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Morphine use in fractures

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https://www.readbyqxmd.com/read/29207772/comparison-of-pain-relief-from-different-intravenous-doses-of-ketorolac-after-reduction-of-mandibular-fractures
#1
Saeed Nezafati, Reza Khorshidi Khiavi, Seyyed Sina Mirinejhad, Dawood Aghamoh Ammadi, Milad Ghanizadeh
Introduction: Pain is an unpleasant feeling due to tissue destruction, which disturbs an individual's daily routines even at its lowest levels. The majority of surgeons and anaesthesiologists are increasingly trying to administer non-opioid analgesics because excessive use of opioids after surgery results in patient dissatisfaction. Aim: To evaluate the analgesic effect of intravenous injection of different doses of ketorolac at different intervals in patients undergoing surgery for unilateral fractures of the mandible...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29200140/evaluating-the-implementation-barriers-of-an-intranasal-fentanyl-pain-pathway-for-pediatric-long-bone-fractures
#2
Tamara Arnautovic, Kathryn Sommese, Paul C Mullan, Steven Barron Frazier, Turaj Vazifedan, Dana Erikson Ramirez
OBJECTIVES: This study aimed to assess physician comfort, knowledge, and implementation barriers regarding the use of intranasal fentanyl (INF) for pain management in patients with long-bone fractures in a pediatric emergency department (ED) with an INF pain pathway. METHODS: A retrospective chart review was conducted of patients, 3 to 21 years old, in our ED with an International Classification of Diseases-9th Revision code for a long-bone fracture from September 1, 2013, to August 31, 2015...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29196879/the-feasibility-of-physiologically-based-pharmacokinetic-modeling-in-forensic-medicine-illustrated-by-the-example-of-morphine
#3
Nadine Schaefer, Daniel Moj, Thorsten Lehr, Peter H Schmidt, Frank Ramsthaler
In forensic medicine, expert opinion is often required concerning dose and time of intake of a substance, especially in the context of fatal intoxications. In the present case, a 98-year-old man died 4 days after admission to a hospital due to a femur neck fracture following a domestic fall in his retirement home. As he had obtained high morphine doses in the context of palliative therapy and a confusion of his supplemental magnesium tablets with a diuretic by the care retirement home was suspected by the relatives, a comprehensive postmortem examination was performed...
December 1, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29189367/oxycodone-ingestion-patterns-in-acute-fracture-pain-with-digital-pills
#4
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Brittany Chapman, Kristin L Schreiber, Robert R Edwards, Adam W Carrico, Edward W Boyer
BACKGROUND: Opioid analgesics are commonly prescribed on an as-needed (PRN) basis for acute painful conditions. Uncertainty of how patients actually take PRN opioids, coupled with a desire to completely cover pain, leads to variable and overly generous opioid prescribing practices, resulting in a surplus of opioids. This opioid surplus becomes a source for diversion and nonmedical opioid use. Understanding patterns of actual opioid ingestion after acute painful conditions can help clinicians counsel patients on safe opioid use, and allow timely recognition and intervention when escalating opioid self-dosing occurs, to prevent tolerance and addiction...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29168404/impact-of-a-chronic-pain-management-pathway-on-opioid-administration-and-prescribing-in-an-emergency-department
#5
Caroline Pace, Sneha Shah, Amy X Zhang, Amy E Zosel
CONTEXT: Prescription opioid abuse and misuse is a significant public health crisis. In 2012, an opioid prescribing pathway for patients with chronic pain presenting to the Emergency Department (ED) was implemented. The objective of this study is to determine the impact of the pathway for administration of opioids in the ED as well as the prescribing of opioids for home use after discharge. METHODS: Retrospective pre- and post-intervention time series study of consecutive patients presenting to the ED with acute and chronic pain complaints before and after implementation of the pathway...
November 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29065039/opioid-prescribing-practices-by-orthopaedic-trauma-surgeons-after-isolated-femur-fractures
#6
Basem Attum, Andres Buitrago Rodriguez, Nichelle Harrison, Adam Evans, William Obremskey, Manish Sethi, Alex Jahangir
OBJECTIVE: The purpose of this retrospective study was to identify opioid prescribing practices, determine the number of morphine milliequivalents (MMEs) prescribed by orthopaedic/non-orthopaedic members to narcotic naive and previously exposed patients and provide narcotic prescribing recommendations. METHODS: Patients over 18 years old with an isolated femur fracture sustained between 2013 and 2015 were identified using the CPT code 27506. Prescribing information was obtained from the State Controlled Substance Monitoring Database (CSMD)...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29052225/peripheral-nerve-block-in-ankle-fracture-surgery-a-qualitative-study-of-patients-experiences
#7
M J Henningsen, R Sort, A M Møller, S F Herling
Peripheral nerve blocks are popular as a mode of anaesthesia for limb surgery and their beneficial effects are well documented in elective surgery. However, concerns have been raised about potential rebound pain outweighing the benefits in acute ankle fracture surgery. Furthermore, pain scores and morphine consumption do not provide a full picture, as pain is subjective. To evaluate the clinical usefulness of peripheral nerve blocks, we explored patients' expectations and experiences by means of semi-structured interviews analysed with systematic text condensation...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/28956669/prehospital-pain-management-disparity-by-age-and-race
#8
Hilary A Hewes, Mengtao Dai, N Clay Mann, Tanya Baca, Peter Taillac
IMPORTANCE: Historically, pain management in the prehospital setting, specifically pediatric pain management, has been inadequate despite many EMS (emergency medical services) transports related to traumatic injury with pain noted as a symptom. The National Emergency Services Information System (NEMSIS) database offers the largest national repository of prehospital data, and can be used to assess current patterns of EMS pain management across the country. OBJECTIVES: To analyze prehospital management of pain using NEMSIS data, and to assess if variables such as patient age and/or race/ethnicity are associated with disparity in pain treatment...
September 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28918661/comparable-postoperative-pain-levels-using-2-different-nerve-blocks-in-the-operative-treatment-of-displaced-intra-articular-calcaneal-fractures
#9
Siem A Dingemans, Kristian J de Ruiter, Merel F N Birnie, J Carel Goslings, Gan van Samkar, Tim Schepers
BACKGROUND: The aim of this study was to compare the postoperative pain levels in patients undergoing osteosynthesis of the calcaneus with either a popliteal nerve block or an ankle block. METHODS: A retrospective analysis of all consecutive patients undergoing operative fixation of a calcaneal fracture via a sinus tarsi approach between August 2012 and April 2017 in a single foot/ankle specialized center was performed. Single-shot popliteal blocks were placed using ultrasound guidance by an anesthesiologist while ankle blocks were placed by a foot/ankle specialized surgeon...
December 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28890120/fascia-iliaca-block-for-pain-control-in-hip-fracture-patients
#10
P Castillón, M Veloso, O Gómez, J Salvador, A Bartra, F Anglés
INTRODUCTION: Pain treatment for patients with hip fracture has been based on the use of nonsteroidal anti-inflammatories and opioid derived drugs. These medications have been associated with multiple adverse effects. Fascia iliaca block is a recent pain management alternative for these patients. The objective of this study was to evaluate the effectiveness of fascia iliaca block performed in the emergency room (ER) for patients over 65years of age with hip fracture. MATERIALS AND METHODS: A cohort of 216 patients, from January to December 2016, was studied prospectively...
November 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28828342/effect-of-intravenous-morphine-and-ketorolac-on-pain-control-in-long-bones-fractures
#11
Babak Masoumi, Behdad Farzaneh, Omid Ahmadi, Farhad Heidari
BACKGROUND: According to the lack of adequate studies on comparing the analgesic effect and complications of ketorolac with morphine in long bone fractures, this study aimed to compare the efficacy of ketorolac with morphine in patients referring to the Emergency Department with long bones damage and fracture. MATERIALS AND METHODS: In this clinical trial study, 88 patients with long bone fracture were selected randomly and divided into two groups. To scale the intensity of pain, visual analog scale (VAS) were used...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28780196/can-we-reduce-morphine-use-in-elderly-proximal-femoral-fracture-patients-using-a-fascia-iliac-block
#12
Al-Amin M Kassam, Anthony T Gough, Joanna Davies, Rathan Yarlagadda
Proximal femoral fractures are becoming increasingly common with an ageing population. Many patients have multiple comorbidities increasing their risk of opiate complications. 40 consecutive patients presenting with a proximal femoral fracture to a trauma centre in the UK were given either a Fascia Iliaca Block (FIB) with oral analgesia or just oral analgesia to control their pre-operative pain. Numeric pain scores and morphine consumption were used as outcome measures. Patients receiving a FIB had significant reduction in their pain scores compared to patients only receiving oral pain relief...
August 2, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28641968/femoral-nerve-catheters-improve-home-disposition-and-pain-in-hip-fracture-patients-treated-with-total-hip-arthroplasty
#13
Diren Arsoy, James I Huddleston, Derek F Amanatullah, Nicholas J Giori, William J Maloney, Stuart B Goodman
BACKGROUND: Opioids have been the mainstay of treatment in the physiologically young geriatric hip fracture patient undergoing total hip arthroplasty (THA). However opioid-related side effects increase morbidity. Regional anesthesia may provide better analgesia, while decreasing opioid-related side effects. The goal of this study was to examine the effect of perioperative continuous femoral nerve blockade with regards to pain scores, opioid-related side effects and posthospital disposition in hip fracture patients undergoing THA...
November 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28611877/emergency-department-pain-management-following-implementation-of-a-geriatric-hip-fracture-program
#14
Scott D Casey, Dane E Stevenson, Bryn E Mumma, Christina Slee, Philip R Wolinsky, Calvin H Hirsch, Katren Tyler
INTRODUCTION: Over 300,000 patients in the United States sustain low-trauma fragility hip fractures annually. Multidisciplinary geriatric fracture programs (GFP) including early, multimodal pain management reduce morbidity and mortality. Our overall goal was to determine the effects of a GFP on the emergency department (ED) pain management of geriatric fragility hip fractures. METHODS: We performed a retrospective study including patients age ≥65 years with fragility hip fractures two years before and two years after the implementation of the GFP...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28576901/anankle-trial-study-protocol-a-randomised-trial-comparing-pain-profiles-after-peripheral-nerve-block-or-spinal-anaesthesia-for-ankle-fracture-surgery
#15
Rune Sort, Stig Brorson, Ismail Gögenur, Ann Merete Møller
INTRODUCTION: Ankle fracture surgery is a common procedure, but the influence of anaesthesia choice on postoperative pain and quality of recovery is poorly understood. Some authors suggest a benefit of peripheral nerve block (PNB) in elective procedures, but the different pain profile following acute fracture surgery and the rebound pain on cessation of the PNB both remain unexplored. We present an ongoing randomised study aiming to compare primary PNB anaesthesia with spinal anaesthesia for ankle fracture surgery regarding postoperative pain profiles and quality of recovery...
June 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28389230/thick-cement-usage-in-percutaneous-vertebroplasty-for-malignant-vertebral-fractures-at-high-risk-for-cement-leakage
#16
R M Reyad, H Z Ghobrial, S M Hakim, R H Hashem, A Elsaman, M H Shaaban
PURPOSE: To assess the feasibility and safety of transpedicular percutaneous vertebroplasty (PVP) using thick bone cement in patients with intractable metastatic vertebral pain and at high risk for cement leakage. METHODS: Unilateral transpedicular PVP using firm bone cement was performed in 77 patients with intractable pain due to vertebral metastases in the thoracolumbar spine, who had one or more relative contraindication to PVP. Primary outcome measures were the severity of pain as assessed on a 100-mm visual analogue scale and daily morphine consumption...
October 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28327184/catestatin-vasostatin-cortisol-and-pain-assessments-in-dogs-suffering-from-traumatic-bone-fractures
#17
Thanikul Srithunyarat, Ragnvi Hagman, Odd V Höglund, Mats Stridsberg, Ulf Olsson, Jeanette Hanson, Chalermkwan Nonthakotr, Anne-Sofie Lagerstedt, Ann Pettersson
BACKGROUND: Traumatic bone fractures cause moderate to severe pain, which needs to be minimized for optimal recovery and animal welfare, illustrating the need for reliable objective pain biomarkers for use in a clinical setting. The objectives of this study were to investigate catestatin (CST) and vasostatin (VS) concentrations as two new potential biomarkers, and cortisol concentrations, scores of the short form of the Glasgow composite measure pain scale (CMPS-SF), and visual analog scale (VAS) in dogs suffering from traumatic bone fractures before and after morphine administration in comparison with healthy dogs...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28286861/nerve-stimulator-versus-ultrasound-guided-femoral-nerve-block-a-randomized-clinical-trial
#18
Arash Forouzan, Kambiz Masoumi, Hasan Motamed, Mohammad Reza Gousheh, Akram Rohani
INTRODUCTION: Pain control is the most important issue in emergency department management of patients with femoral bone fractures. The present study aimed to compare the procedural features of ultrasonography and nerve stimulator guided femoral nerve block in this regard. METHOD: In this randomized clinical trial, patients with proximal femoral fractures presenting to emergency department were randomly divided into two groups of ultrasonography or nerve stimulator guided femoral block and compared regarding success rate, procedural time, block time, and need for rescue doses of morphine sulfate, using SPSS 20...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28038991/local-infiltration-analgesia-with-ropivacaine-in-acute-fracture-of-thoracolumbar-junction-surgery
#19
C Swennen, S Bredin, C Eap, C Mensa, X Ohl, V Girard
STUDY DESIGN: Retrospective study. INTRODUCTION: Local infiltration analgesia is effective in many surgeries as knee arthroplasty, but the analgesic efficacy of local infiltration analgesia with ropivacaine in trauma spine surgery in T10 to L2 has not been clarified. We conducted a trial to assess the analgesic efficacy of intraoperative local infiltration analgesia (LIA) with ropivacaine. OBJECTIVE: The aim of the present study was to clarify the effect of intraoperative local infiltration analgesia with ropivacaine on postoperative pain for patients undergoing thoracolumbar junction fracture surgery...
April 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27847679/opioid-usage-during-admission-in-hip-fracture-patients-the-effect-of-the-continuous-femoral-nerve-block
#20
Ida Helsø, Christopher Jantzen, Jes Bruun Lauritzen, Henrik Løvendahl Jørgensen
INTRODUCTION: The aim of this study was to investigate whether there was a difference in opioid usage during admission for hip fracture patients with continuous femoral nerve block (cFNB) when compared to patients nonfemoral nerve block (nFNB). METHODS AND MATERIALS: Patients were identified from the local database on all hip fracture patients admitted to Bispebjerg University Hospital, Denmark. Four hundred fifty-six hip fracture patients were included during the period September 2008 to October 2010...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
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