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patient control analgesia

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https://www.readbyqxmd.com/read/29330978/intramuscular-diclofenac-vs-periprostatic-lidocaine-injection-for-controlling-pain-undergoing-transrectal-ultrasound-guided-prostatic-biopsy
#1
Syed Iftikhar Alam, Hazratullah, Zeeshan Kibria, Iqra Masood, Rubab Jawed
BACKGROUND: Transrectal ultrasound (TRUS) technique for getting prostatic tissue for histopathology is now the standard procedure for malignant lesions of the prostate and imperative diagnostic investigation of patients with clinical specks of prostatic neoplasia. During TRUS guided biopsy, pain control has been important issue therefore, highly potent analgesia before this procedure should be considered on high priority according to current census. Therefore, we compared intramuscular diclofenac injection with sensory blockade of injection lidocaine to abolish pain undergoing prostatic biopsy with TRUS technique...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29328788/the-role-of-elastomeric-pumps-in-postoperative-analgesia-in-orthopaedics-and-factors-affecting-their-flow-rate
#2
Anthony Andreas Theodorides
Elastomeric pumps are mechanical devices composed of an elastomeric balloon reservoir into which the drug to be infused is stored, a protective casing (used by some manufacturers), a flow controller and a wound catheter. In orthopaedics they are used to provide continuous local infiltration analgesia. In this way patients rely less on other routes of analgesia and thus avoid their systemic side effects. Studies have shown good response to analgesia with these pumps for the first 24 hours but their benefit is not as clear at 48 and 72 hours...
December 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29324496/efficacy-of-ultrasound-guided-serratus-plane-block-on-postoperative-quality-of-recovery-and-analgesia-after-video-assisted-thoracic-surgery-a-randomized-triple-blind-placebo-controlled-study
#3
Do-Hyeong Kim, Young Jun Oh, Jin Gu Lee, Donghun Ha, Young Jin Chang, Hyun Jeong Kwak
BACKGROUND: The optimal regional technique for analgesia and improved quality of recovery after video-assisted thoracic surgery (a procedure associated with considerable postoperative pain) has not been established. The main objective in this study was to compare quality of recovery in patients undergoing serratus plane block (SPB) with either ropivacaine or normal saline on the first postoperative day. Secondary outcomes were analgesic outcomes, including postoperative pain intensity and opioid consumption...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29319718/effects-of-periarticular-injection-on-analgesic-effects-and-nsaid-use-in-total-knee-arthroplasty-and-total-hip-arthroplasty
#4
Wen-Rui Ban, Ery-Ang Zhang, Lei-Feng Lv, Xiao-Qian Dang, Chen Zhang
OBJECTIVES: This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed. METHODS: A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group...
December 2017: Clinics
https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#5
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29316592/the-addition-of-diclofenac-to-a-multimodal-pain-control-regimen-decreases-postoperative-pain-and-opioid-consumption
#6
Nicole E George, Cheryle Gurk-Turner, Jennifer I Etcheson, Chukwuweike U Gwam, Randal De Souza, Spencer S Smith, James Nace, Ronald E Delanois
INTRODUCTION: Total knee arthroplasty (TKA) is a commonly-performed orthopaedic procedure in the United States. However, inadequate postoperative pain management following TKA has been associated with a number of negative consequences, including chronic postoperative pain requiring long-term opioid use. Multimodal pain control is a recently-popularized means of maximizing analgesia and postoperative outcomes. We aimed to evaluate the outcomes of a multimodal pain regimen incorporating diclofenac, including: 1) length of stay (LOS); 2) pain intensity; and 3) opioid consumption in primary TKA patients...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29315129/relative-contributions-of-adductor-canal-block-and-intrathecal-morphine-to-analgesia-and-functional-recovery-after-total-knee-arthroplasty-a-randomized-controlled-trial
#7
Abhijit Biswas, Anahi Perlas, Meela Ghosh, KiJinn Chin, Ahtsham Niazi, Barjind Pandher, Vincent Chan
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia may enhance early rehabilitation after orthopedic surgery. This randomized double-blind trial investigates the relative contributions of adductor canal block and low-dose intrathecal morphine (ITM) to postoperative analgesia and functional recovery after total knee arthroplasty. METHODS: Two-hundred one patients undergoing elective unilateral total knee arthroplasty under spinal anesthesia were randomized to 3 groups...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29312839/safety-and-efficacy-of-the-use-of-intrathecal-morphine-for-spinal-three-column-osteotomy
#8
Jason R Audlin, Swamy Kurra, William Lavelle, Richard A Tallarico, Mike H Sun, Nathaniel R Ordway, Elizabeth A Demers Lavelle
Introduction The use of intrathecal morphine has the potential to help alleviate the pain that patients experience undergoing spinal surgeries. Complications can cause immobilization, which can lead to vascular thrombosis and ileus. Studies have shown epidural analgesia significantly lowered postoperative pain scores in scoliosis surgeries. Intrathecal anesthesia has been shown to have good pain control over the initial 24-hour postoperative period. Purpose Determine if intrathecal morphine would reduce postoperative pain with minimal side effects...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#9
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29310326/efficacy-and-safety-of-remifentanil-for-analgesia-in-cesarean-delivery
#10
Xuan Zhou, Lian-Jin Jin, Chun-Yang Hu, Meng Chen, Ying Li, Yue-Shun Zhang
BACKGROUND: This study aimed to assess the efficacy and safety of remifentanil as a general anesthetic during cesarean delivery. MATERIAL AND METHODS: Fifty women with singleton pregnancies undergoing cesarean delivery were randomly divided into intervention and control groups, each group containing 25 subjects. Participants in the intervention group received remifentanil (infused at 2 μg/kg/h), whereas subjects in the control group were given dexmedetomidine (infused at 0...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29305103/multimodal-analgesia-decreases-opioid-consumption-after-shoulder-arthroplasty-a-prospective-cohort-study
#11
Dell C McLaughlin, Jonathan W Cheah, Pedram Aleshi, Alan L Zhang, C Benjamin Ma, Brian T Feeley
BACKGROUND: Studies on perioperative pain control in shoulder arthroplasty focus on regional anesthesia, with little research on other approaches. Perioperative multimodal analgesia regimens decrease opioid intake and opioid-related side effects in lower-extremity arthroplasty. In this study we compare pain scores, opioid consumption, length of stay, and readmission rates in postoperative shoulder arthroplasty patients treated with a standard or multimodal analgesia regimen. METHODS: A prospective cohort analysis was performed at a single institution...
January 3, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#12
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29300708/medial-open-transversus-abdominis-plane-motap-catheters-reduce-opioid-requirements-and-improve-pain-control-following-open-liver-resection-a-multicenter-blinded-randomized-controlled-trial
#13
Paul Jack Karanicolas, Sean Cleary, Paul McHardy, Alex Kiss, Jason Sawyer, Ramy Behman, Salima Ladak, Stuart A McCluskey, Coimbatore Srinivas, Joel Katz, Natalie Coburn, Calvin Law, Alice C Wei, Paul Greig, Julie Hallet, Hance Clarke
OBJECTIVE: Conventional management of pain following open liver resection involves intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. The objective of this trial was to assess the efficacy of a regional technique called Medial Open Transversus Abdominis Plane (MOTAP) catheter analgesia compared with IV PCA. METHODS: This was a blinded, randomized, controlled parallel-arm trial conducted at 2 high-volume centers. Patients undergoing liver resection through a subcostal incision were enrolled...
January 3, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29290182/urinary-retention-in-unilateral-total-knee-arthroplasty-comparison-between-continuous-epidural-analgesia-and-single-shot-femoral-nerve-block
#14
Ausaf Ahmed Khan, Robyna Irshad Khan
OBJECTIVE: To compare the frequency of urinary retention and requirement of bladder catheterization in patients undergoing total knee arthroplasty while receiving either continuous epidural analgesia or single-shot femoral nerve block. STUDY DESIGN: Randomized controlled study. PLACE AND DURATION OF STUDY: Operating Rooms of Aga Khan University Hospital, Karachi, from January 2014 to January 2015. METHODOLOGY: Patients were randomized in two groups of 30 each, i...
January 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29287863/demonstration-of-analgesic-effect-of-intranasal-ketamine-and-intranasal-fentanyl-for-postoperative-pain-after-pediatric-tonsillectomy
#15
Alper Yenigun, Sinan Yilmaz, Remzi Dogan, Seda Sezen Goktas, Muhittin Calim, Orhan Ozturan
OBJECTIVE: Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children. MATERIAL AND METHOD: This randomized-controlled study was conducted to evaluate the effects of intranasal ketamine and intranasal fentanyl in children undergoing tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29285407/designing-a-pain-management-protocol-for-craniotomy-a-narrative-review-and-consideration-of-promising-practices
#16
REVIEW
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29284877/intravenous-dexmedetomidine-infusion-compared-with-that-of-fentanyl-in-patients-undergoing-arthroscopic-shoulder-surgery-under-general-anesthesia
#17
Mona Hossam Eldin Abdel Hamid
Background: Anesthesia for arthroscopic shoulder surgery is challenging due to the need for oligaemic surgical field as well as a good postoperative recovery profile. Aim: The present study was prospective, randomized to evaluate the efficacy of dexmdetomidine infusion compared to that of fentanyl in patients undergoing arthroscopic shoulder surgery under general anesthesia. Patients and Methods: A total of 60 patients aged from thirty to fifty years, American Society of Anesthesiologists Class I/II of either sex for arthroscopic shoulder surgery, were included...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284865/comparison-of-analgesic-efficacy-of-caudal-dexamethasone-with-intravenous-dexamethasone-as-an-adjuvant-to-caudal-block-in-pediatric-patients-undergoing-urogenital-surgeries
#18
Dhanashree H Dongare, Seema S Karhade
Context: Caudal block is one of the most common regional anesthetic techniques employed in pediatric urogenital surgeries. Adjuvants play an important role to improve postoperative analgesia. Aims: The aim of this study was to evaluate the analgesic effect of dexamethasone when given systemically as against caudally as an adjuvant to caudal block. Subjects and Methods: In this randomized controlled study, sixty American Society of Anesthesiologists Physical Status I and II patients aged 3-6 years were randomly allocated into two groups of thirty each...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284862/comparison-of-enhancement-of-analgesic-effect-of-intrathecal-neostigmine-by-intrathecal-clonidine-and-transdermal-nitroglycerin-patch-on-bupivacaine-spinal-anesthesia
#19
Mathew V Mammen, Manoj Tripathi, Harish C Chandola, Amit Tyagi, Prateek Singh Bais, Om Prakash Sanjeev
Background: Relief of pain is very important goal intraoperatively and postoperatively. Neostigmine has been used successfully intrathecally with other agents such as clonidine and opioids for pain relief. Aims: This study aims to compare and evaluate the efficacy and safety of combining intrathecal (IT) neostigmine with IT clonidine and transdermal nitroglycerin (tNTG) patch for the relief of pain in patients after surgery. Settings and Design: This was a randomized, prospective, and comparative study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284861/a-comparison-of-intrathecal-dexmedetomidine-and-neostigmine-as-adjuvant-to-ropivacaine-for-lower-limb-surgeries-a-double-blind-randomized-controlled-study
#20
Ashutosh Kumar Singh, Abhyuday Kumar, Ashok Kumar, Braj Kishore Prasad, Pradeep Kumar Tiwary, Ranjeet Kumar
Objective: The primary objective of this study was to compare the analgesic effects of intrathecal ropivacaine with or without neostigmine or dexmedetomidine in lower limb surgeries. Secondary objectives were to study the characteristics of block, duration of analgesia, postoperative analgesic requirement, and associated side effects. Materials and Methods: Seventy-five patients posted for elective orthopedic lower limb surgeries under spinal anesthesia were randomly divided into three equal groups to receive intrathecal ropivacaine 0...
October 2017: Anesthesia, Essays and Researches
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