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Patient controlled analgesia

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https://www.readbyqxmd.com/read/27924202/randomized-trial-of-subfascial-infusion-of-ropivacaine-for-early-recovery-in-laparoscopic-colorectal-cancer-surgery
#1
Sang Hyun Lee, Woo-Seog Sim, Go Eun Kim, Hee Cheol Kim, Joo Hyun Jun, Jin Young Lee, Byung-Seop Shin, Heejin Yoo, Sin-Ho Jung, Joungyoun Kim, Seung Hyeon Lee, Deok Kyu Yo, Yu Ri Na
BACKGROUND: There is a need for investigating the analgesic method as part of early recovery after surgery tailored for laparoscopic colorectal cancer (LCRC) surgery. In this randomized trial, we aimed to investigate the analgesic efficacy of an inverse 'v' shaped bilateral, subfascial ropivacaine continuous infusion in LCRC surgery. METHODS: Forty two patients undergoing elective LCRC surgery were randomly allocated to one of two groups to receive either 0.5% ropivacaine continuous infusion at the subfascial plane (n = 20, R group) or fentanyl intravenous patient controlled analgesia (IV PCA) (n = 22, F group) for postoperative 72 hours...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27922774/controlled-drugs-and-the-principle-of-double-effect-the-role-of-the-district-nurse
#2
Richard Griffith
The role of district nurses in the effective management of pain in palliative care has been strengthened by the Misuse of Drugs (Amendment No.2) (England, Wales and Scotland) Regulations 2012 that allow district nurses who are independent or supplementary prescribers to prescribe and administer controlled drugs. However, prescribing controlled drugs brings increased responsibility and accountability for the safe management of these medicines. In this article Richard Griffith considers the principle of double effect that seeks to ensure that patients in intractable pain receive the analgesia they require to manage that pain while district nurses avoid liability and prosecution under the law of murder...
December 2, 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27920502/physicochemical-stability-of-ternary-admixtures-of-butorphanol-ketamine-and-droperidol-in-polyolefin-bags-for-patient-controlled-analgesia-use
#3
Baoxia Fang, Linhai Wang, Junfeng Gu, Fuchao Chen, Xiao-Ya Shi
BACKGROUND: Delivery of drug admixtures by intravenous patient-controlled analgesia is a common practice for the management of postoperative pain; however, analytical confirmation of the compatibility and stability of butorphanol tartrate, ketamine hydrochloride, and droperidol combined in ternary admixtures is not available. METHODS: Butorphanol tartrate, ketamine hydrochloride, and droperidol have been examined for compatibility and stability when combined with 0...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27919773/analgesic-effects-of-alcohol-a-systematic-review-and-meta-analysis-of-controlled-experimental-studies-in-healthy-participants
#4
REVIEW
Trevor Thompson, Charlotte Oram, Christoph U Correll, Stella Tsermentseli, Brendon Stubbs
: Despite the long-standing belief in the analgesic properties of alcohol, experimental studies have produced mixed results. This meta-analysis aimed to clarify whether alcohol produces a decrease in experimentally-induced pain and to determine the magnitude of any such effect. PubMed, PsycINFO and Embase databases were searched from inception until 21/4/2016 for controlled studies examining the effect of quantified dosages of alcohol on pain response to noxious stimulation. Eighteen studies involving 404 participants were identified providing alcohol vs...
December 2, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27919589/preincisional-and-postoperative-epidural-morphine-ropivacaine-ketamine-and-naloxone-treatment-for-postoperative-pain-management-in-upper-abdominal-surgery
#5
Hou-Chuan Lai, Chung-Bao Hsieh, Chih-Shung Wong, Chun-Chang Yeh, Zhi-Fu Wu
OBJECTIVE(S): Previous studies have shown that preincisional epidural morphine, bupivacaine, and ketamine combined with epidural anesthesia (EA) and general anesthesia (GA) provided pre-emptive analgesia for upper abdominal surgery. Recent studies reported that ultralow-dose naloxone enhanced the antinociceptive effect of morphine in rats. This study investigated the benefits of preincisional and postoperative epidural morphine + ropivacaine + ketamine + naloxone (M + R + K + N) treatment for achieving postoperative pain relief in upper abdominal surgery...
December 2, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27918333/effectiveness-of-epidural-analgesia-continuous-surgical-site-analgesia-and-patient-controlled-analgesic-morphine-for-postoperative-pain-management-and-hyperalgesia-rehabilitation-and-health-related-quality-of-life-after-open-nephrectomy-a-prospective-randomized
#6
Xavier Capdevila, Sebastien Moulard, Christian Plasse, Jean-Luc Peshaud, Nicolas Molinari, Christophe Dadure, Sophie Bringuier
BACKGROUND: There is no widely recognized effective technique to optimally reduce pain scores and prevent persistent postoperative pain after nephrectomy. We compared continuous surgical site analgesia (CSSA), epidural analgesia (EA), and a control group (patient-controlled analgesic morphine) in patients undergoing open nephrectomy. METHODS: Sixty consecutive patients were randomized to be part of EA, CSSA, or control groups postoperatively for 72 hours. All patients received patient-controlled analgesic morphine, if needed...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27916036/-effect-of-ultrasound-guided-patient-controlled-paravertebral-block-on-pulmonary-function-in-patients-with-multiple-fractured-ribs
#7
Y Y Ge, X Z Wang, N Yuan, L Y Yuan, W H Ma, Y Hu
Objective: To investigated the effects of patient controlled intravenous analgesia and ultrasound guided patient-controlled paravertebral block on pulmonary function in patients with multiple fractured ribs. Methods: From May 2015 to March 2016, 60 patients with multiple rib fractures in Ningbo NO.6 Hospital with American Society of Anesthesiologists Ⅱ-Ⅲ underwent internal fixation, including 30 males and 30 females aged from 16 to 70 years(mean age (54.6±15.2) years). All patients were randomly divided into 2 groups (n=30 each): patient controlled intravenous analgesia(PCIA) group and patient controlled thoracic paravertebral block(PCPB) group...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#8
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27906949/pulsed-compared-to-thermal-radiofrequency-to-the-medial-calcaneal-nerve-for-management-of-chronic-refractory-plantar-fasciitis-a-prospective-comparative-study
#9
Ayman M Osman, Dina H El-Hammady, Mohamed M Kotb
BACKGROUND: Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations. OBJECTIVES: To evaluate the effect of applying PRF for 6 minutes vs...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#10
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#11
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902584/effect-of-naloxone-on-intravenous-fentanyl-patient-controlled-analgesia-after-laparoscopic-cholecystectomy
#12
Jun Zheng, Wen Han, Xiao-Dong Han, Xiao-Yuan Ma, Pengbo Zhang
This study aims to evaluate the effect of naloxone on intravenous fentanyl patient-controlled analgesia after laparoscopic cholecystectomy under total intravenous anesthesia.A total of 90 patients, who underwent intravenous fentanyl patient-controlled analgesia after laparoscopic cholecystectomy under total intravenous anesthesia, were included into this study. All patients were randomly divided into 3 groups (each group, n=30): naloxone group (naloxone+fentanyl), tropisetron group (tropisetron+fentanyl), and fentanyl group (fentanyl)...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900763/parecoxib-propacetamol-and-their-combination-for-analgesia-after-total-hip-arthroplasty-a-randomized-non-inferiority-trial
#13
F Camu, A Borgeat, R J Heylen, E J Viel, M E Boye, R Y Cheung
BACKGROUND: This study assessed non-inferiority of parecoxib vs. combination parecoxib+propacetamol and compared the opioid-sparing effects of parecoxib, propacetamol, and parecoxib+propacetamol vs. placebo after total hip arthroplasty. METHODS: In this randomized, placebo-controlled, parallel-group, non-inferiority study, patients received one of four IV treatments after surgery: parecoxib 40 mg bid (n = 72); propacetamol 2 g qid (n = 71); parecoxib 40 mg bid plus propacetamol 2 g qid (n = 72); or placebo (n = 38) with supplemental IV patient-controlled analgesia (morphine)...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27899200/-mucoadhesive-buccal-films-of-tramadol-for-effective-pain-management
#14
Xiao-Qin Li, Zhao-Ming Ye, Jian-Bing Wang, Cai-Rong Fan, Ai-Wu Pan, Cong Li, Ren-Bing Zhang
BACKGROUND AND OBJECTIVES: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. METHODS: Buccal films of tramadol hydrochloride were prepared by solvent casting method...
November 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27896461/transversus-abdominis-plane-block-for-postoperative-pain-relief-after-hand-assisted-laparoscopic-colon-surgery-a-randomized-placebo-controlled-clinical-trial
#15
R Tikuisis, P Miliauskas, V Lukoseviciene, N Samalavicius, A Dulskas, L Zabuliene, V Zabulis, J Urboniene
BACKGROUND: Although hand-assisted laparoscopic surgery (HALS) offers patients smaller surgical incisions, they still experience pain. Currently, there is no consensus on the optimal analgesic package for patients undergoing HALS. The aim of this prospective, randomized, double-blinded, placebo-controlled clinical trial was to evaluate the effect of transversus abdominis plane (TAP) block on postoperative pain control (pain score and analgesic use) and other outcomes in colon cancer patients undergoing hand-assisted laparoscopic left hemicolectomy...
November 28, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27895509/effects-of-fentanyl-on-pain-and-motor-behaviors-following-a-collagenase-induced-intracerebral-hemorrhage-in-rats
#16
Laurence Saine, Pierre Hélie, Pascal Vachon
PURPOSE: Intracerebral hemorrhage (IH) and cephalalgia are common consequences of traumatic brain injury. One of the primary obstacles for patient recovery is the paucity of treatments to support an appropriate analgesic protocol. The present study aimed to assess pain and motor behaviors following different doses of fentanyl on a rat model of IH. METHODS: Twenty-one male Sprague Dawley rats underwent a stereotaxic surgery to produce a collagenase-induced IH in the right caudoputamen nucleus...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27891453/efficacy-of-ketamine-as-an-adjunct-to-local-anesthesia-in-the-surgical-removal-of-impacted-mandibular-third-molars-a-split-mouth-prospective-controlled-clinical-study
#17
Anand Shah, Rajshekhar Halli, Yash Merchant, Rajesh Kshirsagar, Jyotsana Khurana
INTRODUCTION: The removal of impacted teeth is one of the most common procedures performed by oral and maxillofacial surgeons. Reduction of discomfort post-operatively and efficient local anesthesia are imperative for success in surgical practice. At sub-anesthetic doses, ketamine has a noticeable analgesic action, which can be used to supplement local anesthesia with minimal side effects. AIM: To assess the efficacy of low-dose ketamine as an adjunct to local anesthesia in the management of pain, swelling and trismus after surgical removal of impacted mandibular third molars...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891424/a-study-on-the-efficacy-of-the-addition-of-low-dose-dexmedetomidine-as-an-adjuvant-to-lignocaine-in-intravenous-regional-anaesthesia-ivra
#18
Esha Nilekani, Yvonne Menezes, Shirley Ann D'souza
INTRODUCTION: Intravenous Regional Anaesthesia (IVRA) is a simple, effective method of providing anaesthesia for short duration surgical procedures on the extremities, its chief drawbacks are tourniquet pain, short duration of block and absence of post-operative analgesia. Dexmedetomidine is known to reduce anaesthetic requirements and also provide analgesia to the patient. AIM: To evaluate the efficacy of dexmedetomidine as an adjuvant to lignocaine in IVRA with respect to the quality of the block, tourniquet pain and post-operative analgesia...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890522/design-and-challenges-of-a-randomized-clinical-trial-of-medical-expulsive-therapy-tamsulosin-for-urolithiasis-in-the-emergency-department
#19
Pamela K Burrows, Judd E Hollander, Allan B Wolfson, Michael C Kurz, Lorna Richards, Sara DiFiore, Phillip Watts, Nivedita Patkar, Jeremy Brown, Stephen Jackman, Ziya Kirkali, John W Kusek, Chloe Michel, Andrew C Meltzer
Urolithiasis or urinary stone disease has been estimated to affect about 1 in 11 Americans. Patients with urinary stone disease commonly present to the emergency department for management of their acute pain. In addition to providing analgesia, administration of drug (medical expulsive therapy) is often prescribed to assist passage of the urinary stone. In this methodology paper, we describe the design of a prospective, multi-center, randomized, double-blind placebo controlled clinical trial of the alpha-adrenergic blocker, tamsulosin, to evaluate its effectiveness as medical expulsive therapy...
November 23, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#20
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
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