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analgesia multimodal

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https://www.readbyqxmd.com/read/28545172/femoral-nerve-block-versus-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty
#1
REVIEW
In Jun Koh, Young Jun Choi, Man Soo Kim, Hyun Jung Koh, Min Sung Kang, Yong In
Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28541968/multimodal-analgesia-for-acute-pain
#2
Frank J Overdyk, Susan Carol Verillo, Nancee Hofmeister, Julie Painter, Kim Bennion, Jeanne Zack
No abstract text is available yet for this article.
June 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28532200/spinal-analgesia-improves-surgical-outcome-after-open-nephrectomy-for-renal-cell-carcinoma-a-randomized-controlled-study
#3
Mascha Thurm, Britt-Inger Kröger Dahlin, Ola Winsö, Börje Ljungberg
OBJECTIVE: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). MATERIALS AND METHODS: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique...
May 22, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28526156/essential-elements-of-multimodal-analgesia-in-enhanced-recovery-after-surgery-eras-guidelines
#4
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/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
#5
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
#6
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/28500436/the-efficacy-of-a-multimodal-analgesia-protocol-in-preventing-heterotopic-ossification-after-acetabular-fractures-surgery
#7
Liang Cheng, Hai-Tao Long, Bu-Hua Sun, Shu-Shan Zhao, Yong Zhu
Background Heterotopic ossification (HO) after joint surgery is always a disturbing problem for patients and surgeons. Prophylaxis is the most effective therapy. Objective To assess the efficacy and safety of a multimodal analgesia protocol that included parecoxib and celecoxib in preventing HO after acetabular fracture surgery. Setting Selecting patients from trauma registry of our hospital. Method We identified 259 patients who had acetabular fracture surgery between January 2008 and December 2014. Hundredsixty-three patients received parecoxib and celecoxib (Group A) and 96 patients received no prophylaxis (Group B)...
May 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28497520/nitrous-oxide-for-procedural-analgesia-at-home-in-a-child-with-epidermolysis-bullosa
#8
Pablo Ingelmo, Andrew Wei, Gonzalo Rivera
Epidermolysis bullosa comprises a range of conditions characterized by fragile skin with painful blistering induced by minor trauma and friction. The Dowling-Meara variant is a severe form characterized by disseminated painful blistering requiring lifelong skin and wound care. The natural history of the disease is characterized by a chronic course that tends to improve with advancing age. Various multimodal analgesic strategies have been proposed for painful procedures in children with epidermolysis bullosa...
May 11, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28489639/evaluation-of-analgesia-tolerance-and-the-mechanism-of-action-of-morphine-6-o-sulfate-across-multiple-pain-modalities-in-sprague-dawley-rats
#9
Jai Shankar K Yadlapalli, Navdeep Dogra, Anqi W Walbaum, William D Wessinger, Paul L Prather, Peter A Crooks, Maxim Dobretsov
BACKGROUND: Morphine-6-O-sulfate (M6S) is a mixed μ/δ-opioid receptor (OR) agonist and potential alternative to morphine for treatment of chronic multimodal pain. METHODS: To provide more support for this hypothesis, the antinociceptive effects of M6S and morphine were compared in tests that access a range of pain modalities, including hot plate threshold (HPT), pinprick sensitivity threshold (PST) and paw pressure threshold tests. RESULTS: Acutely, M6S was 2- to 3-fold more potent than morphine in HPT and PST tests, specifically, derived from best-fit analysis of dose-response relationships of morphine/M6S half-effective dose (ED50) ratios (lower, upper 95% confidence interval [CI]) were 2...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28478713/continuous-infusion-ketorolac-for-postoperative-analgesia-following-unilateral-total-knee-arthroplasty
#10
Amy J Schwinghammer, Alex N Isaacs, Rodney W Benner, Heather Freeman, Jacob A O'Sullivan, Sarah A Nisly
BACKGROUND: Previous clinical trials have demonstrated benefit with the addition of continuous infusion (CI) ketorolac to a multimodal pain regimen in surgical patients. Data following major orthopedic surgery are minimal and conflicting. OBJECTIVES: To evaluate CI ketorolac use following unilateral total knee arthroplasty (TKA) through assessment of patient-reported pain scores, opioid consumption, and safety outcomes. METHODS: This was a retrospective, open-label cohort study that included patients undergoing unilateral TKA at a single-center teaching hospital...
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28475475/preemptive-analgesia-by-using-celecoxib-combined-with-tramadol-apap-alleviates-post-operative-pain-of-patients-undergoing-total-knee-arthroplasty
#11
Zhongwei Xu, Hua Zhang, Jiao Luo, Aiguo Zhou, Jian Zhang
OBJECTIVE: This study was aimed to evaluate the efficacy of preemptive analgesia (PA) by using celecoxib combined with low-dose tramadol/acetaminophen (tramadol/APAP) in treating post-operative pain of patients undergoing unilateral total knee arthroplasty (TKA). METHODS: A total of 132 patients scheduled for TKA were included in this study. Three-day pre-operative medication was administrated in PA group with subsequent effective intra- and post-operative multimodal analgesia, while control patients received multimodal analgesia without PA...
May 17, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28464196/does-addition-of-adductor-canal-blockade-to-multimodal-periarticular-analgesia-improve-discharge-status-pain-levels-opioid-use-and-length-of-stay-after-total-knee-arthroplasty
#12
Chukwuweike U Gwam, Jaydev B Mistry, Ifie V Richards, Dhrudeep Patel, Nirav G Patel, Melbin Thomas, Hephzibah Adamu, Ronald E Delanois
Total knee arthroplasty (TKA) can be associated with substantial postoperative pain that may affect satisfaction and return to function. Various forms of pain control have been used; however, multimodal periarticular analgesia (MPA) and adductor canal block (ACB) have recently gained popularity. The purpose of this study was to compare (1) discharge status, (2) pain levels, (3) postoperative opioid consumption, and (4) length of stay (LOS) between TKA patients who received MPA only and those who received both MPA and ACB...
May 2, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28455600/protective-multimodal-analgesia-with-etoricoxib-and-spinal-anesthesia-in-inguinal-hernia-repair-a-randomized-controlled-trial
#13
Mostafa Somri, Nasir Hawash, Christopher Hadjittofi, Marlain Ghantous-Toukan, Riad Tome, Marina Yodashkin, Ibrahim Matter
BACKGROUND: Inguinal hernia repair is a common procedure, and can be performed under spinal anesthesia. Although adequate analgesia is crucial to postoperative recovery, the optimal protective analgesic regimen remains to be established. PURPOSE: To investigate the effects of preoperative etoricoxib within a protective multimodal analgesic regimen with respect to pain control following open inguinal hernia repair. METHODS: Sixty adult patients undergoing open inguinal hernia repair participated in a single-center, randomized, double-blinded, placebo-controlled trial in a general academic medical center...
April 28, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28449696/perioperative-adjuvant-corticosteroids-for-post-operative-analgesia-in-elective-knee-surgery-a-systematic-review
#14
Hasan Raza Mohammad, Marialena Trivella, Thomas W Hamilton, Louise Strickland, David Murray, Hemant Pandit
BACKGROUND: Elective knee surgery is performed to reduce chronic pain and improve function in degenerate knees. Treatment of acute post-operative pain is suboptimal in 75% of patients despite multimodal analgesic approaches resulting in higher post-operative opiate consumption. The effect of corticosteroids as an adjunct for post-operative pain control remains undefined. METHODS: The databases MEDLINE, EMBASE and CENTRAL (Cochrane library) will be searched from their inception to present using broad search criteria for eligible randomised/quasi-randomised controlled trials investigating perioperative corticosteroid adjunctive use in elective knee surgery...
April 27, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28447227/the-efficacy-of-serratus-anterior-plane-block-in-analgesia-for-thoracotomy-a-retrospective-study
#15
Korgün Ökmen, Burcu Metin Ökmen
PURPOSE: A multimodal analgesic approach is necessary for post-thoracotomy pain, which can be severe. Intravenous access, central and peripheral nerve blocks are frequently used. The aim of this study was to evaluate the efficacy of serratus anterior plane block (SAPB) in the management of post-thoracotomy pain. METHODS: A total of 40 patients who underwent thoracotomy between January 2014 and January 2016 were retrospectively analyzed. The patients were divided into two groups: Group M (intravenous patient-controlled analgesia morphine; n = 20) and Group S (intravenous patient-controlled analgesia morphine + SAPB; n = 20)...
April 26, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28442852/perioperative-systemic-glucocorticoids-in-total-hip-and-knee-arthroplasty-a-systematic-review-of-outcomes
#16
REVIEW
Jeffrey Hartman, Vickas Khanna, Anthony Habib, Forough Farrokhyar, Muzammil Memon, Anthony Adili
BACKGROUND: Perioperative systemic glucocorticoids are frequently included in multimodal analgesia and antiemetic regimens administered to patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this systematic review was to evaluate the available randomized controlled trials (RCTs) to determine the effect of perioperative systemic glucocorticoids on postoperative nausea and vomiting (PONV), pain, narcotic consumption, antiemetic consumption, length of stay in hospital, and major complications in patients undergoing elective THA or TKA...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28431749/pharmacological-advances-in-the-multimodal-management-of-perioperative-analgesia
#17
M Matute Crespo, A Montero Matamala
The concept of multimodal analgesia is currently widespread in our clinical practice. The aim of multimodal analgesia is to reduce the side effects derived from the drugs or techniques used for the control of pain together with greater effectiveness (combination of multiple mechanisms of action) with the maximum efficiency, that is, to combine different pharmacodynamics (synergistic or additive effects) and pharmacokinetics, in the context of a predictable acute pain model, thus allowing a prior strategy such as the model of acute postoperative pain...
April 18, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#18
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28416174/-ultrasound-guided-quadratus-lumborum-block-for-analgesia-after-cesarean-delivery-case-series
#19
Ilana Sebbag, Fatemah Qasem, Shalini Dhir
INTRODUCTION: The majority of women having planned cesarean section receive spinal anesthesia for the procedure. Typically, spinal opioids are administered during the same time as a component of multimodal analgesia to provide pain relief in the 16-24h period postoperatively. The quadratus lumborum block is a regional analgesic technique that blocks T5-L1 nerve branches and has an evolving role in postoperative analgesia for lower abdominal surgeries and may be a potential alternative to spinal opioids...
April 14, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28405033/post-caesarean-analgesia-what-is-new
#20
REVIEW
Sukhyanti Kerai, Kirti Nath Saxena, Bharti Taneja
Adequate post-operative analgesia after caesarean section (CS) is vital as it impacts the distinct surgical recovery requirements of the parturient. Although newer analgesic modalities and drugs for post-caesarean analgesia have been introduced over the recent years, review of the literature suggests suggests that we are far from achieving the goals of optimum post-operative analgesia. We conducted a systematic review of recent advances in modalities for post-caesarean analgesia. After systematic search and quality assessment of studies, we included a total of 51 randomised controlled trials that evaluated the role of opioids, transversus abdominis plane (TAP) block, wound infiltration/infusion, ketamine, gabapentin and ilioinguinal-iliohypogastric nerve block (II-IH NB) for post-caesarean analgesia...
March 2017: Indian Journal of Anaesthesia
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