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https://www.readbyqxmd.com/read/28813550/drug-free-interventions-to-reduce-pain-or-opioid-consumption-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#1
Dario Tedesco, Davide Gori, Karishma R Desai, Steven Asch, Ian R Carroll, Catherine Curtin, Kathryn M McDonald, Maria P Fantini, Tina Hernandez-Boussard
Importance: There is increased interest in nonpharmacological treatments to reduce pain after total knee arthroplasty. Yet, little consensus supports the effectiveness of these interventions. Objective: To systematically review and meta-analyze evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. Data Sources: Database searches of MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Web of Science (ISI database), Physiotherapy Evidence (PEDRO) database, and ClinicalTrials...
August 16, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#2
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28806176/evaluating-the-use-of-ketamine-for-pain-control-with-sickle-cell-crisis-in-pregnancy-a-report-of-2-cases
#3
Alexis C Gimovsky, Kate Fritton, Eugene Viscusi, Amanda Roman
Sickle cell crises occur frequently during pregnancy and are difficult to treat, even with high-dose opioids. Analgesia with ketamine has been suggested as an alternative, but its use during pregnancy is underreported. Two pregnant patients with uncontrolled sickle cell pain were treated with ketamine. Patient A reported no decrease in her pain, but her opioid requirements decreased. Patient B's pain resolved during ketamine administration. No serious maternal or neonatal adverse effects occurred. Ketamine may be considered as an adjunct analgesic in pregnant patients with sickle cell pain, although prospective clinical data are needed to fully assess its efficacy...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28805777/-accelerated-postoperative-rehabilitation-in-patients-undergoing-pancreatoduodenectomy
#4
Z A Kovalenko, V K Lyadov, K V Lyadov
AIM: To assess safety and clinical-economic effectiveness of complex postoperative rehabilitation after pancreatoduodenectomy. MATERIAL AND METHODS: 73 patients were included in the study. Main group consisted of 39 patients who underwent accelerated postoperative rehabilitation that was developed in our clinic. In the control group of 34 patients this protocol was not applied. The main components of rehabilitation were multicomponent analgesia, early enteral nutrition, physical rehabilitation by using of exercise therapy and physiotherapy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28805236/comparison-of-intrathecal-morphine-and-surgical-site-infusion-of-ropivacaine-as-adjuncts-to-intravenous-patient-controlled-analgesia-in-living-donor-kidney-transplant-recipients
#5
Joo-Hyun Jun, Gaab-Soo Kim, Jeong Jin Lee, Justin S Ko, Sung Joo Kim, Pil Hyun Jeon
INTRODUCTION: This prospective observational study compared the postoperative analgesic effectiveness of intrathecal morphine (ITM) and surgical-site infusion (SSI) of ropivacaine as adjuncts to intravenous (IV) patient-controlled analgesia (PCA) (fentanyl) in living-donor kidney transplant recipients. METHODS: Patients undergoing living-donor kidney transplantation receiving ITM or SSI in addition to IV PCA were included. Rescue analgesia was achieved with IV meperidine, as required...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28803601/ultrasound-guided-transversus-abdominis-plane-block-improves-postoperative-analgesia-and-early-recovery-in-patients-undergoing-retroperitoneoscopic-urologic-surgeries-a-randomized-controlled-double-blinded-trial
#6
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
Objective To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. Methods This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28802777/local-infiltration-analgesia-with-liposomal-bupivacaine-improves-pain-scores-and-reduces-opioid-use-after-total-knee-arthroplasty-results%C3%A2-of-a-randomized-controlled-trial
#7
Michael A Mont, Walter B Beaver, Stanley H Dysart, John W Barrington, Daniel J Del Gaizo
BACKGROUND: Local infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. METHODS: Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed with bupivacaine HCl 0...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802618/is-gabapentin-effective-and-safe-in-open-hysterectomy-a-prisma-compliant-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Xiao-Dan Li, Chao Han, Wen-Li Yu
BACKGROUND: Pain management after open hysterectomy has been investigated for years. Owing to the effect of significant analgesic, gabapentin was often administrated for pre-emptive analgesia. However, the relationship between gabapentin and postoperative pain after open hysterectomy is still controversial. This meta-analysis was applied to assess the efficacy of pre-emptive use of gabapentin in open hysterectomy. METHODS: This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in open hysterectomy regarding (1) the mean difference (MD) of postoperative opioid requirements; (2) the changes of visual analogue scale (VAS) scores in two groups; and (3) incidence rate of adverse effects...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28802598/effect-of-parecoxib-sodium-pretreatment-combined-with-dexmedetomidine-on-early-postoperative-cognitive-dysfunction-in-elderly-patients-after-shoulder-arthroscopy-a-randomized-double-blinded-controlled-trial
#9
Jian Lu, Gang Chen, Hongmei Zhou, Qinghe Zhou, Zhipeng Zhu, Cheng Wu
STUDY OBJECTIVE: To evaluate effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy. DESIGN: Randomized, double-blind study. SETTING: University-affiliated teaching hospital. PATIENTS: One hundred and fifty-two elderly patients scheduled for shoulder arthroscopy. INTERVENTIONS: At 15min before the induction of anesthesia, 152 patients received intravenously parecoxib sodium 40mg and dexmedetomidine at a dose of 0...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28802593/evaluation-of-ultrasound-guided-posterior-quadratus-lumborum-block-for-postoperative-analgesia-after-laparoscopic-gynecologic-surgery
#10
Junichi Ishio, Nobuyasu Komasawa, Haruki Kido, Toshiaki Minami
STUDY OBJECTIVE: This study aimed to determine the efficacy of ultrasound-guided posterior quadratus lumborum block (QLB) in treating postoperative pain following laparoscopic gynecologic surgery. DESIGN: Prospective randomized controlled study. PATIENTS: Seventy adult patients scheduled for elective laparoscopic gynaecological surgery under general anesthesia. INTERVENTION: This randomized controlled study involved two groups of adult females who were scheduled to undergo laparoscopic gynecologic surgery under general anesthesia...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28799964/the-effect-of-adductor-canal-block-on-knee-extensor-muscle-strength-6-weeks-after-total-knee-arthroplasty-a-randomized-controlled-trial
#11
Nicolas Rousseau-Saine, Stephan R Williams, François Girard, Luc J Hébert, Florian Robin, Luc Duchesne, Frédéric Lavoie, Monique Ruel
BACKGROUND: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown. We hypothesized that 48 hours of continuous ACB immediately after TKA would improve KES 6 weeks after TKA, compared to placebo...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28797894/neuraxial-magnesium-sulfate-improves-postoperative-analgesia-in-cesarean-section-delivery-women-a-meta-analysis-of-randomized-controlled-trials
#12
Shih-Ching Wang, Po-Ting Pan, Hsiao-Yean Chiu, Chun-Jen Huang
BACKGROUND: We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. METHOD: We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens...
July 29, 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28795060/efficacy-and-safety-of-combination-therapy-with-ketorolac-and-morphine-in-patient-with-acute-renal-colic-a-triple-blind-randomized-controlled-clinical-trial
#13
Seyed Mohammad Hosseininejad, Hamed Amini Ahidashti, Farzad Bozorgi, Iraj Goli Khatir, Seyyed Hosein Montazar, Fatemeh Jahanian, Mehran Amooei Khanabbasi
OBJECTIVE: To compare the efficacy of combination therapy with ketorolac and morphine with monotherapy with each in patients with acute renal colic. METHODS: This triple-blind, randomized clinical trial was conducted during a 6-month period from March to September 2014 in Northern Iran. We included 300 patients with clinical diagnosis of acute renal colic and pain score greater than 4 on 10 cm visual analogue scale (VAS) score. Patients were randomly assigned to three study groups to receive 0...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28794839/effects-of-pregabalin-and-gabapentin-on-postoperative-pain-and-opioid-consumption-after-laparoscopic-cholecystectomy
#14
Mohammad Eidy, Mohammad Reza Fazel, Hossein Abdolrahimzadeh, Ali Reza Moravveji, Ebrahim Kochaki, Mahdi Mohammadzadeh
BACKGROUND: Gabapentin and pregabalin are antiepileptic drugs that are also used for chronic pain treatment. This study evaluated the effects of pregabalin and gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy. METHODS: A total of 108 candidates for elective laparoscopic cholecystectomy were randomly assigned to gabapentin (n = 36), pregabalin (n = 36), and placebo (n = 36) groups. Patients received 800 mg of gabapentin or 150 mg of pregabalin orally one hour before surgery...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28794528/post-operative-effectiveness-of-continuous-wound-infiltration-continuous-epidural-infusion-and-intravenous-patient-controlled-analgesia-on-post-operative-pain-management-in-patients-undergoing-spinal-surgery
#15
Anshuman Singh, Parul Jindal, Gurjeet Khurana, Ranjeet Kumar
BACKGROUND AND AIMS: Very few studies have compared continuous wound infiltration (CWI), continuous epidural infusion (CEI) and intravenous Patient Controlled Analgesia (PCA) with morphine in spine surgery. This study compared these modalities in patients undergoing microdissectomy. METHODS: This prospective, randomized control trial was conducted on 75 patients of American Society of Anesthesiologists' physical status I or II undergoing microdiscectomy. Patients in all the three groups received morphine 1 mg IV, with a lockout period of 10 min after each bolus, and the maximum allowed dose was 15 mg/5 h postoperatively...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28792650/oral-oxycodone-naloxone-for-pain-control-in-liver-cirrhosis-observational-study-in-patients-with-symptomatic-metastatic-hepatocellular-carcinoma
#16
Francesco Tovoli, Stefania De Lorenzo, Boaz Gedaliahu Samolsky Dekel, Fabio Piscaglia, Francesca Benevento, Giovanni Brandi, Luigi Bolondi
BACKGROUND & AIMS: Pain management in liver cirrhosis is a clinical challenge. Most analgesics are metabolized in the liver and cirrhosis may deeply alter their concentration, favoring the appearance of side effects. We aimed to assess the efficacy and safety of oral prolonged-release association of oxycodone/naloxone tablets (OXN) in the treatment of moderate/severe cancer pain in cirrhotic patients with metastatic hepatocellular carcinoma (HCC). METHODS: We enrolled n=32 HCC patients with moderate/severe cancer pain unresponsive to paracetamol alone or associated with codeine or tramadol...
August 9, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28782603/randomized-clinical-trial-of-epidural-compared-to-conventional-analgesia-after-minimally-invasive-colorectal-surgery
#17
Mark H Hanna, Mehraneh D Jafari, Fariba Jafari, Michael J Phelan, Joseph Rinehart, Coral Sun, Joseph C Carmichael, Steven D Mills, Michael J Stamos, Alessio Pigazzi
OBJECTIVE: The effectiveness of thoracic epidural analgesia (EA) versus conventional intravenous analgesia (IV) after minimally invasive surgery (MIS) is still unproven. We designed a randomized controlled trial comparing EA versus IV after MIS colorectal surgery. METHODS: A total of 87 patients who underwent MIS colorectal procedures at a single institution between 2011 and 2014 were enrolled. 8 patients were excluded and 38 were randomized to EA and 41 to IV. Pain was assessed with the visual analogue scale (VAS) and quality of life with the Overall Benefit of Analgesia Score (OBAS) daily until discharge...
August 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28780493/can-an-observational-pain-assessment-tool-improve-time-to-analgesia-for-cognitively-impaired-older-persons-a-cluster-randomised-controlled-trial
#18
Margaret Fry, Lynn Chenoweth, Glenn Arendts
OBJECTIVE: The primary objective of the study was to measure the impact of an observational pain assessment dementia tool on time from ED arrival to first dose of analgesic medicine. METHODS: A multisite cluster randomised controlled trial was conducted to test the Pain Assessment in Advanced Dementia (PAINAD) tool. Patients aged 65 years or older suspected of a long bone fracture were screened for cognitive impairment using the Six-Item Screening (SIS) tool. Patients scoring 4 or less on SIS (intervention sites) were assessed for pain using PAINAD...
August 5, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28780196/can-we-reduce-morphine-use-in-elderly-proximal-femoral-fracture-patients-using-a-fascia-iliac-block
#19
Al-Amin M Kassam, Anthony T Gough, Joanna Davies, Rathan Yarlagadda
Proximal femoral fractures are becoming increasingly common with an ageing population. Many patients have multiple comorbidities increasing their risk of opiate complications. 40 consecutive patients presenting with a proximal femoral fracture to a trauma centre in the UK were given either a Fascia Iliaca Block (FIB) with oral analgesia or just oral analgesia to control their pre-operative pain. Numeric pain scores and morphine consumption were used as outcome measures. Patients receiving a FIB had significant reduction in their pain scores compared to patients only receiving oral pain relief...
August 2, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28774327/could-remifentanil-reduce-duration-of-mechanical-ventilation-in-comparison-with-other-opioids-for-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#20
Yibing Zhu, Yinhua Wang, Bin Du, Xiuming Xi
BACKGROUND: Sedation and analgesia are commonly required to relieve anxiety and pain in mechanically ventilated patients. Fentanyl and morphine are the most frequently used opioids. Remifentanil is a selective μ-opioid receptor that is metabolized by unspecific esterases and eliminated independently of liver or renal function. Remifentanil has a rapid onset and offset and a short context-sensitive half-life regardless of the duration of infusion, which may lead to reductions in weaning and extubation...
August 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
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