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https://www.readbyqxmd.com/read/28103372/the-effect-of-epidural-levobupivacaine-and-fentanyl-on-stress-response-and-pain-management-in-patients-undergoing-percutaneous-nephrolithotomy
#1
A Ahiskalioglu, O Ahiskalioglu, A Dostbil, C Abdullah, A Megnet, M Celik, I Ilker, K Husnu
Objective: The perioperative stress response of patients who were scheduled to have percutaneous nephrolithotomy under epidural anaesthesia with opioids and local anaesthetics has not been investigated in detail yet. Our hypothesis is that the stress response following percutaneous nephrolithotomy can be lessened by epidural analgesia. Methods: A total of 48 patients, between 18-65 years of age and ASA I-II, for whom elective percutaneous nephrolithotomy was planned, were randomly divided into two groups namely: Group GA (n = 24): general anaesthesia by sevoflurane and fentanyl and postoperative intravenous PCA; Group GE (n = 24): epidural anaesthesia and general anaesthesia together with postoperative epidural analgesia (0...
March 14, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/28101968/defined-daily-doses-ddd-do-not-accurately-reflect-opioid-doses-used-in-contemporary-chronic-pain-treatment
#2
Suzanne Nielsen, Natasa Gisev, Raimondo Bruno, Wayne Hall, Milton Cohen, Briony Larance, Gabrielle Campbell, Marian Shanahan, Fiona Blyth, Nicholas Lintzeris, Sallie Pearson, Richard Mattick, Louisa Degenhardt
OBJECTIVE: To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. DESIGN: Descriptive, cross-sectional study, utilising a 7-day medication diary. SETTING: Community-based treatment settings, Australia. SUBJECTS: A sample of 1101 people prescribed opioids for chronic non-cancer pain. METHODS: Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week...
January 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28101697/predictors-of-the-usefulness-of-corticosteroids-for-cancer-related-fatigue-in-end-of-life-patients
#3
Yuko Kanbayashi, Toyoshi Hosokawa
BACKGROUND AND OBJECTIVES: Although some studies have examined the use of corticosteroids, their effectiveness in treating cancer-related fatigue (CRF) has yet to be established. Therefore, this retrospective study attempted to identify factors that would predict the usefulness of corticosteroids in treating CRF. METHODS: We examined 87 hospitalized end-of-life cancer patients who were given betamethasone for relief of CRF at our hospital between January 2008 and January 2014...
January 18, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28101342/pharmacodynamic-analysis-of-target-controlled-infusion-of-propofol-in-patients-with-hepatic-insufficiency
#4
Jing-Ru Pan, Jun Cai, Shao-Li Zhou, Qian-Qian Zhu, Fei Huang, Yi-Han Zhang, Xin-Jin Chi, Zi-Qing Hei
The effect of liver dysfunction on target-controlled infusion (TCI) of propofol remains poorly documented. The pharmacodynamic performance of propofol TCI was evaluated in a cohort of Chinese patients with hepatic insufficiency. Fifty-three patients with hepatic insufficiency were enrolled in the current prospective, observational study. Anesthesia was induced with propofol via TCI to a plasma concentration of 3 µg/ml. Following loss of consciousness (LOC), fentanyl and cisatracurium were administered. Pharmacodynamic parameters were recorded during TCI, including time to LOC, bispectral index (BIS), heart rate (HR) and blood pressure...
December 2016: Biomedical Reports
https://www.readbyqxmd.com/read/28100669/the-preventive-value-of-epidural-calcitonin-in-patients-with-lower-limb-amputation
#5
Ayman A Yousef, Amr M Aborahma
BACKGROUND:  Postamputation pain is highly prevalent after limb amputation with neuropathic nature; calcitonin may effectively relieve many neuropathic pain states. DESIGN:  Double-blind randomized multicenter study. SETTING:  Our study hypothesis is to evaluate the preventive value of epidural calcitonin on postoperative pain, grade of phantom pain, and the development of allodynia and hyperalgesia in patients undergoing lower limb amputation...
January 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28100519/paravertebral-block-in-paediatric-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-trials
#6
E A Page, K L Taylor
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100064/a-risk-stratifying-tool-to-facilitate-safe-late-stage-percutaneous-endoscopic-gastrostomy-in-als
#7
Alexander G Thompson, Victoria Blackwell, Rachael Marsden, Emma Millard, Clare Lawson, Annabel H Nickol, James E East, Kevin Talbot, Philip J Allan, Martin R Turner
BACKGROUND: The safety of percutaneous endoscopic gastrostomy (PEG) insertion in amyotrophic lateral sclerosis (ALS) patients with significant respiratory compromise has been questioned. OBJECTIVES: To review the characteristics of an ALS clinic patient cohort undergoing PEG, and the introduction of a risk stratification tool with procedural adaptations for higher-risk individuals. METHODS: Patients undergoing PEG insertion were analysed (n = 107)...
January 19, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28099291/transcutaneous-carbon-dioxide-measurements-in-women-receiving-intrathecal-morphine-for-cesarean-delivery-a-prospective-observational-study
#8
Jeanette R Bauchat, Robert McCarthy, Paul Fitzgerald, Stephen Kolb, Cynthia A Wong
BACKGROUND: Neuraxial morphine is the most commonly used analgesic technique after cesarean delivery. The incidence of respiratory depression is reported to be very low (0%-1.2%) in this patient population as measured by pulse oximetry and respiratory rates. However, hypercapnia may be a more sensitive measure of respiratory depression. In the current study, the incidence of hypercapnia events (transcutaneous CO2 [TcCO2] >50 mm Hg) for ≥2-minute duration was evaluated using the Topological Oscillation Search with Kinematical Analysis monitor in women who received intrathecal morphine for postcesarean delivery analgesia...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28096575/the-effect-of-epidural-dexmedetomidine-on-oxygenation-and-shunt-fraction-in-patients-undergoing-thoracotomy-and-one-lung-ventilation-a-randomized-controlled-study
#9
Prachi Kar, Padmaja Durga, Ramachandran Gopinath
BACKGROUND AND AIMS: Role of epidural dexmedetomidine in providing analgesia is well documented, but its effect on oxygenation and shunt fraction is not well established. We studied the hypothesis that epidural dexmedetomidine may improve oxygenation and shunt fraction during one-lung ventilation (OLV). MATERIAL AND METHODS: After taking Institutional Ethics Committee approval, sixty patients undergoing thoracotomy and OLV were randomized to receive epidural ropivacaine with saline (RS group) or epidural ropivacaine with dexmedetomidine (RD group)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096225/not-so-patchy-story-of-attempted-suicide%C3%A2-leading-to-24%C3%A2-hours-of-deep-sleep-and-survival
#10
Adam Joseph Trist, Hardeep Sahota, Lucy Williams
Here, we present a somewhat unusual suicide attempt where, despite an unbelievable overdose with transdermal fentanyl patches, the patient survived. The patient-a woman aged 70 years, who has suffered from chronic back pain despite starting transdermal fentanyl patches in 2007. The unconventional method of attempted suicide was based on online research into deaths from fentanyl patch toxicity. She had gradually accumulated 100 µg fentanyl patches from repeat prescriptions, applying 14 patches with fatal intent, alongside 2 45 mg mirtazapine tablets, and concurrent therapeutic doses of tramadol and morphine sulfate oral solution...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28095795/intrathecal-magnesium-sulfate-does-not-reduce-the-ed50-of-intrathecal-hyperbaric-bupivacaine-for-cesarean-delivery-in-healthy-parturients-a-prospective-double-blinded-randomized-dose-response-trial-using-the-sequential-allocation-method
#11
Fei Xiao, Wenping Xu, Ying Feng, Feng Fu, Xiaomin Zhang, Yinfa Zhang, Lizhong Wang, Xinzhong Chen
BACKGROUND: Addition of intrathecal magnesium sulfate to local anesthetics has been reported to potentiate spinal anesthesia and prolong analgesia in parturients. The current study was to determine whether intrathecal magnesium sulfate would reduce the dose of hyperbaric bupivacaine in spinal anesthesia with bupivacaine and sufentanil for cesarean delivery. METHODS: Sixty healthy parturients undergoing scheduled cesarean delivery were randomly assigned to receive spinal anesthesia with 0...
January 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28094477/effects-of-intravenous-lidocaine-dexmedetomidine-and-their-combination-on-the-postoperative-pain-and-recovery-of-bowel-function-in-patients-undergoing-abdominal-hysterectomy
#12
Si Q Xu, Yuan H Li, Shen B Wang, Sheng H Hu, Xia Ju, Jin B Xiao
BACKGROUND: Intravenous (IV) lidocaine and dexmedetomidine have been shown to decrease postoperative pain, reduce analgesic consumption and facilitate return of bowel function. We investigated whether lidocaine combined with dexmedetomidine infusion was superior in controlling pain and recovery of bowel function. METHODS: 240 women undergoing elective abdominal hysterectomy were randomly assigned into four groups: group CON received normal saline infusion, group LIDO received lidocaine infusion (1...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28088741/prevalence-and-correlates-of-fentanyl-contaminated-heroin-exposure-among-young-adults-who-use-prescription-opioids-non-medically
#13
Alexandria Macmadu, Jennifer J Carroll, Scott E Hadland, Traci C Green, Brandon D L Marshall
BACKGROUND: The rate of overdose deaths caused by fentanyl-contaminated heroin (FCH) use is increasing rapidly in the United States. We examined risk factors for exposure to FCH and experiences with FCH use among young adult non-medical prescription opioids (NMPO) users. METHODS: We analyzed data from the Rhode Island Young Adult Prescription Drug Study (RAPiDS), which enrolled young adults aged 18 to 29 reporting prior 30day NMPO use between January 2015 and February 2016...
January 6, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28079812/the-efficacy-of-elastomeric-patient-control-module-when-connected-to-a-balloon-pump-for-postoperative-epidural-analgesia-a-randomized-noninferiority-trial
#14
Myung Hwa Kim, Yon Hee Shim, Min-Soo Kim, Yang-Sik Shin, Hyun Joo Lee, Jeong Soo Lee
When considering the principles of a pain control strategy by patients, reliable administration of additional bolus doses is important for providing the adequate analgesia and improving patient satisfaction. We compared the efficacy of elastomeric patient-control module (PCM) with conventional PCM providing epidural analgesia postoperatively.A noninferiority comparison was used. Eighty-six patients scheduled for open upper abdominal surgery were randomized to use either an elastomeric or conventional PCM connected to balloon pump...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28077538/magnesium-sulphate-attenuates-acute-postoperative-pain-and-increased-pain-intensity-after-surgical-injury-in-staged-bilateral-total-knee-arthroplasty-a-randomized-double-blinded-placebo-controlled-trial
#15
H-J Shin, E-Y Kim, H-S Na, T K Kim, M-H Kim, S-H Do
BACKGROUND: We evaluated the effect of magnesium sulphate on increased pain in 44 patients undergoing staged bilateral total knee arthroplasty (TKA). METHODS: The magnesium group (n=22) and the control group (n=22) received magnesium sulphate and isotonic saline, respectively, throughout the surgery. Postoperative pain (visual analogue scale, VAS) at rest and the amounts of patient-controlled analgesia (PCA, fentanyl) and rescue analgesia (ketoprofen) administered during the first 48 h were compared between the two groups and within each group between the first and second TKA...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074831/rgs9-2-modulates-responses-to-oxycodone-in-pain-free-and-chronic-pain-states
#16
Sevasti Gaspari, Valeria Cogliani, Lefteris Manouras, Ethan M Anderson, Vasiliki Mitsi, Kleopatra Avrampou, Fiona B Carr, Venetia Zachariou
Regulator of G protein signalling 9-2 (RGS9-2) is a striatal enriched signal transduction modulator, known to play a critical role in the development of addiction-related behaviours following exposure to psychostimulants or opioids. RGS9-2 controls the function of several GPCRs, including dopamine and mu opioid (MOR) receptors. We previously showed that RGS9-2 complexes negatively control morphine analgesia, and promote the development of morphine tolerance. In contrast, RGS9-2 positively modulates the actions of other opioid analgesics, such as fentanyl and methadone...
January 11, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28072722/dexmedetomidine-prevent-postoperative-nausea-and-vomiting-on-patients-during-general-anesthesia-a-prisma-compliant-meta-analysis-of-randomized-controlled-trials
#17
Shenhui Jin, Dong Dong Liang, Chengyu Chen, Minyuan Zhang, Junlu Wang
BACKGROUND: Postoperative nausea and vomiting (PONV) is a frequent complication in postoperative period. The aim of this article was to evaluate the effect of dexmedetomidine on PONV. METHOD: RevMan 5.3 software was applied for performing statistic analysis. Twenty-four trials with 2046 patients were included. RESULTS: The PONV of the dexmedetomidine group was significantly lower compared with the placebo group (0.56, 95% CI: 0.46, 0.69). Subgroup analysis further confirmed the effect of dexmedetomidine (irrespective of administration mode) (P < 0...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068563/a-review-fentanyl-and-non-pharmaceutical-fentanyls
#18
REVIEW
Joji Suzuki, Saria El-Haddad
BACKGROUND: Fentanyl and non-pharmaceutical fentanyls (NPFs) have been responsible for numerous outbreaks of overdoses all over the United States since the 1970s. However, there has been a growing concern in recent years that NPFs are contributing to an alarming rise in the number of opioid-related overdoses. METHODS: The authors conducted a narrative review of the published and grey literature on fentanyl and NPFs in PubMed, Google Scholar, and Google using the following search terms: "fentanyl", "non-pharmaceutical fentanyl", "fentanyl analogs", "fentanyl laced heroin" and "fentanyl overdose"...
December 16, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28067707/dural-puncture-epidural-technique-improves-labor-analgesia-quality-with-fewer-side-effects-compared-with-epidural-and-combined-spinal-epidural-techniques-a-randomized-clinical-trial
#19
Anthony Chau, Carolina Bibbo, Chuan-Chin Huang, Kelly G Elterman, Eric C Cappiello, Julian N Robinson, Lawrence C Tsen
BACKGROUND: The dural puncture epidural (DPE) technique is a modification of the combined spinal epidural (CSE) technique, where a dural perforation is created from a spinal needle but intrathecal medication administration is withheld. The DPE technique has been shown to improve caudal spread of analgesia compared with epidural (EPL) technique without the side effects observed with the CSE technique. We hypothesized that the onset of labor analgesia would follow this order: CSE > DPE > EPL techniques...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28066970/implementation-of-a-pharmacist-led-patient-controlled-analgesia-dosing-service
#20
Alen L Dezia, Tim D Baccus, Allycia M Natavio, Sean M Conroy, Levi M Hall
PURPOSE: The development and implementation of a pharmacist-led patient controlled analgesia (PCA) dosing service in a large academic institution is described. SUMMARY: To improve pain management at our institution and expand pharmacy clinical services, a pharmacist-led PCA dosing service was developed and implemented. The service is modeled after established antimicrobial and anticoagulation dosing services at our institution. A core group of pharmacists (service leaders) and a pain physician champion developed a policy and guideline and designed electronic medical record (EMR) tools to support the service...
January 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
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