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https://www.readbyqxmd.com/read/27931700/pediatric-tonsillectomy-and-ketorolac
#1
Lesley D Phillips-Reed, Paul N Austin, Ricardo E Rodriguez
BACKGROUND: The use of ketorolac in children undergoing tonsillectomy remains limited because of the concern about postoperative bleeding. METHODS: A search was performed addressing the question: For patients undergoing a surgical tonsillectomy, does a weight-appropriate single dose of intravenous ketorolac affect the incidence of postoperative hemorrhage? RESULTS: Five systematic reviews met the inclusion criteria. A Cochrane Review included 15 studies with 1,101 pediatric subjects and focused on perioperative bleeding requiring intervention...
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27927519/a-rapid-recovery-pathway-for-adolescent-idiopathic-scoliosis-that-improves-pain-control-and-reduces-time-to-inpatient-recovery-after-posterior-spinal-fusion
#2
Alex L Gornitzky, John M Flynn, Wallis T Muhly, Wudbhav N Sankar
STUDY DESIGN: Retrospective comparative cohort. OBJECTIVES: To determine if a standardized multimodal analgesic and rehabilitation protocol (rapid recovery pathway [RRP]) in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) could improve pain control, reduce opioid-related complications, and expedite early mobilization. BACKGROUND: Several reports have described postoperative recovery pathways for AIS patients undergoing PSF that shorten length of stay (LOS) without reporting the impact such pathways might have on patients' pain or quality of recovery...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27923161/antinociceptive-tolerance-to-nsaids-in-the-rat-formalin-test-is-mediated-by-the-opioid-mechanism
#3
Nana Tsiklauri, Ivliane Nozadze, Gulnaz Gurtskaia, Merab G Tsagareli
BACKGROUND: In the past decade it has been shown that tolerance develops to the antinociceptive effect of repeated systemic administration of commonly used non-steroidal anti-inflammatory drugs (NSAIDs) in acute pain models using rats. This is similar to the tolerance observed with opioid-induced analgesia. In the present study, we investigated the development of tolerance to the analgesic effects of NSAIDs diclofenac, ketorolac and xefocam in a chronic inflammatory pain model, the formalin test...
October 6, 2016: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/27904951/pre-emptive-injection-of-peri-articular-multimodal-drug-for-post-operative-pain-management-in-total-knee-arthroplasty-a-double-blind-randomized-clinical-trial
#4
Mahdi Motififard, Ali Omidian, Sajad Badiei
PURPOSE: Severe post-operative pain is one of the main problems after total knee arthroplasty. In this study, we investigated the effect of a peri-articular multimodal drugs injections pre-emptively on post-operative pain control and knee functions following total knee arthroplasty. METHODS AND MATERIALS: This study was a double-blind randomized clinical trial. Eligible cases including 137 patients-aged 30 to 80 years old-were randomly divided into one of two groups: the drug group received a cocktail consisting of bupivacaine hydrochloride, morphine sulphate, epinephrine, and ketorolac...
November 30, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27899387/activation-of-cytomegalovirus-corneal-endotheliitis-following-laser-in-situ-keratomileusis
#5
Tien-En Tan, Chui Ming Gemmy Cheung, Jodhbir S Mehta
A case of Cytomegalovirus (CMV) corneal endotheliitis following laser in-situ keratomileusis (LASIK) is presented. A 32-year-old man presented 3 weeks after uncomplicated myopic LASIK with unilateral LASIK flap oedema, interface fluid accumulation, keratic precipitates, anterior uveitis and raised intraocular pressure. Despite treatment with topical corticosteroids, he had 3 further recurrent episodes. Specular microscopy showed decreased endothelial cell density and aqueous humour. Polymerase chain reaction (PCR) testing was positive for CMV DNA...
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27896461/transversus-abdominis-plane-block-for-postoperative-pain-relief-after-hand-assisted-laparoscopic-colon-surgery-a-randomized-placebo-controlled-clinical-trial
#6
R Tikuisis, P Miliauskas, V Lukoseviciene, N Samalavicius, A Dulskas, L Zabuliene, V Zabulis, J Urboniene
BACKGROUND: Although hand-assisted laparoscopic surgery (HALS) offers patients smaller surgical incisions, they still experience pain. Currently, there is no consensus on the optimal analgesic package for patients undergoing HALS. The aim of this prospective, randomized, double-blinded, placebo-controlled clinical trial was to evaluate the effect of transversus abdominis plane (TAP) block on postoperative pain control (pain score and analgesic use) and other outcomes in colon cancer patients undergoing hand-assisted laparoscopic left hemicolectomy...
November 28, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27889630/1-2-3-triazolyl-ester-of-ketorolac-a-click-chemistry-based-highly-potent-pak1-blocking-cancer-killer
#7
Binh Cao Quan Nguyen, Hideaki Takahashi, Yoshihiro Uto, M D Shahinozzaman, Shinkichi Tawata, Hiroshi Maruta
An old anti-inflammatory/analgesic drug called Toradol is a racemic form of Ketorolac (50% R-form and 50% S-form) that blocks the oncogenic RAC-PAK1-COX-2 (cyclooxygenase-2) signaling, through the direct inhibition of RAC by the R-form and of COX-2 by the S-form, eventually down-regulating the production of prostaglandins. However, due to its COOH moiety which is clearly repulsive to negatively-charged phospholipid-based plasma membrane, its cell-permeability is rather poor (the IC50 against the growth of human cancer cells such as A549 is around 13 μM)...
November 20, 2016: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/27885591/the-impact-of-non-steroidal-anti-inflammatory-agents-after-phacoemulsification-on-quality-of-life-a-randomized-study
#8
Irini P Chatziralli, Theodoros N Sergentanis, Efstratios A Parikakis, Leonidas E Papazisis, Panagiotis Mitropoulos, Marilita M Moschos
INTRODUCTION: The purpose of our study was to investigate the impact of ketorolac addition to the well-established combination of antibiotic-steroid agent in terms of vision-related quality of life. METHODS: Patients were randomized to: (1) fixed combination of tobramycin 0.3%-dexamethasone 0.1%, one drop qid (n = 68) and (2) fixed combination of tobramycin 0.3%-dexamethasone 0.1%, one drop qid, plus ketorolac tromethamine 0.5%, one drop tid (n = 70). All patients completed the VFQ-25 questionnaire to assess their functional vision before cataract surgery and postoperatively on days 7, 28 and 42...
November 24, 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27878902/a-retrospective-comparison-of-intrathecal-morphine-and-epidural-hydromorphone-for-analgesia-following-posterior-spinal-fusion-in-adolescents-with-idiopathic-scoliosis
#9
Rebecca A Hong, Kathleen M Gibbons, G Ying Li, Ashlee Holman, Terri Voepel-Lewis
BACKGROUND: Posterior spinal fusion to correct idiopathic scoliosis is associated with severe postoperative pain. Intrathecal morphine is commonly used for analgesia after adolescent posterior spinal fusion; however, anticipating and managing the increase in pain scores after resolution of analgesic effect of intrathecal morphine analgesia is challenging. In 2014, we developed a clinical protocol detailing both the administration of intrathecal morphine intraoperatively and the transition to routine, scheduled oral analgesics at 18 h postoperatively...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27875919/adverse-drug-reactions-associated-with-off-label-use-of-ketorolac-with-particular-focus-on-elderly-patients-an-analysis-of-the-italian-pharmacovigilance-database-and-a-population-based-study
#10
E Viola, G Trifirò, Y Ingrasciotta, L Sottosanti, M Tari, F Giorgianni, U Moretti, R Leone
OBJECTIVE: This study aims to evaluate the frequency of off-label use of ketorolac in Italy and the related suspected adverse drug reactions (ADRs) reported. METHODS: All the suspected cases associated with ketorolac recorded in the Italian Pharmacovigilance database were retrieved. Case evaluations were carried out in order to identify the off-label use of ketorolac. Moreover, an analysis of the inappropriate use of ketorolac was conducted using the 'Arianna' database of Caserta local health unit...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#11
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27861473/-direct-cost-of-primary-care-of-mild-traumatic-brain-injury-in-adults-by-grd-in-third-level-of-care
#12
Rodolfo Barragán-Hervella, Álvaro Montiel-Jarquín, Iván Limón-Serrano, Víctor Escobedo-Sosa, Jorge Loría-Castellanos
OBJECTIVE: To describe the direct cost of primary health care for patients with mild traumatic head injury in a third level medical facility. DESIGN: Cross-sectional study in 219 patients with mild traumatic brain injury (GRD 090 S06.0 ICD-10 including uncomplicated concussion without complication and increased comorbidity). LOCATION: A medical unit of tertiary care in the State of Puebla, Mexico. MAIN MEASUREMENTS: Direct costs were taken from ACDO...
November 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27861435/intramuscular-fentanyl-and-ketorolac-associated-with-superior-pain-control-after-pediatric-bilateral-myringotomy-and-tube-placement-surgery-a-retrospective-cohort-study
#13
Paul A Stricker, Wallis T Muhly, Ellen C Jantzen, Yue Li, Abbas F Jawad, Alexander S Long, Marcia Polansky, Scott D Cook-Sather
BACKGROUND: Bilateral myringotomy and pressure equalization tube insertion (BMT) is the most common surgery in children. Multiple anesthetic techniques for BMT have been proposed, but that which reliably promotes ideal recovery remains unclear. We sought to assess associations between anesthetic regimens that included single-agent (fentanyl or ketorolac) or dual-agent (fentanyl and ketorolac) analgesic therapy and the primary outcome of maximal postanesthesia care unit (PACU) pain score...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27849187/inhibition-of-5-lipoxygenase-by-zileuton-in-a-rat-model-of-myocardial-infarction
#14
Leyla Abueid, Ünal Uslu, Alev Cumbul, Ayliz Velioğlu Öğünç, Feriha Ercan, İnci Alican
OBJECTIVE: The goal of the present study was to investigate the effects of 5-lipoxygenase (5-LOX) inhibition, alone and with cyclooxygenase (COX) inhibitors, on inflammatory parameters and apoptosis in ischemia/reperfusion (I/R)-induced myocardial damage in rats. For this purpose, zileuton, a selective and potent inhibitor of 5-LOX, resulting in suppression leukotriene production, was used. METHODS: Male Wistar rats (200-250 g; n=12 per group) were used in the study...
November 10, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27843229/a-comparative-study-of-various-topical-nonsteroidal-anti-inflammatory-drugs-to-steroid-drops-for-control-of-post-cataract-surgery-inflammation
#15
Anu Malik, Anup Sadafale, Yogesh Kumar Gupta, Alka Gupta
BACKGROUND: Postoperative inflammation continues to be a cause of patient discomfort, delayed recovery, and in some cases, suboptimal visual results. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid are commonly used in the management and prevention of noninfectious ocular inflammation following cataract surgery. AIMS: The aim was to study the safety and efficacy of various NSAIDs drops for control of postoperative inflammation following cataract surgery and compare with steroid eye drops in a patient following cataract surgery...
September 2016: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/27830044/acute-pain-management-in-symptomatic-cholelithiasis
#16
Tahir Masudi, Helen Capitelli-McMahon, Suhail Anwar
AIM: To review the evidence for the use of different non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of biliary colic. METHODS: The strategies employed included an extensive literature review for articles and studies related to biliary colic from electronic databases including PubMed, Science Direct, Wiley Inter Science, Medline and Cochrane from last 15 years. Keywords: "Biliary colic", "management of biliary colic", "non-steroidal anti-inflammatory drugs", "cholelithiasis" and "biliary colic management"...
October 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27829018/paravertebral-block-plus-thoracic-wall-block-versus-paravertebral-block-alone-for-analgesia-of-modified-radical-mastectomy-a-retrospective-cohort-study
#17
Nai-Liang Li, Ben-Long Yu, Chen-Fang Hung
BACKGROUND AND OBJECTIVES: Paravertebral block placement was the main anesthetic technique for modified radical mastectomy in our hospital until February 2014, when its combination with blocks targeting the pectoral musculature was initiated. We compared the analgesic effects of paravertebral blocks with or without blocks targeting the pectoral musculature for modified radical mastectomy. METHODS: We retrospectively collected data from a single surgeon and anesthesiologist from June 1, 2012, to May 31, 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27828892/exploring-opioid-sparing-multimodal-analgesia-options-in-trauma-a-nursing-perspective
#18
Denise Sullivan, Mary Lyons, Robert Montgomery, Ann Quinlan-Colwell
Challenges with opioids (e.g., adverse events, misuse and abuse with long-term administration) have led to a renewed emphasis on opioid-sparing multimodal management of trauma pain. To assess the extent to which currently available evidence supports the efficacy and safety of various nonopioid analgesics and techniques to manage trauma pain, a literature search of recently published references was performed. Additional citations were included on the basis of authors' knowledge of the literature. Effective options for opioid-sparing analgesics include oral and intravenous (IV) acetaminophen; nonsteroidal anti-inflammatory drugs available via multiple routes; and anticonvulsants, which are especially effective for neuropathic pain associated with trauma...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27806350/enteral-docosahexaenoic-acid-reduces-analgesic-administration-in-neonates-undergoing-cardiovascular-surgery
#19
Mariela Bernabe-Garcia, Mardia López-Alarcon, Alfredo Salgado-Sosa, Raul Villegas-Silva, Jorge Maldonado-Hernandez, Maricela Rodríguez-Cruz, Rodolfo Rivas-Ruiz, Luis Chavez-Sanchez, Francisco A Blanco-Favela, Javier Mancilla-Ramirez, Virginia Gordillo-Alvarez, Olivia Madrigal-Muñiz
BACKGROUND: Neonates undergoing surgery require analgesic medication to ameliorate acute pain. These medications produce negative side effects. Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but this has not been evaluated in human neonates. We evaluated the DHA effect on cumulative dose and duration of analgesics administered to neonates undergoing cardiovascular surgery. METHODS: A secondary analysis was performed with data from a clinical trial, in which enteral DHA was administered perioperatively compared with sunflower oil (SO)...
2016: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/27801522/prophylactic-non-steroidal-anti-inflammatory-drugs-for-the-prevention-of-macular-oedema-after-cataract-surgery
#20
REVIEW
Blanche X Lim, Chris Hl Lim, Dawn K Lim, Jennifer R Evans, Catey Bunce, Richard Wormald
BACKGROUND: Macular oedema (MO) is the accumulation of extracellular fluid in the central retina (the macula). It may occur after cataract surgery and may give rise to poor visual outcome, with reduced visual acuity and distortion of the central vision. MO is often self-limiting with spontaneous resolution, but a small proportion of people with chronic persistent MO may be difficult to treat. Chronic oedema may lead to the formation of cystic spaces in the retina termed 'cystoid macular oedema' (CMO)...
November 1, 2016: Cochrane Database of Systematic Reviews
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