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analgesia multimodal

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https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#1
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28726995/effects-of-transdermal-flunixin-meglumine-on-pain-biomarkers-at-dehorning-in-calves
#2
M D Kleinhenz, N K Van Engen, P J Gorden, J Ji, P Walsh, J F Coetzee
The objective of this study was to evaluate the analgesic properties of transdermal flunixin meglumine when given at the time of dehorning on pain biomarkers. Twenty-four weaned male Holstein calves, 6 to 8 wk of age were enrolled into the study. The calves were randomly assigned to 1 of 3 treatment groups: 1) transdermal flunixin and dehorn (DH-FLU); 2) transdermal flunixin and sham dehorn (SHAM-FLU); and 3) placebo and dehorn (DH-PLBO). Transdermal flunixin at a label dose of 3.33 mg/kg (or placebo at an equivalent volume) was administered as a pour-on along the top-line of the calves in each treatment group concurrently with electrocautery dehorning or sham dehorning...
May 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28724492/evaluation-of-pain-assessment-techniques-and-analgesia-efficacy-in-a-female-guinea-pig-cavia-porcellus-model-of-surgical-pain
#3
Vanessa L Oliver, Stephanie Athavale, Katherine E Simon, Lon V Kendall, Jean A Nemzek, Jennifer L Lofgren
Guinea pigs (Cavia porcellus) are a frequently used species in research, often involving potentially painful procedures. Therefore, evidence-based recommendations regarding analgesia are critically needed to optimize their wellbeing. Our laboratory examined the efficacy of carprofen and extended-release (ER) buprenorphine, alone and as a multimodal combination, for relieving postsurgical pain in guinea pigs. Animals were assessed by using evoked (mechanical hypersensitivity), nonevoked (video ethogram, cageside ethogram, time-to-consumption test), and clinical (weight loss) measurements for 96 h during baseline, anesthesia-analgesia, and hysterectomy conditions...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28720398/perinatal-and-neonatal-use-of-paracetamol-for-pain-relief
#4
REVIEW
Karel Allegaert, John N van den Anker
Paracetamol (acetaminophen) is the most widely used drug to treat pain or fever in pregnant women or neonates, but its pharmacokinetics (PK) and pharmacodynamics (PD) warrant a focused analysis. During pregnancy, there is an important increase in paracetamol clearance. Consequently, it is reasonable to anticipate that the analgesic effect of paracetamol will decrease faster, whereas higher doses may result in even higher oxidative toxic metabolites. Therefore, most peripartal PD data relate to multimodal analgesia strategies...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#5
John J Savarese, Norman G Tabler
Clinicians have long been aware of the danger of overreliance on opioids to manage acute pain, such as the pain accompanying surgery. The risk of adverse drug events is higher with opioids than with any other common class of drugs. Overreliance on opioids increases length of stay and hospital costs, while decreasing patient satisfaction. Opioids can lead to problems that continue well after discharge, including chronic pain, abuse and addiction, and even death. Increasingly, prescribed opioids have proved to lead to heroin addiction...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28716513/update-in-the-treatment-of-chronic-pain-within-pediatric-patients
#6
Jeffrey Rabin, Mackenzie Brown, Sean Alexander
Pediatric chronic pain is a challenging entity to evaluate and treat as it encompasses a wide variety of presentations often with overlapping psychosocial implications. Chronic pain may have significant effects upon a child's involvement in academic, athletic, and social participation. If unrecognized, it may have deleterious effects upon family interactions and stability. The treatment of pediatric chronic pain is focused on not only providing analgesia, but also on assisting the child and family with reintegrating into a more functional lifestyle...
July 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28705592/effect-of-perioperative-intravenous-lidocaine-infusion-on-postoperative-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#7
Xiaoli Song, Yanxia Sun, Xiaomei Zhang, Tianzuo Li, Binbin Yang
BACKGROUND AND OBJECTIVE: Intravenous lidocaine infusion has been shown to facilitate postoperative recovery after major abdominal surgery. The current randomized controlled study was performed to assess the effect of perioperative intravenous lidocaine infusion on pain intensity, bowel function and cytokine response after larparoscopic cholecystectomy. METHODS: Eighty patients undergoing laparoscopic cholecystectomy were randomly allocated to receive intravenous lidocaine (bolus injection of 1...
July 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28705543/oral-multimodal-analgesia-for-total-joint-arthroplasty
#8
Gregory J Golladay, Karl R Balch, David F Dalury, Jibanananda Satpathy, William A Jiranek
BACKGROUND: Oral multimodal analgesia for hip and knee arthroplasty is increasingly used as part of enhanced recovery protocols designed to minimize early postoperative pain and to facilitate early discharge, while minimizing undesirable side effects related to single-agent opioid administration. METHODS: This article is a review of previously published data evaluating the use of various oral medications in the management of postoperative pain after lower extremity arthroplasty and was presented as part of a symposium at the November 2016 AAHKS Annual Meeting...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28690041/intravenous-vs-oral-acetaminophen-as-an-adjunct-to-multimodal-analgesia-after-total-knee-arthroplasty-a-prospective-randomized-double-blind-clinical-trial
#9
Jason B O'Neal, Andrew A Freiberg, Marc D Yelle, Yandong Jiang, Chengwei Zhang, Yin Gu, Xiangyi Kong, Wenling Jian, Wesley T O'Neal, Jingping Wang
BACKGROUND: The efficacy of intravenous (IV) acetaminophen compared with its oral formulation for postoperative analgesia is unknown. We hypothesized that the addition of acetaminophen to a multimodal analgesia regimen would provide improved pain management in patients after total knee arthroplasty (TKA) and that the effect of acetaminophen would be variable based on the route of delivery. METHODS: The study was a single-center, randomized, double-blinded, placebo-controlled clinical trial on the efficacy of IV vs oral acetaminophen in patients undergoing unilateral TKA...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28682644/assessing-analgesia-equivalence-and-appetite-following-alfaxalone-or-ketamine-based-injectable-anesthesia-for-feline-castration-as-an-example-of-enhanced-recovery-after-surgery
#10
Tatum Armstrong, Marika C Wagner, Jagjit Cheema, Daniel Sj Pang
Objectives The primary study objective was to assess two injectable anesthetic protocols, given to facilitate castration surgery in cats, for equivalence in terms of postoperative analgesia. A secondary objective was to evaluate postoperative eating behavior. Methods Male cats presented to a local clinic were randomly assigned to receive either intramuscular ketamine (5 mg/kg, n = 26; KetHD) or alfaxalone (2 mg/kg, n = 24; AlfHD) in combination with dexmedetomidine (25 μg/kg) and hydromorphone (0.05 mg/kg)...
February 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28674840/a-multimodal-analgesic-protocol-reduces-opioid-related-adverse-events-and-improves-patient-outcomes-in-laparoscopic-sleeve-gastrectomy
#11
Jun Jie Ng, Wei Qi Leong, Chuen Seng Tan, Keah How Poon, Davide Lomanto, Jimmy B Y So, Asim Shabbir
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed procedures for the treatment of obesity. Patients with obesity are more prone to experience opioid-related adverse events (ORAE). OBJECTIVES: The objective of this study is to determine if a multimodal analgesia protocol (MAP) reduces ORAE and provides effective pain relief for patients after LSG. SETTING: This study was conducted at University Hospital, Singapore...
July 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28667547/transversus-abdominis-plane-tap-block-versus-thoracic-epidural-analgesia-tea-in-laparoscopic-colon-surgery-in-the-eras-program
#12
Basilio Pirrera, Vincenzo Alagna, Andrea Lucchi, Pierluigi Berti, Carlo Gabbianelli, Giacomo Martorelli, Lorella Mozzoni, Federico Ruggeri, Alessandro Ingardia, Giuseppe Nardi, Gianluca Garulli
AIM: The enhanced recovery after surgery (ERAS) pathway and laparoscopic approach had been proven beneficial for patients and should now be considered as a standard of care in colorectal surgery. Multimodal analgesia is the gold standard in the ERAS program with the use of thoracic epidural analgesia (TEA). Few data are available on Transversus abdominis plane (TAP) blocks in laparoscopic colorectal surgery and ERAS pathway. The aim of this study is to evaluate the efficacy of TAP block compared to TEA in the management of postoperative pain and the impact on the recurrence of postoperative nausea, vomiting and ileus in laparoscopic colorectal surgery in the ERAS program...
July 1, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28664348/paravertebral-blocks-for-same-day-breast-surgery
#13
REVIEW
Mark R Jones, Graham R Hadley, Alan D Kaye, Philipp Lirk, Richard D Urman
PURPOSE OF REVIEW: Breast surgery, performed for medical or cosmetic reasons, remains one of the most frequently performed procedures, with over 500,000 cases performed annually in the USA alone. Historically, general anesthesia (GA) has been widely accepted as the gold-standard technique, while epidural anesthesia was largely considered too invasive and thus unnecessary for breast surgery. Over the past years, paravertebral block (PVB) has emerged as an alternative analgesic or even anesthetic technique...
August 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28663631/influence-of-difference-in-timing-of-perioperative-administration-of-low-dose-ketamine-on-postoperative-analgesia
#14
Ragi Jain, Namrata Kochhar
BACKGROUND: Preemptive analgesia is a part of multimodal regime for effective postoperative analgesia. Ketamine is said to possess preemptive effects, which has been simultaneously refuted by other studies. Hence, we designed this randomized, double-blinded trial to establish the influence of timing of perioperative ketamine administration for superior postoperative analgesia. METHODS: Ninety patients undergoing infraumbilical surgeries under spinal anesthesia were randomized to receive ketamine either preincision (Group KI), preincision and during skin closure (Group KII), or only during skin closure (Group KIII)...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663629/the-effect-of-multimodal-analgesia-on-intraoperative-morphine-requirement-in-lumbar-spine-surgeries
#15
Keelara Shivalingaiah Savitha, Radhika Dhanpal, Apoorwa N Kothari
BACKGROUND: Lumbar spine surgery demands intense analgesia. Preemptive multimodal analgesia (MMA) is a novel approach to attenuate the stress response to surgical stimulus. AIMS: The aim of the study was to assess the intraoperative morphine consumption in patients undergoing lumbar spine surgery. PATIENTS AND METHODS: A randomized, prospective, double-blind study involving 42 patients belonging to the American Society of Anesthesiologists Class I and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663613/hemodynamic-responses-at-intubation-change-of-position-and-skin-incision-a-comparison-of-multimodal-analgesia-with-conventional-analgesic-regime
#16
Keelara Shivalingaiah Savitha, Radhika Dhanpal, M S Vikram
BACKGROUND: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes. AIM: To assess the relative effectiveness of preemptive MMA compared with the conventional analgesic regime in suppressing the hemodynamic response to endotracheal intubation, prone positioning, and skin incision. SETTINGS AND DESIGN: A randomized, prospective study involving 42 patients belonging to the American Society of Anesthesiologists Physical Status 1 and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28655956/post-operative-analgesic-effect-of-dexmedetomidine-administration-in-wound-infiltration-for-abdominal-hysterectomy-a-randomised-control-study
#17
Swati Singh, Chandrakant Prasad
BACKGROUND AND AIMS: Local infiltration of the surgical wound is one of the important components of multimodal analgesia for post-operative pain relief. This study determines the post-operative analgesic effect of addition of dexmedetomidine to bupivacaine for local infiltration of the surgical wound. METHODS: Sixty women belonging to American Society of Anesthesiologists' Grade 1 or 2 posted for abdominal hysterectomy were randomly allocated to Group I (control group) where patients received wound infiltration with 30 mL 0...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28628572/multimodal-analgesia-and-the-vigilance-of-heimdall
#18
Darin J Correll
No abstract text is available yet for this article.
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#19
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#20
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
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