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Opioid free anesthesia

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https://www.readbyqxmd.com/read/28806217/the-effect-of-ondansetron-on-acute-opioid-tolerance-in-patients-receiving-intrathecal-opioids-prior-to-cesarean-delivery
#1
Kevin C Greer, Abdullah S Terkawi, Siny Tsang, Priyanka Singla, Marcel E Durieux, Mohamed Tiouririne
BACKGROUND: Multiple animal studies suggest that ondansetron ameliorates opioid-induced hyperalgesia and tolerance. In this study, we aimed to determine if the administration of ondansetron prior to spinal anesthesia would have an effect on intrathecal opioid-induced acute opioid tolerance, postoperative pain, and analgesic requirements in patients undergoing cesarean delivery with spinal anesthesia. METHODS: Eighty-six patients undergoing elective cesarean delivery were recruited and randomly allocated to receive either 8 mg intravenous ondansetron (n = 44) or placebo (n = 42) in a prospective, double-blind design...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28676317/anterograde-amnesia-and-disorientation-are-associated-with-in-patients-without-traumatic-brain-injury-taking-opioids-retrograde-amnesia-ra-is-absent-ra-assessment-should-be-integral-to-post-traumatic-amnesia-testing
#2
Jessica McLellan, Laurence A G Marshman, Maria Hennessy
The Glasgow Coma Scale (GCS) only assesses orientation after traumatic brain injury (TBI). 'Post-traumatic amnesia' (PTA) comprises orientation, anterograde amnesia (AA) and retrograde amnesia (RA). However, RA is often disregarded in formalized PTA assessment. Drugs can potentially confound PTA assessment: e.g. midazolam can cause AA. However, potential drug confounders are also often disregarded in formalized PTA testing. One study of medium-stay elective-surgery orthopaedic patients (without TBI) demonstrated AA in 80% taking opiates after general anesthesia...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28663616/effect-of-pregabalin-premedication-on-the-requirement-of-anesthetic-and-analgesic-drugs-in-laparoscopic-cholecystectomy-randomized-comparison-of-two-doses
#3
Prasoon Gupta, Anudeep Saxena, Lalita Chaudhary
BACKGROUND: Preoperative medication has a vital role in anesthesia. Pregabalin (PG) is a newer drug of gabapentinoid class and is six times more potent than gabapentin. Our study was designed to evaluate the effect of PG as premedication on the perioperative anesthetic requirement and analgesia. MATERIALS AND METHODS: The study was conducted on ninety patients of American Society of Anesthesiologists Grade I and II of age group 20-60 years, allocated to one of the three groups of thirty patients each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#4
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28431750/opioid-free-general-anesthesia-a-paradigm-shift
#5
J Mulier
No abstract text is available yet for this article.
April 18, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#6
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#7
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27781372/sufentanil-sublingual-tablet-30-mcg-for-the-management-of-pain-following-abdominal-surgery-a-randomized-placebo-controlled-phase-3-study
#8
Harold S Minkowitz, David Leiman, Timothy Melson, Neil Singla, Karen P DiDonato, Pamela P Palmer
BACKGROUND: Results from a phase-3, prospective, randomized, double-blind, placebo-controlled trial evaluating sufentanil sublingual tablet 30 mcg (SST) for the management of pain after ambulatory abdominal surgery are presented. METHODS: Adults with American Society of Anesthesiologists status 1 to 3 scheduled to undergo abdominoplasty, open tension-free inguinal hernioplasty, or laparoscopic abdominal surgery under general or spinal anesthesia that did not include intrathecal opioids during the operation were eligible...
September 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27746532/comparison-of-spinal-block-after-intrathecal-clonidine-bupivacaine-buprenorphine-bupivacaine-and-bupivacaine-alone-in-lower-limb-surgeries
#9
Major Vishal Arora, Mohammad Zafeer Khan, Major Sanjay Choubey, Mohammad Asim Rasheed, Arindam Sarkar
CONTEXT: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. The α2-adrenergic agonist clonidine and potent opioid buprenorphine have the ability to potentiate the effects of local anesthetics. AIMS: The purpose of this prospective, double-blind study was to compare onset, duration of sensory and motor block, effect on hemodynamics, level of sedation, duration of postoperative analgesia, and any adverse effects of clonidine and buprenorphine...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746526/efficacy-of-lipophilic-vs-lipophobic-opioids-in-addition-to-hyperbaric-bupivacaine-for-patients-undergoing-lower-segment-caeserean-section
#10
Amit Agrawal, Veena Asthana, J P Sharma, Vineeta Gupta
BACKGROUND: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27687125/electroacupuncture-in-conscious-free-moving-mice-reduces-pain-by-ameliorating-peripheral-and-central-nociceptive-mechanisms
#11
Ying Wang, Jianxun Lei, Mihir Gupta, Fei Peng, Sarah Lam, Ritu Jha, Ellis Raduenz, Al J Beitz, Kalpna Gupta
Integrative approaches such as electroacupuncture, devoid of drug effects are gaining prominence for treating pain. Understanding the mechanisms of electroacupuncture induced analgesia would benefit chronic pain conditions such as sickle cell disease (SCD), for which patients may require opioid analgesics throughout life. Mouse models are instructive in developing a mechanistic understanding of pain, but the anesthesia/restraint required to administer electroacupuncture may alter the underlying mechanisms. To overcome these limitations, we developed a method to perform electroacupuncture in conscious, freely moving, unrestrained mice...
September 30, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27685344/the-impact-of-paravertebral-block-analgesia-on-breast-cancer-survival-after-surgery
#12
Juan P Cata, Mariana Chavez-MacGregor, Vicente Valero, Walter Black, Daliah M Black, Farzin Goravanchi, Ifey C Ifeanyi, Mike Hernandez, Andrea Rodriguez-Restrepo, Vijaya Gottumukkala
BACKGROUND AND OBJECTIVES: The impact of regional anesthesia on breast cancer recurrence is controversial. We tested the hypothesis that the use of paravertebral block (PVB) analgesia during breast cancer surgery prolongs the recurrence-free survival (RFS) and overall survival (OS) of women with breast cancer. METHODS: Seven hundred ninety-two women with nonmetastatic breast cancer were included in this retrospective study. Patients were divided based on the administration of PVB analgesia for mastectomy surgeries...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27631259/opioid-free-general-anesthesia-in-patient-with-steinert-syndrome-myotonic-dystrophy-case-report
#13
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27243152/arterial-ph-and-blood-lactate-levels-of-anesthetized-mongolian-khulan-equus-hemionus-hemionus-in-the-mongolian-gobi-correlate-with-induction-time
#14
Hanno Gerritsmann, Gabrielle L Stalder, Petra Kaczensky, Bayarbaatar Buuveibaatar, John Payne, Sukhbaatar Boldbaatar, Chris Walzer
Research and conservation of wide-ranging wild equids in most cases necessitate capture and handling of individuals. For free-roaming Mongolian khulan ( Equus hemionus hemionus), also known as the khulan, capture involves a strenuous, high-speed chase, and physiologic responses have yet to be elucidated. We analyzed sequential arterial blood gas (ABG) samples as a proxy for respiratory and metabolic status of khulan during capture-related anesthesia. We recorded precise chase and induction times and monitored vital parameters and ABG from free-ranging khulan during anesthesia performed for GPS collaring...
July 2016: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/27066202/effects-of-propofol-based-total-intravenous-anesthesia-on-recurrence-and-overall-survival-in-patients-after-modified-radical-mastectomy-a-retrospective-study
#15
Ji Heui Lee, Seok Hee Kang, Yunkwang Kim, Hyun Ah Kim, Bong Seog Kim
BACKGROUND: The optimal combination of anesthetic agent and technique may have an influence on long-term outcomes in cancer surgery. In vitro and in vivo studies suggest that propofol independently reduces migration of cancer cells and metastasis. Thus, the authors retrospectively examined the link between propofol-based total intravenous anesthesia (TIVA) and recurrence or overall survival in patients undergoing modified radical mastectomy (MRM). METHODS: A retrospective analysis of the electronic database of all patients undergoing MRM for breast cancer between January 2007 and December 2008 was undertaken...
April 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27025133/-opioid-free-anesthesia-analgesia-and-sedation-in-surgery-of-head-and-neck-tumor
#16
V V Balandin, E S Gorobec
62 adult patients had highly traumatic cancer head and neck surgery under multimodal non-opioid general anesthesia consisted of dexmedetomidine, lidocane, nefopam and sevoflurane. 18 patients had been intubatedwith fiber optic bronchoscope because of II-IV grade trismus. 10 patients with laryngeal stenosis had been tracheotomizedfor intubation. All these 28 patients had been sedated with dexmedetomidine, lidocane and small doses (10-20 mg) ketamine additionally to local anesthesia. All these patients maintained consciousness and breathed spontaneously...
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26861147/ultrasound-guided-popliteal-sciatic-nerve-blockade-in-the-severely-and-morbidly-obese-a-prospective-and-randomized-study
#17
RANDOMIZED CONTROLLED TRIAL
José R Soberón, Carrie McInnis, Kim S Bland, Allison L Egger, Matthew E Patterson, Clint E Elliott, Robert J Treuting, Kristie Osteen
PURPOSE: Limited research data exist regarding optimal block techniques in the severely and morbidly obese patient population. We compared two approaches to sciatic nerve blockade at the popliteal fossa in severely and morbidly obese patients. The purpose of this study was to identify differences in pain scores, block onset characteristics, and adverse events between the proximal (prebifurcation) and the distal (postbifurcation) sites. METHODS: Patients with a body mass index ≥35 scheduled for unilateral foot surgery with a popliteal block were randomized to receive an ultrasound-guided popliteal block proximal or distal to the bifurcation of the sciatic nerve...
2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26453530/urinary-retention-is-rare-after-total-joint-arthroplasty-when-using-opioid-free-regional-anesthesia
#18
Eric H Tischler, Camilo Restrepo, Jennifer Oh, Christopher N Matthews, Antonia F Chen, Javad Parvizi
BACKGROUND: Postoperative urinary retention (POUR) is a relatively common complication after total joint arthroplasty (TJA). Based on the findings of a randomized, prospective study from our institution, we abandoned the routine use of indwelling urinary catheters in patients undergoing elective TJA using opioid-free spinal anesthesia. The aim of this study was to determine the incidence of and the risk factors for POUR in this patient population. PATIENTS AND METHODS: A total of 842 consecutive patients underwent TJA between January 2012 and September 2014 using opioid-free spinal anesthesia in whom indwelling urinary catheters were not used...
February 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26316813/regional-anesthesia-for-the-trauma-patient-improving-patient-outcomes
#19
REVIEW
Jeff Gadsden, Alicia Warlick
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement in trauma patients, and is safe and easy to perform...
2015: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/26121899/the-use-of-paravertebral-blockade-for-analgesia-after-anterior-approach-total-hip-arthroplasty
#20
Alberto E Ardon, Roy A Greengrass, Upasna Bhuria, Steven B Porter, Christopher B Robards, Kurt Blasser
BACKGROUND: Anterior approaches for total hip arthroplasty (ATHA) are becoming increasingly popular. We postulated that the use of PVB of the T12, L1, and L2 roots would provide adequate analgesia for ATHA while allowing motor sparing. METHODS: The medical records of 20 patients undergoing primary ATHA were reviewed. T12, L1 and L2 paravertebral blockade was accomplished with 3-4 ml of 1% ropivacaine with epinephrine 1:200,000 and 0.5 mg/ml of preservative-free dexamethasone per level...
February 2015: Middle East Journal of Anesthesiology
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