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Analgesia review

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https://www.readbyqxmd.com/read/27900067/common-analgesic-agents-and-their-roles-in-analgesic-nephropathy-a-commentary-on-the-evidence
#1
REVIEW
Julian Yaxley
An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment...
November 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#2
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27884758/magnesium-enhances-opioid-induced-analgesia-what-we-have-learnt-in-the-past-decades
#3
REVIEW
Magdalena Bujalska-Zadrożny, Jan Tatarkiewicz, Kamila Kulik, Małgorzata Filip, Marek Naruszewicz
Opioids are increasingly used in alleviating pain, including cancer-related pain and postoperative pain. Unfortunately, the development of tolerance, the resistance of neuropathic pain on opioid analgesia or other undesirable effects may limit their utility. In order to reduce opioid doses, and thereby to avoid the risk of side effects and sudden deaths due to overdosing, attempts have been made to introduce co-analgesics. Due to an increasing amount of data concerning a potential enhance of opioid analgesia by the physiological antagonist of N-methyl-d-aspartate receptors, magnesium ions (Mg(2+)), a concomitant use of such a combination seems to be interesting from a clinical point of view...
November 21, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27884494/consensus-conference-on-tips-management-techniques-indications-contraindications
#4
Stefano Fagiuoli, Raffaele Bruno, Wilma Debernardi Venon, Filippo Schepis, Francesco Vizzutti, Pierluigi Toniutto, Marco Senzolo, Paolo Caraceni, Francesco Salerno, Paolo Angeli, Roberto Cioni, Alessandro Vitale, Maurizio Grosso, Andrea De Gasperi, Gennaro D'Amico, Alfredo Marzano
The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty...
October 29, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27884220/multimodal-pain-management-for%C3%A2-enhanced-recovery-reinforcing-the-shift-from-traditional-pathways-through-nurse-led-interventions
#5
Robert Montgomery, Sharon A McNamara
Despite recent advances in perioperative patient care, postsurgical pain continues to be undermanaged. There is increasing acceptance of the concept that effective postsurgical pain management is best achieved through combined use of more than one analgesic agent or technique, and overreliance on opioids produces unwanted side effects limiting their utility. Accordingly, a balanced, multimodal approach to pain management within the larger framework of an Enhanced Recovery After Surgery (ERAS) pathway has become standard at many institutions for perioperative care, to control postsurgical pain, reduce opioid-related adverse events, hasten postsurgical recovery, and shorten length of hospital stay...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27873010/regional-block-via-continuous-caudal-infusion-as-sole-anesthetic-for-inguinal-hernia-repair-in-conscious-neonates
#6
Claudia M Mueller, Tiffany J Sinclair, Megan Stevens, Micaela Esquivel, Noah Gordon
PURPOSE: The use of general anesthesia in young children has come under increasing scrutiny due to its potential long-term neurotoxic effects. Meanwhile, regional anesthesia for surgical procedures in neonates has many advantages, including preservation of respiratory status and faster return to feeding. We describe the successful use of 3% 2-chloroprocaine administered via continuous caudal infusion as the sole anesthetic agent during elective surgical procedures in infants. METHODS: A retrospective chart review of all patients who underwent elective surgical procedures under continuous caudal regional anesthetic at a single institution was performed...
November 21, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#7
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871536/novel-methods-of-local-anesthetic-delivery-in-the-perioperative-and-postoperative-setting-potential-for-fibrin-hydrogel-delivery
#8
REVIEW
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P Clover
The benefits of high-quality postoperative analgesia are well documented and include earlier mobilization, fewer respiratory and cardiovascular complications, and shorter hospital stay. Local anesthesia-based acute pain regimens are at worst equal to and at best superior to opiate-based regimens from the perspective of analgesia. A multimodal approach limiting opioids by combining with local anesthetics has additional beneficial effect on outcomes such as nausea and vomiting, pruritus, gastrointestinal function, respiratory complications, and neutrophil function...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870743/epidural-local-anesthetics-versus-opioid-based-analgesic-regimens-for-postoperative-gastrointestinal-paralysis-vomiting-and-pain-after-abdominal-surgery-a-cochrane-review
#9
Joanne Guay, Mina Nishimori, Sandra L Kopp
BACKGROUND: The aim of this review was to compare the effects of postoperative epidural analgesia with local anesthetics to postoperative systemic or epidural opioids in terms of return of gastrointestinal transit, postoperative pain control, postoperative vomiting, incidence of gastrointestinal anastomotic leak, hospital length of stay, and cost after abdominal surgery. METHODS: Trials were identified by computerized searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 12), Medical Literature Analysis and Retrieval System Online (MEDLINE) (from 1950 to December, 2014) and Excerpta Medica dataBASE (EMBASE) (from 1974 to December 2014) and by checking the reference lists of trials retained...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27870735/combination-of-5-ht3-antagonist-and-dexamethasone-is-superior-to-5-ht3-antagonist-alone-for-ponv-prophylaxis-after-laparoscopic-surgeries-a-meta-analysis
#10
Anirban Som, Sulagna Bhattacharjee, Souvik Maitra, Mahesh K Arora, Dalim Kumar Baidya
INTRODUCTION: 5-Hydroxytryptamine type 3 (5-HT3) receptor antagonists are the most commonly used drugs for postoperative nausea vomiting (PONV) prophylaxis. Dexamethasone is another antiemetic with proven efficacy in reducing PONV. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the combination of dexamethasone and 5-HT3 antagonist versus a 5-HT3 antagonist alone as prophylaxis of PONV in laparoscopic surgical patients...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27870418/sex-differences-in-innate-immunity-and-its-impact-on-opioid-pharmacology
#11
REVIEW
Hillary H Doyle, Anne Z Murphy
Morphine has been and continues to be one of the most potent and widely used drugs for the treatment of pain. Clinical and animal models investigating sex differences in pain and analgesia demonstrate that morphine is a more potent analgesic in males than in females. In addition to binding to the neuronal μ-opioid receptor, morphine binds to the innate immune receptor toll-like receptor 4 (TLR4), located on glial cells. Activation of glial TLR4 initiates a neuroinflammatory response that directly opposes morphine analgesia...
January 2, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27867511/is-tapentadol-different-from-classical-opioids-a-review-of-the-evidence
#12
Richard M Langford, Roger Knaggs, Paul Farquhar-Smith, Anthony H Dickenson
Tapentadol is a single molecule able to deliver analgesia by two distinct mechanisms, a feature which differentiates it from many other analgesics. Pre-clinical data demonstrate two mechanisms of action: mu-opioid receptor agonist activity and noradrenaline re-uptake inhibition. From these, one may predict that tapentadol would be applicable across a broad spectrum of pain from nociceptive to neuropathic. The evidence in animal models suggests that norepinephrine re-uptake inhibition (NRI) is a key mechanism and may even predominate over opioid actions in chronic (and especially neuropathic) pain states, reinforcing that tapentadol is different to classical opioids and may, therefore, be an a priori choice for the treatment of neuropathic and mixed pain...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27867051/total-laparoscopic-hysterectomy-versus-vaginal-hysterectomy-a-systematic-review-and-meta-analysis
#13
REVIEW
E M Sandberg, A R H Twijnstra, S R C Driessen, F W Jansen
Hysterectomies performed laparoscopically have greatly increased within the last few decades and even exceed the number of vaginal hysterectomies (VH). This systematic review compares surgical outcomes of total laparoscopic hysterectomy (TLH) and VH to evaluate which approach offers the most benefits and was conducted according to the Meta-analysis of Observational Studies in Epidemiology guidelines. A literature search was performed in PubMed, Embase, Web of Science for all relevant publications from January 2000 through February 2016...
November 17, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#14
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27849111/pharmacological-interventions-for-pruritus-in-adult-palliative-care-patients
#15
REVIEW
Waldemar Siemens, Carola Xander, Joerg J Meerpohl, Sabine Buroh, Gerd Antes, Guido Schwarzer, Gerhild Becker
BACKGROUND: This is an update of the original Cochrane review published in 2013 (Issue 6). Pruritus occurs in patients with disparate underlying diseases and is caused by different pathologic mechanisms. In palliative care patients, pruritus is not the most prevalent but is one of the most puzzling symptoms. It can cause considerable discomfort and affects patients' quality of life. OBJECTIVES: To assess the effects of different pharmacological treatments for preventing or treating pruritus in adult palliative care patients...
November 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#16
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843269/pediatric-adenotonsillectomy-in-a-low-resource-setting-lessons-and-implications
#17
Sanyaolu Alani Ameye, Afolabi Muyiwa Owojuyigbe, Adekunle Adeyemo, Anthony T Adenekan, Sylvia Ouche
OBJECTIVES: To examine the practices related paediatric adenotonsillectomy in our setting especially in relation to blood request and transfusion, routine investigations, post-operative analgesic practice and complications. METHODS: We reviewed the record of paediatric patients who had adenotonsillectomy in our facility over a 5-year period to obtain relevant information to our study. RESULTS: There were 33 males and 19 females with mean age of 3...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/27842920/nitroxidative-signaling-mechanisms-in-pathological-pain
#18
REVIEW
Peter M Grace, Andrew D Gaudet, Vasiliki Staikopoulos, Steven F Maier, Mark R Hutchinson, Daniela Salvemini, Linda R Watkins
Tissue injury can initiate bidirectional signaling between neurons, glia, and immune cells that creates and amplifies pain. While the ability for neurotransmitters, neuropeptides, and cytokines to initiate and maintain pain has been extensively studied, recent work has identified a key role for reactive oxygen and nitrogen species (ROS/RNS; nitroxidative species), including superoxide, peroxynitrite, and hydrogen peroxide. In this review we describe how nitroxidative species are generated after tissue injury and the mechanisms by which they enhance neuroexcitability in pain pathways...
November 11, 2016: Trends in Neurosciences
https://www.readbyqxmd.com/read/27837343/effect-of-preoperative-oral-analgesics-on-pulpal-anesthesia-in-patients-with-irreversible-pulpitis-a-systematic-review-and-meta-analysis
#19
REVIEW
Armin Shirvani, Sayna Shamszadeh, Mohammad Jafar Eghbal, Laleh Alim Marvasti, Saeed Asgary
OBJECTIVES: The objectives of this study were to assess the efficacy of preemptive oral administration of single dose of non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen on the local anesthetic success in adults with irreversible pulpitis and to find the possible covariates that could predict treatment effect. MATERIALS AND METHODS: A systematic search using electronic databases up to March 2015 was conducted. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated using random and fixed-effect inverse variance method...
November 11, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27828798/effects-of-epidural-labor-analgesia-with-low-concentrations-of-local-anesthetics-on-obstetric-outcomes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
Ting-Ting Wang, Shen Sun, Shao-Qiang Huang
BACKGROUND: Low concentrations of local anesthetics (LCLAs) are increasingly popular for epidural labor analgesia. The effects of epidural analgesia with low concentrations of anesthetics on the duration of the second stage of labor and the instrumental birth rate, however, remain controversial. A systematic review was conducted to compare the effects of epidural analgesia with LCLAs with those of nonepidural analgesia on obstetric outcomes. METHODS: The databases of PubMed, Embase, and the Cochrane controlled trials register were independently searched by 2 researchers, and randomized controlled trials that compared epidural labor analgesia utilizing LCLAs with nonepidural analgesia were retrieved...
November 8, 2016: Anesthesia and Analgesia
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