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https://www.readbyqxmd.com/read/28750840/electroacupuncture-reduced-sedative-and-analgesic-requirements-for-diagnostic-eus-a-prospective-randomized-double-blinded-sham-controlled-study
#1
Anthony Yuen Bun Teoh, Charing Ching Ning Chong, Wing Wa Leung, Simon Kin Cheong Chan, Yee Kit Tse, Enders Kwok Wai Ng, Paul Bo San Lai, Justin Che Yuen Wu, James Yun Wong Lau
BACKGROUND AND AIMS: The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of the current study is to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS. METHODS: This was a double-blinded randomized controlled study conducted between March 2014 and July 2016. Consecutive patients who were scheduled for diagnostic EUS were recruited and randomized to receive electroacupuncture (EA) or sham-electroacupuncture (SA)...
July 24, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28688027/pharmacokinetics-of-fentanyl-and-its-derivatives-in-children-a-comprehensive-review
#2
REVIEW
Victoria C Ziesenitz, Janelle D Vaughns, Gilbert Koch, Gerd Mikus, Johannes N van den Anker
Fentanyl and its derivatives sufentanil, alfentanil, and remifentanil are potent opioids. A comprehensive review of the use of fentanyl and its derivatives in the pediatric population was performed using the National Library of Medicine PubMed. Studies were included if they contained original pharmacokinetic parameters or models using established routes of administration in patients younger than 18 years of age. Of 372 retrieved articles, 44 eligible pharmacokinetic studies contained data of 821 patients younger than 18 years of age, including more than 46 preterm infants, 64 full-term neonates, 115 infants/toddlers, 188 children, and 28 adolescents...
July 7, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28504483/comparison-of-a-new-intranasal-naloxone-formulation-to-intramuscular-naloxone-results-from-hypothesis-generating-small-clinical-studies
#3
B T Gufford, G R Ainslie, J R White, M E Layton, J M Padowski, G M Pollack, M F Paine
Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of i.v., i.m., and a new i.n. naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to i.m. naloxone, geometric mean (90% confidence interval [CI]) absolute bioavailability of i.n. naloxone was modestly lower (55%; 90% CI, 43-70% vs. 41%; 90% CI, 27-62%), whereas average (±SE) mean absorption time was substantially shorter (74 ± 8.8 vs. 6.7 ± 4.9 min). The opioid-attenuating effects of i...
May 15, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28464270/effect-of-intravenous-alfentanil-on-nonpainful-thermally-induced-hyperalgesia-in-healthy-volunteers
#4
Carolyn Schifftner, Gery Schulteis, Mark S Wallace
Experimental interventions that activate specific components of clinical pain are necessary for characterization of underlying mechanisms and pharmacology. Cutaneous hyperalgesia has been described that uses nonpainful heat to induce secondary hyperalgesia. This study evaluated the effect of intravenous alfentanil on experimental cutaneous hyperalgesia created using this method. Eighteen subjects participated in a randomized, double-blinded, placebo-controlled crossover study consisting of 2 sessions, 1 with alfentanil and 1 with placebo...
September 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28438447/randomized-clinical-trial-of-propofol-versus-alfentanil-for-moderate-procedural-sedation-in-the-emergency-department
#5
James R Miner, Brian E Driver, Johanna C Moore, Erik Faegerstrom, Lauren Klein, Matthew Prekker, Jon B Cole
STUDY OBJECTIVE: To compare the frequency of airway and respiratory adverse events leading to an intervention between moderate sedation using alfentanil or propofol. METHODS: We performed a randomized clinical trial in which adults undergoing moderate sedation in the ED received either alfentanil or propofol. Our primary outcome was the frequency of airway and respiratory adverse events leading to an intervention. Other outcomes included sedation depth, efficacy, sedation time, patient satisfaction, pain, and satisfaction...
April 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28296748/efficacy-of-lidocaine-on-preventing-incidence-and-severity-of-pain-associated-with-propofol-using-in-pediatric-patients-a-prisma-compliant-meta-analysis-of-randomized-controlled-trials
#6
Bing-Chen Lang, Chun-Song Yang, Ling-Li Zhang, Wen-Sheng Zhang, Yu-Zhi Fu
BACKGROUND: Propofol injection pain was considered as one conundrum during clinical anesthesia. The systematic review about the effect of lidocaine in reducing injection pain among children has not been established. The aim of the study was to systematically evaluate the efficacy and safety of such intervention. METHODS: The literature search was performed from the inception to the May 31, 2016 in PubMed, Ovid EMBASE, and Cochrane database. All randomized controlled trials that using lidocaine for propofol injection pain in children were enrolled...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28259933/synergistic-antinociceptive-effects-of-alfentanil-and-propofol-in-the-formalin-test
#7
Na Jia, Xiaochun Zuo, Chao Guo, Yuwen Li, Jia Cui, Chao Zhao, Shanshan Cao, Chao Wang, Ruili Li, Yin Wu, Aidong Wen
The present study was conducted to determine the combined analgesic effect of alfentanil and propofol in the formalin test. Diluted formalin was injected into the dorsal surface of the right hind paw in rats. Nociceptive behavior was determined by counting the number of flinches of the injected paw for 1 h after injection; a reduction in formalin‑induced flinching was interpreted as an antinociceptive effect. Isobolographic analysis was used to determine the type of antinociceptive interaction (additivity, antagonism or synergism)...
April 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28096580/randomized-double-blind-comparison-of-remifentanil-and-alfentanil-in-patients-undergoing-laparoscopic-cholecystectomy-using-total-intravenous-anesthesia
#8
José M Beleña, Mónica Núñez, Alfonso Vidal, Diego Anta
BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28001306/doxapram-mediated-increase-in-cardiac-output-reduces-opioid-plasma-concentrations-a-pk-pd-pk-pd-modeling-study-in-healthy-volunteers
#9
Margot Roozekrans, Erik Olofsen, Rutger van der Schrier, Merel Boom, René Mooren, Albert Dahan
Doxapram is an analeptic that induces ventilatory stimulation and increases blood pressure and cardiac output (CO). Its mechanism of action is blockade of background K(+) -channels expressed on type 1 carotid body cells. In the randomized controlled trial, the authors explored the role of the increase in CO by doxapram (plasma concentration (Cp) 1000-3,500 ng/mL) on the pharmacokinetics (PK) and pharmacodynamics of the potent opioid alfentanil (Cp 100-200 ng/mL). Population PK-PD analyses were performed on the doxapram PK-CO data and the alfentanil PK-antinociception data...
December 21, 2016: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27973590/investigating-power-density-and-the-degree-of-nonlinearity-in-intrinsic-components-of-anesthesia-eeg-by-the-hilbert-huang-transform-an-example-using-ketamine-and-alfentanil
#10
RANDOMIZED CONTROLLED TRIAL
Feng-Fang Tsai, Shou-Zen Fan, Yi-Shiuan Lin, Norden E Huang, Jia-Rong Yeh
Empirical mode decomposition (EMD) is an adaptive filter bank for processing nonlinear and non-stationary signals, such as electroencephalographic (EEG) signals. EMD works well to decompose a time series into a set of intrinsic mode functions with specific frequency bands. An IMF therefore represents an intrinsic component on its correspondingly intrinsic frequency band. The word of 'intrinsic' means the frequency is totally adaptive to the nature of a signal. In this study, power density and nonlinearity are two critical parameters for characterizing the amplitude and frequency modulations in IMFs...
2016: PloS One
https://www.readbyqxmd.com/read/27871575/dose-requirements-of-alfentanil-to-eliminate-autonomic-responses-during-rapid-sequence-induction-with-thiopental-4-mg-kg-and-rocuronium-0-6-mg-kg
#11
Mohammad H Abou-Arab, Morten Rostrup, Tom Heier
STUDY OBJECTIVE: Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. DESIGN: Prospective, randomized, observer-blinded, interventional clinical study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27832553/pharmacological-agents-for-reducing-the-haemodynamic-response-to-tracheal-intubation-in-paediatric-patients-a-systematic-review
#12
REVIEW
M Nazir, B Salim, F A Khan
The primary aim of this review was to assess the effect of pharmacological agents administered to attenuate the haemodynamic response to tracheal intubation in paediatric patients up to 16 years of age undergoing elective surgery. Secondary aims were to identify adverse effects related to these agents, and the agents' roles in decreasing arrhythmias. A systematic search was conducted for articles listed in PubMed, CINAHL or the Cochrane database between January 1980 and June 2014. We included randomised controlled trials where the stated aim of the study included observing the effects of pharmacological agents on the haemodynamic response to tracheal intubation...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27788680/national-survey-and-point-prevalence-study-of-sedation-practice-in-uk-critical-care
#13
Alvin Richards-Belle, Ruth R Canter, G Sarah Power, Emily J Robinson, Henrik Reschreiter, Hannah Wunsch, Sheila E Harvey
BACKGROUND: The present study was designed to (1) establish current sedation practice in UK critical care to inform evidence synthesis and potential future primary research and (2) to compare practice reported via a survey with actual practice assessed in a point prevalence study (PPS). METHODS: UK adult general critical care units were invited to participate in a survey of current sedation practice, and a representative sample of units was invited to participate in a PPS of sedation practice at the patient level...
October 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27787363/the-safety-and-efficacy-of-alfentanil-based-induction-in-bronchoscopy-sedation-a-randomized-double-blind-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Chung-Hsing Hsieh, Ting-Yu Lin, Tsai-Yu Wang, Chih-Hsi Kuo, Shu-Min Lin, Han-Pin Kuo, Yu-Lun Lo
BACKGROUND: Alfentanil in combination with propofol produces a synergistic sedative effect in patients undergoing flexible bronchoscopy (FB). However, the use of this combination is controversial due to the risk of cardiopulmonary depression. The aim of this study was to evaluate the proper induction regimen of alfentanil in propofol target-controlled infusion for FB sedation. METHODS: One hundred seventy-three patients were assigned randomly into 5 regimens: Group 1 and 2, alfentanil 2...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27761556/alfentanil-versus-ketamine-combined-with-propofol-for-sedation-during-upper-gastrointestinal-system-endoscopy-in-morbidly-obese-patients
#15
RANDOMIZED CONTROLLED TRIAL
Ertugrul Kılıc, Barış Demiriz, Nurgül Isıkay, Abdullah E Yıldırım, Selman Can, Cem Basmacı
OBJECTIVES: To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP). METHODS: In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction...
November 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27744535/the-use-of-opioids-in-cancer-patients-with-renal-impairment-a-systematic-review
#16
REVIEW
Tonje A Sande, Barry J A Laird, Marie T Fallon
PURPOSE: Opioids are recommended for moderate to severe cancer pain; however, in patients with cancer, impaired renal function can affect opioid metabolism. The aim of this systematic review was to evaluate the current evidence for the use of opioids in cancer patients with renal impairment. METHODS: A systematic review was conducted and the following databases were searched: MEDLINE (1966 to 2015), EMBASE (1980 2015) and Cochrane Central Register of Controlled Trials (up to 2015)...
February 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27725791/a-comparison-of-oxycodone-and-alfentanil-in-intravenous-patient-controlled-analgesia-with-a-time-scheduled-decremental-infusion-after-laparoscopic-cholecystectomy
#17
RANDOMIZED CONTROLLED TRIAL
Young Suk Kwon, Ji Su Jang, Na Rea Lee, Seong Su Kim, Young Ki Kim, Byeong Mun Hwang, Seong Sik Kang, Hee Jeong Son, So Young Lim
Background. Oxycodone, a semisynthetic opioid, has been widely used for acute and chronic pain. Objectives. The aim of this study was to compare the analgesic and adverse effects of oxycodone and alfentanil on postoperative pain after laparoscopic cholecystectomy. Methods. This was a prospective, randomized, double-blind study. A total of 82 patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either oxycodone or alfentanil using intravenous patient-controlled analgesia (PCA). PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass for 48 hours postoperatively...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27613475/feasibility-of-monomodal-analgesia-with-iv-alfentanil-during-burn-dressing-changes-at-bedside-in-spontaneously-breathing-non-intubated-patients
#18
Mathieu Fontaine, Jacques Latarjet, Jacqueline Payre, Jean-Charles Poupelin, François Ravat
INTRODUCTION: The severe pain related to repeated burn dressing changes at bedside is often difficult to manage. However these dressings can be performed at bedside on spontaneously breathing non-intubated patients using powerful intravenous opioids with a quick onset and a short duration of action such as alfentanil. The purpose of this study is to demonstrate the efficacy and safety of the protocol which is used in our burn unit for pain control during burn dressing changes. PATIENTS AND METHODS: Cohort study began after favorable opinion from local ethic committee has been collected...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27484339/effects-of-remifentanil-and-remifentanil-alfentanil-administration-on-emergence-agitation-after-brief-ophthalmic-surgery-in-children
#19
RANDOMIZED CONTROLLED TRIAL
Yi Hwa Choi, Kyung Mi Kim, Soo Kyung Lee, Yi Seul Kim, Seon Ju Kim, Woon Suk Hwang, Jin Huan Chung
BACKGROUND: Sevoflurane is commonly usedin pediatric anesthesia due to its non-irritating airway properties, and rapid induction and emergence. However, it is associated with emergence agitation (EA) in children. EA may cause injury to the child or damage to the surgical site and is a cause of stress to both caregivers and families. The efficacy of remifentanil and additional alfentanil on EA in the pediatric patients underwent ophthalmic surgery with sevofluraneanesthesiawas not well evaluated to date...
August 2, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27435752/towards-a-best-practice-approach-in-pbpk-modeling-case-example-of-developing-a-unified-efavirenz-model-accounting-for-induction-of-cyps-3a4-and-2b6
#20
A Ke, Z Barter, K Rowland-Yeo, L Almond
In this study, we present efavirenz physiologically based pharmacokinetic (PBPK) model development as an example of our best practice approach that uses a stepwise approach to verify the different components of the model. First, a PBPK model for efavirenz incorporating in vitro and clinical pharmacokinetic (PK) data was developed to predict exposure following multiple dosing (600 mg q.d.). Alfentanil i.v. and p.o. drug-drug interaction (DDI) studies were utilized to evaluate and refine the CYP3A4 induction component in the liver and gut...
July 2016: CPT: Pharmacometrics & Systems Pharmacology
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