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Analgesic combination

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https://www.readbyqxmd.com/read/28526156/essential-elements-of-multimodal-analgesia-in-enhanced-recovery-after-surgery-eras-guidelines
#1
REVIEW
Anair Beverly, Alan D Kaye, Olle Ljungqvist, Richard D Urman
Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS)...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525981/combination-of-gabapentin-and-ramosetron-for-the-prevention-of-postoperative-nausea-and-vomiting-after-gynecologic-laparoscopic-surgery-a-prospective-randomized-comparative-study
#2
Kyung Mi Kim, Jin Huh, Soo Kyung Lee, Eun Young Park, Jung Min Lee, Hyo Ju Kim
BACKGROUND: As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. METHODS: One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0...
May 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#3
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525509/analgesic-choice-in-management-of-rib-fractures-paravertebral-block-or-epidural-analgesia
#4
Mahdi Malekpour, Ammar Hashmi, James Dove, Denise Torres, Jeffrey Wild
BACKGROUND: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). METHODS: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28515517/a-clinical-comparison-between-0-5-levobupivacaine-and-0-5-levobupivacaine-with-dexamethasone-8-mg-combination-in-brachial-plexus-block-by-the-supraclavicular-approach
#5
Nibedita Pani, Sidharth Sraban Routray, Debasis Mishra, Basant Kumar Pradhan, Bishnu Prasad Mohapatra, Deepti Swain
BACKGROUND AND AIMS: Dexamethasone as an adjuvant to bupivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, the effect of dexamethasone (8 mg) when added to levobupivacaine has not been well studied. This study was conducted to find out analgesic efficacy of dexamethasone as adjuvant to levobupivacaine in SCBP block. METHODS: Ultrasound- guided SCBP block was given to sixty patients, randomly assigned into two groups...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515426/tolerability-of-opioid-analgesia-for-chronic-pain-a-network-meta-analysis
#6
Zengdong Meng, Jing Yu, Michael Acuff, Chong Luo, Sanrong Wang, Lehua Yu, Rongzhong Huang
Aim of this study was to study the tolerability of opioid analgesia by performing a network meta-analysis (NMA) of randomized-controlled trials (RCTs) which investigated effectiveness of opioids for the management of chronic pain. Research articles reporting outcomes of RCT/s comparing 2 or more opioid analgesics for the management of chronic pain were obtained by database search. Bayesian NMAs were performed to combine direct comparisons between treatments with that of indirect simulated evidence. Study endpoints were: incidence of adverse events, incidence of constipation, trial withdrawal rate, and patient satisfaction with treatment...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28511406/effect-of-sodium-valproate-and-docosahexaenoic-acid-on-pain-in-rats
#7
REVIEW
Sushil Kiran Kunder, Laxminarayana Kurady Bairy, Avinash Arivazhahan
INTRODUCTION: Analgesics are commonly prescribed medications used to alleviate pain of various aetiologies without affecting the patient's consciousness. They interfere with the transmission of pain signals. A commonly used antiepileptic drug, sodium valproate has been used in various non-epileptic conditions like migraine prophylaxis and in the treatment of bipolar disorder because of the multiple mechanisms by which it acts. Docosahexanoic Acid (DHA), an omega 3 fatty acid, is known to possess analgesic activity...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28510996/tramadol-with-or-without-paracetamol-acetaminophen-for-cancer-pain
#8
REVIEW
Philip J Wiffen, Sheena Derry, R Andrew Moore
BACKGROUND: Tramadol is an opioid analgesic licensed for use in moderate to severe pain. It is considered as a low risk for abuse, so control regulations are not as stringent as for 'strong' opioids such as morphine. It has a potential role as a step 2 option of the World Health Organization (WHO) analgesic ladder. OBJECTIVES: To assess the benefits and adverse effects of tramadol with or without paracetamol (acetaminophen) for cancer-related pain. SEARCH METHODS: We searched the following databases using a wide range of search terms: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS...
May 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28508561/diclofenac-for-pain-associated-with-intravitreal-injections-a-prospective-randomized-placebo-controlled-study
#9
Olga E Makri, Foteini N Tsapardoni, Dionisios D Pagoulatos, Nikolaos Pharmakakis, Constantine D Georgakopoulos
IMPORTANCE: Intravitreal injections (IVI) are often associated with pain. BACKGROUND: To evaluate the analgesic effect of diclofenac in patients undergoing IVI. DESIGN: Single-centre, prospective, randomized, triple-arm, placebo-controlled, interventional study in the University Hospital of Patras. PARTICIPANTS: Seventy-four patients. METHODS: Group 1 (n = 25) received topical diclofenac 45 minutes before IVI, Group 2 (n = 25) received oral diclofenac 4 hours before IVI and topical diclofenac while Group 3 (n = 24) received placebo before IVI...
May 15, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28507661/bone-marrow-aspirate-concentrate-in-combination-with-intravenous-iloprost-increases-bone-healing-in-patients-with-avascular-necrosis-of-the-femoral-head-a-matched-pair-analysis
#10
Hakan Pilge, Bernd Bittersohl, Johannes Schneppendahl, Tobias Hesper, Christoph Zilkens, Martin Ruppert, Rüdiger Krauspe, Marcus Jäger
With disease progression, avascular necrosis (AVN) of the femoral head may lead to a collapse of the articular surface. The exact pathophysiology of AVN remains unclear, although several conditions are known that can result in spontaneous cell death, leading to a reduction of trabecular bone and the development of AVN. Hip AVN treatment is stage-dependent in which two main stages of the disease can be distinguished: pre-collapse (ARCO 0-II) and post-collapse stage (ARCO III-IV, crescent sign). In the pre-collapse phase, core decompression (CD), with or without the addition of bone marrow (e...
November 17, 2016: Orthopedic Reviews
https://www.readbyqxmd.com/read/28506867/towards-personalized-treatment-of-pain-using-a-quantitative-systems-pharmacology-approach
#11
Sebastiaan C Goulooze, Elke H J Krekels, Monique van Dijk, Dick Tibboel, Piet H van der Graaf, Thomas Hankemeier, Catherijne A J Knibbe, J G Coen van Hasselt
Pain is a complex biopsychosocial phenomenon of which the intensity, location and duration depends on various underlying components. Treatment of pain is associated with considerable inter-individual variability, and as such, requires a personalized approach. However, a priori prediction of optimal analgesic treatment for individual patients is still challenging. Another challenge is the assessment and treatment of pain in patients unable to self-report pain. In this mini-review, we first provide a brief overview of the various components underlying pain, and their associated biomarkers...
May 12, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28505689/-pain-management-in-palliative-care
#12
Martin B Steins, Corinna Eschbach, Matthias Villalobos, Michael Thomas
A consistent pain management together with treatment of dyspnoea belongs to the main issues in symptom control in particular in palliative thoracic oncology. Together with the medicamentous therapy the psychologic and social circumstances of the affected patients have to be considered as factors influencing the experience of pain. The therapeutic fundament according to the WHO guideline for cancer pain is the opiate based medicamentous adjustment combined with non-opioids. In principle, this should be performed preferably orally, as simply as possible, according to a fix drug schedule and individually adjusted to the needed dosage...
May 2017: Pneumologie
https://www.readbyqxmd.com/read/28503221/management-of-musculoskeletal-pain-in-retail-drug-outlets-within-a-nigerian-community-a-descriptive-study
#13
Samirah N Abdu-Aguye, Aishatu Shehu, Ubaidullah I Ahmad
OBJECTIVE: This work aimed to describe attitudes and practices of both community pharmacies and patent and proprietary medicine vendor (PPMV) outlets towards over-the-counter (OTC) analgesic use for musculoskeletal pain states within Zaria, Nigeria. METHODS: The study was carried out in 2 phases from May to August 2016. Phase one was a cross-sectional survey of 40 retail drug outlets (10 community pharmacies and 30 PPMVs). A simulated patient scenario of a young adult male complaining of acute onset back pain was used to collect data on the type and quality of analgesic recommended, duration of consultation, as well as nature of information provided during the drug dispensing process...
January 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28496461/simultaneous-optimization-of-multiple-response-variables-for-the-gelatin-chitosan-microcapsules-containing-angelica-essential-oil
#14
Qiang Li, Li-Jian Sun, Xian-Feng Gong, Yang Wang, Xue-Ling Zhao
Angelica essential oil (AO), a major pharmacologically active component of Angelica sinensis (Oliv.) Diels, possesses hemogenesis, analgesic activities, and sedative effect. The application of AO in pharmaceutical systems had been limited because of its low oxidative stability. The AO-loaded gelatin-chitosan microcapsules with prevention from oxidation were developed and optimized using response surface methodology. The effects of formulation variables (pH at complex coacervation, gelatin concentration, and core/wall ratio) on multiple response variables (yield, encapsulation efficiency, antioxidation rate, percent of drug released in 1 h, and time to 85% drug release) were systemically investigated...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/28494395/conformational-and-vibrational-reassessment-of-solid-paracetamol
#15
Ana M Amado, Celeste Azevedo, Paulo J A Ribeiro-Claro
This work provides an answer to the urge for a more detailed and accurate knowledge of the vibrational spectrum of the widely used analgesic/antipyretic drug commonly known as paracetamol. A comprehensive spectroscopic analysis - including infrared, Raman, and inelastic neutron scattering (INS) - is combined with a computational approach which takes account for the effects of intermolecular interactions in the solid state. This allows a full reassessment of the vibrational assignments for Paracetamol, thus preventing the propagation of incorrect data analysis and misassignments already found in the literature...
April 27, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
https://www.readbyqxmd.com/read/28493094/new-minimally-invasive-surgical-approach-for-excision-of-left-atrial-myxoma
#16
Cristiano Spadaccio, Karim Elkasrawy, Fraser W H Sutherland
A novel minimally invasive technique for left atrial myxoma surgery involving a combination of mini-sternotomy and restricted left atrial dome incision is described. Surgery is performed through a mini-J sternotomy at third intercostal space and a standard aorto-right atrial cannulation. Exposure of cardiac mass is obtained by a restricted incision of the left atrial dome which provides excellent view of the entire interatrial septum. Base of the tumor base is clearly visualized making the en-bloc excision extremely easy...
May 10, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28491208/joint-pain-epidemiology-and-analgesic-usage-in-madagascar
#17
Luc Hervé Samison, Fidiniaina Mamy Randriatsarafara, Stéphane Ralandison
INTRODUCTION: To describe the epidemiology of joint pains and document analgesics usage in an African context. METHODS: Patients suffering from joint pain were recruited from nine sites located in Antananarivo, Madagascar, including 6 hospital services and 3 clinics. Doctors collected information on the etiology and characteristics of the patients' pain. Analgesics prescribed by these doctors were also documented. RESULTS: In total, 400 patients were enrolled in the study (52...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28489797/a-previously-published-propofol-remifentanil-response-surface-model-does-not-predict-patient-response-well-in-video-assisted-thoracic-surgery
#18
Hsin-Yi Wang, Chien-Kun Ting, Jing-Yang Liou, Kun-Hui Chen, Mei-Young Tsou, Wen-Kuei Chang
Modern anesthesia usually employs a hypnotic and an analgesic to produce synergistic sedation and analgesia. Two remifentanil-propofol interaction response surface models were used to predict sedation using Observer's Assessment of Alertness/Sedation (OAA/S) scores; one predicts an OAA/S <2 and the other <4. We hypothesized that both models would predict regained responsiveness (RR) after video-assisted thoracic surgery (VATS) to reduce total anesthesia time and make early extubation clinically relevant...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489643/factors-influencing-quality-of-pain-management-in-a-physician-staffed-helicopter-emergency-medical-service
#19
Nicole Oberholzer, Alexander Kaserer, Roland Albrecht, Burkhardt Seifert, Mario Tissi, Donat R Spahn, Konrad Maurer, Philipp Stein
BACKGROUND: Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. METHODS: For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score < VI...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28489477/combined-sciatic-and-lumbar-plexus-nerve-blocks-for-the-analgesic-management-of-hip-arthroscopy-procedures-a-retrospective-review
#20
J Douglas Jaffe, Theodore Ross Morgan, Gregory B Russell
Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumption during the post anesthesia care unit (PACU) stay was recorded; no significant differences in opioid consumption out to 24 hours were discovered...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
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