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Patient controlled analgesia

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https://www.readbyqxmd.com/read/28719527/pupillometry-guided-intraoperative-remifentanil-administration-versus-standard-practice-influences-opioid-use-a-randomized-study
#1
Nada Sabourdin, Jérôme Barrois, Nicolas Louvet, Agnès Rigouzzo, Marie-Laurence Guye, Christophe Dadure, Isabelle Constant
BACKGROUND: Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. METHODS: After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28719378/chemical-stability-of-morphine-ropivacaine-and-ziconotide-in-combination-for-intrathecal-analgesia
#2
Julien Robert, Jérémy Sorrieul, Elsa Rossignol, Hélène Beaussart, Hélène Kieffer, Caroline Folliard, Denis Dupoiron, Catherine Devys
Pain is the most feared symptom amongst individuals living with cancer. In 15% to 20% of patients, conventional analgesic therapy either fails to relieve pain or induces adverse effects. Intrathecal drug delivery systems may present an effective alternative for pain management. The Cancerology Center Paul Papin protocol includes an admixture of morphine, ropivacaine, and ziconotide in intrathecal preparations. These drugs are administered by a fully implantable or an external pump. Syringes or polyolefin infusion bags are prepared for refill just before use...
July 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#3
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/28717706/cancer-pain-management-insights-and-reality-in-southeast-asia-expert-perspectives-from-six-countries
#4
Francis O Javier, Cosphiadi Irawan, Marzida Binti Mansor, Wimonrat Sriraj, Kian Hian Tan, Dang Huy Quoc Thinh
This expert opinion report examines the current realities of the cancer pain management landscape and the various factors that hinder optimal pain control in six countries in Southeast Asia, describes ongoing efforts to advance patient care, and discusses approaches for improving cancer pain management. Information was gathered from leading experts in the field of cancer pain management in each country through an initial meeting and subsequent e-mail discussions. Overall, there are vast disparities in cancer pain management practices and access to opioids in the Southeast Asian countries...
August 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28712103/randomised-controlled-trial-of-analgesic-effectiveness-of-three-different-techniques-of-single-shot-interscalene-brachial-plexus-block-using-20-ml-of-0-5-ropivacaine-for-shoulder-arthroscopy
#5
Michał Jan Stasiowski, Michał Kolny, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Bartłomiej Możdżyński
Background Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation. METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I-III status scheduled for elective shoulder arthroscopy ...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28711570/anesthetic-management-of-reversible-cerebral-vasoconstriction-syndrome-a-case-report
#6
Hiroshi Hoshijima, Naoki Itoh, Yoshinori Iwase, Hiroshi Nagasaka
Reversible cerebral vasoconstriction syndrome (RCVS) is a group of disorders characterized by prolonged reversible cerebral vasoconstriction, associated with acute-onset, severe, episodic "thunderclap" headaches with or without other neurologic clinical features. We describe the first reported case, to our knowledge, of a patient with RCVS who was managed under general anesthesia in the field of oral and maxillofacial surgery. A 67-year-old woman with a diagnosis of RCVS made 2 months earlier was scheduled to undergo surgical extraction of the mandibular right third molar...
June 14, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28706951/effectiveness-of-different-pain-control-methods-in-patients-with-knee-osteoarthritis-after-knee-arthroplasty
#7
Jin-Lain Ming, Shiao-Pei Hung, Hui-Mei Huang, Li-Hua Tseng, Chiung-Hui Huang, I-Chun Chen, Yu-Ping Chen, Chien-Kun Ting, Chen-Yin Tung
The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n = 120) and patient-controlled analgesia (PCA) Group 2 (n = 57) according to the treatment methods they received...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28705592/effect-of-perioperative-intravenous-lidocaine-infusion-on-postoperative-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#8
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/28705534/neuraxial-labor-analgesia-is-not-an-independent-predictor-of-perineal-lacerations-after-vaginal-delivery-of-patients-with-intrauterine-fetal-demise
#9
Ji H Lee, Feyce M Peralta, Anna Palatnik, Christina Lewicky Gaupp, Robert J McCarthy
INTRODUCTION: The role of neuraxial labor analgesia in perineal trauma following live births is controversial, and no studies have assessed the association in women delivering an intrauterine fetal demise. We evaluated the relationship between neuraxial labor analgesia and perineal laceration in these patients. METHODS: This was a retrospective case-control study of women with a diagnosis of fetal death after 20weeks of gestation, a vaginal delivery, and an Apgar score of 0 at delivery, during the period from January 2007 through December 2015...
June 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28700506/effectiveness-of-corticosteroid-injections-in-adhesive-capsulitis-of-shoulder-a-meta-analysis
#10
Wei Wang, Mingmin Shi, Chenhe Zhou, Zhongli Shi, Xunzi Cai, Tiao Lin, Shigui Yan
BACKGROUND: Primary adhesive capsulitis is mainly characterized by spontaneous chronic shoulder pain and the gradual loss of shoulder motion. The main treatment for adhesive capsulitis is a trial of conservative therapies, including analgesia, exercise, physiotherapy, oral nonsteroidal anti-inflammation drugs, and intra-articular corticosteroid injections. Previously, it was reported that intra-articular corticosteroid lead to fast pain relief and improvement of range of motion (ROM)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700455/perioperative-ketamine-for-analgesia-in-spine-surgery-a-meta-analysis-of-randomized-controlled-trials
#11
Arif Pendi, Ryan Field, Saifal-Deen Farhan, Martin Eichler, Stacey Samuel Bederman
STUDY DESIGN: Meta-analysis of randomized controlled trials. OBJECTIVE: To evaluate the effectiveness of perioperative supplemental ketamine to reduce postoperative opioid analgesic consumption following spine surgery. SUMMARY OF BACKGROUND DATA: Although low-dose supplemental ketamine has been known to reduce pain after surgery, there is conflicting evidence regarding whether ketamine can be effective to reduce opioid consumption following spine surgery...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28700368/regional-anesthesia-and-analgesia-in-cancer-care-is-it-time-to-break-the-bad-news
#12
Mir W Sekandarzad, André A J van Zundert, Chris W Doornebal, Markus W Hollmann
PURPOSE OF REVIEW: There is ongoing controversy regarding the tumor-protective effects of regional anesthesia in patients undergoing cancer surgery. Evidence of up-to-date systematic reviews will be presented alongside recent updates on the effects of opioids and local anesthetics. RECENT FINDINGS: In recent years, the literature regarding the effects of regional anesthesia techniques on cancer recurrence has raised many unanswered questions. Ongoing randomized controlled trials may not be able to shed light on the controversial discussion regarding the tumor protective effects of regional anesthesia because the expected effect size and event rate in those studies may be overstated...
July 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28698351/subdissociative-intranasal-ketamine-plus-standard-pain-therapy-versus-standard-pain-therapy-in-the-treatment-of-paediatric-sickle-cell-disease-vaso-occlusive-crises-in-resource-limited-settings-study-protocol-for-a-randomised-controlled-trial
#13
James R Young, Hendry Robert Sawe, Juma A Mfinanga, Ernest Nshom, Ethan Helm, Charity G Moore, Michael S Runyon, Stacy L Reynolds
INTRODUCTION: Pediatric sickle cell disease, highly prevalent in sub-Saharan Africa, carries great morbidity and mortality risk. Limited resources and monitoring make management of acute vaso-occlusive crises challenging. This study aims to evaluate the efficacy and safety of subdissociative intranasal ketamine as a cheap, readily available and easily administered adjunct to standard pain therapy. We hypothesise that subdissociative, intranasal ketamine may significantly augment current approaches to pain management in resource-limited settings in a safe and cost-effective manner...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697780/local-infiltration-of-analgesia-and-sciatic-nerve-block-provide-similar-pain-relief-after-total-knee-arthroplasty
#14
Hidenori Tanikawa, Kengo Harato, Ryo Ogawa, Tomoyuki Sato, Shu Kobayashi, So Nomoto, Yasuo Niki, Kazunari Okuma
BACKGROUND: Although femoral nerve block provides satisfactory analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We conducted a randomized controlled trial to clarify the efficacy of the sciatic nerve block (SNB) and local infiltration of analgesia with steroid (LIA) regarding postoperative analgesia after TKA, when administrated in addition to femoral nerve block (FNB). METHODS: Seventy-eight patients were randomly allocated to the two groups: concomitant administration of FNB and SNB or FNB and LIA...
July 11, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28695814/effect-of-different-sufentanil-concentration-regimens-on-postoperative-pain-control-and-its-adverse-events-in-intravenous-patient-controlled-analgesia
#15
Jiaying Xu, Nuoer Sang, Liying Ren, Yuguang Huang
Objective To compare the analgesic effect and incidences of adverse events of different sufentanil concentration regimens in postoperative intravenous patient-controlled analgesia(PCA).Methods We retrospectively analyzed the clinical data of 6231 patients undergoing elective general anesthesia using sufentanil as postoperative intravenous PCA regimen in Peking Union Medical College Hospital from January 2004 to December 2016.These patients were subcategorized into 4 groups according to the sufentanil concentration regimens:0...
June 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28695584/patient-controlled-analgesia-with-remifentanil-vs-alternative-parenteral-methods-for-pain-management-in-labour-a-cochrane-systematic-review
#16
REVIEW
Y Jelting, S Weibel, A Afshari, N L Pace, J Jokinen, T Artmann, L H J Eberhart, P Kranke
We aimed to assess the effectiveness of remifentanil used as intravenous patient-controlled analgesia for the pain of labour. We performed a systematic literature search in December 2015 (updated in December 2016). We included randomised, controlled and cluster-randomised trials of women in labour with planned vaginal delivery receiving patient-controlled remifentanil compared principally with other parenteral and patient-controlled opioids, epidural analgesia and continuous remifentanil infusion or placebo...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28693439/combatting-pain-after-orthopedic-trauma-surgery-perioperative-oral-extended-release-tapentadol-vs-extended-release-oxycodone-naloxone
#17
Gertrud Haeseler, Dirk Schaefers, Natalie Prison, Jörg Ahrens, Xiaofei Liu, Annika Karch
BACKGROUND: High post-operative pain scores after "minor" orthopedic/trauma surgery are in part attributed to inadequate prescription of opioid analgesics. Novel concepts aiming to achieve sufficient analgesia while minimizing opioid-related side effects by avoiding fluctuating plasma levels are based on perioperative oral administration of extended-release opioids beginning with the first dose pre-operatively. This is the first study to evaluate analgesic efficacy and side effect rates of extended-release tapentadol compared to oxycodone/naloxone following orthopedic/trauma surgery...
July 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28691979/perioperative-management-for-abdominal-surgery-in-bilateral-diaphragmatic-paralysis-a-case-report-and-literature-review
#18
Glenio B Mizubuti, Louie Wang, Anthony M-H Ho, Robert C Tanzola, Jordan Leitch
The optimal approach to postoperative analgesia in patients with bilateral diaphragmatic paralysis undergoing abdominal surgery remains unclear. We report a 69-year-old woman with bilateral diaphragmatic paralysis who underwent a laparoscopic hernia repair and an open laparotomy for reversal of a Hartmann procedure under general anesthesia. Postoperative analgesia was provided by intravenous opioid and epidural local anesthetic and opioid, respectively. The patient's trachea was successfully extubated at the end of both surgical procedures...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28690076/patient-non-adherence-to-guideline-recommended-care-in-acute-low-back-pain
#19
Jasper D Bier, Steven J Kamper, Arianne P Verhagen, Christopher G Maher, Christopher M Williams
OBJECTIVE: To describe the magnitude of patient reported non-adherence with guideline-recommended care for acute low back pain. DESIGN: Secondary analysis of data from participants enrolled in the PACE trial, a randomised controlled trial evaluating the effectiveness of paracetamol for acute low back pain. PARTICIPANTS: Data from 1643 participants with acute low back pain. INTERVENTIONS: Guideline recommendend care including; reassurance, simple analgesia, and the advice to stay active and avoid bed rest...
July 6, 2017: Archives of Physical Medicine and Rehabilitation
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
#20
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
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