominal-surgery-a-systematic-review-and-meta-analysis
#18
Timothy H Mungroop, Marinde J Bond, Philipp Lirk, Olivier R Busch, Markus W Hollmann, Denise P Veelo, Marc G Besselink
OBJECTIVE: To assess whether the location of wound catheters (ie, preperitoneal vs. subcutaneous) impacts outcomes, when compared with alternatives such as epidural analgesia. BACKGROUND: Continuous wound infiltration is an alternative for epidural analgesia in abdominal surgery but studies have shown conflicting results. This difference could be explained by different efficacy of preperitoneal versus subcutaneous placement of the infiltrative catheters. METHODS: A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines until April 3, 2017...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29781530/a-comparison-between-methadone-and-buprenorphine-for-perioperative-analgesia-in-dogs-undergoing-ovariohysterectomy
#19
M D Shah, D Yates, J Hunt, J C Murrell
OBJECTIVE: To investigate whether preoperative methadone provides superior perioperative analgesia compared to buprenorphine in dogs undergoing ovariohysterectomy. METHODS: Eighty female dogs were recruited to an assessor-blinded, randomised, clinical trial. Dogs received a premedication dose of 0·05 mg/kg acepromazine or 10 μg/kg medetomidine combined with either 0·3 mg/kg methadone or 20 μg/kg buprenorphine intramuscularly. Anaesthesia was induced with propofol and maintained with isoflurane...
May 21, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#20
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
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