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https://www.readbyqxmd.com/read/29471504/anodyne-by-design-measuring-the-prevalence-of-esoteric-designer-opioids-in-pain-management-patients
#1
Melissa M Goggin, Stephanie D Gozum, Anna Miller, Gregory C Janis
The recent increase in illicit opioids sold on the black market, cut into heroin and masqueraded as prescription pills prompts a significant public health concern. Most designer opioids possess unknown potencies and unknown pharmacokinetics and their unregulated, variable dosages lead to rashes of overdoses. Additionally, many of the designer opioids, especially the fentanyl analogs are significantly more potent than heroin. High-profile cases involving overdoses of U-47700 and carfentanil have been reported in the media; however, the true prevalence of these and other designer opioids is unknown...
February 17, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29470801/episodic-breathlessness-in-patients-with-advanced-cancer-characteristics-and-management
#2
REVIEW
Sebastiano Mercadante
The aim of this review is to present the way in which episodic breathlessness (EB) has been recognized over the years, with regard to definition, characteristics, and management of these acute episodes that have serious consequences for patients. EB is characterized by a sudden increase in intensity of dyspnea over a short duration of time, leading to high levels of anxiety. A significant aggravation of dyspnea may occur in patients with a background of dyspnea or intermittently even without basal breathlessness...
February 22, 2018: Drugs
https://www.readbyqxmd.com/read/29468508/ultrasound-guided-bilateral-superficial-cervical-block-and-preemptive-single-dose-oral-tizanidine-for-post-thyroidectomy-pain-a-randomized-controlled-double-blind-study
#3
Ali Ahiskalioglu, Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Aysenur Dostbil, Omer Doymus, Erdem Karadeniz, Muhammet Ali Ari, Furkan Sengoz, Haci Ahmet Alici, Erkan Cem Celik
PURPOSES: The postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery. METHODS: Sixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C, n = 20) received BSCPB with 0...
February 21, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29465247/viability-of-single-balloon-enteroscopy-performed-under-endoscopist-directed-sedation
#4
Leopoldo López Rosés, Beatriz Álvarez, Abel González Ramírez, Alina López Baz, Alexia Fernández López, Sara Alonso, Andrés Dacal, Eva Martí, Gino Albines, Julieta Fernández Molina, Ángel Lancho
INTRODUCTION: there is a lot of controversy with regard to who should be responsible for sedation during digestive endoscopy, particularly in advanced procedures that require deep sedation such as enteroscopy. The aim of this study was to evaluate the endoscopist-directed sedation viability during single balloon enteroscopy. MATERIAL AND METHOD: this was a prospective, observational study of a series of consecutive enteroscopies. The clinical staff included an endoscopist, scrub nurse and a nurse in charge of monitoring and sedative administration...
February 21, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29460263/methadone-as-anticancer-treatment-hype-hope-or-hazard-a-series-of-case-reports-and-a-short-review-of-the-current-literature-and-recommendations-of-the-societies
#5
Gudrun Kreye, Eva-Katharina Masel, Klaus Hackner, Beate Stich, Friedemann Nauck
Recently, the use of methadone in cancer patients has increased due to in vitro studies indicating that methadone is capable of inducing cell death. However, thus far there are no relevant clinical studies indicating that the use of methadone can prolong survival in cancer patients. Based on low-quality evidence, methadone is a drug that has similar analgesic benefits to morphine and has a role in the management of cancer pain in adults. Other opioids such as morphine, hydromorphone, and fentanyl are easier to manage but may be more expensive than methadone in many economies...
February 19, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29459328/risk-of-fentanyl-involved-overdose-among-those-with-past-year-incarceration-findings-from-a-recent-outbreak-in-2014-and-2015
#6
Lauren Brinkley-Rubinstein, Alexandria Macmadu, Brandon D L Marshall, Andrew Heise, Shabbar I Ranapurwala, Josiah D Rich, Traci C Green
Overdose is the leading cause of unintentional injury-related death. Rhode Island (RI) has the highest rate of illicit drug use nationally and the 5th highest overdose mortality rate. RI has experienced an outbreak of fentanyl-related overdoses. In incarcerated populations, risk of overdose is greatly elevated. However, little is known about fentanyl-related overdose post-release. In the current analyses, we identify changes in fentanyl-related fatal overdose among those who died in 2014 and 2015 who were incarcerated in the year before death...
February 9, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29458790/non-pharmacological-interventions-and-non-fentanyl-pharmacological-treatments-for-breakthrough-cancer-pain-a-systematic-and-critical-review
#7
REVIEW
Sebastiano Mercadante
BACKGROUND: Oral opioids or other pharmacological or non-pharmacological interventions are often suggested in the management of breakthrough cancer pain (BTcP). The aim of this systematic and critical review was to analyse and critically comment the evidence of any non-fentanyl therapies proposed for BTcP. METHODS: A systematic literature search was carried out to find studies providing clinical data on any treatment excluding fentanyl products. RESULTS: No data exist about the use of oral opioids...
February 2018: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/29457123/general-anesthesia-with-propofol-for-ovarian-teratoma-excision-associated-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#8
Masami Sato, Hiroaki Yasumoto, Toshiyuki Arai
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder caused by production of anti-NMDAR antibodies that is often associated with ovarian teratoma and exhibits various manifestations including psychiatric symptoms, seizures, hypoventilation, and autonomic nerve instability. Patients with this disorder who receive early surgical tumor resection along with immunotherapy have better outcome than the rest of the patients. To establish an anesthetic plan, it is important to understand the pharmacological interaction between the anesthetic agents and the disabled NMDAR, because NMDAR is one of the major sites of action for commonly-used anesthetic agents...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29455092/internet-pseudoscience-testing-opioid-containing-formulations-with-tampering-potential
#9
Jennifer P Pascali, Paolo Fais, Fabio Vaiano, Nicola Pigaiani, Stefano D'Errico, Sandra Furlanetto, Diego Palumbo, Elisabetta Bertol
Drug tampering practices, with the aim to increase availability of drug delivery and/or enhance drug effects, are accessible on Internet and are practiced by some portion of recreational drug users. Not rarely, recreational misuse may result in toxic and even fatal results. The aim of the present study was to assess the tampering risk of medicaments containing different formulations of an opioid in combination with paracetamol or dexketoprofen, following the procedures reported in dedicated forums on the web...
February 10, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29451660/economic-assessment-of-postoperative-pain-control-strategies-for-treatment-of-adult-patients-with-cancer
#10
Rafael Freitas Dos Santos, Fernando Bliacheriene, Flavia Mori Sarti
OBJECTIVE: The authors performed an economic assessment of opioids currently being used for control of postoperative pain relating to the surgical treatment of cancer (fentanyl and sufentanil) within the Brazilian Unified Health System (SUS, in the Portuguese acronym). METHOD: The assessment was based on the perspective of the government, in order to collaborate with the promotion of effectiveness in public policies of health, and to optimize the allocation of public resources into health...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29450305/the-grimace-scale-reliably-assesses-chronic-pain-in-a-rodent-model-of-trigeminal-neuropathic-pain
#11
Titilola Akintola, Charles Raver, Paige Studlack, Olivia Uddin, Radi Masri, Asaf Keller
The limited success in translating basic science findings into effective pain management therapies reflects, in part, the difficulty in reliably assessing pain in experimental animals. This shortcoming is particularly acute in the field of chronic, ongoing pain. Quantitative analysis of facial expressions-the grimace score-was introduced as a promising tool, however, it is thought to reliably assess only pain of short or medium duration (minutes to hours). Here, we test the hypothesis that grimace scores are a reliable metric of ongoing neuropathic pain, by testing the prediction that chronic constriction injury of the infraorbital nerve (CCI-ION) will evoke significant increases in grimace scale scores...
August 2017: Neurobiology of Pain
https://www.readbyqxmd.com/read/29449944/dexmedetomidine-use-during-epiduroscopy-reduces-fentanyl-use-and-postoperative-nausea-and-vomiting-a-single-center-retrospective-study
#12
Takashi Suzuki, Ryota Inokuchi, Kazuo Hanaoka, Machi Suka, Hiroyuki Yanagisawa
Objectives: Minimally invasive epiduroscopy has recently been reported as an effective treatment procedure for chronic and intractable low back pain. However, no study has determined safe anesthetics for monitored anesthesia care during epiduroscopy. We aimed to compare and evaluate conventional monitored anesthesia care drugs with dexmedetomidine. Methods: A retrospective study including all patients who underwent epiduroscopy at the JR Tokyo General Hospital from April 2011 to March 2016 was designed...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29448876/evaluation-of-injectable-anaesthesia-with-five-medetomidine-midazolam-based-combinations-in-egyptian-fruit-bats-rousettus-aegyptiacus
#13
Avishag Tuval, Liora Las, Yael Shilo-Benjamini
Egyptian fruit bats are increasingly used as model animals in neuroscience research. Our aim was to characterize suitable injectable anaesthesia for this species, possibly replacing inhalant anaesthesia, thus minimizing occupational health hazards. Eight bats were randomly assigned by a crossover design for subcutaneously administered combinations of medetomidine-midazolam with: saline (MM-Sal), ketamine (MM-Ket), fentanyl (MM-Fen), morphine (MM-Mor), or butorphanol (MM-But). The anaesthetic depth and vital signs were monitored at baseline and every 10 min until bats recovered...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29447999/late-heartbeat-evoked-potentials-are-associated-with-survival-after-cardiac-arrest
#14
André Schulz, Pascal Stammet, Angelika M Dierolf, Claus Vögele, Stefan Beyenburg, Christophe Werer, Yvan Devaux
RATIONALE: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication. The aim of this study was to address the association between HEPs and survival after CA. METHODS: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 hours after resuscitation...
February 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29443860/a-novel-rat-model-of-extremity-trauma-for-pre-hospital-pain-management-research
#15
Lusha Xiang, Harold G Klemcke, Nathan A Wienandt, Kathy L Ryan, Carmen Hinojosa-Laborde
BACKGROUND: Pain management is important in pre-hospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for pre-hospital pain research, and validate it using pain behaviors and analgesics. METHODS: Rats were anesthetized using isoflurane and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 sec, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency, PWL), mechanical allodynia (paw withdrawal pressure, PWP), and weight bearing (WB) were determined before and 90 minutes after ET...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#16
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29441176/intravenous-lidocaine-infusions-for-48-hours-in-open-colorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#17
Matthew Liang Jinn Ho, Stephen John Kerr, Jennifer Stevens
Background: Although intravenous (i.v.) lidocaine is used as a perioperative analgesic in abdominal surgery, evidence of efficacy is limited. The infusion dose and duration remain unclear. This study aimed to investigate the effect of a longer low-dose 48-hour infusion regimen on these outcomes. Methods: Fifty-eight adults undergoing elective open colorectal surgery were randomized into the lidocaine group (1.5 mg/kg bolus followed by 1 mg/kg/h infusion for 48 hours) and control group...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29441174/comparison-of-propofol-alone-and-in-combination-with-ketamine-or-fentanyl-for-sedation-in-endoscopic-ultrasonography
#18
Shweta A Singh, Kelika Prakash, Sandeep Sharma, Gaurav Dhakate, Vikram Bhatia
Background: We evaluated whether the addition of a small dose of ketamine or fentanyl would lead to a reduction in the total dose of propofol consumed without compromising the safety and recovery of patients having endoscopic ultrasonography (EUS). Methods: A total of 210 adult patients undergoing elective EUS under sedation were included in the study. Patients were randomized into three groups. Patients were premedicated intravenously with normal saline in group 1, 50 µg fentanyl in group 2, and 0...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29440467/fentanyl-lozenge-story-part-2-from-military-procurement-to-package
#19
REVIEW
Edward Rogers, C Wright, P King
This paper describes the selection of fentanyl as a replacement for morphine as the United Kingdom Ministry of Defence's first-line battlefield analgesic agent. It is a detailed review of the 6 year journey from selection to eventual roll-out in October 2017. It concentrates on the procurement and governance process of the deployment of fentanyl for individual issue and self-use. It highlights the significant differences in military and civilian legislation, the specialist environment we work in and the safety concerns surrounding controlled drugs in the austere environment...
February 12, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29432946/postoperative-cerebral-infarction-risk-factors-and-postoperative-management-of-pediatric-moyamoya-disease-patients
#20
Shinsuke Muraoka, Yoshio Araki, Goro Kondo, Michihiro Kurimoto, Yoshiki Shiba, Kenji Uda, Shinji Ota, Sho Okamoto, Toshihiko Wakabayashi
OBJECT: Though revascularization surgery for moyamoya disease patients can effectively prevent ischemic events and thus improve the long-term clinical outcome, the incidence of postoperative ischemic complications affects patients' quality of life. This study aimed to clarify the risk factors associated with postoperative ischemic complications and to discuss the appropriate perioperative management. METHODS: Fifty-eight revascularization operations were performed in 37 children with moyamoya disease...
February 9, 2018: World Neurosurgery
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