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Analgesia

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https://www.readbyqxmd.com/read/29346247/concurrent-versus-sequential-intrapleural-instillation-of-tissue-plasminogen-activator-and-deoxyribonuclease-for-pleural-infection
#1
Fayez Kheir, George Cheng, Estefania Rivera, Alejandro Folch, Erik Folch, Fernandez-Bussy Sebastian, Colleen Keyes, Mihir Parikh, Colleen Channick, Alex Chee, Adnan Majid
BACKGROUND: Treatment of pleural infection with instillation of sequential intrapleural tissue plasminogen activator (tPA) and human recombinant deoxyribonuclease (DNase) twice daily for a total of 6 doses has been shown to decrease surgical referral and improve radiographic imaging. This labor-intensive regimen was empirically chosen. Thus, it remains unclear whether the 2 drugs can be administered immediately one after the other (concurrent administration) instead of instilling them separately with a 1-hour to 2-hour interval in between (sequential administration)...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29346231/the-complex-association-of-race-ethnicity-with-pain-treatment-quality-in-an-urban-medical-center-with-2-pediatric-emergency-departments
#2
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346228/analgesia-of-combined-femoral-triangle-and-obturator-nerve-blockade-is-superior-to-local-infiltration-analgesia-after-total-knee-arthroplasty-with-high-dose-intravenous-dexamethasone
#3
Charlotte Runge, Jan Mick Jensen, Louise Clemmesen, Henriette Bach Knudsen, Carsten Holm, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: High-dose intravenous dexamethasone reduces the postoperative opioid requirement and is often included in the multimodal analgesia strategy after total knee arthroplasty (TKA). Combined obturator nerve and femoral triangle blockade (OFB) reduces the opioid consumption and pain after TKA better than local infiltration analgesia (LIA). The question is whether preoperative high-dose intravenous dexamethasone would cancel out the superior analgesic effect of OFB compared with LIA...
January 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29345594/should-stemi-patients-receive-opiate-analgesia-the-morphine-paradox
#4
Mohamed Farag, Nikolaos Spinthakis, Manivannan Srinivasan, Diana Adrienne Gorog
BACKGROUND: The very significant benefit of P2Y12 receptor inhibitor administration in patients with ST-elevation myocardial infarction (STEMI), in reducing future ischaemic events and stent thrombosis, is undisputed. Morphine analgesia is very frequently co-administered to these patients for pain relief, along with antiplatelet therapy, at the time of presentation, and prior to reperfusion with primary percutaneous coronary intervention. METHODS: Research and online content related to opiates use in STEMI was reviewed...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344736/predictors-of-analgesic-efficacy-of-neurolytic-celiac-plexus-block-in-patients-with-unresectable-pancreatic-cancer-the-importance-of-timing
#5
Duck Mi Yoon, Kyung Bong Yoon, In Chan Baek, Seo Hee Ko, Shin Hyung Kim
BACKGROUND: Neurolytic celiac plexus block (NCPB) is a safe and effective method for reducing abdominal cancer pain. However, the analgesic efficacy of NCPB is not always guaranteed. The aim of this retrospective study was to identify predictors for the analgesic efficacy of NCPB in patients with unresectable pancreatic cancer. METHODS: Patients with unresectable pancreatic cancer who underwent NCPB from 2006 to 2015 were enrolled. Good analgesia after NCPB was defined as ≥ 50% reduction in pain score at day 30...
January 17, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29343983/does-transcutaneous-electrical-nerve-stimulation-reduce-pain-and-improve-quality-of-life-in-patients-with-idiopathic-chronic-orchialgia-a-randomized-controlled-trial
#6
Sayed A Tantawy, Dalia M Kamel, Walid Kamal Abdelbasset
Background: Chronic orchialgia is defined as testicular pain, which may be either unilateral or bilateral, lasting for more than 3 months. It disturbs a patient's daily activities and quality of life (QoL), inciting the patient to search for treatments to alleviate the pain. It is estimated that 25% of chronic orchialgia cases are idiopathic. Purpose: The purpose of this study was to investigate how effective transcutaneous electrical nerve stimulation (TENS) is in pain reduction and how it consequently affects the QoL in patients with idiopathic chronic orchialgia (ICO)...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29343477/role-of-asic3-nav1-7-and-nav1-8-in-electroacupuncture-induced-analgesia-in-a-mouse-model-of-fibromyalgia-pain
#7
Liang-Ta Yen, Yu-Chan Hsu, Jaung-Geng Lin, Ching-Liang Hsieh, Yi-Wen Lin
BACKGROUND: The mechanisms underlying fibromyalgia (FM) pain are not understood. The US Food and Drug Administration has recommended three drugs for treating FM-namely, pregabalin, duloxetine and milnacipran; however, these medications are associated with severe side effects. OBJECTIVE: To create a mouse model of FM pain using dual injections of acidic saline to cause mechanical hyperalgesia and test whether ASIC3, Nav1.7 and Nav1.8 are involved in this process and whether electroacupuncture (EA) can reverse these phenomena...
January 17, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29343448/optimizing-the-dose-of-local-infiltration-analgesia-and-gabapentin-for-total-knee-arthroplasty-a-randomized-single-blind-trial-in-128-patients
#8
Maurik H M van Haagen, Hennie Verburg, Brechtje Hesseling, Lauri Coors, Nick T van Dasselaar, Pim N J Langendijk, Nina M C Mathijssen
BACKGROUND AND PURPOSE: Effective analgesia is essential for postoperative recovery and rehabilitation in TKA. The challenge of analgesic regimes is to obtain adequate pain relief and maximum muscle control to mobilize and rehabilitate patients early. However, the optimal dose and best composition are not known. We hypothesized that there would be no differences in reported postoperative pain on the day of the TKA surgery as well as the first day after surgery when different combinations of ropivacain for LIA and gabapentin are given...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29343049/the-ultrasound-guided-mid-point-transverse-process-to-pleura-block-for-postoperative-analgesia-in-video-assisted-thoracoscopic-surgery
#9
Paolo Scimia, Pierfrancesco Fusco, Andrea Droghetti, Fabiola Harizaj, Erika Basso Ricci
No abstract text is available yet for this article.
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29340809/randomized-controlled-study-of-intraincisional-infiltration-versus-intraperitoneal-instillation-of-standardized-dose-of-ropivacaine-0-2-in-post-laparoscopic-cholecystectomy-pain-do-we-really-need-high-doses-of-local-anesthetics-time-to-rethink
#10
Singh Mathuria Kaushal-Deep, Afzal Anees, Shehtaj Khan, Mohammad Amanullah Khan, Mehershree Lodhi
BACKGROUND: Earlier studies done to compare the efficacy of use of local anesthetics at intraperitoneal location versus intraincisional use had utilized equal amount of drugs at the two locations, usually 10-20 ml. Using this large amount of drug in the small space of intraincisional location as compared to similar amount of drug in large intraperitoneal space created an inadvertent bias in favor of patients receiving the drug intraincisionally so these patients naturally experienced less pain...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29339657/the-practical-management-of-chronic-pancreatitis-a-multidisciplinary-symposium-held-at-the-annual-meeting-of-the-pancreatic-society-of-great-britain-and-ireland-manchester-2016
#11
Santhalingam Jegatheeswaran, Joanne M Puleston, Sinead Duggan, Andrew Hart, Kevin C Conlon, Ajith K Siriwardena
AIM: This study is about a questionnaire survey of delegates attending the chronic pancreatitis symposium at the 2016 meeting of the Pancreatic Society of Great Britain and Ireland and seeks a multidisciplinary "snapshot" overview of practice. METHODS: A questionnaire was developed with multidisciplinary input. Questions on access to specialist care, methods of diagnosis and treatment including specific scenarios were incorporated. Eighty-three (66%) of 125 delegates effectively participated in this survey...
January 16, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29338151/oral-prolonged-release-oxycodone-naloxone-offers-equivalent-analgesia-to-intravenous-morphine-patient-controlled-analgesia-after-total-knee-replacement-a-randomized-controlled-trial
#12
Alberto Manassero, Andrea Fanelli, Susanna Ugues, Cristian Bailo, Stefano Dalmasso
BACKGROUND: The purpose of this study was to determine whether oral prolonged- release oxycodone-naloxone combination (OXN) could provide equivalent analgesia and a side-effect profile similar to intravenous morphine patient-controlled analgesia (IVPCA) for the control of pain in the immediate postoperative period after total knee replacement (TKR). METHODS: All patients received a sciatic nerve block with 0.3% ropivacaine 15ml, femoral nerve block with 0.5% ropivacaine 20 ml, spinal anesthesia and postoperative continuous femoral nerve infusion (ropivacaine 0...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29338150/the-role-of-cannabinoids-in-pain-control-the-good-the-bad-and-the-ugly
#13
Joseph V Pergolizzi, Jo Ann Lequang, Robert Taylor, Robert B Raffa, Daniel Colucci
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29338142/patient-controlled-epidural-analgesia-with-and-without-basal-infusion-using-ropivacaine-0-15-and-fentanyl-2%C3%AE-ml-for-labour-analgesia-a-prospective-comparative-randomised-trial
#14
Paraskevi K Matsota, Kalliopi H Drachtidi, Chrysanthi Z Batistaki, Agathi V Karakosta, Ioanna C Koukopoulou, Eugenia I Koursoumi, Georgia G Kostopanagiotou
BACKGROUND: Patient-Controlled Epidural Analgesia (PCEA) is a common practice for labour pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labour analgesia. METHODS: Fifty two parturients were randomly allocated to receive ropivacaine 0.15% and fentanyl 2γ/mL via a PCEA device either as a background infusion of 5mL/h plus 5mL demand bolus doses with 10 min lockout (group B/D, n=26) or as only demand bolus doses of 5mL with 10 min lockout (group D, n=26)...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29338141/comparison-of-the-efficacy-of-femoral-nerve-block-and-fascia-iliaca-compartment-block-in-patients-with-total-knee-replacement
#15
Hasan Kanadli, Serkan Dogru, Tuğba Karaman, Serkan Karaman, Hakan Tapar, Aynur Şahin, Murat Aşçi, Keriman A Kanadli, Mustafa Süren
BACKGROUND: Blocking the femoral nerve reduces postoperative pain and analgesic consumption in patients who have undergone total knee and hip replacement surgery. A limited number of studies have compared the efficacy of the fascia iliaca compartment and femoral nerve block techniques. Therefore, this study aimed to investigate the analgesic effectiveness of fascia iliaca compartment block and femoral nerve block using ultrasound. METHODS: A total of 100 patients were included in the study...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29337220/botaf-a-new-buthus-occitanus-tunetanus-scorpion-toxin-produces-potent-analgesia-in-rodents
#16
Riadh Maatoug, Jed Jebali, Régis Guieu, Michel De Waard, Riadh Kharrat
This work reports the purification of new potent scorpion neuropeptide, named BotAF, by an activity-guided screening approach. BotAF is a 64-residue long-chain peptide that shares very high similarity with the original β-like scorpion toxin group, in which several peptides have been characterized to be anti-nociceptive in rodents. BotAF administration to rodents does not produce any toxicity or motor impairment, including at high doses. In all models investigated, BotAF turned out to be an efficient peptide in abolishing acute and inflammatory (both somatic and visceral) pain in rodents...
January 11, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29337008/ice-pack-induced-perineal-analgesia-after-spontaneous-vaginal-birth-randomized-controlled-trial
#17
Adriana Amorim Francisco, Sonia Maria Junqueira Vasconcellos De Oliveira, Mary Steen, Moacyr Roberto Cuce Nobre, Eder Viana De Souza
BACKGROUND: Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy. AIMS: To evaluate if a 10min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2h. METHODS: A randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6-24h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10min or standard care...
January 11, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29336964/continuous-erector-spinae-plane-esp-block-for-postoperative-analgesia-after-minimally-invasive-mitral-valve-surgery
#18
Felipe Muñoz Leyva, Wilman E Mendiola, Antonio J Bonilla, Javier Cubillos, Diego A Moreno, Ki Jinn Chin
No abstract text is available yet for this article.
December 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29336785/the-erector-spinae-plane-block-in-4-cases-of-video-assisted-thoracic-surgery
#19
J C Luis-Navarro, M Seda-Guzmán, C Luis-Moreno, J L López-Romero
Multimodal anaesthesia, combining epidural catheter and general anaesthesia, is a common technique in thoracic surgery, however, epidural catheter placement is not always possible. Recently, erector spinae plane block has been described, which provides analgesia like that of the epidural block, although unilateral, and which has been used in various procedures at thoracic level. At present, there are no studies comparing the efficacy or safety of this block with those commonly used in thoracic surgery. However, its safety profile and contraindications seem different from those of the epidural catheter, since its placement is done under ultrasound view, the needle introduction is done in plane and the ultrasound target, the transverse process, is easily identifiable and is relatively remote from major neural or vascular structures and the pleura...
January 11, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29335811/surgical-stress-response-and-promotion-of-metastasis-in-colorectal-cancer-a-complex-and-heterogeneous-process
#20
Corina Behrenbruch, Carolyn Shembrey, Sophie Paquet-Fifield, Christina Mølck, Hyun-Jung Cho, Michael Michael, Benjamin N J Thomson, Alexander G Heriot, Frédéric Hollande
Surgery remains the curative treatment modality for colorectal cancer in all stages, including stage IV with resectable liver metastasis. There is emerging evidence that the stress response caused by surgery as well as other perioperative therapies such as anesthesia and analgesia may promote growth of pre-existing micro-metastasis or potentially initiate tumor dissemination. Therapeutically targeting the perioperative period may therefore reduce the effect that surgical treatments have in promoting metastases, for example by combining β-adrenergic receptor antagonists and cyclooxygenase-2 (COX-2) inhibitors in the perioperative setting...
January 15, 2018: Clinical & Experimental Metastasis
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