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anti-inflammatory effects of perioperative intensive

Renan C Castillo, Srinivasa N Raja, Katherine P Frey, Heather A Vallier, Paul Tornetta, Todd Jaeblon, Brandon J Goff, Allan Gottschalk, Daniel O Scharfstein, Robert V OʼToole
Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures...
April 2017: Journal of Orthopaedic Trauma
Lars Peter Holst Andersen
The hormone, melatonin is produced with circadian rhythm by the pineal gland in humans. The melatonin rhythm provides an endogenous synchronizer, modulating e.g. blood pressure, body temperature, cortisol rhythm, sleep-awake-cycle, immune function and anti-oxidative defence. Interestingly, a number of experimental animal studies demonstrate significant dose-dependent anti-nociceptive effects of exogenous melatonin. Similarly, recent experimental- and clinical studies in humans indicate significant analgesic effects...
October 2016: Danish Medical Journal
Alberto Zangrillo, Gabriele Alvaro, Antonio Pisano, Fabio Guarracino, Rosetta Lobreglio, Nikola Bradic, Rosalba Lembo, Stefano Gianni, Maria Grazia Calabrò, Valery Likhvantsev, Evgeny Grigoryev, Giuseppe Buscaglia, Giovanni Pala, Elisabetta Auci, Bruno Amantea, Fabrizio Monaco, Giovanni De Vuono, Antonio Corcione, Nicola Galdieri, Claudia Cariello, Tiziana Bove, Evgeny Fominskiy, Stefano Auriemma, Massimo Baiocchi, Alessandro Bianchi, Mario Frontini, Gianluca Paternoster, Fabio Sangalli, Chew-Yin Wang, Maria Chiara Zucchetti, Giuseppe Biondi-Zoccai, Marco Gemma, Michael J Lipinski, Vladimir V Lomivorotov, Giovanni Landoni
OBJECTIVE: Patients undergoing cardiac surgery are at risk of perioperative low cardiac output syndrome due to postoperative myocardial dysfunction. Myocardial dysfunction in patients undergoing cardiac surgery is a potential indication for the use of levosimendan, a calcium sensitizer with 3 beneficial cardiovascular effects (inotropic, vasodilatory, and anti-inflammatory), which appears effective in improving clinically relevant outcomes. DESIGN: Double-blind, placebo-controlled, multicenter randomized trial...
July 2016: American Heart Journal
Pascal L Langlois, Gil Hardy, William Manzanares
BACKGROUND: Omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation is an attractive therapeutic option for patients undergoing open-heart surgery due to their anti-inflammatory and anti-arrhythmic properties. Several randomized controlled trials (RCT) have found contradictory results for perioperative ω-3 PUFA administration. Therefore, we conducted an updated systematic review and meta-analysis evaluating the effects of perioperative ω-3 PUFA on some clinically important outcomes for cardiac surgery...
May 27, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Philip J Banerjee, Wen Xing, Catey Bunce, Malcolm Woodcock, Aman Chandra, Robert A H Scott, David G Charteris
PURPOSE: To investigate the feasibility of conducting a randomised controlled trial in patients undergoing pars plana vitrectomy surgery following open globe trauma (OGT). Additionally, to investigate the treatment effect and toxicity of intensive anti-inflammatory agents. METHODS: A 2-year, pilot, single-centre prospective, participant and surgeon-masked randomised controlled trial (RCT). Forty patients requiring vitrectomy surgery following OGT were randomised to either standard (control) or study treatment (adjuncts) in a 1:1 allocation ratio...
July 2016: British Journal of Ophthalmology
E Rebecca Longbottom, Hew D T Torrance, Helen C Owen, Paraskevi C Fragkou, Charles J Hinds, Rupert M Pearse, Michael J O'Dwyer
OBJECTIVE: The aim of this study was to evaluate the role of interleukin (IL)-6 pathways in postoperative immune suppression and to assess the reversibility of this phenomenon. BACKGROUND: The postoperative period is characterized by increased IL-6 production and features of immune suppression. In vitro, IL-6 mediates anti-inflammatory effects through inhibition of interferon gamma (IFN-γ) pathways. The significance of the immunomodulatory effects of IL-6 in the clinical setting of postoperative immune suppression remains unclear...
August 2016: Annals of Surgery
Michael Linecker, Perparim Limani, Florin Botea, Irinel Popescu, Ruslan Alikhanov, Michail Efanov, Pavel Kim, Igor Khatkov, Dimitri Aristotele Raptis, Christoph Tschuor, Beatrice Beck-Schimmer, John Bonvini, Andrea Wirsching, Philipp Kron, Ksenija Slankamenac, Bostjan Humar, Rolf Graf, Henrik Petrowsky, Pierre-Alain Clavien
BACKGROUND: The body is dependent on the exogenous supply of omega-3 polyunsaturated fatty acids (n3-PUFA). These essential fatty acids are key players in regulating metabolic signaling but also exert anti-inflammatory and anti-carcinogenic properties. The liver is a major metabolic organ involved in fatty acid metabolism. Under experimental conditions, n3-PUFA exert beneficial effect on hepatic steatosis, regeneration and inflammatory insults such as ischemic injury after surgery. Some of these effects have also been observed in human subjects...
August 14, 2015: BMC Gastroenterology
Ahmed Ali Abd Elhafz, Ahmed Said Elgebaly, Ahmed Sobhy Bassuoni, Ahmed Ali El Dabaa
OBJECTIVE: To evaluate the efficacy of lidocaine patch applied around wound in laparoscopic colorectal surgery in reduction of postoperative pain and illus compared to intravenous lidocaine infusion and placebo. BACKGROUND: Postoperative illus and pain after colorectal surgery is a challenging problem associated with increased morbidity and cost. Inflammatory response to surgery plays crucial rule in inducing postoperative illus. Systemic local anesthetics proved to have anti-inflammatory properties that may be beneficial in preventing ileus added to its analgesic actions...
July 2012: Anesthesia, Essays and Researches
Joyce S Willens, Iwona Bucior, Shay Bujanover, Neel Mehta
When used in multimodal analgesia for acute pain, nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the requirement for opioids during the perioperative period. To provide more insight into pain treatment during the outpatient period, we examined the use of opioid rescue medication (RM) and described the relationship between pain intensity and RM use in patients with acute pain after bunionectomy. Patients received placebo or 25 mg of a liquid-filled capsule version of the NSAID diclofenac potassium (DPLFC; n=188 patients/group) every 6 hours during the 48-hour inpatient period through the end of outpatient dosing on day 4...
2015: Journal of Pain Research
Yun Zhang, Zhi Zeng, Yu Cao, Xiaodong Du, Zhi Wan
OBJECTIVES: A meta-analysis was conducted to investigate the effects of ulinastatin treatment on adult patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). METHODS: Seven electronic databases were searched for reports of randomized, controlled trials conducted up to February 2014 in which patients undergoing cardiac surgery with CPB were administered ulinastatin in the perioperative period. RESULTS: Fifty-two studies with 2025 patients were retained for analysis...
2014: PloS One
Stefan Bushuven, Daniel Heise, Juliane Bolbrinker
The non-opioid analgesic diclofenac is used worldwide for musculoskeletal and perioperative pain therapy. Despite its frequent use and easy access as an "over the counter" drug, gastrointestinal, cardiovascular, and renal adverse drug effects have to be considered. Availability of diverse formulations (e.g. tablets, suppository, gel-formulations) with different indications, dosage recommendations and contraindications may easily lead to confusion, thus accounting for inadequate use on the one hand or withholding of an effective analgesic...
October 2014: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
V M Popkov, B I Bliumberg, O V Osnovin, T V Shatylko
Despite the high efficacy and safety of ESWL used to disintegrate stones in pyelocaliceal system and upper ureter, the issue of further reduction of the risk of complications of this procedure remains unresolved. The inclusion ofphytopreparations with anti-inflammatory and lithokinetic properties in the scheme of perioperative treatment is one of the ways for prevent complications of ESWL. The effect of the drug Rowatinex on the process of discharge of calculi fragments after ESWL is evaluated. The frequency and intensity of qualitative changes of urine after appointment this drug were assessed...
March 2014: Urologii︠a︡
Peyman Sahbaie, Yuan Sun, De-Yong Liang, Xiao-You Shi, J David Clark
BACKGROUND: Acute pain after surgery remains moderate to severe for 20% to 30% of patients despite advancements in the use of opioids, adjuvant drugs, and regional anesthesia. Depending on the type of surgery, 10% to 50% of patients experience persistent pain postoperatively, and there are no established methods for its prevention. Curcumin (diferuloylmethane) is one of the phenolic constituents of turmeric that has been used in Eastern traditional medicine as an antiseptic, antioxidant, anti-inflammatory, and analgesic agent...
June 2014: Anesthesia and Analgesia
Giuseppe Scrascia, Crescenzia Rotunno, Pietro Guida, Lillà Amorese, Debora Polieri, Daniela Codazzi, Domenico Paparella
OBJECTIVE: To evaluate the effects of prophylactic perioperative corticosteroid administration, compared with placebo, on postoperative mortality and clinical outcomes (renal dysfunction, duration of mechanical ventilation, and ICU length of stay) in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. DATA SOURCES: MEDLINE and Cochrane Library were screened through August 2013 for randomized controlled trials in which perioperative steroid treatment was adopted...
June 2014: Pediatric Critical Care Medicine
Shinji Ogawa, Yasuhide Okawa, Yoshihiro Goto, Masakazu Aoki, Hiroshi Baba
OBJECTIVES: Atrial fibrillation after cardiac surgery is associated with increases in the risk of complications, length of intensive care unit stay, and cost of care. Beta blockers are effective for controlling myocardial ischemia and arrhythmia and suppressing inflammatory cytokines. The purpose of this study was to examine the effect of administrating a short-acting beta-adrenoceptor antagonist, landiolol, on postoperative atrial fibrillation. METHODS: 136 patients undergoing off-pump coronary artery bypass grafting were single-blindly assigned randomly to landiolol (n = 68) and non-landiolol (control, n = 68) groups...
June 2013: Asian Cardiovascular & Thoracic Annals
Chao Liu, Jinghui Wang, Daofeng Yiu, Kunshen Liu
AIMS: cardiopulmonary bypass and cardiac surgery are associated with a significant systemic inflammatory response that has been suggested playing a causative role in the development of perioperative atrial fibrillation (POAF). The goal of this meta-analysis was to determine the efficacy of glucocorticoid prophylaxis in preventing POAF, or length of intensive care unite (ICU) or hospital stay. METHODS: A systematic electronic database literature search of Cochrane controlled trials register (2013, issue 4) and MEDLINE (1966 to April, 2013) was conducted using specific search terms for all relevant articles...
June 2014: Cardiovascular Therapeutics
Mingyang Sun, Qin Liao, Lingling Wen, Xuebin Yan, Fan Zhang, Wen Ouyang
OBJECTIVE: To explore whether perioperative intravenous flurbiprofen axetil can reduce the incidence and intensity of chronic pain for breast cancer after surgical treatment. METHODS: This randomized, double-blind, controlled trial enrolled 60 patients undergoing mastectomy and axillary lymph node dissection under general anesthesia. All patients accepted Hospital Anxiety and Depression Scale (HAD) tests the day before the surgery to evaluate depression and anxiety...
July 2013: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Eric M Graham, Andrew M Atz, Kimberly E McHugh, Ryan J Butts, Nathaniel L Baker, Robert E Stroud, Scott T Reeves, Scott M Bradley, Francis X McGowan, Francis G Spinale
OBJECTIVE: Neonatal cardiac surgery requiring cardiopulmonary bypass results in a heightened inflammatory response. Perioperative glucocorticoid administration is commonly used in an attempt to reduce the inflammatory cascade, although characterization of the cytokine response to steroids in neonatal cardiac surgery remains elusive because of highly variable approaches in administration. This randomized trial was designed to prospectively evaluate the effect of specific glucocorticoid dosing protocols on inflammatory markers in neonatal cardiac surgery requiring cardiopulmonary bypass...
March 2014: Journal of Thoracic and Cardiovascular Surgery
Cielo Alborada Ureña-Frausto, Ricardo Plancarte-Sánchez, Juan Ignacio Reyes-Torres, José Manuel Ramírez-Aranda
INTRODUCTION: Neuraxial anesthesia in upper abdominal laparoscopic surgery decreases perioperative morbidity and mortality. However, shoulder pain is common and difficult to control. Use of a major opioid (e.g., fentanyl) for the control of this event may depress respiratory function. This is why we believe that a safe and effective therapeutic control of this disease pain is a multimodal analgesic scheme which we have called infusional therapy. OBJECTIVE: To compare various schemes for controlling shoulder pain secondary to pneumoperitoneum...
May 2013: Cirugia y Cirujanos
E Paula, S Kossatz, D Fernandes, A Loguercio, A Reis
OBJECTIVE: This study determined the effect of the administration of perioperative ibuprofen 400 mg on tooth sensitivity caused by in-office bleaching. METHODS: A triple-blind, parallel-design, randomized clinical trial was conducted on 30 adults who received placebo or ibuprofen before and after bleaching. The drugs were administered three times per day for 48 hours; the first dose was given one hour prior to the bleaching treatment. Two bleaching sessions with 35% hydrogen peroxide gel were performed with a one-week interval...
November 2013: Operative Dentistry
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