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Morphine use in fractures

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https://www.readbyqxmd.com/read/28890120/fascia-iliaca-block-for-pain-control-in-hip-fracture-patients
#1
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...
September 7, 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
#2
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
#3
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
#4
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...
June 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28611877/emergency-department-pain-management-following-implementation-of-a-geriatric-hip-fracture-program
#5
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
#6
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
#7
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...
April 4, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28327184/catestatin-vasostatin-cortisol-and-pain-assessments-in-dogs-suffering-from-traumatic-bone-fractures
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27704039/a-prospective-observational-cohort-study-on-orthopaedic-and-anaesthetic-registrars-performing-femoral-nerve-block-on-patients-with-an-acute-hip-fracture
#12
Åsa Thelaus, Tobias Pettersson, Max Gordon, Ferid Krupic, Olof Sköldenberg
We investigated if a femoral nerve block (FNB) for patients with a proximal femoral fracture (PFF) and administered by an orthopaedic registrar (OR) instead of an anaesthesiology registrar (AR) lowers the lead time to block and reduces the total amount of rescue analgesics during the preoperative phase. 205 patients were included in a prospective observational cohort study. The main outcome variable was rescue analgesics as total intravenous morphine prior to surgery. All results were adjusted for confounding using age, sex, cognitive dysfunction, and ASA classification...
2016: Surgery Research and Practice
https://www.readbyqxmd.com/read/27692801/risk-of-prolonged-opioid-use-among-opioid-na%C3%A3-ve-patients-following-common-hand-surgery-procedures
#13
Shepard P Johnson, Kevin C Chung, Lin Zhong, Melissa J Shauver, Michael J Engelsbe, Chad Brummett, Jennifer F Waljee
PURPOSE: To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. METHODS: We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients)...
September 7, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27658581/postoperative-analgesic-effect-of-preoperatively-administered-dexamethasone-after-operative-fixation-of-fractured-neck-of-femur-randomised-double-blinded-controlled-study
#14
Szilard Szucs, David Jessop, Gabriella Iohom, George D Shorten
BACKGROUND: Fractured neck of femur is a common cause of hospital admission in the elderly and usually requires operative fixation. In a variety of clinical settings, preoperative glucocorticoid administration has improved analgesia and decreased opioid consumption. Our objective was to define the postoperative analgesic efficacy of single dose of dexamethasone administered preoperatively in patients undergoing operative fixation of fractured neck of femur. METHODS: Institutional ethical approval was granted and written informed consent was obtained from each patient...
September 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27642581/effect-of-preoperative-oral-amantadine-on-acute-and-chronic-postoperative-pain-after-mandibular-fracture-surgery
#15
Javad Yazdani, Davood Aghamohamadi, Masoomeh Amani, Ali Hossein Mesgarzadeh, Davood Maghbooli Asl, Tannaz Pourlak
BACKGROUND: Postoperative pain from open reduction and internal fixation of mandibular fracture is a serious issue. Amantadine is an N-methyl-D-aspartic acid or N-methyl-D-aspartate (NMDA) receptor antagonist that can be effective against postoperative pain. OBJECTIVES: The present study examined the efficacy of amantadine in alleviating the postoperative pain of mandibular fracture surgery. PATIENTS AND METHODS: In this double-blind study, 60 patients (ASA physical status I-II) were randomly divided into two groups...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27609854/study-protocol-of-a-randomised-controlled-trial-of-intranasal-ketamine-compared-with-intranasal-fentanyl-for-analgesia-in-children-with-suspected-isolated-extremity-fractures-in-the-paediatric-emergency-department
#16
Stacy L Reynolds, Jonathan R Studnek, Kathleen Bryant, Kelly VanderHave, Eric Grossman, Charity G Moore, James Young, Melanie Hogg, Michael S Runyon
INTRODUCTION: Fentanyl is the most widely studied intranasal (IN) analgesic in children. IN subdissociative (INSD) ketamine may offer a safe and efficacious alternative to IN fentanyl and may decrease overall opioid use during the emergency department (ED) stay. This study examines the feasibility of a larger, multicentre clinical trial comparing the safety and efficacy of INSD ketamine to IN fentanyl and the potential role for INSD ketamine in reducing total opioid medication usage. METHODS AND ANALYSIS: This double-blind, randomised controlled, pilot trial will compare INSD ketamine (1 mg/kg) to IN fentanyl (1...
September 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27496317/clinical-concentrations-of-morphine-are-cytotoxic-on-proliferating-human-fibroblasts-in-vitro
#17
José Aguirre, Alain Borgeat, Melanie Hasler, Philipp Bühler, John M Bonvini
BACKGROUND: Morphine and other opioids are routinely used systemically and as wound infusions in the postoperative period. Their effect on wound and fracture healing remains unclear. OBJECTIVE: The primary outcome was to assess the potential cytotoxicity of clinically relevant concentrations of morphine on human fibroblasts. DESIGN: Laboratory in-vitro study. SETTING: Institute of Physiology, Zurich Center for Integrative Human Physiology, University of Zurich...
November 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27478111/opioid-use-among-metastatic-prostate-cancer-patients-with-skeletal-related-events
#18
Avin Yaldo, Lonnie Wen, Augustina Ogbonnaya, Adriana Valderrama, Jonathan Kish, Michael Eaddy, Charles Kreilick, Krishna Tangirala, Katarzyna Shields
PURPOSE: The development of skeletal-related events (SREs) (pathologic fracture, need for surgery and/or radiation to bone, spinal cord compression, and hypercalcemia of malignancy) in metastatic prostate cancer (MPC) is associated with worsened pain and compromised quality of life. Opioids are frequently used throughout the course of SRE treatment. This study describes the treatment patterns and incremental use of opioids in MPC patients diagnosed with SREs. METHODS: PC patients with bone metastases newly diagnosed with an SRE between January 1, 2005, and September 30, 2014, were identified using MarketScan Commercial and Medicare databases...
August 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27270854/posterior-paramedian-subrhomboidal-analgesia-versus-thoracic-epidural-analgesia-for-pain-control-in-patients-with-multiple-rib-fractures
#19
Casey L Shelley, Stepheny Berry, James Howard, Martin De Ruyter, Melissa Thepthepha, Niaman Nazir, Tracy McDonald, Annemarie Dalton, Michael Moncure
BACKGROUND: Rib fractures are common in trauma admissions and are associated with an increased risk of pulmonary complications, intensive care unit admissions, and mortality. Providing adequate pain control in patients with multiple rib fractures decreases the risk of adverse events. Thoracic epidural analgesia is currently the preferred method for pain control. This study compared outcomes in patients with multiple acute rib fractures treated with posterior paramedian subrhomboidal (PoPS) analgesia versus thoracic epidural analgesia (TEA)...
September 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27060632/evaluation-of-antinociceptive-activity-of-methanolic-extract-of-leaves-of-stephania-japonica-linn
#20
Md Moniruzzaman, Md Sarwar Hossain, Partha Sharoti Bhattacharjee
ETHNAPHARMACOLOGICAL RELEVANCE: Stephania japonica is a common plant, widely distributed in all over Bangladesh. Traditionally, this plant is considered as one of the important ingredients in treatment of a variety of ailments including inflammation, pain, rheumatism, cancer, bone fracture, fever etc. However, the scientific reports regarding the antinociceptive effect of this plant are very limited. This study evaluated the antinociceptive effect of methanolic extract of S. japonica (MESJ) leaves...
June 20, 2016: Journal of Ethnopharmacology
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