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Analgesic for minor injuries

Hannah A Blair, James E Frampton
Methoxyflurane (Penthrox(®)) is a halogenated ether first used clinically as a volatile inhalational anaesthetic. It has been used as an analgesic in Australia and New Zealand for the past 30 years. In the UK and Europe, methoxyflurane has been approved for the emergency relief of moderate to severe trauma pain in conscious adult patients. Methoxyflurane is self-administered using a hand-held inhaler. This article reviews the pharmacological properties of methoxyflurane and its clinical efficacy and tolerability in these patients...
October 13, 2016: Clinical Drug Investigation
Katarzyna Kozera, Bogdan Ciszek
The aim of this paper is to compare anatomic descriptions of posterior branches of the lumbar spinal nerves and, on this basis, present the location of these structures. The majority of anatomy textbooks do not describe these nerves in detail, which may be attributable to the fact that for many years they were regarded as structures of minor clinical importance. The state of knowledge on these nerves has changed within the last 30 years. Attention has been turned to their function and importance for both diagnostic practice and therapy of lower back pain...
January 2016: Ortopedia, Traumatologia, Rehabilitacja
Paola Nicoletti, Anneke N Werk, Ashley Sawle, Yufeng Shen, Thomas J Urban, Sally A Coulthard, Einar S Bjornsson, Ingolf Cascorbi, Aris Floratos, Thomas Stammschulte, Ursula Gundert-Remy, Matthew R Nelson, Guruprasad P Aithal, Ann K Daly
OBJECTIVE: Flupirtine is a nonopioid analgesic with regulatory approval in a number of European countries. Because of the risk of serious liver injury, its use is now limited to short-term pain management. We aimed to identify genetic risk factors for flupirtine-related drug-induced liver injury (DILI) as these are unknown. MATERIALS AND METHODS: Six flupirtine-related DILI patients from Germany were included in a genome-wide association study (GWAS) involving a further 614 European cases of DILI because of other drugs and 10,588 population controls...
May 2016: Pharmacogenetics and Genomics
Leonard J Paulozzi, Gail K Strickler, Peter W Kreiner, Caitlin M Koris
PROBLEM/CONDITION: Drug overdose is the leading cause of injury death in the United States. The death rate from drug overdose in the United States more than doubled during 1999-2013, from 6.0 per 100,000 population in 1999 to 13.8 in 2013. The increase in drug overdoses is attributable primarily to the misuse and abuse of prescription drugs, especially opioid analgesics, sedatives/tranquilizers, and stimulants. Such drugs are prescribed widely in the United States, with substantial variation by state...
October 16, 2015: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
Deborshi Sharma, Kamal Yadav, Priya Hazrah, Saurabh Borgharia, Romesh Lal, Shaji Thomas
INTRODUCTION: Bilateral inguinal hernias form a part of the complex spectrum of weakness in the region of the myopectineal orifice. Laparoscopic surgery is one of the standard approaches for bilateral hernias. We describe the results of a randomized trial that was undertaken to compare and evaluate TAPP and TEP repair for bilateral inguinal hernias. METHODS: Sixty patients were randomized into two groups. Group I (TAPP) and Group II (TEP) were compared in terms of procedure related variables, conversion, post-operative recovery and complications...
October 2015: International Journal of Surgery
Mohamed Habib Grissa, Hamdi Boubaker, Asma Zorgati, Kaouthar Beltaïef, Wafa Zhani, Mohamed Amine Msolli, Nasri Bzeouich, Wahid Bouida, Riadh Boukef, Semir Nouira
BACKGROUND: Our aim was to compare the efficacy and safety of intravenous (IV) titrated morphine with nebulized morphine given at 2 different doses in severe traumatic pain. METHODS: In a prospective, randomized, controlled double-blind study, we included 300 patients with severe traumatic pain. They were assigned to 3 groups: Neb10 group received 1 nebulization of 10-mg morphine; Neb20 group received 1 nebulization of 20-mg morphine, repeated every 10 minutes with a maximum of 3 nebulizations; and the IV morphine group received 2-mg IV morphine repeated every 5 minutes until pain relief...
November 2015: American Journal of Emergency Medicine
Hans Georg Predel, Helmut Pabst, Axel Schäfer, Diedrich Voss, Nicola Giordan
BACKGROUND: This study aimed to assess the efficacy and the safety of a newly-developed patch containing diclofenac sodium 140 mg in patients affected by acute soft tissue sport injuries, such as contusion, strain and sprain with a randomised, double-blind, placebo-controlled trial. METHODS: One hundred and sixty-four subjects were recruited within 3 hours of a soft-tissue sport injury and were equally assigned to receive diclofenac or placebo patch applied twice a day for 7 days...
January 2016: Journal of Sports Medicine and Physical Fitness
Ludwig Oberkircher, Natalie Schubert, Daphne-Asimenia Eschbach, Christopher Bliemel, Antonio Krueger, Steffen Ruchholtz, Benjamin Buecking
INTRODUCTION: As a part of aging, hip fractures are becoming more common. The connection between increased pain and a poor outcome has previously been shown. Therefore, even in prehospital situations, analgesic therapy appears to be reasonable. We established a prospective study with 153 patients to evaluate the patients' pain levels during the prehospital phase of treatment and prehospital analgesic therapy. METHODS: We performed a prospective study on 153 patients the age of 60 years or older in a University hospital setting between 2010 and 2011 who suffered hip fracture...
June 2016: Pain Practice: the Official Journal of World Institute of Pain
Koorosh Ahmadi, Amir Masoud Hashemian, Elham Pishbin, Ali Taheriniya, Saba Jafarpour, Vafa Rahimi-Movaghar
BACKGROUND: The aim of this study was to examine the association between the responses of headache to IV morphine and the findings of brain CT scan in minor head injury (MHI), and to propose a new risk indicator to identify patients requiring CT scanning. METHODS: A total of 1857 MHI patients ≥15 years of age, presenting with headache and a GCS score of 14 or 15 were included in the study. Intravenous morphine sulfate was administered, and thereafter, patients were assessed for the relief or persistence of headache...
November 2014: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Andis Graudins, Robert Meek, Dianna Egerton-Warburton, Ed Oakley, Robert Seith
STUDY OBJECTIVE: We compare the analgesic effectiveness of intranasal fentanyl and ketamine in children. METHODS: This was a double-blind, randomized, controlled trial comparing fentanyl at 1.5 μg/kg with ketamine at 1 mg/kg in children aged 3 to 13 years and weighing less than 50 kg, with isolated limb injury and pain of more than 6 of 10 at triage. The sample size was 40 in each arm. Subjects were coadministered oral ibuprofen at 10 mg/kg. The primary outcome was median pain rating reduction at 30 minutes...
March 2015: Annals of Emergency Medicine
J Lieber
BACKGROUND: The distal forearm fracture is the most common injury (40%) in pediatric traumatology. OBJECTIVES: The treatment of distal forearm fractures in the growth phase contains two contrasting phenomena which are incompatible with the patient's interests and are discussed in this article. METHODS: A selective literature search was carried out and selected cases are discussed. RESULTS: On the one hand there is a unique property of the juvenile skeleton with an enormous potential for spontaneous correction enabling conservative treatment for the majority of fractures...
December 2014: Der Unfallchirurg
Alessio Moriconi, Thiago M Cunha, Guilherme R Souza, Alexandre H Lopes, Fernando Q Cunha, Victor L Carneiro, Larissa G Pinto, Laura Brandolini, Andrea Aramini, Cinzia Bizzarri, Gianluca Bianchini, Andrea R Beccari, Marco Fanton, Agostino Bruno, Gabriele Costantino, Riccardo Bertini, Emanuela Galliera, Massimo Locati, Sérgio H Ferreira, Mauro M Teixeira, Marcello Allegretti
Chronic pain resulting from inflammatory and neuropathic disorders causes considerable economic and social burden. Pharmacological therapies currently available for certain types of pain are only partially effective and may cause severe adverse side effects. The C5a anaphylatoxin acting on its cognate G protein-coupled receptor (GPCR), C5aR, is a potent pronociceptive mediator in several models of inflammatory and neuropathic pain. Although there has long been interest in the identification of C5aR inhibitors, their development has been complicated, as for many peptidomimetic drugs, mostly by poor drug-like properties...
November 25, 2014: Proceedings of the National Academy of Sciences of the United States of America
Steven C Curry, Angela Padilla-Jones, Ayrn D O'Connor, Anne-Michelle Ruha, Dale S Bikin, Diana G Wilkins, Douglas E Rollins, Matthew H Slawson, Richard D Gerkin
Elevated concentrations of serum acetaminophen-protein adducts, measured as protein-derived acetaminophen-cysteine (APAP-CYS), have been used to support a diagnosis of APAP-induced liver injury when histories and APAP levels are unhelpful. Adducts have been reported to undergo first-order elimination, with a terminal half-life of about 1.6 days. We wondered whether renal failure would affect APAP-CYS elimination half-life and whether continuous venovenous hemodiafiltration (CVVHDF), commonly used in liver failure patients, would remove adducts to lower their serum concentrations...
June 2015: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Erin Mills, Simon Craig, Ed Oakley
OBJECTIVE: The primary objective was to assess use of splinting prior to X-ray in paediatric ED patients with deformed upper limb fractures. Secondary objectives were to evaluate pharmaceutical analgesia use and the impact of demographic, hospital and clinical variables on splint and analgesia provision. METHODS: A retrospective study of 1407 paediatric ED patients who received upper limb X-rays. The records of those with fractures requiring manipulation were identified, and reviewed for data on demographics, mode of arrival, triage category, site of fracture, clinician seniority, pain scoring, splint application and analgesic use...
August 2014: Emergency Medicine Australasia: EMA
Jie Ma, Junhai Zhang, Tao Yang, Kaihua Fan, Jianwen Gu, Guangfu Yin
BACKGROUND/AIM: It is significant for patients with traumatic brain injury (TBI) to receive prehospital emergency treatment as early as possible to reduce mortality. Therefore, a new prefilled multi-drug injector was developed to improve the treatment of TBI. Here, we studied the pharmacokinetics of dexamethasone (DXM) and nefopam using the injector to investigate the significance of drug interactions and the necessity of dose adjustment. METHODS: Rats were administered DXM and nefopam intramuscularly alone or in combination using the injector...
2014: Pharmacology
Ombretta Caspani, Marie-Céline Reitz, Angelo Ceci, Andreas Kremer, Rolf-Detlef Treede
Depression and anxiety are common comorbidities of neuropathic pain (NP). Pharmacological preclinical studies on NP have given abundant information on the effects of drugs on reflex measures of stimulus-evoked pain. However, few preclinical studies focus on relief of comorbidities evoked by NP. In this study, we investigated the effects of tramadol on nociceptive reflex, depression-associated and anxiety-related behaviors in a NP model in rats. We used chronic constriction injury (CCI) of the sciatic nerve as an animal model of neuropathic pain...
September 2014: Pharmacology, Biochemistry, and Behavior
Taralyn M McCarrel, Nathan A Mall, Andrew S Lee, Brian J Cole, Davietta C Butty, Lisa A Fortier
The use of platelet-rich plasma (PRP) is expanding to numerous medical fields, including orthopedic surgery and sports medicine. The popularity of this new treatment option has prompted a rapid increase in research endeavors; however, the differences in application technique and the composition of PRP have made it difficult to compare results or make any firm conclusions regarding efficacy. The purpose of this article is twofold. First, to recommend details that should be provided in basic science and clinical PRP studies to allow meaningful comparisons between studies which may lead to a better understanding of efficacy...
August 2014: Sports Medicine
Craig DiTommaso, Jeanne M Hoffman, Sylvia Lucas, Sureyya Dikmen, Nancy Temkin, Kathleen R Bell
OBJECTIVE: To describe patient self-report of headache treatment in the first year following mild traumatic brain injury (TBI). BACKGROUND: An understanding of appropriate management of symptoms after mild TBI is crucial for improving acute care and long-term outcomes. This is particularly true for post-traumatic headaches as recent studies suggest that headaches after mild TBI are common with multiple phenotypes. In addition, symptoms such as headache after mild TBI are often managed by primary care providers without specialty training, and often in medically underserved areas...
March 2014: Headache
Danielle Reddi, Natasha Curran
Interest in chronic pain after surgery has grown since the finding that more than a fifth of patients attending chronic pain clinics cite surgery as the cause for their chronic pain. The problem is not limited to major surgery; even common minor procedures such as hernia repair have a significant risk of chronic pain. Surgical technique can influence the development of chronic postsurgical pain (CPSP) and techniques to minimise nerve injury should be used where possible. Central nervous system changes contribute to the development of persistent pain following surgical trauma and nerve injury...
April 2014: Postgraduate Medical Journal
Jaiben George, Sachin Jose Pulickal, Anurag Singh, Mayank Gautam, Pranav Prasoon, Rahul Kumar, Subrata Basu Ray
Opioids like morphine form the mainstay of treatment for moderate to severe burn pain. However, lack of dedicated burn care service and potentially serious side effects of opioids often compromise effective treatment. Newer drugs as well as newer routes of administration of analgesic drugs are long-felt needs in the management of burn pain. Bradykinin is a potent inflammatory mediator present at sites of tissue damage. The present study investigated the analgesic effect of bradykinin type 2 receptor antagonist HOE 140 after direct intrawound administration in rats...
November 2014: Journal of Burn Care & Research: Official Publication of the American Burn Association
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