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analgesia multimodal

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https://www.readbyqxmd.com/read/28928585/postoperative-analgesic-efficacy-of-bilateral-transversus-abdominis-plane-block-in-patients-undergoing-midline-colorectal-surgeries-using-ropivacaine-a-randomized-double-blind-placebo-controlled-trial
#1
Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool
BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine. MATERIALS AND METHODS: Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928570/gabapentinoids-as-a-part-of-multi-modal-drug-regime-for-pain-relief-following-laproscopic-cholecystectomy-a-randomized-study
#2
Anjali Kochhar, Kanika Chouhan, Pratibha Panjiar, Homay Vajifdar
BACKGROUND: Gabapentinoids have been used as preemptive analgesics for pain management following laparoscopic cholecystectomy. Recently, multimodal analgesic techniques have been found superior to preemptive analgesia alone. AIM: The aim of this study is to evaluate and compare a single preoperative dose of pregabalin 150 mg and gabapentin 300 mg for pain relief following laparoscopic cholecystectomy as a part of multimodal drug regime. SETTINGS AND DESIGN: This randomized, single-blind study was conducted after Ethical Committee approval and written informed consent from the patients...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28921903/risk-factors-for-postoperative-ileus-after-colorectal-cancer-surgery
#3
E G Rybakov, Y A Shelygin, E A Khomyakov, I V Zarodniuk
AIM: To assess the rate and independent risk factors of postoperative ileus (POI) after colorectal cancer surgery. METHODS: Three hundred consecutive patients underwent colorectal surgery for cancer at the State Scientific Centre of coloproctology, Moscow, Russia, between November 2015 and August 2016. POI was diagnosed as an absence of intestinal function for 72 hours or more after operation and confirmed by plain radiography. Uni- and multivariate logistic regression of the tumour-, patient- and treatment-related factors was performed...
September 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#4
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28919091/intravenous-acetaminophen-as-an-adjunct-to-multimodal-analgesia-after-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#5
REVIEW
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to investigate the impact of additional intravenous acetaminophen for pain management after total joint arthroplasty (TJA). METHODS: We conducted electronic searches of Medline (1966-2017.07), PubMed (1966-2017.07), Embase (1980-2017.07), ScienceDirect (1985-2017.07) and the Cochrane Library. Randomized controlled trials (RCTs) and non-RCTs were included. The quality assessments were performed according to the Cochrane systematic review method...
September 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28914700/use-of-ketorolac-after-outpatient-urogynecologic-surgery-a-randomized-control-trial
#6
Elisa R Trowbridge, Dahea Kim, Lauren Caldwell, Denise Franko, Jessica Nicole Jackson, Ashley Shilling, Kathie L Hullfish
OBJECTIVE: Patient surveys highlight a prevalence of moderate to severe pain in the postanesthesia care unit. Multimodal analgesia has been promoted to improve this with fewer opioid-induced adverse effects. The aim of this study was to evaluate the opioid sparing and analgesic effect of postoperative intravenous (IV) ketorolac after outpatient transvaginal surgery. METHODS: Forty patients were enrolled in this institutional review board-approved, randomized, double-blind, placebo-controlled study, to receive either 30 mg of IV ketorolac or IV saline placebo postoperatively...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28901981/multimodal-approaches-to-analgesia-in-enhanced-recovery-after-surgery-pathways
#7
Erik M Helander, Craig B Billeaud, Ryan J Kline, Patrick I Emelife, Chris M Harmon, Amit Prabhakar, Richard D Urman, Alan D Kaye
No abstract text is available yet for this article.
2017: International Anesthesiology Clinics
https://www.readbyqxmd.com/read/28895776/evaluation-of-analgesic-effect-and-absorption-of-buprenorphine-after-buccal-administration-in-cats-with-oral-disease
#8
Thaleia-Rengina Stathopoulou, Maria Kouki, Bruno H Pypendop, Atholl Johnston, Serafeim Papadimitriou, Ludovic Pelligand
Objectives The objective of this study was to evaluate the analgesic effect and absorption of buprenorphine after buccal administration in cats with oral disease. Methods Six adult client-owned cats with chronic gingivostomatitis (weighing 5.1 ± 1.1 kg) were recruited for a randomised, prospective, blinded, saline-controlled, crossover study. Pain scores, dental examination, stomatitis score and buccal pH measurement were conducted on day 1 under sedation in all cats. On day 2, animals were randomised into two groups and administered one of the two treatments buccally (group A received buprenorphine 0...
September 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28893013/effects-of-intraperitoneal-local-anaesthetics-bupivacaine-and-ropivacaine-versus-placebo-on-postoperative-pain-after-laparoscopic-cholecystectomy-a-randomised-double-blind-study
#9
Neha T Das, Charulata Deshpande
INTRODUCTION: Laparoscopic Cholecystectomy (LC) is the most frequently performed elective daycare surgery and provision of postoperative pain relief is of importance. After laparoscopic cholecystectomy shoulder and abdominal pain causes considerable distress. Visceral pain during coughing, respiration and mobilization increases morbidity, hospital stay and costs. AIM: To compare the analgesic efficacy of intraperitoneally instilled equipotent concentrations of bupivacaine and ropivacaine versus placebo in relieving postoperative pain after laparoscopic cholecystectomy when used as a part of multimodal analgesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28888299/principles-of-burn-pain-management
#10
REVIEW
Dominika Lipowska James, Maryam Jowza
This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28870309/multimodal-analgesia-in-foot-and-ankle-surgery
#11
REVIEW
Jessica M Kohring, Nathan G Orgain
Progress in surgical acute pain management has allowed most foot and ankle surgery to be performed in ambulatory outpatient surgical centers. Multimodal analgesia focuses on improving postoperative pain by combining pharmacologic and other modalities, addressing multiple pain mechanisms and receptor pathways while reducing adverse effects through lower doses of oral medications. Local anesthesia techniques provide excellent pain relief with few adverse events. Multimodal analgesia in foot and ankle surgery provides superior pain relief, and reduced opioid dependence and opioid-related side effects, improving patient satisfaction, safety, and timely return to function...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870301/perioperative-pain-management-and-anesthesia-a-critical-component-to-rapid-recovery-total-joint-arthroplasty
#12
REVIEW
Matthew W Russo, Nancy L Parks, William G Hamilton
Multimodal pain management has become the standard of care following total hip and knee replacement. The advantages include decreasing opioid consumption and its associated side effects, facilitating earlier mobilization, and faster return to function. An effective rapid recovery protocol includes the use of multiple different types of medications targeting each area of the pain pathway, preemptive analgesia, regional nerve blockade, and local infiltration analgesia.
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28869145/the-early-diagnosis-and-management-of-mixed-delirium-in-a-patient-placed-on-ecmo-and-with-difficult-sedation-a-case-report
#13
María Acevedo-Nuevo, Maria Teresa González-Gil, Miguel Ángel Romera-Ortega, Ignacio Latorre-Marco, Maria Dolores Rodríguez-Huerta
Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula)...
August 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28867907/preemptive-analgesia-in-thumb-basal-joint-arthroplasty-immediate-postoperative-pain-with-preincision-versus-postincision-local-anesthesia
#14
Joseph T Labrum, Asif M Ilyas
Purpose  Currently no guidelines exist for the timing of the injection of anesthetics in surgeries performed under general anesthesia to minimize postoperative pain. To better understand the role of timing of the injection of local anesthesia in hand surgery performed under general anesthesia, we evaluated the effect of pre- versus postincisional local analgesic injection on immediate postoperative pain experience. We hypothesize that the preincisional (preemptive) injection will result in decreased immediate postoperative pain experience and analgesic use when compared with postincisional injection...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28860845/dexmedetomidine-in-perioperative-acute-pain-management-a-non-opioid-adjuvant-analgesic
#15
REVIEW
Chaoliang Tang, Zhongyuan Xia
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28856631/implications-of-entropy-and-surgical-pleth-index-guided-general-anaesthesia-on-clinical-outcomes-in-critically-ill-polytrauma-patients-a-prospective-observational-non-randomized-single-centre-study
#16
Alexandru Florin Rogobete, Dorel Sandesc, Carmen Alina Cradigati, Mirela Sarandan, Marius Papurica, Sonia Elena Popovici, Corina Vernic, Ovidiu Horea Bedreag
Being highly unstable, the critically ill polytrauma patient represents a challenge for the anaesthesia team. The aim of this study was to compare the Entropy and Surgical Pleth Index (SPI)-guided general anaesthesia with standard haemodynamic monitoring methods used in the critically ill polytrauma patients and to evaluate the incidence of hemodynamic events, as well as the opioid and vasopressor demand. 72 patients were included in this prospective observational study, divided in two groups, the ESPI Group (N = 37, patients that benefited from Entropy and SPI monitoring) and the STDR Group (N = 35 patients that benefited from standard hemodynamic monitoring)...
August 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28853055/quantification-of-the-pharmacodynamic-interaction-of-morphine-and-gabapentin-using-a-response-surface-approach
#17
Theodoros Papathanasiou, Rasmus Vestergaard Juul, Charlotte Gabel-Jensen, Mads Kreilgaard, Anne-Marie Heegaard, Trine Meldgaard Lund
The combination of morphine and gabapentin has shown to be promising for managing postoperative pain but finding the right dose for the combination has proven to be a challenge. The purpose of this study was to quantitatively characterize the pharmacodynamic interaction between the two drugs and to identify the optimal concentration-effect relationship of the combination. Information regarding plasma concentrations and von Frey withdrawal thresholds following incisional surgery on Sprague Dawley rats, after administration of morphine, gabapentin, or their combination was available from published studies...
August 29, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#18
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28835871/multimodal-pain-management-in-older-elective-arthroplasty-patients
#19
Elaine Brooks, Susan H Freter, Susan K Bowles, David Amirault
BACKGROUND: Pain management after elective arthroplasty in older adults is complicated due to the risk of undertreatment of postoperative pain and potential adverse effects from analgesics, notably opioids. Using combinations of analgesics has been proposed as potentially beneficial to achieve pain control with lower opioid doses. OBJECTIVE: We compared a multimodal pain protocol with a traditional one, in older elective arthroplasty patients, measuring self-rated pain, incidence of postoperative delirium, quantity and cost of opioid analgesics consumed...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28829221/enhanced-recovery-after-surgery-in-laparoscopic-surgery
#20
Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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