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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27909198/anaesthesia-and-analgesia-in-laboratory-adult-zebrafish-a-question-of-refinement
#2
Tânia Martins, Ana M Valentim, Nuno Pereira, Luis M Antunes
Anaesthesia is used daily in fish experimental procedures; however, the use of an inadequate anaesthetic protocol can compromise not only the animal's welfare but also the reliability of results. The use of zebrafish (Danio rerio) in biomedical research has increased in the last decades, highlighting the importance of appropriate anaesthetic regimens for this species. This article reviews the main anaesthetic agents and protocols used in laboratory adult zebrafish, and some of the analgesic methods to be used in this species that still need more research...
December 2016: Laboratory Animals
https://www.readbyqxmd.com/read/27891424/a-study-on-the-efficacy-of-the-addition-of-low-dose-dexmedetomidine-as-an-adjuvant-to-lignocaine-in-intravenous-regional-anaesthesia-ivra
#3
Esha Nilekani, Yvonne Menezes, Shirley Ann D'souza
INTRODUCTION: Intravenous Regional Anaesthesia (IVRA) is a simple, effective method of providing anaesthesia for short duration surgical procedures on the extremities, its chief drawbacks are tourniquet pain, short duration of block and absence of post-operative analgesia. Dexmedetomidine is known to reduce anaesthetic requirements and also provide analgesia to the patient. AIM: To evaluate the efficacy of dexmedetomidine as an adjuvant to lignocaine in IVRA with respect to the quality of the block, tourniquet pain and post-operative analgesia...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27843772/long-term-evaluation-of-continuous-epidural-anesthesia-in-an-improved-canine-model
#4
Kyoko Sasauchi, Katsuhisa Sunada, Tatsuo Nakamura
BACKGROUND: Continuous epidural analgesia with catheterization is a useful technique, because it has a wide adaptation range and provides prolonged analgesia. Problems that may arise from long-term epidural analgesia are changes in the analgesic area, duration of analgesia and catheter-related problems. Few articles have evaluated gradual changes of long-term epidural analgesia. In the animal models used in those studies, the catheter was inserted by an invasive surgical procedure. In the present study, we evaluated changes in a canine model in which the catheter was inserted by a minimally invasive procedure...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27836553/how-much-alcohol-is-in-ketamine-s-antidepressant-action
#5
REVIEW
Udo Bonnet
Ketamine is approved to start and maintain anaesthesia or analgesia. Ketamine is also known to be neurotoxic and an old drug of abuse. Numerous studies have proven a rapid and strong antidepressant response (AR) following parenteral sub-anaesthetic ketamine doses when applied the first time to patients with treatment resistant unipolar or bipolar major depression. This rapid and robust AR is encouraging, though short-lived (usually up to seven days). There is growing evidence that repeated und escalating ketamine administrations exert longer-lasting AR than single infusions...
November 8, 2016: Life Sciences
https://www.readbyqxmd.com/read/27810215/development-of-a-peripheral-nerve-stimulator-guided-technique-for-equine-pudendal-nerve-blockade
#6
K Gallacher, L C Santos, L Campoy, A J Bezuidenhout, R O Gilbert
The aim of this study was to develop and evaluate a procedure for equine pudendal nerve block using a peripheral nerve locator. In the first experiment, six ponies were used to determine the relationship between elicited muscle contractions (anal, perineal or both) and nerves serving the perineal region (pudendal, caudorectal and perineal nerves) when methylene blue dye was injected using the electrolocation technique. This experiment showed that the pudendal nerve was approached effectively when both anal and perineal twitch were elicited during electrolocation...
November 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27807964/analgesia-nociception-monitoring-for-opioid-guidance-meta-analysis-of-randomized-clinical-trials
#7
Matthias Gruenewald, Astrid Dempfle
BACKGROUND: The adequate suppression of nociception is, besides induction of unconsciousness and immobility, the main objective during anaesthesia. Analgesics, most commonly opioids, are usually titrated by established clinical surrogates of nociception. Recently, monitoring techniques became available to evaluate analgesia/nociception during anaesthesia and provide better measures then clinical evaluation alone. They are primarily derived from autonomic response on physiologic standard measures...
November 3, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27799171/reporting-of-method-comparison-studies-a-review-of-advice-an-assessment-of-current-practice-and-specific-suggestions-for-future-reports
#8
REVIEW
A Abu-Arafeh, H Jordan, G Drummond
BACKGROUND: Anaesthetic journals frequently publish studies comparing measurement methods. A common method of analysis is the Bland and Altman plot, which relates the difference between paired measurements to the mean of the pair. Previous reviews have shown that key data are often omitted from reports using this method of analysis, and the analysis of more complex data is frequently insufficient. METHODS: We identified articles by searching reports, and subsequent citations, considering use of the method...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27790557/oral-clonidine-vs-oral-pregabalin-premedication-to-attenuate-pressor-response-to-direct-laryngoscopy-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-double-blind-study
#9
Shirin Parveen, Devendra Singh Negi, Rajesh Kumar, Mohd Chand Bagwan
INTRODUCTION: Direct laryngoscopy and tracheal intubation has adverse effects like tachycardia, hypertension, myocardial ischemia and cerebral haemorrhage. There are several studies on various pharmacological agents to attenuate this response. AIM: This study was designed to compare efficacy and safety of oral clonidine and oral pregabalin premedication to attenuate stress response in patients undergoing laparoscopic cholecystectomy. MATERIALS AND METHODS: Total 80 patients of ASA grade I and II, aged between 20-60 years of both sexes scheduled for elective laparoscopic cholecystectomy were included in the study...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27790556/efficacy-of-sciatic-nerve-block-for-pain-management-in-below-knee-orthopaedic-surgery
#10
Subhadra Arun Sinha, Sandeep Champalal Mutha, Deepak Sadashiv Phalgune
INTRODUCTION: Perioperative pain management is an integral part of anaesthesia and patients are most satisfied if there is minimal or no pain after surgery. Sciatic nerve block provides postoperative pain relief after below knee surgery and knee surgery. Many studies with different approaches for sciatic nerve block have been conducted to demonstrate the efficacy of sciatic nerve block with different local anaesthetic drugs over the past decade. AIM: To study the efficacy of single-shot sciatic nerve block for postoperative pain management in below knee orthopaedic surgery...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27790555/efficacy-and-safety-of-clonidine-as-an-adjuvant-to-bupivacaine-for-caudal-analgesia-in-paediatric-infra-umbilical-surgeries
#11
Samita Priolkar, Shirley Ann D'Souza
INTRODUCTION: Caudal analgesia, has gained popularity in paediatric intraoperative and postoperative pain management, more so with the use of adjuvants to prolong its duration, each of them having various results. Clonidine, an alpha2-adrenergic agonist is being used for its analgesic effects in various doses with 0.25% Bupivacaine. AIM: The study was conducted to compare the analgesic efficacy, haemodynamic safety and side effects of 1 μg/kg Clonidine added to 1 ml/kg of 0...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27785357/perioperative-regional-anaesthesia-and-postoperative-longer-term-outcomes
#12
REVIEW
Jan Jakobsson, Mark Z Johnson
Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks-that is, spinal and epidural blocks-are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques...
2016: F1000Research
https://www.readbyqxmd.com/read/27777355/analgesia-in-the-surgical-intensive-care-unit
#13
REVIEW
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
October 24, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27746556/a-comparison-of-dexamethasone-and-clonidine-as-an-adjuvant-for-caudal-blocks-in-pediatric-urogenital-surgeries
#14
Chandni Sinha, Bindey Kumar, Umesh Kumar Bhadani, Ajeet Kumar, Amarjeet Kumar, Alok Ranjan
BACKGROUND: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation. Lately dexamethasone has become popular as an adjuvant in paediatric caudals due to its safety profile. AIM: The aim of this study was to compare dexamethasone and clonidine coadministered with bupivicaine caudally in paediatric patients undergoing urogenital surgeries in terms of analgesia and adverse effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746540/effect-of-intravenous-dexmedetomidine-on-spinal-anaesthesia-with-0-5-hyperbaric-bupivacaine-in-lower-abdominal-surgeries-a-prospective-randomized-control-study
#15
Madhavi Unmesh Santpur, Govind Marutrao Kahalekar, Nowreen Saraf, Aparna Losari
BACKGROUND: Regional anesthesia is the preferred technique for most of lower abdominal and lower limb surgeries. For decades, lignocaine had been the local anesthetic of choice for spinal anesthesia. Recent studies show that intravenous clonidine and dexmedetomidine can prolong the duration of the spinal anesthesia. Dexmedetomidine is a more suitable adjuvant compared to clonidine due to its more selective α2A receptor agonist activity. AIM: The study was undertaken to evaluate the effects of intravenous administration of dexmedetomidine on spinal anesthesia with 0...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27744107/a-targeted-remifentanil-administration-protocol-based-on-the-analgesia-nociception-index-during-vascular-surgery
#16
Georges Daccache, Edouard Caspersen, Michel Pegoix, Kelly Monthé-Sagan, Ludovic Berger, Dominique Fletcher, Jean-Luc Hanouz
BACKGROUND: The intraoperative modulation of opioids continues to be based on clinical signs. This may result in adverse events such as sympathetic reactivity or opioid induced hyperalgesia. Recently, the Analgesia/Nociception Index (ANI), a non-invasive 0-100 index derived from heart rate variability analysis, has been proposed for nociception assessment. However, the ability of the ANI to adequately guide intraoperative opioid administration has never been demonstrated. We designed a prospective study to evaluate the ability of the ANI to guide remifentanil administration in vascular surgery...
October 12, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27734470/remifentanil-tolerance-and-hyperalgesia-short-term-gain-long-term-pain
#17
E H Y Yu, D H D Tran, S W Lam, M G Irwin
The unique pharmacology of remifentanil makes it a popular intra-operative analgesic. Short-acting opioids like remifentanil have been associated with acute opioid tolerance and/or opioid-induced hyperalgesia, two phenomena which have different mechanisms and are pharmacologically distinct. Clinical studies show heterogeneity of remifentanil infusion regimens, durations of infusion, maintenance of anaesthesia, cumulative dose of remifentanil and pain measures, which makes it difficult to draw conclusions about the incidence of acute tolerance or hyperalgesia...
November 2016: Anaesthesia
https://www.readbyqxmd.com/read/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#18
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27723695/-the-results-of-combined-surgical-treatment-of-thromboangiitis-obliterans-and-critical-lower-limb-ischemia-using-prolonged-epidural-analgesia-and-autohemotherapy-with-ozone
#19
N S Abyshov, A G Abdullaev, E D Zakirdzhaev, R A Guliev, M B Akhmedov, G T Tagizade, G M Zeinalova, L D Mamedova
AIM: to evaluate the results of combined treatment of thromboangiitis obliterans with severe lower limb ischemia using prolonged epidural anaesthesia and autohemotherapy with ozone. MATERIAL AND METHODS: It was analyzed treatment of 125 patients with thromboangiitis obliterans and severe lower limb ischemia. Patients were divided into 2 groups. Control group consisted of 60 patients who underwent conventional perioperative therapy with anticoagulants, antiplatelet agents, dextrans, metabolic drugs, glucocorticoids, angioprotectors, narcotic and non-narcotic analgesics...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27718435/suspected-total-spinal-in-patient-having-emergent-caesarean-section-a-case-report-and-literature-review
#20
H Virgin, E Oddby, J G Jakobsson
INTRODUCTION: Epidural analgesia is commonly used for management of pain during childbirth. Need for emergent Caesarean section e.g. because of signs of foetal distress or lack of progress is however not an uncommon event. In females having an established epidural; general anaesthesia, top-up of the epidural or putting a spinal are all possible options. Dosing of the spinal anaesthesia in females having epidural is a matter of discussion. PRESENTATION OF CASE: We describe a healthy 32 years, 0 para mother in gestation week 36 having labour epidural analgesia but due to foetal distress scheduled for an emergent Caesarean section category 2 that developed upper extremity weakness and respiratory depression after administration of standard dose high density bupivacaine/morphine/fentanyl intrathecal anaesthesia...
2016: International Journal of Surgery Case Reports
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