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https://www.readbyqxmd.com/read/29135590/the-analgesic-effect-of-ultrasound-guided-quadratus-lumborum-block-after-cesarean-delivery-a-randomized-clinical-trial
#1
Anders Krohg, Kyrre Ullensvang, Leiv Arne Rosseland, Eldrid Langesæter, Axel R Sauter
BACKGROUND: Landmark and ultrasound-guided transversus abdominis plane blocks have demonstrated an opioid-sparing effect postoperatively after cesarean delivery. The more posterior quadratus lumborum (QL) might provide superior local anesthetic spread to the thoracolumbar fascia and paravertebral space. The aim of our study was to evaluate the efficacy of the QL block after cesarean delivery. METHODS: A randomized, double-blind, controlled trial was performed. Forty parturients undergoing cesarean delivery received bilateral ultrasound-guided QL blocks with either 2 mg/mL ropivacaine or saline postoperatively...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29133161/the-efficacy-of-high-volume-of-local-infiltration-analgesia-for-postoperative-pain-relief-after-total-hip-arthroplasty-under-general-anaesthesia-a-randomised-controlled-trial
#2
Saskia Titman, Ami Hommel, Igor Dobrydnjov, Anders Johansson
BACKGROUND AND AIM: Research regarding patients undergoing total hip arthroplasty (THA) has shown no significant difference in postoperative pain with or without the use of local infiltration analgesia (LIA). The aim was to evaluate whether intra-operative LIA with Ropivacaine in patients undergoing THA under general anaesthesia reduces postoperative pain. METHOD: A randomised, placebo-controlled trial. Forty patients undergoing elective primary THA under general anaesthesia were allocated to an intervention group (RG) who received 150 ml of LIA or a placebo group (CG) who received 150 ml of saline solution...
October 31, 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/29131433/suppressive-effects-of-morphine-injected-into-the-ventral-bed-nucleus-of-the-stria-terminalis-on-the-affective-but-not-sensory-component-of-pain-in-rats
#3
Chikashi Maruyama, Satoshi Deyama, Yusuke Nagano, Soichiro Ide, Katsuyuki Kaneda, Mitsuhiro Yoshioka, Masabumi Minami
Pain is a complex experience with both sensory and affective components. Clinical and preclinical studies have shown that the affective component of pain can be reduced by doses of morphine lower than those necessary to reduce the sensory component. Although the neural mechanisms underlying the effects of morphine on the sensory component of pain have been investigated extensively, those influencing the affective component remain to be elucidated. The bed nucleus of the stria terminalis (BNST) has been implicated in the regulation of various negative emotional states, including aversion, anxiety, and fear...
November 13, 2017: European Journal of Neuroscience
https://www.readbyqxmd.com/read/29121296/are-perioperative-therapeutic-doses-of-statins-associated-with-postoperative-pain-and-opioid-consumption-after-hip-surgery-under-spinal-anaesthesia
#4
W Saasouh, S Leung, H O Yilmaz, O Koyuncu, J You, N M Zimmerman, K Ruetzler, A Turan
Background: The anti-inflammatory effects of statins have been suggested to relieve postoperative pain. This retrospective study tested the association between the perioperative routine use of statins in therapeutic doses, and opioid requirements and pain scores, after hip replacement surgery. Methods: With IRB approval, data was obtained for adult patients who had elective hip replacement surgery under spinal anaesthesia at Cleveland Clinic between 2005 and 2015...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121294/low-dose-buprenorphine-infusion-to-prevent-postoperative-hyperalgesia-in-patients-undergoing-major-lung-surgery-and-remifentanil-infusion-a-double-blind-randomized-active-controlled-trial
#5
Marco Mercieri, Stefano Palmisani, Roberto A De Blasi, Antonio D'Andrilli, Alessia Naccarato, Barbara Silvestri, Sara Tigano, Domenico Massullo, Monica Rocco, Roberto Arcioni
Background: Postoperative secondary hyperalgesia arises from central sensitization due to pain pathways facilitation and/or acute opioid exposure. The latter is also known as opioid-induced hyperalgesia (OIH). Remifentanil, a potent μ-opioid agonist, reportedly induces postoperative hyperalgesia and increases postoperative pain scores and opioid consumption. The pathophysiology underlying secondary hyperalgesia involves N-methyl-D-aspartate (NMDA)-mediated pain pathways. In this study, we investigated whether perioperatively infusing low-dose buprenorphine, an opioid with anti-NMDA activity, in patients receiving remifentanil infusion prevents postoperative secondary hyperalgesia...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29064627/interpreting-the-effectiveness-of-opioids-and-pregabalin-for-pain-severity-pain-interference-and-fatigue-in-fibromyalgia-patients
#6
Fred Davis, Mark Gostine, Bradley A Roberts, Rebecca Risko, Joseph C Cappelleri, Alesia Sadosky
OBJECTIVE: To evaluate the effectiveness of opioids and/or pregabalin on patient-reported outcomes among fibromyalgia (FM) patients based on levels of improvement. METHODS: A total of 1,421 FM patients were identified with 3,082 observational periods of opioids with or without pregabalin use between April 2008 and February 2015. Patients were categorized by opioids, and pregabalin with and without opioids; opioids were designated by morphine equivalent dose (MED) of ≤20 (low MED), >20 to <100 (moderate MED), ≥100 (high MED), and pregabalin dosages ≤150mg, 151- 300mg, and 301-450mg...
October 24, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29053731/determination-of-%C3%AE-%C3%AE-and-%C3%AE%C2%BA-opioid-receptors-in-forebrain-cortex-of-rats-exposed-to-morphine-for-10-days-comparison-with-animals-after-20-days-of-morphine-withdrawal
#7
COMPARATIVE STUDY
Hana Ujcikova, Martina Hlouskova, Kristina Cechova, Katerina Stolarova, Lenka Roubalova, Petr Svoboda
BACKGROUND: Chronic exposure of mammalian organism to morphine results in adaption to persistent high opioid tone through homeostatic adjustments. Our previous results indicated that in the frontal brain cortex (FBC) of rats exposed to morphine for 10 days, such a compensatory adjustment was detected as large up-regulation of adenylylcyclases I (8-fold) and II (2.5-fold). The other isoforms of AC (III-IX) were unchanged. Importantly, the increase of ACI and ACII was reversible as it disappeared after 20 days of morphine withdrawal...
2017: PloS One
https://www.readbyqxmd.com/read/28937443/reducing-disability-durations-and-medical-costs-for-patients-with-a-carpal-tunnel-release-surgery-through-the-use-of-opioid-prescribing-guidelines
#8
Fraser W Gaspar, Roman Kownacki, Catherine S Zaidel, Craig F Conlon, Kurt T Hegmann
OBJECTIVE: The impacts of compliance with opioid prescribing guidelines on disability durations and medical costs for carpal tunnel release (CTR) were examined. METHODS: Using a dataset of insured US employees, opioid prescriptions for 7840 short-term disability cases with a CTR procedure were identified. Opioids prescriptions were compared with the American College of Occupational and Environmental Medicine (ACOEM)'s opioid prescribing guidelines for postoperative, acute pain, which recommends no more than a 5-day supply, a maximum morphine equivalent dose of 50 mg/day, and only short-acting opioids...
September 20, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#9
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVES: We compared the tolerability and efficacy of intranasal subdissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger noninferiority trial that could investigate the potential opioid-sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared 1 mg/kg intranasal ketamine to 1.5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28918556/effects-of-pregabalin-on-postoperative-pain-after-hysterectomy-under-spinal-anesthesia-with-intrathecal-morphine-a-randomized-controlled-trial
#10
Taniga Kiatchai, Vimolluck Sanansilp, Namtip Triyasunant, Sasithorn Saengprateep, Paksiree Changkittirat, Vuthinun Achariyapota
PURPOSE: To determine if preoperative pregabalin could decrease 24-h postoperative morphine consumption after spinal anesthesia with intrathecal morphine compared with placebo. METHODS: A randomized, double-blind, controlled trial was performed in the tertiary care center. Patients aged between 18 and 65 years who were American Society of Anesthesiologists class I-II and scheduled for abdominal hysterectomy with or without salpingo-oophorectomy were randomly allocated to a placebo or a pregabalin group...
December 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28913379/is-spinal-anesthesia-with-low-dose-lidocaine-better-than-sevoflorane-anesthesia-in-patients-undergoing-hip-fracture-surgery
#11
Mohammad Haghighi, Abbas Sedighinejad, Bahram Naderi Nabi, Mohsen Mardani-Kivi, Samaneh Ghazanfar Tehran, Seyed Abdollah Mirfazli, Ahmadreza Mirbolook, Nasim Ashoori Saheli
BACKGROUND: To evaluate general anesthesia with sevoflurane vs spinal anesthesia with low dose lidocaine 5% on hemodynamics changes in patients undergoing hip fracture surgery. METHODS: In this randomized double blind trial 100 patients (50 patients in each group) older than 60 years under hip surgery were randomized in general anesthesia with sevoflurane and spinal anesthesia with lidocaine 5%. Hemodynamic changes including mean arterial pressure (MAP) and heart rate, blood loss, pain severity, nausea and vomiting and opioids consumption were compared in two groups...
July 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28902707/impact-of-human-ca8-on-thermal-antinociception-in-relation-to-morphine-equivalence-in-mice
#12
Eugene S Fu, Diana M Erasso, Gerald Z Zhuang, Udita Upadhyay, Mehtap Ozdemir, Timothy Wiltshire, Konstantinos D Sarantopoulos, Shad B Smith, William Maixner, Eden R Martin, Roy C Levitt
Recently, we showed that murine dorsal root ganglion (DRG) Car8 expression is a cis-regulated eQTL that determines analgesic responses. In this report, we show that transduction through sciatic nerve injection of DRG with human wild-type carbonic anhydrase-8 using adeno-associated virus viral particles (AAV8-V5-CA8WT) produces analgesia in naive male C57BL/6J mice and antihyperalgesia after carrageenan treatment. A peak mean increase of about 4 s in thermal hindpaw withdrawal latency equaled increases in thermal withdrawal latency produced by 10 mg/kg intraperitoneal morphine in these mice...
December 13, 2017: Neuroreport
https://www.readbyqxmd.com/read/28864105/morphine-and-metabolites-plasma-levels-after-administration-of-sustained-release-morphine-in-roux-en-y-gastric-bypass-subjects-versus-matched-control-subjects
#13
Lorry Hachon, Rafael Reis, Laurence Labat, Christine Poitou, Aude Jacob, Xavier Declèves, Celia Lloret-Linares
BACKGROUND: Better knowledge of opioid pharmacology after Roux-en-Y gastric bypass (RYGB) is required for optimizing their use in this growing population. OBJECTIVE: The aim of this case-controlled pharmacokinetic (PK) study was to compare morphine and its glucuronidated metabolites (morphine-3-glucuronide and morphine-6-glucuronide) plasma PKs between patients with RYGB and their controls. SETTINGS: University hospital, Lariboisière Hospital, Paris...
August 3, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28856110/the-analgesic-efficiency-of-ultrasound-guided-rectus-sheath-analgesia-compared-with-low-thoracic-epidural-analgesia-after-elective-abdominal-surgery-with-a-midline-incision-a-prospective-randomized-controlled-trial
#14
Hany Mahmoud Yassin, Ahmed Tohamy Abd Elmoneim, Hatem El Moutaz
BACKGROUND: Ultrasound-guided rectus sheath blockade has been described to provide analgesia for midline abdominal incisions. We aimed to compare thoracic epidural analgesia (TEA) and rectus sheath analgesia (RSA) with respect to safety and efficacy. METHODS: Sixty patients who underwent elective laparotomies through a midline incision were assigned randomly to receive either continuous TEA (TEA group, n = 31) or intermittent RSA (RSA group, n = 29). The number of patients who required analgesia, the time to first request analgesia, the interval and the cumulative morphine doses consumption during 72 hours postoperatively, and pain intensity using visual analog score (VAS) at rest and upon coughing were reported in addition to any side effects related to both techniques or administered drugs...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28805336/matrix-stimulation-in-cancer-pain-methodology-safety-and-effectiveness
#15
M Mücke, M Tils, R Conrad, D Kravchenko, H Cuhls, L Radbruch, M Marinova, V Peuckmann-Post, R Rolke
BACKGROUND: This feasibility study addresses the applicability of matrix electrodes for the reduction of ongoing pain in cancer patients via low-frequency electrical stimulation (LFS). METHODS: Low-frequency matrix stimulation (4 Hz) was applied to the skin within the 'Head's zones' referring to the tumour localization of cancer pain patients. Pain at baseline was compared to a 3-day treatment interval consisting of 5 min of matrix stimulation in the morning and evening followed by a 3-day follow-up period without therapy...
August 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28757829/effect-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-femoral-nerve-block-for-perioperative-analgesia-in-patients-undergoing-total-knee-replacement-arthroplasty-a-dose-response-study
#16
Senthil K Packiasabapathy, Lokesh Kashyap, Mahesh K Arora, Ravinder Kumar Batra, V K Mohan, Ganga Prasad, C S Yadav
CONTEXT: Dexmedetomidine is being increasingly used in nerve blocks. However, there are only a few dose determination studies. AIMS: To compare two doses of dexmedetomidine, in femoral nerve block, for postoperative analgesia after total knee arthroplasty (TKA). SETTINGS AND DESIGN: A prospective, randomized, controlled trial was conducted in the Department of Anesthesia at AIIMS, a Tertiary Care Hospital. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists I-II patients undergoing TKA under subarachnoid block were randomized to three Groups A, B, and C...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28690183/perinatal-protein-deprivation-facilitates-morphine-cross-sensitization-to-cocaine-and-enhances-%C3%AE-fosb-expression-in-adult-rats
#17
María Cecilia Perondi, María Cecilia Gutiérrez, Analía Valdomero, Gabriel Ricardo Cuadra
Previous studies have indicated that neural changes induced by early nutritional insult cause an altered response to pharmacological treatments, including addictive drugs. This study evaluates the influence of perinatal protein malnutrition in developing cross-sensitization to cocaine-induced rewarding effects in animals pre-exposed to morphine. Different groups of well-nourished (C-rats) and protein-deprived animals (D-rats) were treated twice a day for three days with increasing doses of morphine or with saline...
July 6, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28663006/effect-of-an-emergency-department-opioid-prescription-policy-on-prescribing-patterns
#18
COMPARATIVE STUDY
Jerel Chacko, Josh Greenstein, Brahim Ardolic, Nicole Berwald
BACKGROUND: Staten Island University Hospital is located in NYC, where the opioid epidemic has resulted in significant mortalities from unintentional overdoses. In 2013 as a response to the rising threat to our community, our Emergency Department (ED) administration adopted a clinical practice policy focused on decreasing the prescription of controlled substances. The effects of this policy on our provider prescription patterns are presented here. METHODS: A retrospective chart review of patients prescribed opioids from the ED before and after policy implementation was performed...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28635651/effects-of-tetrodotoxin-in-mouse-models-of-visceral-pain
#19
Rafael González-Cano, Miguel Ángel Tejada, Antonia Artacho-Cordón, Francisco Rafael Nieto, José Manuel Entrena, John N Wood, Cruz Miguel Cendán
Visceral pain is very common and represents a major unmet clinical need for which current pharmacological treatments are often insufficient. Tetrodotoxin (TTX) is a potent neurotoxin that exerts analgesic actions in both humans and rodents under different somatic pain conditions, but its effect has been unexplored in visceral pain. Therefore, we tested the effects of systemic TTX in viscero-specific mouse models of chemical stimulation of the colon (intracolonic instillation of capsaicin and mustard oil) and intraperitoneal cyclophosphamide-induced cystitis...
June 21, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#20
RANDOMIZED CONTROLLED TRIAL
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
October 2017: Acta Orthopaedica
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