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Pain analgesia

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https://www.readbyqxmd.com/read/28528536/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-and-rectus-sheath-block-with-ropivacaine-and-dexmedetomidine-in-elderly-high-risk-patients-undergoing-emergency-abdominal-surgery
#1
Lili Xu, Zhiyong Hu, Jianjun Shen, Patrick M McQuillan
BACKGROUND: This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery. METHODS: Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 ml of 0.25% ropivacaine+0...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28526158/revisiting-oxycodone-analgesia-a-review-and-hypothesis
#2
REVIEW
Xiulu Ruan, Ken F Mancuso, Alan D Kaye
Oxycodone, a semisynthetic opioid analgesic, is widely used in clinical practice. Oxycodone and morphine seem to be equally effective and equipotent; however, morphine is 10 times more potent than oxycodone when given epidurally. This article provides an updated review of the basic pharmacology of oxycodone with a special focus on pharmacokinetic/pharmacodynamics properties. The controversy regarding oxycodone-mediated effects for visceral pain via agonism and the possible role of peripheral opioid analgesia are discussed in the present investigation in an attempt to propose a plausible explanation to the perplexing question of oxycodone analgesia...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526156/essential-elements-of-multimodal-analgesia-in-enhanced-recovery-after-surgery-eras-guidelines
#3
REVIEW
Anair Beverly, Alan D Kaye, Olle Ljungqvist, Richard D Urman
Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS)...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525981/combination-of-gabapentin-and-ramosetron-for-the-prevention-of-postoperative-nausea-and-vomiting-after-gynecologic-laparoscopic-surgery-a-prospective-randomized-comparative-study
#4
Kyung Mi Kim, Jin Huh, Soo Kyung Lee, Eun Young Park, Jung Min Lee, Hyo Ju Kim
BACKGROUND: As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. METHODS: One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0...
May 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#5
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525497/enhanced-recovery-after-surgery-for-suspected-ovarian-malignancy-a-survey-of-perioperative-practice-among-gynecologic-oncologists-in-australia-and-new-zealand-to-inform-a-clinical-trial
#6
Kristina Lindemann, Peey-Sei Kok, Martin Stockler, Peter Sykes, Alison Brand
OBJECTIVES: The objective of this survey was to review the current standard of perioperative care of patients with suspected advanced ovarian cancer in Australia and New Zealand in order to determine the level of equipoise for specific interventions. METHODS: In May 2016, a web-based questionnaire (SurveyMonkey Inc, Palo Alto, CA) was sent to all gynecologic oncologists in Australia and New Zealand (n = 56). Descriptive statistics were used. RESULTS: Response rate was 75%...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28525409/preserved-analgesia-with-reduction-in-opioids-through-the-use-of-an-acute-pain-protocol-in-enhanced-recovery-after-surgery-for-open-hepatectomy
#7
Michael C Grant, Philip M Sommer, Cathy He, Sylvia Li, Andrew J Page, Alexander B Stone, Deborah Hobson, Elizabeth Wick, Christopher L Wu
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways are designed to restore baseline physiology, mitigate surgical stressors, and hasten recovery. Paramount to this approach is optimal pain control through multimodal analgesia and limiting reliance on opioid-based medications. Recent studies have fostered growing controversy surrounding the use of epidural analgesia in the ERAS setting, especially for higher-risk procedures. We examine the analgesic end points associated with the use of epidural within the ERAS framework for open hepatectomy...
May 18, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28524911/cancer-related-acute-pain-a-systematic-review-of-evidence-based-interventions-for-putting-evidence-into-practice
#8
Thiruppavai Sundaramurthi, Natalie Gallagher, Bethany Sterling
BACKGROUND: Identifying and implementing evidence-based interventions for cancer-related acute pain can decrease adverse effects and improve quality of life. 
. OBJECTIVES: This article presents current evidence supporting interventions to reduce cancer-related acute pain. 
. METHODS: PubMed and CINAHL® databases were searched to identify studies addressing interventions to manage acute pain in patients with cancer. The interventions are categorized according to the Putting Evidence Into Practice classification schema...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28521658/foetal-responses-to-dexmedetomidine-in-parturients-undergoing-caesarean-section-a-systematic-review-and-meta-analysis
#9
Jian Zhang, Haibin Zhou, Kaihua Sheng, Tian Tian, Anshi Wu
Objective This current meta-analysis was conducted to evaluate effects of dexmedetomidine on neonatal maternal factors. Methods The electronic databases of PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched. The primary outcomes were neonatal parameters, including umbilical blood gases and Apgar scores. The secondary outcomes were maternal parameters. Results We identified six randomized controlled trials (RCTs). No differences in neonatal umbilical blood gases, and Apgar scores at 1 min (WMD: -0...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28520955/effect-of-intrathecally-administered-ketamine-morphine-and-their-combination-added-to-bupivacaine-in-patients-undergoing-major-abdominal-cancer-surgery-a-randomized-double-blind-study
#10
Ahmad M Abd El-Rahman, Ashraf A Mohamed, Sahar A Mohamed, Mohamed A M Mostafa
Objective. : Effective postoperative pain control reduces postoperative morbidity. In this study, we investigated the effects of intrathecal morphine, ketamine, and their combination with bupivacaine for postoperative analgesia in major abdominal cancer surgery. Study Design. : Prospective, randomized, double-blind. Setting. : Academic medical center. Patients and Methods.:  Ninety ASA I-III patients age 30 to 50 years were divided randomly into three groups: the morphine group (group M) received 10 mg of hyperbaric bupivacaine 0...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28520654/systematic-review-of-hydrotherapy-research-does-a-warm-bath-in-labor-promote-normal-physiologic-childbirth
#11
Jenna Shaw-Battista
Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices...
May 17, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28516471/topical-non-steroidal-anti-inflammatory-drugs-for-analgesia-in-traumatic-corneal-abrasions
#12
REVIEW
Abel Wakai, John G Lawrenson, Annali L Lawrenson, Yongjun Wang, Michael D Brown, Michael Quirke, Omar Ghandour, Ryan McCormick, Cathal D Walsh, Ahmed Amayem, Eddy Lang, Nick Harrison
BACKGROUND: Traumatic corneal abrasions are relatively common and there is a lack of consensus about analgesia in their management. It is therefore important to document the clinical efficacy and safety profile of topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) in the management of traumatic corneal abrasions. OBJECTIVES: To identify and evaluate all randomised controlled trials (RCTs) comparing the use of topical NSAIDs with placebo or any alternative analgesic interventions in adults with traumatic corneal abrasions (including corneal abrasions arising from foreign body removal), to reduce pain, and its effects on healing time...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28516288/efficacy-and-safety-of-ibuprofen-in-infants-aged-between-3-and-6-months
#13
Victoria C Ziesenitz, Andreas Zutter, Thomas O Erb, Johannes N van den Anker
Ibuprofen is a non-steroidal anti-inflammatory drug frequently administered to children of various ages for relief of fever and pain and is approved as an over-the-counter medication in many countries worldwide. Although there are extensive data on its efficacy and safety in children and adults, there are divergent dosing recommendations for analgesia and treatment of fever in infants, especially in the age group between 3 and 6 months of age. In this article, we have assessed the safety and efficacy of ibuprofen use in infants in an attempt to find the optimal method of pain and fever management in this specific age group...
May 17, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28515426/tolerability-of-opioid-analgesia-for-chronic-pain-a-network-meta-analysis
#14
Zengdong Meng, Jing Yu, Michael Acuff, Chong Luo, Sanrong Wang, Lehua Yu, Rongzhong Huang
Aim of this study was to study the tolerability of opioid analgesia by performing a network meta-analysis (NMA) of randomized-controlled trials (RCTs) which investigated effectiveness of opioids for the management of chronic pain. Research articles reporting outcomes of RCT/s comparing 2 or more opioid analgesics for the management of chronic pain were obtained by database search. Bayesian NMAs were performed to combine direct comparisons between treatments with that of indirect simulated evidence. Study endpoints were: incidence of adverse events, incidence of constipation, trial withdrawal rate, and patient satisfaction with treatment...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28514889/pain-perception-in-nicu-a-pilot-questionnaire
#15
C V Bellieni, M Tei, S Cornacchione, S Di Lucia, V Nardi, A Verrotti, G Buonocore
PURPOSE: Neonatal pain management has made a great step forward over the last several years. Despite the drafting of International guidelines, an under-treatment of neonatal pain is still reported. MATERIALS AND METHODS: Medical and paramedical personnel working in 5 Italian NICUs were asked to complete a questionnaire about pain management. The questionnaire was comprised of three sections: (i) brief explanation of the purpose; (ii) demographic information, including age, profession, religious beliefs, and hospital level; (iii) questionnaire about pain management and prevention...
May 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#16
Herman Sehmbi, Rohan D'Souza, Anuj Bhatia
BACKGROUND: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. METHODS: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery...
May 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28514299/application-of-a-buprenorphine-transdermal-patch-for-the-perioperative-analgesia-in-patients-who-underwent-simple-lumbar-discectomy
#17
Jian Tang, Jin Fan, Yilun Yao, Weihua Cai, Guoyong Yin, Wei Zhou
This study aimed to investigate the perioperative analgesic effect of a buprenorphine transdermal patch in patients who underwent simple lumbar discectomy.In total, 96 patients were randomly divided into parecoxib intravenous injection (Group A), oral celecoxib (Group B), and buprenorphine transdermal patch groups (Group C). The pain status, degree of satisfaction, adverse effects, and condition in which the patient received tramadol hydrochloride for uncontrolled pain were recorded on the night before surgery, postoperative day 1, postoperative day 3, and postoperative day 5...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28511452/the-effect-of-entonox-on-labour-pain-relief-among-nulliparous-women-a-randomized-controlled-trial
#18
Parisa Parsa, Nafiseh Saeedzadeh, Ghodratallah Roshanaei, Fatameh Shobeiri, Faryar Hakemzadeh
INTRODUCTION: Labour pain is one of the most severe pain in humans. Fear of labour pain is the most dreadful reason for Caesarean Section (CS). Entonox (a mixture of nitrous oxide+oxygen) is a safe inhalational analgesia during labour pain. AIM: This study investigated the effect of entonox on pain relief and length of labour in nulliparous women. MATERIALS AND METHODS: A clinical trial study was conducted among 120 nulliparous women (60 in intervention and 60 in control group) in 2015 in Atieh Hospital, Hamadan city, Iran...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509780/hypnosis-and-axillary-compartment-block-for-breast-cancer-surgery-a-case-report
#19
Régis Fuzier, Sylviane Achelous, Geneviève Salvignol, Eva Jouve
Hypnosis has been proven to be a powerful tool in the management of anxiety and pain. It allows for an increase of pain threshold, which can reach the level of surgical analgesia. Recently injection of local anesthetics around the serratus muscle has been presented as an alternative to paravertebral block for cancer breast surgery. We report the successful use of hypnosis in combination with an axillary compartment block for lumpectomy and axillary lymph node dissection.
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28508254/comparison-of-pain-within-24%C3%A2-h-after-uterine-artery-embolization-with-tris-acryl-gelatin-microspheres-versus-gelatin-sponge-particles-for-leiomyoma
#20
Tetsuya Katsumori, Hisatomi Arima, Shunsuke Asai, Natsuko Hayashi, Hiroshi Miura
PURPOSE: To compare acute pain after uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM) versus gelatin sponge particles (GS) for leiomyoma. MATERIALS AND METHODS: This was a single-institution, retrospective study. Between July 2008 and November 2016, 101 consecutive patients with symptomatic uterine leiomyoma underwent UAE with the same protocol for post-procedural pain. GS was employed with near-stasis endpoint for the first 49 patients, whereas TAGM was used with limited endpoint for the next 52 patients...
May 15, 2017: Cardiovascular and Interventional Radiology
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