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https://www.readbyqxmd.com/read/29782405/the-impact-of-anesthesia-influenced-process-measure-compliance-on-length-of-stay-results-from-an-enhanced-recovery-after-surgery-for-colorectal-surgery-cohort
#1
Michael C Grant, Claro M Pio Roda, Joseph K Canner, Philip Sommer, Daniel Galante, Deborah Hobson, Susan Gearhart, Christopher L Wu, Elizabeth Wick
BACKGROUND: Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. METHODS: From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS)...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29776346/a-systematic-review-of-the-risk-factors-for-clinical-response-to-opioids-for-all-age-patients-with-cancer-related-pain-and-presentation-of-the-paediatric-stop-pain-study
#2
Ersilia Lucenteforte, Laura Vagnoli, Alessandra Pugi, Giada Crescioli, Niccolò Lombardi, Roberto Bonaiuti, Maurizio Aricò, Sabrina Giglio, Andrea Messeri, Alessandro Mugelli, Alfredo Vannacci, Valentina Maggini
BACKGROUND: Inter-patient variability in response to opioids is well known but a comprehensive definition of its pathophysiological mechanism is still lacking and, more importantly, no studies have focused on children. The STOP Pain project aimed to evaluate the risk factors that contribute to clinical response and adverse drug reactions to opioids by means of a systematic review and a clinical investigation on paediatric oncological patients. METHODS: We conducted a systematic literature search in EMBASE and PubMed up to the 24th of November 2016 following Cochrane Handbook and PRISMA guidelines...
May 18, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#3
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#4
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29759061/role-of-ultrasound-guided-transversus-abdominis-plane-block-as-a-component-of-multimodal-analgesic-regimen-for-lower-segment-caesarean-section-a-randomized-double-blind-clinical-study
#5
Ashok Jadon, Priyanka Jain, Swastika Chakraborty, Mayur Motaka, Sudhansu Sekhar Parida, Neelam Sinha, Amit Agrawal, Asit Kumar Pati
BACKGROUND: While opioids are the mainstay for post-operative analgesia after lower segment caesarean section, they are associated with various untoward effects. Ultrasound guided transversus abdominis plane (TAP) block has been postulated to provide effective analgesia for caesarean section. We evaluated the analgesic efficacy of this block for post caesarean analgesia in a randomised controlled trial. METHODS: One hundred thirty-nine mothers undergoing caesarean delivery were randomised to receive TAP block with either 20 ml 0...
May 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29732145/rapid-acting-fentanyl-formulations-in-breakthrough-pain-in-cancer-drug-selection-by-means-of-the-system-of-objectified-judgement-analysis
#6
Robert Janknegt, Marieke van den Beuken, Sjouke Schiere, Michael Überall, Roger Knaggs, Jaquie Hanley, Morten Thronaes
Drug selection of rapid acting fentanyl formulations in the treatment of breakthrough pain in patients with cancer is performed by the System of Objectified Judgement Analysis method. All seven available formulations were included in the analysis. The following selection criteria were used: number of available strengths, variability in the rate of absorption, interactions, clinical efficacy, side effects, ease of administration and documentation. No direct double-blind comparative studies between two or more formulations were identified and the clinical documentation of all formulations is limited...
May 2018: European Journal of Hospital Pharmacy. Science and Practice
https://www.readbyqxmd.com/read/29721765/a-survey-of-perceptions-attitudes-knowledge-and-practices-of-medical-oncologists-about-cancer-pain-management-in-spain
#7
Jesús García-Mata, Cecilio Álamo, Javier de Castro, Jorge Contreras, Rafael Gálvez, Carlos Jara, Antonio Llombart, Concepción Pérez, Pedro Sánchez, Susana Traseira, Juan-Jesús Cruz
PURPOSE: To monitor oncologists' perspective on cancer pain management. METHODS: An anonymized survey was conducted in two waves. First, over a convenience sample of oncologists known to be particularly concerned with the management of pain. Second, using a random sample of oncologists. RESULTS: In total, 73 and 82 oncologists participated in the first and second wave, respectively. Many oncologists reported to have good knowledge of analgesic drugs (95...
May 2, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29714994/issues-in-geriatric-care-alzheimer-disease
#8
Kathy Kemle, Richard J Ackermann
Alzheimer disease (AD) occurs in 8.8% of older US adults and is the sixth leading cause of death among older adults. Medicare annual wellness visits require screening for cognitive impairment but do not specify screening methods. Numerous screening instruments are available. If results are positive, evaluation with well-validated assessment tools is needed. If cognitive impairment is confirmed, laboratory tests and imaging studies should be obtained to rule out reversible etiologies. If patients meet diagnostic criteria for AD, clinicians should educate patients and families on the expected course and help them complete advance directives...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29708926/pain-management-after-photorefractive-keratectomy
#9
Oren Golan, J Bradley Randleman
PURPOSE OF REVIEW: To review current concepts regarding the mechanisms of postoperative pain after photorefractive keratectomy (PRK) and review available treatment options. RECENT FINDINGS: Many clinical studies have established the safety and efficacy of different topical and systematic therapeutic agents and techniques for the treatment of postoperative pain after PRK, especially topical nonsteroidal anti inflammatory agents and oral nonsteroidal and narcotic medications...
April 27, 2018: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29701557/stereotactic-radiosurgery-for-trigeminal-pain-secondary-to-recurrent-malignant-skull-base-tumors
#10
Jack Phan, Courtney Pollard, Paul D Brown, Nandita Guha-Thakurta, Adam S Garden, David I Rosenthal, Clifton D Fuller, Steven J Frank, G Brandon Gunn, William H Morrison, Jennifer C Ho, Jing Li, Amol J Ghia, James N Yang, Dershan Luo, He C Wang, Shirley Y Su, Shaan M Raza, Paul W Gidley, Ehab Y Hanna, Franco DeMonte
OBJECTIVE The objective of this study was to assess outcomes after Gamma Knife radiosurgery (GKRS) re-irradiation for palliation of patients with trigeminal pain secondary to recurrent malignant skull base tumors. METHODS From 2009 to 2016, 26 patients who had previously undergone radiation treatment to the head and neck received GKRS for palliation of trigeminal neuropathic pain secondary to recurrence of malignant skull base tumors. Twenty-two patients received single-fraction GKRS to a median dose of 17 Gy (range 15-20 Gy) prescribed to the 50% isodose line (range 43%-55%)...
April 27, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29691187/home-care-with-acupuncture-increased-the-quality-of-life-in-a-patient-with-advanced-cancer-with-neuropathic-pain-induced-by-bone-metastasis-a-case-report
#11
Ching-Feng Su
A 66-year-old female patient was diagnosed with hepatocellular carcinoma accompanied by neuropathic pain induced by a metastatic tumor that compromised root and spinal canal. Although her pain was relieved following medical treatment, breakthrough pain occurring 1-2 times a day was still distressing. Neuropathic pain in her right lower limb caused discomfort and irritability and decreased her quality of life. We had limited options to adjust her prescription drug regime, due to the side effect of these drugs...
April 12, 2018: Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29668636/spinal-dural-arteriovenous-fistula-presenting-with-subarachnoid-hemorrhage-a-case-report
#12
Jingzhe Han, Duanhua Cao, Hongmei Wang, Ye Ji, Zhilei Kang, Jianguo Zhu
RATIONALE: Subarachnoid hemorrhage (SAH) is a common and serious disease and one of the most important differential diagnoses in the emergency department. PATIENT CONCERNS: A 39-year-old female patient with a 12 years' history of migraine, presented with a sudden headache combined with motor aphasia. Physical examination suggested probable positive neck resistance. SAH was confirmed by magnetic resonance imaging. In addition, spinal digital subtraction angiography and spinal vascular computed tomography angiography indicated spinal arteriovenous malformation (SAVM)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29667940/the-importance-of-the-saphenous-nerve-block-for-analgesia-following-major-ankle-surgery-a-randomized-controlled-double-blind-study
#13
Siska Bjørn, Wan Yi Wong, Jørgen Baas, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery. METHODS: Eighteen patients were enrolled and received a popliteal sciatic nerve block...
March 26, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29650818/-combinatorial-use-of-rapid-onset-opioid-and-short-acting-opioid-is-effective-against-breakthrough-cancer-pain
#14
Yasunori Shikada, Yasunori Emi, Takuro Kometani, Toshiaki Ochiai, Misa Fujii, Yoko Noda, Mie Kajiwara, Munehiko Ikeda, Shinichi Asonuma, Minami Mori
Breakthrough cancer pain is divided into "predictable breakthrough pain" and "unpredictable breakthrough pain". Uncontrolled breakthrough pain in cancer negatively affects the quality of life of the patients. The short-acting opioid(SAO) requires considerable time to produce analgesia, and is not adequate as a rescue drug. The rapid-onset opioid(ROO)immediately produces analgesia, but its appropriate usage is difficult. For instance, the frequency and interval of ROO usage is limited, making the optimization of dosage cumbersome...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29605036/ketamine-versus-hydromorphone-patient-controlled-analgesia-for-acute-pain-in-trauma-patients
#15
Sheila C Takieddine, Christopher A Droege, Neil Ernst, Molly E Droege, Megan Webb, Richard D Branson, Travis W Gerlach, Bryce R H Robinson, Jay A Johannigman, Eric W Mueller
BACKGROUND: It is unknown whether ketamine administered via patient-controlled analgesia (PCA) provides adequate analgesia while reducing opioid consumption in the traumatically injured patient. Differences in opioid consumption, pain scores, and adverse effects between ketamine and hydromorphone PCA were studied. MATERIALS AND METHODS: This is an investigator-initiated, single-center, double-blinded, randomized, pilot trial conducted from 2014 to 2016 at a level 1 trauma center...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29590446/cancer-pain-management-education-rectifies-patients-misconceptions-of-cancer-pain-reduces-pain-and-improves-quality-of-life
#16
Su-Jin Koh, Bhumsuk Keam, Min Kyung Hyun, Jeong Ju Seo, Keon Uk Park, Sung Yong Oh, Jinseok Ahn, Ja Youn Lee, JinShil Kim
Objectives: More than half of the patients have reported improper management of breakthrough cancer pain. Empirical evidence is lacking concerning the effectiveness of cancer pain education on breakthrough pain control. This study aimed to examine the effects of individual pain education on pain control, use of short-acting analgesics for breakthrough pain, quality of life outcomes, and rectification of patients' misconceptions regarding cancer pain. Design: A quasi-experimental design was used...
March 26, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29587920/-treatment-experience-of-continuous-negative-pressure-drainage-in-the-acute-anterior-mediastinal-infection-of-oropharyngeal-origined
#17
Anping Chen, Gang Xu, Jian Li, Yongxiang Song, Qingyong Cai
BACKGROUND: Mediastinal infection is a serious infection of mediastinal connective tissue, with more complications and higher mortality. Application of broad-spectrum antibiotics and nutritional support, early sufficient drainage is the key to successful treatment. In the mode of drainage, this paper discusses the application of continuous negative pressure drainage technique to treat acute anterior mediastinal infection of severe mouth pharynx source, and the good results are summarized and shared...
April 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29572732/efficacy-and-safety-of-sublingual-fentanyl-tablets-in-breakthrough-cancer-pain-management-according-to-cancer-stage-and-background-opioid-medication
#18
Jordi Guitart, María Isabel Vargas, Vicente De Sanctis, Jordi Folch, Rafael Salazar, José Fuentes, Joan Coma, Julia Ferreras, Jordi Moya, Albert Tomás, Pere Estivill, Francisco Rodelas, Antonio Javier Jiménez, Almudena Sanz
OBJECTIVE: Our objective was to assess the effect of sublingual fentanyl tablets (SFTs) on pain relief, quality of life, and adverse effects in patients with cancer pain, according to cancer stage and background opioid regimen. METHODS: Subgroup analyses from a recently completed study were performed according to cancer stage (locally advanced cancer [LAC] vs. metastatic cancer) and most frequent background opioid medication (fentanyl vs. oxycodone/naloxone). The efficacy and safety of SFTs were evaluated, recording pain intensity (PI), onset of pain relief, and adverse events (AEs)...
March 23, 2018: Drugs in R&D
https://www.readbyqxmd.com/read/29560295/a-case-of-sciatica-during-labor-due-to-an-occiput-posterior-fetus
#19
Cassandra Wasson, Telianne Chon
A 28-year-old term G3P0020 received an epidural with complete pain relief. Approximately 19 hours after the epidural placement, the pain increased. Sensory levels were rechecked and were bilateral and adequate at T8. Further discussion revealed that the pain was unrelated to her contractions; it was in her buttocks and radiating down the leg. The possibility of the fetus being positioned occiput posterior (OP) was discussed. The patient was placed into knee-chest position with instantaneous relief of her pain...
January 17, 2018: Curēus
https://www.readbyqxmd.com/read/29557092/-transmucosal-fentanyl-administration-sublingual-buccal-nasal-all-the-same-treatment-of-breakthrough-cancer-pain
#20
Michael A Überall
BACKGROUND: Transient exacerbation of pain in cancer patients (breakthrough cancer pain, BTCP) despite adequately controlled background pain should be regarded as an independent disease and receive targeted treatment. The opioid of choice is fentanyl, a rapid onset and highly potent WHO category III analgesic. Fentanyl has a strong first pass effect when administered orally and resorbed enterally, however it is well suited for transmucosal administration, e.g. on the oral or nasal mucosa...
October 2017: MMW Fortschritte der Medizin
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