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Opioid free anesthesia

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https://www.readbyqxmd.com/read/29771731/effect-of-intravenous-dexmedetomidine-during-general-anesthesia-on-acute-postoperative-pain-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Xiuqin Wang, Naifu Liu, Jinlong Chen, Zan Xu, Fumei Wang, Chuan Ding
BACKGROUND: Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies. METHODS: Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials (RCTs). The relative risk (RR) and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. RESULTS: Compared to the normal saline group, patients using dexmedetomidine showed a significantly decreased pain intensity within 6 hours (WMD=-0...
May 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29757780/effects-of-intraoperative-opioid-use-on-recurrence-free-and-overall-survival-in-patients-with-esophageal-adenocarcinoma-and-squamous-cell-carcinoma
#2
Kim N Du, Lei Feng, Abigail Newhouse, Jeel Mehta, Javier Lasala, Gabriel E Mena, Wayne L Hofstetter, Juan P Cata
BACKGROUND: Perioperative opioid use is associated with poor survival in patients with esophageal squamous cell carcinoma. The most common histological type of esophageal cancer in western countries is adenocarcinoma. The objective of this study was to evaluate the association between intraoperative opioid consumption and survival in patients with adenocarcinoma and squamous cell carcinoma of the esophagus. METHODS: Records of patients who had undergone esophageal cancer surgery between January 2000 and January 2017 were reviewed...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29739542/different-protocols-used-today-to-achieve-total-opioid-free-general-anesthesia-without-locoregional-blocks
#3
REVIEW
Eckhard Mauermann, Wilhelm Ruppen, Oliver Bandschapp
With increasing awareness of both short- and long-term problems associated with liberal perioperative opioid administration, the need for routinely and clinically feasible alternatives is greater than ever. Opioid-free anesthesia-previously reserved for bariatric surgery-is receiving increasing attention in mainstream anesthesia. In this review, we present the truly multimodal concept of opioid-free anesthesia, which circumvents a number of opioid-related problems. For a concrete clinical perspective, we present in depth our opioid-free protocol for bariatric surgery...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739541/stable-anesthesia-with-alternative-to-opioids-are-ketamine-and-magnesium-helpful-in-stabilizing-hemodynamics-during-surgery-a-systematic-review-and-meta-analyses-of-randomized-controlled-trials
#4
REVIEW
Patrice Forget, Juan Cata
INTRODUCTION: The role of ketamine and magnesium in improving postoperative pain and diminish opioid consumption has been largely described. Synthetic opioids are known to provide hemodynamic stability when given for major noncardiac surgery. Definitive evidence on the role of ketamine and/or magnesium on intraoperative hemodynamic control would support their potential as alternatives to opioids during surgery. METHODS: The available literature published on PubMed/Medline and EMBASE was reviewed systematically to perform meta-analyses of randomized controlled trials (RCTs) assessing the effect of ketamine and/or magnesium on hemodynamic response to surgery as the primary outcome...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739540/intravenous-lidocaine
#5
REVIEW
Jean-Pierre Estebe
Lidocaine has analgesic effect and antihyperalgesic and anti-inflammatory properties, which enable its use as a general anesthetic adjuvant. Lidocaine can reduce nociception and/or cardiovascular responses to surgical stress, postoperative pain, and/or analgesic requirements. However, its mechanisms of action remain unclear, despite its different known properties. Although the exact mechanism of action remains uncertain, initial bolus followed by a continuous lidocaine infusion has clear analgesic benefits...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739537/opioid-free-anesthesia-opioid-side-effects-tolerance-and-hyperalgesia
#6
REVIEW
Patricia Lavand'homme, Arnaud Steyaert
Opioids are the most potent drugs used to control severe pain. However, neuroadaptation prevents opioids' ability to provide long-term analgesia and produces opposite effects, i.e., enhancement of existent pain and facilitation of chronic pain development. Neuroadaptation to opioids use results in the development of two interrelated phenomena: tolerance and "opioid-induced hyperalgesia" (OIH). Tolerance, a pharmacologic concept, and OIH, a clinical syndrome, have been mostly observed under experimental conditions in animals and in human volunteers...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739534/opioid-free-general-anesthesia-a-new-paradigm
#7
EDITORIAL
J Mulier, M Dekock
No abstract text is available yet for this article.
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29643620/opioid-free-anesthesia-for-breast-cancer-surgery-an-observational-study
#8
Swagata Tripathy, Satyajit Rath, Suresh Agrawal, P Bhaskar Rao, A Panda, T S Mishra, Sukdev Nayak
Background and Aims: Opioids are associated with postoperative nausea, vomiting, drowsiness, and increased analgesic requirement. A nonopioid anesthesia technique may reduce morbidity, enable day care surgery, and possibly decrease tumor recurrence. We compared opioid-free, nerve block-based anesthesia with opioid-based general anesthesia for breast cancer surgery in a prospective cohort study. Material and Methods: Twenty four adult American Society of Anesthesiologists grade I-III patients posted for modified radical mastectomy (MRM) with axillary dissection were induced with propofol and maintained on isoflurane (0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29370902/opioid-free-anesthesia-with-bis-emg-monitored-propofol-ketamine
#9
B L Friedberg
No abstract text is available yet for this article.
January 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29241172/neurophysiological-monitoring-and-awake-craniotomy-for-resection-of-intracranial-gliomas
#10
Taiichi Saito, Manabu Tamura, Mikhail F Chernov, Soko Ikuta, Yoshihiro Muragaki, Takashi Maruyama
Aggressive resection of intracranial gliomas has a positive impact on patients' prognosis, but is associated with a risk of neurological complications. For preservation of brain functions and avoidance of major postoperative morbidity various methods of intraoperative neurophysiological monitoring have been introduced into clinical practice. At present, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), brainstem auditory evoked potentials (BAEP), and electrocorticography (ECoG) are used routinely during neurosurgical procedures...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29230120/the-relationship-between-regional-anesthesia-and-cancer-a-metaanalysis
#11
REVIEW
Ravi K Grandhi, Samuel Lee, Alaa Abd-Elsayed
Background: Some studies have suggested using epidural analgesia after cancer surgery to reduce metastasis. This article examines the relationship between regional anesthesia (RA) and cancer metastasis in an array of cancers. Methods: We conducted a review of the literature using PubMed and included 67,577 patients across 28 studies in a metaanalysis, evaluating the hazard ratios (HRs) of overall survival, recurrence-free survival, and biochemical recurrence-free survival...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29225793/recent-advances-in-acute-pain-management-understanding-the-mechanisms-of-acute-pain-the-prescription-of-opioids-and-the-role-of-multimodal-pain-therapy
#12
REVIEW
Richa Wardhan, Jacques Chelly
In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the "opioid epidemic". In this regard, we propose that a fundamental principle in acute pain management is identifying patients who are most at risk and providing an "opioid free anesthesia and postoperative analgesia"...
2017: F1000Research
https://www.readbyqxmd.com/read/29225750/opioid-free-anesthesia-using-continuous-dexmedetomidine-and-lidocaine-infusions-in-spine-surgery
#13
David J Kim, Raheel Bengali, T Anthony Anderson
No abstract text is available yet for this article.
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29176373/obstructive-sleep-apnea-and-bariatric-surgical-guidelines-summary-and-update
#14
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...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29049123/impact-of-enhanced-recovery-after-surgery-and-opioid-free-anesthesia-on-opioid-prescriptions-at-discharge-from-the-hospital-a-historical-prospective-study
#15
Delara Brandal, Michelle S Keller, Carol Lee, Tristan Grogan, Yohei Fujimoto, Yann Gricourt, Takashige Yamada, Siamak Rahman, Ira Hofer, Kevork Kazanjian, Jonathan Sack, Aman Mahajan, Anne Lin, Maxime Cannesson
BACKGROUND: The United States is in the midst of an opioid epidemic, and opioid use disorder often begins with a prescription for acute pain. The perioperative period represents an important opportunity to prevent chronic opioid use, and recently there has been a paradigm shift toward implementation of enhanced recovery after surgery (ERAS) protocols that promote opioid-free and multimodal analgesia. The objective of this study was to assess the impact of an ERAS intervention for colorectal surgery on discharge opioid prescribing practices...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28806217/the-effect-of-ondansetron-on-acute-opioid-tolerance-in-patients-receiving-intrathecal-opioids-prior-to-cesarean-delivery
#16
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
#17
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
#18
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
#19
Arthur Davy, Julien Fessler, Marc Fischler, Morgan LE Guen
INTRODUCTION: 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. EVIDENCE ACQUISITION: 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...
December 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28431750/opioid-free-general-anesthesia-a-paradigm-shift
#20
EDITORIAL
J Mulier
No abstract text is available yet for this article.
October 2017: Revista Española de Anestesiología y Reanimación
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