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Non-Opioid Analgesics

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https://www.readbyqxmd.com/read/29157034/effects-of-single-dose-preemptive-pregabalin-and-intravenous-ibuprofen-on-postoperative-opioid-consumption-and-acute-pain-after-laparoscopic-cholecystectomy
#1
Omer Karaca, Huseyin U Pınar, Emin Turk, Rafi Dogan, Ali Ahiskalioglu, Sezen K Solak
PURPOSE: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ıv ibuprofen. METHODS: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ıv ibuprofen before surgery...
November 20, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29156328/role-of-hair-pigmentation-in-drug-incorporation-into-hair
#2
Hyerim Yu, Won-Jun Jang, Jung-Hee Jang, Byoungduck Park, Young Ho Seo, Chul-Ho Jeong, Sooyeun Lee
Hair analysis has notably expanded its application as a bio-monitor for drug or toxicant exposure. Hair pigmentation is proposed as a major factor affecting drug incorporation into hair; however, the mechanisms underlying the incorporation of drugs into hair are still unclear. In the present study, the effect of hair pigmentation on drug incorporation into hair was examined using rats carrying hair with different melanin status and human cells (SK-Mel-28 cells, HaCaT cells and the co-cultured HaCaT cells with SK-Mel-28 cells) representing the main pigmentary unit in hair...
November 11, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29155288/investigation-of-the-practices-legislation-supply-chain-and-regulation-of-opioids-for-clinical-pain-management-in-southern-africa-a-multi-sectoral-cross-national-mixed-methods-study
#3
Eve Namisango, Matthew J Allsop, Richard A Powell, Stefan J Friedrichsdorf, Emmanuel Bk Luyirika, Fatia Kiyange, Edward Mukooza, Chris Ntege, Eunice Garanganga, Mavis Ntombifuthi Ginindza-Mdluli, Faith Mwangi-Powell, Lidia Justino Mondlane, Richard Harding
CONTEXT: Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. OBJECTIVES: To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29155208/inflammatory-renin-angiotensin-system-disruption-attenuates-sensory-hyperinnervation-and-mechanical-hypersensitivity-in-a-rat-model-of-provoked-vestibulodynia
#4
Anuradha Chakrabarty, Zhaohui Liao, Ying Mu, Peter G Smith
Vestibulodynia is characterized by peri-vaginal mechanical hypersensitivity, hyperinnervation, and abundant inflammatory cells expressing renin-angiotensin system proteins. We developed a tractable rat model of vestibulodynia to further assess the contributions of the renin-angiotensin system. Complete Freund's adjuvant (CFA) injected into the posterior vestibule induced marked vestibular hypersensitivity throughout a 7-day test period. Numbers of axons immunoreactive for PGP9.5, calcitonin gene-related peptide, and GFRα2 were increased...
November 15, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29154229/iliac-fascia-compartment-block-and-analgesic-consumption-in-patients-operated-on-for-hip-fracture
#5
Mateusz Klukowski, Rafał Kowalczyk, Grzegorz Górniewski, Paweł Łęgosz, Marek Janiak, Janusz Trzebicki
BACKGROUND: Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal. MATERIAL AND METHODS: A retrospective analysis of perioperative medical records of 78. patients undergoing surgical treatment of proximal femur fractures was performed. Group 1 (n=35)consisted of patients who were treated with pharmacologic analgesia only (systemic analgesics) and Group 2 (n=43) involved patients who re-ceived a preoperative fascia iliaca compartment block (FICB) and pharmacologic analgesia...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/29152935/heterogenic-control-groups-in-randomized-controlled-analgesic-trials-of-total-hip-and-knee-arthroplasty
#6
Anders P Karlsen, Ole Mathiesen, Jørgen B Dahl
BACKGROUND: Postoperative analgesic interventions are often tested adjunct to basic non- opioid analgesics in randomized controlled trials (RCTs). Consequently, treatment in control groups, and assay sensitivity, differs between trials. We hypothesized that postoperative opioid requirements and pain intensities varies between different control groups in analgesic trials. METHODS: Control groups from RCTs investigating analgesic interventions after total hip and knee arthroplasty were categorized based on standardized basic analgesic treatment...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29149151/sacroplasty-a-ten-year-analysis-of-prospective-patients-treated-with-percutaneous-sacroplasty-literature-review-and-technical-considerations
#7
Michael E Frey, Christopher Warner, Samuel M Thomas, Karan Johar, Heathpaul Singh, Maheen S Mohammad, Douglas P Beall
BACKGROUND: The treatment of sacral fractures has evolved since its first description in 1982. Several techniques for sacral augmentation have been developed since 2001, and the rate of improvement is rapid with over 50% reduction in pain achieved prior to post-procedure discharge of the patient. Pain reduction occurs primarily within the first 3 months and is sustained at 12 months; however, the long-term outcomes have not previously been studied. OBJECTIVES: We aim to evaluate the long-term efficacy of sacroplasty versus non-surgical management (NSM) in treating sacral insufficiency fractures (SIFs), including the effect on pain relief, opioid and other analgesic use, patient satisfaction, and complication rates...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148295/is-naloxone-the-best-antidote-to-reverse-tramadol-induced-neuro-respiratory-toxicity-in-overdose-an-experimental-investigation-in-the-rat
#8
Camille Lagard, Isabelle Malissin, Wassila Indja, Patricia Risède, Lucie Chevillard, Bruno Mégarbane
CONTEXT: Since the banning of dextropropoxyphene from the market, overdoses, and fatalities attributed to tramadol, a WHO step-2 opioid analgesic, have increased markedly. Tramadol overdose results not only in central nervous system (CNS) depression attributed to its opioid properties but also in seizures, possibly related to non-opioidergic pathways, thus questioning the efficiency of naloxone to reverse tramadol-induced CNS toxicity. OBJECTIVE: To investigate the most efficient antidote to reverse tramadol-induced seizures and respiratory depression in overdose...
November 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29140925/mobilization-of-cd4-t-lymphocytes-in-inflamed-mucosa-reduces-pain-in-colitis-mice-towards-a-vaccinal-strategy-to-alleviate-inflammatory-visceral-pain
#9
Lilian Basso, Jérôme Boué, Céline Augé, Céline Deraison, Catherine Blanpied, Nicolas Cenac, Philippe Lluel, Nathalie Vergnolle, Gilles Dietrich
T lymphocytes play a pivotal role in endogenous regulation of inflammatory visceral pain. The analgesic activity of T lymphocytes is dependent on their production of opioids, a property acquired upon antigen activation. Accordingly, we investigated whether an active recruitment of T lymphocytes within inflamed colon mucosa via a local vaccinal strategy may counteract inflammation-induced visceral pain in mice. Mice were immunized against ovalbumin (OVA). One month after immunization, colitis was induced by adding 3% (w/v) Dextran Sulfate Sodium (DSS) into drinking water containing either cognate antigen OVA or control antigen BSA for 5 days...
November 13, 2017: Pain
https://www.readbyqxmd.com/read/29135590/the-analgesic-effect-of-ultrasound-guided-quadratus-lumborum-block-after-cesarean-delivery-a-randomized-clinical-trial
#10
Anders Krohg, Kyrre Ullensvang, Leiv Arne Rosseland, Eldrid Langesæter, Axel R Sauter
BACKGROUND: Landmark and ultrasound-guided transversus abdominis plane blocks have demonstrated an opioid-sparing effect postoperatively after cesarean delivery. The more posterior quadratus lumborum (QL) might provide superior local anesthetic spread to the thoracolumbar fascia and paravertebral space. The aim of our study was to evaluate the efficacy of the QL block after cesarean delivery. METHODS: A randomized, double-blind, controlled trial was performed. Forty parturients undergoing cesarean delivery received bilateral ultrasound-guided QL blocks with either 2 mg/mL ropivacaine or saline postoperatively...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#11
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#12
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/29121296/are-perioperative-therapeutic-doses-of-statins-associated-with-postoperative-pain-and-opioid-consumption-after-hip-surgery-under-spinal-anaesthesia
#13
W Saasouh, S Leung, H O Yilmaz, O Koyuncu, J You, N M Zimmerman, K Ruetzler, A Turan
Background: The anti-inflammatory effects of statins have been suggested to relieve postoperative pain. This retrospective study tested the association between the perioperative routine use of statins in therapeutic doses, and opioid requirements and pain scores, after hip replacement surgery. Methods: With IRB approval, data was obtained for adult patients who had elective hip replacement surgery under spinal anaesthesia at Cleveland Clinic between 2005 and 2015...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29114413/perioperative-factors-affecting-ambulatory-outcomes-following-laparoscopic-adjustable-gastric-banding
#14
Mirsad Dupanovic, Ron Krebill, Iris Dupanovic, John Nachtigal, Melissa Rockford, Walter Orr
Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29113970/no-difference-in-efficacy-of-opioids-and-non-opioid-analgesics-for-arm-or-leg-pain
#15
Jacqui Wise
No abstract text is available yet for this article.
November 7, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29101904/the-attribution-of-a-death-to-heroin-a-model-to-help-improve-the-consistent-and-transparent-classification-and-reporting-of-heroin-related-deaths
#16
Nathan C Stam, Dimitri Gerostamoulos, Paul M Dietze, Sarah Parsons, Karen Smith, Belinda Lloyd, Jennifer L Pilgrim
INTRODUCTION: Accurate attribution of heroin-related deaths, as well as the differentiation from other opioid analgesic-related deaths, is essential from a public health perspective. Heroin-related deaths involve a number of complexities where heroin-specific or non-specific metabolites and indicators (6-acetylmorphine [6-AM], morphine, and codeine) may or may not be detected. The aims of this study were therefore to develop a model for improved consistency in the attribution of heroin-related deaths and to determine areas of variation in the current decision-making processes...
October 18, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29098567/oxycodone-naloxone-prolonged-release-a-review-in-severe-chronic-pain
#17
Esther S Kim
Oral oxycodone/naloxone prolonged release (PR) [Targin(®), Targinact(®), Targiniq(®)] is a 12-hourly opioid receptor agonist and opioid receptor antagonist fixed-dose combination product that is approved in countries in the EU for the management of severe pain (adequately manageable only with opioid analgesics) in adults. Oral naloxone prevents oxycodone from binding to μ-receptors in the gastrointestinal (GI) tract, thereby counteracting opioid-induced constipation (OIC). In short-term (5- to 12-week) clinical trials of adults with moderate to severe, chronic pain and OIC (OXN3001, OXN3006, OXN3506), oxycodone/naloxone PR significantly improved OIC while providing noninferior analgesia relative to oxycodone PR; results were consistent between cancer and non-cancer patients in OXN3506...
December 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29080097/hydromorphone-hydrochloride-use-during-various-interventional-radiology-procedures-pain-control-and-adverse-events-a-case-series-audit-analysis
#18
Thea Moran, Amit Prabhakar, James H Diaz, Alan David Kaye
INTRODUCTION: This project studied pain control and the development of adverse events before, during, and after the administration of hydromorphone hydrochloride for various interventional radiology (IR) procedures. METHODS: We performed a retrospective analysis of 100 patients (men = 58; women = 42) sedated with peri-procedural intravenous (IV) hydromorphone in association with various IR procedures. We stratified the procedures as follows: abscess drainages (M = 8; F = 8), arteriograms (M = 1; F = 0), biliary interventions (M = 3; F = 2), bone biopsies (M = 2; F = 2), non-bone biopsies (M = 26; F = 19), non-tunneled venous catheters (M = 1; F = 1), tunneled venous catheters (M = 7; F = 5), embolization (M = 4; F = 0), IVC filter placement (M = 1; F = 1), nephrostomy tube placement (M = 1; F = 4), and percutaneous nephrolithotomy tube placements (M = 4; F = 0)...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29069153/comparison-of-two-combinations-of-opioid-and-non-opioid-analgesics-for-acute-periradicular-abscess-a-randomized-clinical-trial
#19
Manuela Favarin Santini, Ricardo Abreu da Rosa, Maria Beatriz Cardoso Ferreira, Maria Isabel Fischer, Erick Miranda Souza, Marcus Vinícius Reis Só
INTRODUCTION: Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain. OBJECTIVE: The aim of this study was to compare the overall analgesic effectiveness of two combinations of opioid and non-opioid analgesics for acute periradicular abscess. MATERIAL AND METHODS: This study included 26 patients who sought emergency care in a Brazilian dental school...
September 2017: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/29067087/effectiveness-of-interventions-for-pain-relief-in-hysterosalpingographyanetwork-meta-analysis-and-systematic-review
#20
REVIEW
Xin Guo, Zongjian Tan
OBJECTIVE: We aimed to evaluate the effectiveness of placebo, oral opioid analgesic (OOA), intravenous opioid analgesic (IOA), non-opioid analgesic (NOA), topical anesthetic (TA) and locally injected anesthetic (LIA) for pain relief duringhysterosalpingography (HSG) using a Bayesian network meta-analysis of data from randomized controlled trials. METHODS: PUBMED, EMBASE, and CENTRAL search engines were used to search and identify clinical trials that evaluated interventions for pain relief in HSG...
July 2017: Pakistan Journal of Medical Sciences Quarterly
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