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Analgesia review

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https://www.readbyqxmd.com/read/28432468/population-pharmacokinetics-of-intravenous-acetaminophen-in-japanese-patients-undergoing-elective-surgery
#1
Tsuyoshi Imaizumi, Shinju Obara, Midori Mogami, Yuzo Iseki, Makiko Hasegawa, Masahiro Murakawa
INTRODUCTION: Intravenous (i.v.) acetaminophen is administered during surgery for postoperative analgesia. However, little information is available on the pharmacokinetics of i.v. acetaminophen in Japanese patients undergoing surgery under general anesthesia. METHODS: The study was approved by the Institutional Review Board and registered at UMIN-CTR (UMIN000013418). Patients scheduled to undergo elective surgery under general anesthesia were enrolled after obtaining written informed consent...
April 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28430165/treatments-for-latrodectism-a-systematic-review-on-their-clinical-effectiveness
#2
REVIEW
Nicole M Ryan, Nicholas A Buckley, Andis Graudins
Latrodectism or envenomation by widow-spiders is common and clinically significant worldwide. Alpha-latrotoxin is the mammalian-specific toxin in the venom that results in toxic effects observed in humans. Symptoms may be incapacitating and include severe pain that can persist for days. The management of mild to moderate latrodectism is primarily supportive while severe cases have variously been treated with intravenous calcium, muscle relaxants, widow-spider antivenom and analgesic opioids. The object of this systematic review is to examine the literature on the clinical effectiveness of past and current treatments for latrodectism...
April 21, 2017: Toxins
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#3
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28422881/comparison-of-effects-of-desflurane-and-sevoflurane-on-postoperative-nausea-vomiting-and-pain-in-patients-receiving-opioid-based-intravenous-patient-controlled-analgesia-after-thyroidectomy-propensity-score-matching-analysis
#4
Il Jae Yoon, Hyun Kang, Chong Wha Baek, Geun Joo Choi, Yong-Hee Park, Yong Hun Jung, Young Cheol Woo, Sangseok Lee
In this study, we aimed to compare the effect of desflurane and sevoflurane on postoperative nausea and vomiting and pain in patients receiving opioid-based intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy.We reviewed the electronic medical records of 1042 patients administered opioid-based IV-PCA after a thyroidectomy at Chung-Ang University Hospital between January 1, 2010 and June 30, 2016. We classified the patients into 2 groups according to the inhalation anesthetic used for anesthesia: desflurane versus sevoflurane (groups D and S, n = 587 and 455, respectively)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422794/intrathecal-morphine-in-spine-surgery-a-meta-analysis-of-randomized-controlled-trials
#5
Arif Pendi, Frank L Acosta, Alexander Tuchman, Rana Movahedi, Lakshmanan Sivasundaram, Ibraheem Arif, Gligor Gucev
STUDY DESIGN: Meta-analysis of randomized controlled trials (RCTs). OBJECTIVE: To evaluate the effectiveness of intrathecal morphine (ITM) in reducing postoperative pain and opioid analgesic consumption following spine surgery. SUMMARY OF BACKGROUND DATA: The use of ITM following adult spine surgery is of particular interest due to the ease of access to the thecal sac and the potential to provide adequate analgesia at low doses. However, previous studies of ITM have been limited by small sample sizes and conflicting results...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28418641/classics-in-chemical-neuroscience-ketamine
#6
Marshall W Tyler, Harmony B Yourish, Dawn F Ionescu, Stephen J Haggarty
Ketamine, a molecule of many faces, has contributed immeasurably to numerous realms of clinical practice and scientific inquiry. From anesthesia and analgesia to depression and schizophrenia, it continues to shed light on the molecular underpinnings of pain, consciousness, and the pathophysiology of neuropsychiatric disorders. In particular, research on ketamine's mechanism of action is providing new hope in the search for therapies for treatment-resistant depression and affords insights into disorders of glutamatergic dysfunction...
April 21, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28417354/perioperative-epidural-analgesia-is-not-associated-with-increased-survival-from-renal-cell-cancer-but-overall-survival-may-be-improved-a-retrospective-chart-review
#7
Evan Kovac, Farhad Firoozbakhsh, Homayoun Zargar, Amr Fergany, Hesham Elsharkawy
PURPOSE: We investigated the possible association between perioperative epidural and both cancer-specific survival (CSS) and overall survival (OS) in patients undergoing partial or radical nephrectomy for localized renal cell carcinoma (RCC). METHODS: A retrospective chart review was performed on patients who underwent complete surgical resection of localized RCC from 1994-2008 at our institution. Baseline demographics and pathological and survival data were collected...
April 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28413629/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-1-from-the-preoperative-period-to-pacu
#8
Matthew D McEvoy, Michael J Scott, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413628/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#9
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413269/localization-of-epidural-space-a-review-of-available-technologies
#10
REVIEW
Hesham Elsharkawy, Abraham Sonny, Ki Jinn Chin
Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#11
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28405033/post-caesarean-analgesia-what-is-new
#12
REVIEW
Sukhyanti Kerai, Kirti Nath Saxena, Bharti Taneja
Adequate post-operative analgesia after caesarean section (CS) is vital as it impacts the distinct surgical recovery requirements of the parturient. Although newer analgesic modalities and drugs for post-caesarean analgesia have been introduced over the recent years, review of the literature suggests suggests that we are far from achieving the goals of optimum post-operative analgesia. We conducted a systematic review of recent advances in modalities for post-caesarean analgesia. After systematic search and quality assessment of studies, we included a total of 51 randomised controlled trials that evaluated the role of opioids, transversus abdominis plane (TAP) block, wound infiltration/infusion, ketamine, gabapentin and ilioinguinal-iliohypogastric nerve block (II-IH NB) for post-caesarean analgesia...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403398/systematic-review-of-the-systemic-concentrations-of-local-anaesthetic-after-transversus-abdominis-plane-block-and-rectus-sheath-block
#13
J Rahiri, J Tuhoe, D Svirskis, N J Lightfoot, P B Lirk, A G Hill
Background.: Safe and efficacious modalities of perioperative analgesia are essential for enhanced recovery after surgery. Truncal nerve blocks are one potential adjunct for analgesia of the abdominal wall, and in recent years their popularity has increased. Transversus abdominis plane block (TAPB) and rectus sheath block (RSB) have been shown to reduce morphine consumption and improve pain relief after abdominal surgery. These blocks typically require large volumes of local anaesthetic (LA)...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28402744/single-incision-versus-three-port-laparoscopic-appendectomy-short-and-long-term-outcomes
#14
Samatha Vellei, Alessandro Borri
AIM: To compare the outcome of patients who had undergone single-incision laparoscopic appendectomy (SILA) with others who had undergone three-port laparoscopic appendectomy (3-PORT). MATERIALS AND METHODS: Data from all adults with uncomplicated appendicitis treated by laparoscopic appendectomy between June 2012 and December 2015 were prospectively collected. Patients with chronic pain, appendix malignancy, at least two previous laparotomies, and those undergoing concomitant surgery for different condition were excluded from analysis...
April 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#15
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10 - 17% in the general population. Its prevalence in the surgical population seems to be higher. However, a proportion of up to 60% of patients may not have a formal diagnosis at the moment of preoperative visit. OSA is associated with a number of comorbidities and increased perioperative risks. However, most interventions for the perioperative management of OSA patients lack high quality evidence...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28399049/evaluation-of-gabapentin-and-clonidine-use-in-children-following-spinal-fusion-surgery-for-idiopathic-scoliosis-a-retrospective-review
#16
Dinesh K Choudhry, B Randall Brenn, Karen Sacks, Suken Shah
BACKGROUND: Opioids are the mainstay of therapy for pain relief following posterior spinal fusion (PSF) surgery. Various adjunctive medications are being used to augment analgesia and to reduce opioid-related side effects. At our institution, we have sequentially added 2 adjuncts to a standard morphine patient-controlled analgesia (PCA) regimen. The goal of our study was to evaluate pain control and the benefit of gabapentin and the combination of gabapentin and clonidine, whereas morphine PCA was in use in children following PSF surgery...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28397548/pre-natal-diagnosis-of-thalassaemia-in-sri-lanka-a-ten-year-review
#17
Kalinga Khemal Nanayakkara, Undugodage Ganganath Rodrigo, Kuda Liyanage Nandika Perera, Chinthani Deepthi Nanayakkara
Thalassaemia is the commonest monogenic disease in Sri Lanka, affecting over 3500 children and half-a-million thalassaemia carriers. This is a review of 82 amniocenteses performed from 2006 to 2016, in the largest prenatal diagnoses study for thalassaemia carried out in Sri Lanka. Amniocenteses were performed between 11 and 12 weeks of ultrasonically confirmed gestation, on mothers with previous thalassaemia major children pregnant for the second time and nulliparous thalassaemia trait women married to trait partners...
April 11, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#18
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#19
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28383425/ropivacaine-versus-levobupivacaine-in-peripheral-nerve-block-a-prisma-compliant-meta-analysis-of-randomized-controlled-trials
#20
Ang Li, Zhijian Wei, Yang Liu, Jiaxiao Shi, Han Ding, Haoshuai Tang, Pengyuan Zheng, Yanzheng Gao, Shiqing Feng
BACKGROUND: To determine which is more potent in peripheral nerve block between ropivacaine and levobupivacaine. METHODS: A literature search was performed in the EMBASE, Medline, the Cochrane Library, and the Web of Science. The trials that were found were then evaluated for eligibility. The Cochrane Collaboration's Review Manager software was used to perform the meta-analyses. RESULTS: Twelve studies including 556 patients were included for final analysis...
April 2017: Medicine (Baltimore)
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