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Tomasz Dzierżanowski, Aleksandra Ciałkowska-Rysz
PURPOSE: Based on the international reports, consumption of opioid analgesics in Poland is relatively low. There is limited information on possible impediments to optimal opioid use. This study was aimed to identify possible barriers to access to opioid analgesics and causes of failure to comply with current clinical guidelines. METHODS: Consumption data per capita in 2000-2015 were analyzed in terms of oral morphine equivalents in total, per prescription type, per reimbursement status, to identify the impact of regulations specific for Poland...
October 22, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
F Y Kwok, S Venugobal
BACKGROUND: Induction of anaesthesia with propofol is often associated with a significant decrease in arterial pressure, especially in the older population. The aim of this study is to determine the efficacy of phenylephrine in two different doses i.e. 100mcg and 200mcg, given during induction to counteract the anticipated hypotensive effect of propofol in older patients aged over 55 years. METHODS: Seventy-two ASA physical status I - II patients aged 55 years or older were randomly allocated to group 1 (received propofol mixed with normal saline), group 2 (propofol mixed with 100mcg of phenylephrine) or group 3 (propofol mixed with 200mcg of pheynylphrine)...
August 2016: Medical Journal of Malaysia
Xin Jiang, Dong Chen, Yahao Lou, Zhongshi Li
BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015...
October 20, 2016: Aging Clinical and Experimental Research
Faramarz Mosaffa, Seyed Amir Mohajerani, Reza Aminnejad, Ali Solhpour, Shideh Dabir, Gholam Reza Mohseni
BACKGROUND: Preemptive analgesia is the blocking of pain perception afferent pathways before noxious painful stimuli. Clonidine is an alpha agonist drug that is partially selective for α-2 adrenoreceptors. Clonidine is used as anti-anxiety medication and an, analgesic, and it prolongs the duration of the block in the brachial plexus block. OBJECTIVES: To compare the effect of preemptive clonidine with midazolam on intraoperative sedation, duration of block, and postoperative pain scores...
June 2016: Anesthesiology and Pain Medicine
Gilvandro Lins de Oliveira, Fernando Cesar Serralheiro, Fernando Luiz Affonso Fonseca, Onésimo Duarte Ribeiro, Fernando Adami, Denise Maria Christofolini, Bianca Bianco, Caio Parente Barbosa
Objective: To compare the anesthetic techniques using propofol and fentanyl versus midazolam and remifentanil associated with a paracervical block with lidocaine in performing ultrasound-guided transvaginal oocyte aspiration. Methods: A randomized double-blind clinical trial (#RBR-8kqqxh) performed in 61 women submitted to assisted reproductive treatment. The patients were divided into two groups: anesthetic induction with 1mcg/kg of fentanyl associated with 1.5mg/kg of propofol (FP Group, n=32), in comparison with anesthetic induction using 0...
July 2016: Einstein
Bo Young Oh, Yoon Ah Park, Hye Young Koo, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Juhee Cho, Woo Seog Sim, Yong Beom Cho
PURPOSE: Local anesthetic wound infusion has been previously investigated in postoperative pain management. However, a limited number of studies have evaluated its use in laparoscopic colorectal surgery. This study aims to evaluate whether ropivacaine wound infusion is effective for postoperative pain management after laparoscopic surgery in patients with colorectal cancer. METHODS: This prospective study included 184 patients who underwent laparoscopic surgery for colorectal cancer between July 2012 and June 2013...
October 2016: Annals of Surgical Treatment and Research
Marcelo Epsztein Kanczuk, Nicholas Martin Barrett, Cristian Arzola, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: Most studies that have compared programmed intermittent epidural bolus (PIEB) with continuous epidural infusion regimens have included patient-controlled epidural analgesia and/or manual bolus as rescue analgesia for breakthrough pain. Consequently, the optimal time interval between PIEB is yet to be determined. We designed a study to establish the optimal time interval between PIEB of 10 mL of bupivacaine 0.0625% with fentanyl 2 μg/mL to produce effective analgesia in 90% of women during first stage of labor without breakthrough pain...
October 11, 2016: Anesthesia and Analgesia
Meghan MacKenzie, Richard Hall
PURPOSE: Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. SOURCE: We selected relevant literature to illustrate the important concepts contained within. PRINCIPAL FINDINGS: Two main approaches have been used to identify genetic abnormalities - the candidate gene approach and the genome-wide approach...
October 17, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Julie Latimer, Stephen Ling, Ian Flaherty, Marianne Jauncey, Allison M Salmon
BACKGROUND: Fentanyl is a powerful analgesic, the prescription of which has increased markedly in recent years. The emergence of the drug at the Sydney Medically Supervised Injecting Centre (MSIC) warranted a retrospective clinical audit to assess the risk of fentanyl overdose in comparison with other opioids, in the context of a drug consumption room. METHOD: Heroin, fentanyl or other prescription opioids (PO) injections resulting in overdose were audited (September 1, 2012 and August 31, 2015)...
October 14, 2016: International Journal on Drug Policy
Jui-Hsiang Tang, Chi-Liang Cheng, Yen-Lin Kuo, Yi-Ning Tsui
BACKGROUND/AIMS: Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence of the procedure with carbon dioxide insufflation is not well established. In this study, we investigated the optimal sequence for same-day BDE without polypectomy under moderate sedation and carbon dioxide insufflation in terms of sedation doses and colonoscopy performance. PATIENTS AND METHODS: We performed a prospective observational study of 63 asymptomatic patients who were admitted for physical check-ups...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Jeremiah Wasserlauf, Bradley P Knight, Zhi Li, Adin-Cristian Andrei, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Albert C Lin, Nishant Verma, Martha M Bohn, Rod S Passman
BACKGROUND: Cryoballoon ablation (CBA) for paroxysmal atrial fibrillation (pAF) can be performed under general anesthesia (GA) or moderate sedation (MS). Our objective was to compare the effectiveness, safety, procedure duration, and time spent in the electrophysiology (EP) laboratory for CBA performed under GA and MS. METHODS: . Patients undergoing a first CBA for pAF were identified. Patients received either GA administered by an anesthesiologist or MS with midazolam and fentanyl administered by EP laboratory staff...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
Abhyuday Kumar, Anita Seth, Smita Prakash, Mangilal Deganwa, Anoop Raj Gogia
BACKGROUND: The present study was undertaken to compare and evaluate the efficacy of intravenous (IV) fentanyl and lignocaine airway nebulization and a combination of both in attenuating the hemodynamic response to laryngoscopy and tracheal intubation. MATERIALS AND METHODS: Ninety-six patients of either sex aged between 18 and 65 years of age, belonging to the American Society of Anesthesiologists (ASA) health status Classes I and II, undergoing elective surgery requiring general anesthesia with endotracheal intubation were included in the study...
September 2016: Anesthesia, Essays and Researches
Umesh K Dash, S Kiran, Urvashi Tandon, Kavitha Jinjil
BACKGROUND: The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established. AIMS: This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia. SETTINGS AND DESIGN: A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital. MATERIALS AND METHODS: Sixty patients were divided randomly into two groups, Group C and Group F...
September 2016: Anesthesia, Essays and Researches
P Rani, V R Hemanth Kumar, M Ravishankar, T Sivashanmugam, R Sripriya, M Trilogasundary
BACKGROUND: Fentanyl and dexmedetomidine have been tried to attenuate airway and circulatory reflexes during emergence and extubation individually but have not been compared with respect to the level of sedation to evolve a reliable technique for rapid and smooth extubation. AIM: To compare the effects of fentanyl and dexmedetomidine in attenuating airway and circulatory reflexes during emergence and extubation of the endotracheal tube. SETTING AND DESIGN: This double-blind, randomized, controlled study was done in patients undergoing surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status 1 or 2...
September 2016: Anesthesia, Essays and Researches
Ejas P Bava, Rashmi Ramachandran, Vimi Rewari, Chandralekha, Virinder Kumar Bansal, Anjan Trikha
BACKGROUND: Transversus abdominis plane (TAP) block has been used to provide intra- and post-operative analgesia with single incision laparoscopic (SIL) bariatric and gynecological surgery with mixed results. Its efficacy in providing analgesia for SIL cholecystectomy (SILC) via the same approach remains unexplored. AIMS: The primary objective of our study was to compare the efficacy of bilateral TAP block with local anesthetic infiltration for perioperative analgesia in patients undergoing SILC...
September 2016: Anesthesia, Essays and Researches
Radhe Sharan, Rajan Verma, Akshay Dhawan, Jugal Kumar
BACKGROUND: Ropivacaine, a newer local anesthetic, is gaining increased acceptance due to its improved safety profile over bupivacaine and lignocaine. Analgesic adjuvants have proved to be valuable in improving the quality of anesthesia and duration of analgesia. AIM: To compare the efficacy of clonidine and fentanyl as adjuvants to ropivacaine in spinal anesthesia in lower abdominal surgeries. MATERIALS AND METHODS: A randomized, double-blind control study was carried out in 100 patients who were randomly divided into two groups...
September 2016: Anesthesia, Essays and Researches
Khaled Elbahrawy, Alaa El-Deeb
BACKGROUND: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. AIMS: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. SETTINGS AND DESIGN: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study...
September 2016: Anesthesia, Essays and Researches
Arvind Kumar, Ritesh Kumar, Vinod Kumar Verma, Chandrakant Prasad, Rajesh Kumar, Shashi Kant, Gunjan Kumar, Neha Singh, Rupam Kumari
INTRODUCTION: Opioids are widely used in conjunction with local anesthetics as they permit the use of lower dose of local anesthetics while providing adequate anesthesia and analgesia. It both provides adequate anesthesia as well as lower drug toxicity neuraxial administration of opioids in conjunction with local anesthetics improves the quality of intraoperative analgesia and prolongs the duration of postoperative analgesia. Bupivacaine is the most commonly used drug for subarachnoid block due to its lesser side effects...
September 2016: Anesthesia, Essays and Researches
Joginder Pal Attri, Reena Makhni, Savinder Sethi
BACKGROUND: Combined spinal-epidural analgesia has become the preferred technique for labor analgesia as it combines the benefits of both spinal analgesia and flexibility of epidural catheter. Study was carried out with the primary aim to compare levobupivacaine and ropivacaine with fentanyl in terms of onset and duration of sensory block and to know maternal and fetal outcome. MATERIALS AND METHODS: In a prospective randomized double-blind study, 60 primipara of the American Society of Anesthesiologists health status Class I and II with singleton pregnancy in active stage of labor were randomly allocated into two groups of 30 each...
September 2016: Anesthesia, Essays and Researches
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