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Analgesia review

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https://www.readbyqxmd.com/read/29221974/criteria-for-postoperative-mechanical-ventilation-after-thymectomy-in-patients-with-myasthenia-gravis-a-retrospective-analysis
#1
Keerthi Chigurupati, Shrinivas Gadhinglajkar, Rupa Sreedhar, Muraleedharan Nair, Madathipat Unnikrishnan, Manjusha Pillai
OBJECTIVE: To determine the criteria for postoperative mechanical ventilation after thymectomy in patients with Myasthenia Gravis. DESIGN: Retrospective study. SETTING: Teritiary care centre. PARTICIPANTS: 77 Myasthenia gravis patients operated for thymectomy were studied. INTERVENTIONS: After obtaining clearance from Institutional ethics committee, medical records of 77 patients with MG, who were operated for thymectomy between January 2005 and December 2015 were reviewed in a retrospective manner...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#2
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29210330/subcutaneous-local-anesthetic-infusion-could-eliminate-use-of-epidural-analgesia-after-the-nuss-procedure
#3
Sandra K Kabagambe, Laura F Goodman, Y Julia Chen, Benjamin A Keller, James C Becker, Gary W Raff, Rebecca A Stark, Jacob T Stephenson, Amy Rahm, Diana L Farmer, Shinjiro Hirose
AIM: To compare outcomes of continuous subcutaneous infusion of local anesthetic and epidural analgesia following the Nuss procedure. PATIENTS & METHODS: A retrospective chart review compared patients managed with subcutaneous local anesthetic infusion (n = 12) versus thoracic epidural (n = 19) following the Nuss procedure from March 2013 to June 2015. RESULTS: There was no difference in hospital length of stay or days on intravenous narcotics...
December 6, 2017: Pain Management
https://www.readbyqxmd.com/read/29207737/factors-affecting-post-caesarean-pain-intensity-among-women-in-the-northern-peninsular-of-malaysia
#4
Hanan Hussein Jasim, Syed Azhar Bin Syed Sulaiman, Amer Hayat Khan, Usha A/P S Rajah
Introduction: Caesarean section (CS) rate has increased considerably during the past years, accounting for 15% to 25% of births. During post-CS period, moderate to severe postoperative pain is a regularly reported problem. Ideally, the intensity of postoperative pain should be predicted so as to customize analgesia. Aim: To document the CS rate, assess the pain intensity and preoperative factors that may predict post caesarean pain among women in the Obstetric unit of a Hospital Pulau Pinang in Malaysia...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29200071/evidence-basis-for-regional-anesthesia-in-ambulatory-anterior-cruciate-ligament-reconstruction-part-iii-local-instillation-analgesia-a-systematic-review-and-meta-analysis
#5
Eric M Yung, Richard Brull, Eric Albrecht, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and meta-analysis evaluates the analgesic benefits of LIA for outpatient ACLR. METHODS: We sought randomized controlled trials investigating the analgesic effects of LIA versus control in adults having outpatient ACLR and receiving multimodal analgesia (excluding nerve blocks, which are examined in parts I and II of this project)...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29198625/transversus-abdominis-plane-block-improves-perioperative-outcome-after-esophagectomy-versus-epidural
#6
Gal Levy, Mark A Cordes, Alexander S Farivar, Ralph W Aye, Brian E Louie
BACKGROUND: Pain control is challenging during esophagectomy. An epidural is commonly used, but the sympathetic blockade can have unintended consequences such as hypotension or delayed return of bowel function. A transversus abdominis plane (TAP) block has the potential to control upper abdominal pain without these adverse consequences. We aimed to compare bilateral TAP blocks with patient-controlled analgesia (PCA) for immediate management after esophagectomy with a cohort using a thoracic (T5 to T8) epidural...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29197838/leg-length-discrepancy-the-importance-of-a-complete-history-and-examination
#7
Duncan Coffey, Sarah Patricia Hudson-Phillips, Sarkhell Saadi Radha, Simon Ball
A 26-year-old woman with a 1-year history of right knee pain had failed to respond to analgesia and activity modification in the community. Her general practitioner referred her to the orthopaedic department for specialist review. A thorough history revealed that she had multiple orthopaedic interventions as a child. The patient had significant postoperative infection of the left knee following knee surgery at 7 years of age. Examination demonstrated the presence of a limp, scoliosis and suspected leg length discrepancy...
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29191343/an-age-based-approach-to-dermatologic-surgery-kids-are-not-just-little-people
#8
Breton Yates, James Whalen, Hanspaul Makkar
Surgical dermatologic procedures in children pose unique challenges that differ from those in adults. Child and parental anxiety, along with procedural anxiety in adults, necessitate different approaches. Special considerations are reviewed in the application of topical anesthesia and administration of local anesthesia in children as opposed to adults, and the use and safety of general anesthesia in children is highlighted. In addition, management of postprocedural analgesia differs in children, largely due to concern for safety of opioids in children...
November 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/29189495/lumbar-spine-anatomy-in-women-sustaining-unintentional-dural-puncture-during-labor-epidural-placement-a-descriptive-study-using-magnetic-resonance-imaging-and-ultrasound
#9
Nicholas M Barrett, Cristian Arzola, Timo Krings, Kristi Downey, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: Unintentional dural puncture is one of the most frequent complications of the epidural technique. One previous study suggested that atypical sonoanatomy of the ligamentum flavum/dura mater unit may be a risk factor for this complication. In this study, we describe the anatomy of the lumbar spine, assessed by magnetic resonance imaging (MRI) and ultrasound, in women sustaining unintentional dural puncture during epidural catheter placement for labor analgesia...
November 15, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29189318/standardised-noxious-stimulation-guided-individual-adjustment-of-remifentanil-target-controlled-infusion-to-prevent-haemodynamic-responses-to-laryngoscopy-and-surgical-incision-a-randomised-controlled-trial
#10
Aline Defresne, Luc Barvais, François Clement, Vincent Bonhomme
BACKGROUND: The surgical plethysmographic index (SPI) is one of the available indexes of the nociception-antinociception (NAN) balance. Individually adjusting the NAN balance to prevent somatic responses to noxious stimulation remains a challenge. OBJECTIVES: To assess whether guiding remifentanil administration according to the SPI response to a calibrated noxious stimulus (NANCAL) can blunt the haemodynamic response to tracheal intubation and surgical incision...
November 18, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29182798/pharmacological-interventions-for-pain-relief-during-orthodontic-treatment
#11
REVIEW
Aoife B Monk, Jayne E Harrison, Helen V Worthington, Annabel Teague
BACKGROUND: Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29180895/postoperative-pain-management-in-the-postanesthesia-care-unit-an-update
#12
REVIEW
Jie Luo, Su Min
Acute postoperative pain remains a major problem, resulting in multiple undesirable outcomes if inadequately controlled. Most surgical patients spend their immediate postoperative period in the postanesthesia care unit (PACU), where pain management, being unsatisfactory and requiring improvements, affects further recovery. Recent studies on postoperative pain management in the PACU were reviewed for the advances in assessments and treatments. More objective assessments of pain being independent of patients' participation may be potentially appropriate in the PACU, including photoplethysmography-derived parameters, analgesia nociception index, skin conductance, and pupillometry, although further studies are needed to confirm their utilities...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29176373/obstructive-sleep-apnea-and-bariatric-surgical-guidelines-summary-and-update
#13
Christel A L de Raaff, Nico de Vries, Bart A van Wagensveld
PURPOSE OF REVIEW: Increasing numbers of bariatric surgical procedures and the high prevalence of obstructive sleep apnea (OSA) in this population have resulted in a growing interest in the perioperative management of OSA in bariatric surgery. This review provides a summary of the first consensus guideline on this topic as well as an update of the newest literature available. RECENT FINDINGS: All bariatric patients should be screened for OSA and obesity hypoventilation syndrome (OHS) to reduce the risk of perioperative complications...
November 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29174762/efficacy-of-intravenous-acetaminophen-for-postoperative-analgesia-in-primary-total-knee-arthroplasty
#14
Philip S Huang, Scott M Gleason, Jalaal A Shah, Amy F Buros, David A Hoffman
BACKGROUND: The use of intravenous acetaminophen has seen recent enthusiasm as one component of a multimodal approach to pain management. However, there is a lack of literature examining the efficacy of intravenous acetaminophen for pain control in total joint arthroplasty. The purpose of this study was to evaluate the efficacy of intravenous acetaminophen following primary total knee arthroplasty. METHODS: This is a retrospective review of 38 patients undergoing primary total knee arthroplasty by a single surgeon at one institution...
November 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29174580/a-systematic-review-and-meta-analysis-comparing-the-efficacy-of-nonsteroidal-anti-inflammatory-drugs-opioids-and-paracetamol-in-the-treatment-of-acute-renal-colic
#15
REVIEW
Sameer A Pathan, Biswadev Mitra, Peter A Cameron
CONTEXT: Renal colic is a common, acute presentation of urolithiasis that requires immediate pain relief. European Association of Urology guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) as the preferred analgesia. However, the fear of NSAID adverse effects and the uncertainty about superior analgesic effect have maintained the practice of advocating intravenous opioids as the initial analgesia. OBJECTIVE: The objective of this systematic review and meta-analysis was to compare the safety and efficacy of NSAIDs with opioids and paracetamol (acetaminophen) for the management of acute renal colic...
November 21, 2017: European Urology
https://www.readbyqxmd.com/read/29173273/incidence-of-bleeding-in-children-undergoing-circumcision-with-ketorolac-administration
#16
Bruce Gao
INTRODUCTION: Circumcision is the most common surgical procedure performed by pediatric urologists. Ketorolac has been shown to have an efficacy similar to morphine in multimodal analgesic regimens without the commonly associated adverse effects. Concerns with perioperative bleeding limit the use of ketorolac as an adjunct for pain control in surgical patients. As such, we sought to evaluate our institutional outcomes with respect to ketorolac and postoperative bleeding. METHODS: We retrospectively reviewed all pediatric patients undergoing circumcision from January 1, 2014 to December 31, 2015 at the Alberta Children's Hospital...
December 1, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29170344/47%C3%A2-systematic-review-and-meta-analysis-of-analgesic-efficacy-and-safety-profile-of-single-injection-fascia-iliaca-compartment-blocks-in-the-acute-pre-operative-pain-management-of-hip-fractures
#17
Fiqry Fadhlillah, David Chan
BACKGROUND: It is hypothesised that a single injection fascia iliaca compartment block (FICB) administered in the pre-operative setting provides better analgesic control for traumatic hip fractures and is not associated with major adverse effects. Systemic analgesics, whilst effective, could lead to cardiovascular, respiratory and cognitive impairment. As a consequence, undertreatment of acute pain remains prevalent in adult patients with hip fractures, with a consistent decline seen in analgesic administration with age...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170325/28%C3%A2-are-we-measuring-what-we-think-we-are-measuring-qualitative-research-exploring-the-role-of-the-0-10-pain-score-within-the-adult-emergency-department
#18
Fiona Sampson, Alicia O'cathain, Steve Goodacre
OBJECTIVES AND BACKGROUND: The assessment of pain in the emergency department (ED) is difficult but important for appropriate management of pain. Guidelines for the management of acute pain in the ED worldwide advocate using numeric rating scales such as the 0-10 pain score as tools to ensure consistency of documenting patient's pain, and this is mandated at initial assessment in many EDs. Studies of interventions to improve pain management in the ED indicate that whilst the inclusion of mandatory pain scoring within interventions may improve documentation of pain, there was mixed evidence as to whether this resulted in improvements in provision of analgesia...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170308/11%C3%A2-topical-nsaids-for-analgesia-in-traumatic-corneal-abrasions-a-systematic-review-and-meta-analysis
#19
Annali Lawrenson, Abel Wakai
BACKGROUND: Traumatic corneal abrasions are common ocular presenTations in the ED. There is no consensus regarding the most appropriate analgesia for this condition. Topical non-steroidal anti-inflammatory drugs (NSAIDs) have been suggested as pain-relief to minimise systemic adverse events associated with oral analgesia. AIM: To identify and evaluate all randomised controlled trials (RCTs) comparing the use of topical NSAIDs with placebo or any alternative analgesic interventions in adults with traumatic corneal abrasions (including corneal abrasions arising from foreign body removal), to reduce pain, and its effects on healing time...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#20
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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