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Patient controlled analgesia

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https://www.readbyqxmd.com/read/29778340/prospective-randomized-controlled-trial-of-polymer-cable-ties-versus-standard-wire-closure-of-midline-sternotomy
#1
Silvana F Marasco, Louise Fuller, Adam Zimmet, David McGiffin, Michael Seitz, Stephanie Ch'ng, Shivanand Gangahanumaiah, Michael Bailey
OBJECTIVE: Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. METHODS: A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60)...
April 16, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29777714/efficiency-of-neuromuscular-electrical-stimulation-and-transcutaneous-nerve-stimulation-on-hemiplegic-shoulder-pain-a-prospective-randomized-controlled-trial
#2
Meimei Zhou, Fang Li, Weibo Lu, Junfa Wu, Song Pei
OBJECTIVE: To compare the efficacy of neuromuscular electrical stimulation (NMES) and transcutaneous nerve stimulation (TENS) on hemiplegic shoulder pain (HSP). DESIGN: This is a prospective randomized controlled trial (RCT). SETTING: A total of 184 HSP patients, aged 18-80 years, were recruited in the Rehabilitation Hospital from February 2014 to July 2016. The Ethics approval was obtained from the Institutional Review Board of the Hospital...
May 16, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29776324/intraoperative-cryoanalgesia-for-reducing-post-tonsillectomy-pain-a-systemic-review
#3
Blake S Raggio, Blair M Barton, Maria C Grant, Edward D McCoul
OBJECTIVE: Summarize the effectiveness of intraoperative cryoanalgesia in the management of postoperative pain among patients undergoing palatine tonsillectomy. METHODS: A systematic review of PubMED, MEDLINE, EMBASE, Google Scholar, and Cochrane trial registries was performed through January 2017 using the PRISMA standards. We included English-language randomized controlled trials evaluating patients of all age groups with benign pathology who underwent tonsillectomy with cryoanalgesia versus without...
June 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29773484/the-effect-of-a-single-intraoperative-dose-of-intravenous-dexamethasone-8-mg-on-post-cesarean-delivery-analgesia-a-randomized-controlled-trial
#4
U Ituk, K Thenuwara
BACKGROUND: A single perioperative dose of dexamethasone has been shown to improve postoperative analgesia and reduce opioid consumption. However, this analgesic and opioid sparing effect has not been well assessed as part of a multimodal analgesic regimen in women post-cesarean delivery. METHODS: Healthy women having cesarean delivery under spinal anesthesia were randomly assigned to receive intravenous dexamethasone 8 mg or placebo after delivery and clamping of the umbilical cord...
March 26, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#5
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771731/effect-of-intravenous-dexmedetomidine-during-general-anesthesia-on-acute-postoperative-pain-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Xiuqin Wang, Naifu Liu, Jinlong Chen, Zan Xu, Fumei Wang, Chuan Ding
BACKGROUND: Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies. METHODS: Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials (RCTs). The relative risk (RR) and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. RESULTS: Compared to the normal saline group, patients using dexmedetomidine showed a significantly decreased pain intensity within 6 hours (WMD=-0...
May 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#7
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29769507/a-randomized-controlled-trial-to-compare-the-efficacy-of-intravenous-dexmedetomidine-and-clonidine-as-adjuvants-to-low-dose-opioid-in-attenuation-of-hemodynamic-response-to-laryngoscopy-and-tracheal-intubation
#8
N Gupta, A Kumar, A Jain, N Hayaran, P Mishra
Increase in sympathetic activity as a result of cardiovascular stress response to laryngoscopy can be detrimental to the patient. The primary objective is to compare intravenous dexmedetomidine and clonidine as adjuvants to low dose opioid (fentanyl) for attenuation of hemodynamic response to laryngoscopy and tracheal intubation. The secondary objectives are to compare the perioperative dose requirement of fentanyl and thiopentone, to compare the duration of postoperative analgesia, and to look for side effects in all three groups...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29769140/local-infiltration-anesthesia-versus-epidural-analgesia-for-postoperative-pain-control-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#9
Chen Li, Ji Qu, Su Pan, Yang Qu
BACKGROUND: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of local infiltration anesthesia (LIA) versus epidural analgesia (EPA) for postoperative pain control in total knee arthroplasty (TKA). METHODS: In December 2017, a systematic computer-based search was conducted in Pubmed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared LIA versus EPA for postoperative pain control in TKA were retrieved...
May 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#10
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29763594/patient-controlled-paravertebral-block-for-video-assisted-thoracic-surgery-a-randomized-trial
#11
Zixiang Wu, Shuai Fang, Qi Wang, Cong Wu, Tianwei Zhan, Ming Wu
BACKGROUND: Paravertebral block (PVB) has been proven to be an efficient way to control postoperative pain in patients who have undergone a thoracotomy. This study aimed to explore whether the utilization of a patient-controlled PVB can provide benefits over intravenous patient-controlled analgesia (PCA) for three-port single-intercostal video-assisted thoracic surgery. METHODS: From May 2015 to December 2016, patients who had solitary pulmonary nodules or spontaneous pneumothorax and underwent single-intercostal video-assisted thoracic surgery were randomly allocated to receive patient-controlled PVB or intravenous PCA...
May 12, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29761478/pain-relief-for-women-undergoing-oocyte-retrieval-for-assisted-reproduction
#12
REVIEW
Irene Kwan, Rui Wang, Emily Pearce, Siladitya Bhattacharya
BACKGROUND: Various methods of conscious sedation and analgesia (CSA) have been used during oocyte retrieval for assisted reproduction. The choice of agent has been influenced by the quality of sedation and analgesia and by concerns about possible detrimental effects on reproductive outcomes. OBJECTIVES: To assess the effectiveness and safety of different methods of conscious sedation and analgesia for pain relief and pregnancy outcomes in women undergoing transvaginal oocyte retrieval...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29760856/continuous-intravenous-sub-dissociative-dose-ketamine-infusion-for-managing-pain-in-the-emergency-department
#13
Sergey Motov, Jefferson Drapkin, Antonios Likourezos, Tyler Beals, Ralph Monfort, Christian Fromm, John Marshall
Introduction: Our objective was to describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: We conducted a retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over six years (2010-2016)...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#14
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#15
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29750992/transcriptome-analysis-of-dorsal-root-ganglia-s-diabetic-neuropathy-reveals-mechanisms-involved-in-pain-and-regeneration
#16
Maria Carolina Pedro Athie, Andre Schwambach Vieira, Juliana Maia Teixeira, Gilson Gonçalves Dos Santos, Elayne Vieira Dias, Claudia Herrera Tambeli, Cesar Renato Sartori, Carlos A Parada
Peripheral diabetic neuropathy (DN) manifests in nearly 60% of diabetic patients, being pain its most debilitating symptom. Although electrophysiological and morphological aspects are well described, little is known about its development and progression, undermining effective therapies. Hyperglycemia and insulin signaling impairment are considered the triggering events of oxidative stress observed in the dying nerves, however there are still many gaps in the knowledge of intracellular plastic changes it generates...
May 8, 2018: Life Sciences
https://www.readbyqxmd.com/read/29750900/robot-guided-neuronavigated-repetitive-transcranial-magnetic-stimulation-rtms-in-central-neuropathic-pain-an-update-of-long-term-follow-up
#17
Charles Quesada, Benjamin Pommier, Camille Fauchon, Claire Bradley, Christelle Créac'h, François Vassal, Roland Peyron
OBJECTIVE: To confirm and extend previous results involving repetitive transcranial magnetic stimulation (rTMS) aimed at alleviating refractory central neuropathic pain(CNP). To evaluate pain relief in detail and to assess ongoing benefits after one year of treatment. DESIGN: Prospective observational study. SETTING: University hospital. Outpatient settings. PARTICIPANTS: 80 patients with chronic central pain after brain or spinal cord injuries...
May 8, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29750760/prospective-randomized-controlled-comparison-of-local-anesthetic-infusion-pump-versus-depofoam-bupivacaine-for-pain-management-after-unilateral-delayed-deep-inferior-epigastric-perforator-free-flap-reconstruction
#18
James Gatherwright, Rebecca Knackstedt, Amir Ghaznavi, Steven Bernard, Graham Schwarz, Andrea Moreira, Raffi Gurunluoglu, Risal Djohan
BACKGROUND: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. METHODS: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29750688/feasibility-of-fully-automated-hypnosis-analgesia-and-fluid-management-using-2-independent-closed-loop-systems-during-major-vascular-surgery-a-pilot-study
#19
Alexandre Joosten, Vincent Jame, Brenton Alexander, Thierry Chazot, Ngai Liu, Maxime Cannesson, Joseph Rinehart, Luc Barvais
Automated titration of intravenous anesthesia and analgesia using processed electroencephalography monitoring is no longer a novel concept. Closed-loop control of fluid administration to provide goal-directed fluid therapy has also been increasingly described. However, simultaneously combining 2 independent closed-loop systems together in patients undergoing major vascular surgery has not been previously detailed. The aim of this pilot study was to evaluate the clinical performance of fully automated hypnosis, analgesia, and fluid management using 2 independent closed-loop controllers in patients undergoing major vascular surgery before implementation within a larger study evaluating true patient outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29745071/short-term-outcomes-in-patients-with-colon-cancer-treated-with-robotic-right-colectomy
#20
Argyrios Ioannidis, Konstantinos Kontzoglou, Gregory Kouraklis, Nikolaos Machairas, Periklis Chrysoheris, Fotis Antonakopoulos, Michalis Konstantinidis, Dimitrios Filippou, Panagiotis Skandalakis, Konstantinos Konstantinidis
PURPOSE: To report a single surgeon series of consecutive robotic right colectomies (RRC) performed for non-metastatic right colon cancer. METHODS: A retrospective review of a prospectively maintained database of patients who underwent elective robotic right colectomy for right colon adenocarcinoma was conducted. Patients with stage 0-III disease were included in the study. Outcomes evaluated included operative time, number of lymph nodes harvested, estimated blood loss, time to return of bowel function, length of hospital stay, complications and a minimum of 6-month follow up...
March 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
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