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patient control analgesia

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https://www.readbyqxmd.com/read/28547753/the-cost-effectiveness-of-patient-controlled-analgesia-vs-standard-care-in-patients-presenting-to-the-emergency-department-in-pain-who-are-subsequently-admitted-to-hospital
#1
C Pritchard, J E Smith, S Creanor, R Squire, A Barton, J Benger, L Cocking, P Ewings, M Rockett
The clinical effectiveness of patient-controlled analgesia has been demonstrated in a variety of settings. However, patient-controlled analgesia is rarely utilised in the emergency department. The aim of this study was to compare the cost-effectiveness of patient-controlled analgesia vs. standard care in participants admitted to hospital from the emergency department with pain due to traumatic injury or non-traumatic abdominal pain. Pain scores were measured hourly for 12 h using a visual analogue scale. Cost-effectiveness was measured as the additional cost per hour in moderate to severe pain avoided by using patient-controlled analgesia rather than standard care (the incremental cost-effectiveness ratio)...
May 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28547269/effect-of-intermittent-versus-continuous-bladder-catheterization-on-duration-of-the-second-stage-of-labor-among-nulliparous-women-with-an-epidural-a-randomized-controlled-trial
#2
Abeer Suleiman, Sobhiya Mruwat-Rabah, Gali Garmi, Dorit Dagilayske, Tair Zelichover, Raed Salim
INTRODUCTION AND HYPOTHESIS: Catheterization type among women laboring with epidural analgesia who develop bladder retention has been reported to affect labor duration and mode of delivery. We aimed to compare the effect of continuous bladder catheterization (CC) with that of intermittent bladder catheterization (IC) on the duration of the second stage of labor. METHODS: In a randomized trial, term nulliparous women with singleton gestation who requested epidural analgesia and were unable to void spontaneously were eligible and randomized to either CC or IC...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28546014/-anesthetic-requirements-measured-by-bilateral-bispectral-analysis-and-femoral-blockade-in-total-knee-arthroplasty
#3
Maylin Koo, Javier Bocos, Antoni Sabaté, Vinyet López, Carmina Ribes
BACKGROUND AND OBJECTIVES: A continuous peripheral nerve blockade has proved benefits on reducing postoperative morphine consumption; the combination of a femoral blockade and general anesthesia on reducing intraoperative anesthetic requirements has not been studied. The objective of this study was to determine the relevance of timing in the performance of femoral block to intraoperative anesthetic requirements during general anesthesia for total knee arthroplasty. METHODS: A single-center, prospective cohort study on patients scheduled for total knee arthroplasty, were sequentially allocated to receive 20mL of 2% mepivacaine throughout a femoral catheter, prior to anesthesia induction (Preoperative) or when skin closure started (Postoperative)...
May 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28545564/dexmedetomidine-in-combination-with-sufentanil-for-postoperative-analgesia-after-partial-laryngectomy
#4
Minju Qin, Kaizheng Chen, Tingjie Liu, Xia Shen
BACKGROUND: Dexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy. METHODS: A total of 60 adult male patients were recruited and randomly allocated to receive sufentanil 1...
May 25, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28545172/femoral-nerve-block-versus-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty
#5
REVIEW
In Jun Koh, Young Jun Choi, Man Soo Kim, Hyun Jung Koh, Min Sung Kang, Yong In
Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28542052/continuous-interscalene-block-for-postoperative-analgesia-and-shoulder-immobilization-after-pectoralis-major-tendon-reinsertion-a-case-report
#6
John J Finneran, Brian M Ilfeld, Jacklynn F Sztain
We present the case of a 38-year-old man undergoing surgical repair of his pectoralis major tendon. An interscalene catheter was placed between the middle and lower trunks of the brachial plexus. Postoperatively, ropivacaine 0.2% was infused through postoperative day. The patient had excellent pain control requiring minimal opioid analgesics. A catheter between the middle and lower trunks of the brachial plexus provided excellent postoperative analgesia after pectoralis major tendon reinsertion. Additionally, the block likely protected the surgical repair during emergence from anesthesia and in the early postoperative period by providing a motor block of the pectoralis major muscle...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28540716/single-dose-oral-ketoprofen-or-dexketoprofen-for-acute-postoperative-pain-in-adults
#7
REVIEW
Helen Gaskell, Sheena Derry, Philip J Wiffen, R Andrew Moore
BACKGROUND: This review is an update of "Single dose oral ketoprofen and dexketoprofen for acute postoperative pain in adults" last updated in Issue 4, 2009. Ketoprofen is a non-selective nonsteroidal anti-inflammatory drug (NSAID) used to treat acute and chronic painful conditions. Dexketoprofen is the (S)-enantiomer, which is believed to confer analgesia. Theoretically dexketoprofen is expected to provide equivalent analgesia to ketoprofen at half the dose, with a consequent reduction in gastrointestinal adverse events...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#8
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28538458/continuous-femoral-nerve-catheters-decrease-opioid-related-side-effects-and-increase-home-disposition-rates-among-geriatric-hip-fracture-patients
#9
Diren Arsoy, Michael J Gardner, Derek F Amanatullah, James I Huddleston, Stuart B Goodman, William J Maloney, Julius A Bishop
OBJECTIVE: To evaluate the effect of continuous femoral nerve catheter (CFNC) for postoperative pain control in geriatric proximal femur fractures compared with standard analgesia (SA) treatment. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 trauma center. PATIENTS/PARTICIPANTS: We retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment. INTERVENTION: One hundred forty-nine patients were treated with standard analgesia without nerve catheter whereas 116 patients received an indwelling CFNC...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28537982/selective-cannabinoids-for-chronic-neuropathic-pain-a-systematic-review-and-meta-analysis
#10
Howard Meng, Bradley Johnston, Marina Englesakis, Dwight E Moulin, Anuj Bhatia
BACKGROUND: There is a lack of consensus on the role of selective cannabinoids for the treatment of neuropathic pain (NP). Guidelines from national and international pain societies have provided contradictory recommendations. The primary objective of this systematic review and meta-analysis (SR-MA) was to determine the analgesic efficacy and safety of selective cannabinoids compared to conventional management or placebo for chronic NP. METHODS: We reviewed randomized controlled trials that compared selective cannabinoids (dronabinol, nabilone, nabiximols) with conventional treatments (eg, pharmacotherapy, physical therapy, or a combination of these) or placebo in patients with chronic NP because patients with NP may be on any of these therapies or none if all standard treatments have failed to provide analgesia and or if these treatments have been associated with adverse effects...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#11
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537569/inguinal-pain-syndrome-the-influence-of-intraoperative-local-administration-of-0-5-bupivacaine-on-postoperative-pain-control-following-lichtenstein-hernioplasty-a-prospective-case-control-study
#12
Bartosz Cybułka
With current technological advancement and availability of synthetic materials used in inguinal hernia repair, a recurrence after first intervention is not a common and important adverse event. On the other hand, however, some patients complain about chronic pain of the operated site after surgeries using a polypropylene mesh. Many patients are constrained to a prolonged use of analgesics and increased frequency of control visits, which may eventually result in loss of trust in the operator. Every surgical intervention is associated with the risk of immediate or delayed complications...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28536837/controlled-sedation-with-midazolam-and-analgesia-with-nalbuphine-to-alleviate-pain-in-patients-undergoing-subcutaneous-implantable-cardioverter-defibrillator-implantation
#13
Michaël Peyrol, Jérémie Barraud, Jennifer Cautela, Baptiste Maille, Marc Laine, Laurent Bonello, Franck Thuny, Franck Paganelli, Frédéric Franceschi, Linda Koutbi, Samuel Levy
PURPOSE: Subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD to prevent sudden cardiac death. Subcutaneous ICD implantation frequently requires general anesthesia because of procedure nociceptive steps during creation of a large device pocket and lead tunneling. This study aims to determine if a strategy of operator-guided controlled sedation with midazolam and analgesia with nalbuphine is effective in alleviating pain during S-ICD implantation...
May 23, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28536526/dexmedetomidine-improves-postoperative-patient-controlled-analgesia-following-radical-mastectomy
#14
Wei Fan, Hong Xue, Yong Sun, HaiKou Yang, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Acute postoperative pain following radical mastectomy is a high risk for prolonged convalescence and potential persistent pain in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on acute postoperative pain following radical mastectomy under general anesthesia. Forty-five patients were enrolled into the study and divided into two groups that were maintained with propofol/remifentanil/Ringer's solution or propofol/remifentanil/Dexmedetomidine followed by morphine-based patient-controlled analgesia...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28533694/the-improved-quality-of-postoperative-analgesia-after-intrathecal-morphine-does-not-result-in-improved-recovery-and-quality-of-life-in-the-first-6-months-after-orthopedic-surgery-a-randomized-controlled-pilot-study
#15
Nilufar Foadi, Matthias Karst, Anika Frese-Gaul, Niels Rahe-Meyer, Stefan Krömer, Christian Weilbach
OBJECTIVE: In orthopedic surgery, it is well known that the use of intrathecal morphine (ITM) leads to an improved quality of postoperative analgesia. Little is known how this improved analgesia affects the long-term course after surgery. STUDY DESIGN: A randomized, double-blind trial. SETTING: Academic medical center. SUBJECTS: Forty-nine patients undergoing total hip or knee replacement surgery in spinal anesthesia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28532200/spinal-analgesia-improves-surgical-outcome-after-open-nephrectomy-for-renal-cell-carcinoma-a-randomized-controlled-study
#16
Mascha Thurm, Britt-Inger Kröger Dahlin, Ola Winsö, Börje Ljungberg
OBJECTIVE: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). MATERIALS AND METHODS: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique...
May 22, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28528536/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-and-rectus-sheath-block-with-ropivacaine-and-dexmedetomidine-in-elderly-high-risk-patients-undergoing-emergency-abdominal-surgery
#17
Lili Xu, Zhiyong Hu, Jianjun Shen, Patrick M McQuillan
BACKGROUND: This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery. METHODS: Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 ml of 0.25% ropivacaine+0...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28527646/high-dose-amino-acid-administration-achieves-an-anabolic-response-in-type-2-diabetic-patients-that-is-independent-of-glycaemic-control-a-randomized-clinical-trial
#18
Chelsia Gillis, Patricia S Roque, Jürgen Bläss, Albert Urwyler, Harald Schepperle, Guido Kunz, Thomas Peters, Thomas Schricker, Linda Wykes, Andrea Kopp Lugli
BACKGROUND & AIMS: Surgical stress provokes protein catabolism and hyperglycaemia that is enhanced in patients with type 2 diabetes (T2DM), and increases perioperative morbidity. This study hypothesized that perioperative administration of high dose intravenous (IV) amino acids (AA) will augment protein balance in T2DM patients receiving tight plasma glucose control via continuous IV insulin compared to standard plasma glucose control via subcutaneous (SC) insulin sliding scale. METHODS: Eighteen patients with well-controlled T2DM (HbA1C% < 7...
May 3, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28525981/combination-of-gabapentin-and-ramosetron-for-the-prevention-of-postoperative-nausea-and-vomiting-after-gynecologic-laparoscopic-surgery-a-prospective-randomized-comparative-study
#19
Kyung Mi Kim, Jin Huh, Soo Kyung Lee, Eun Young Park, Jung Min Lee, Hyo Ju Kim
BACKGROUND: As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. METHODS: One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0...
May 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#20
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
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