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Drug administration pain relief

Kristy Bultema, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike Beck
INTRODUCTION: In the treatment of patients with symptomatic irreversible pulpitis, endodontic debridement is a predictable method to relieve pain. However, there are clinical situations in which emergency care cannot be provided immediately. An unexplored treatment option in these cases may be the use of a long-acting anesthetic to reduce pain in untreated irreversible pulpitis. Some medical studies have shown potential for infiltrations of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals, San Diego, CA) to prolong pain relief and reduce opioid use postoperatively...
October 18, 2016: Journal of Endodontics
Sheena Derry, Cathy Stannard, Peter Cole, Philip J Wiffen, Roger Knaggs, Dominic Aldington, R Andrew Moore
BACKGROUND: Opioid drugs, including fentanyl, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for fentanyl, at any dose, and by any route of administration. Other opioids are considered in separate reviews. OBJECTIVES: To assess the analgesic efficacy of fentanyl for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials...
October 11, 2016: Cochrane Database of Systematic Reviews
Uroš B Pecikoza, Maja A Tomić, Ana M Micov, Radica M Stepanović-Petrović
BACKGROUND: Metformin is a widely used and safe antidiabetic drug that has recently been shown to possess analgesic properties in models of inflammatory pain. Because various arthritic inflammatory disorders are highly prevalent in diabetic patients, we aimed to examine the type of interaction between metformin and several conventional and adjuvant analgesic drugs (ibuprofen, aspirin, tramadol, and pregabalin) in a rat model of somatic inflammatory hyperalgesia. METHODS: Inflammation of the rat hind paw was induced by an intraplantar injection of carrageenan (0...
September 23, 2016: Anesthesia and Analgesia
Reza Shariat Moharari, Ali Valizade, Atabak Najafi, Farhad Etezadi, Seyed Reza Hosseini, Patricia Khashayar, Mohammad Reza Khajavi, Mojtaba Mojtahedzadeh
BACKGROUND: Recently, the use of ketamine as a systemic and local analgesic drug in reducing post-operative pain is studied more frequently. OBJECTIVES: The aim of the present study was to assess the analgesic efficacy of IV ketamine injection inaddition to nephrostomy tract infiltration of ketamine-bupivacaine on postoperative pain relief after tubeless percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: Patients (n = 100), with renal stone who were candidates for PCNL were randomized to five groups with 20 cases in each: Group C, 10 mL of saline solution was infiltrated into the nephrostomy tract; Group B, 10 mL of 0...
2016: Iranian Journal of Pharmaceutical Research: IJPR
Hassan Solhi, Hossein Sanaei-Zadeh, Sadra Solhi, Mohammad Ali Azizi Nadian, Morteza Gharibi, Bahman Sadeghi Sedeh
The present study aimed to evaluate the effectiveness of morphine and meperidine (pethidine) as pain relief in opioid-dependent patients with acute pain. A total of 122 opioid-dependent patients with acute pain were included in the study. Their pain severity was assessed, using visual analog scale (VAS) scores ranging from 0 to 10. The patients randomly received intravenous morphine (up to 0.15 mg/kg) or meperidine (up to 1.5 mg/kg) for pain control by patient control analgesia (PCA) pump. The clinical opioid withdrawal scale (COWS) was employed for the assessment of withdrawal symptoms...
2016: Open Access Emergency Medicine: OAEM
Junndeep Sidhu, Neil Tickner
AIM: To evaluate clinical management of acute pain with respect to pain assessment, scoring and timing of analgesia and whether appropriate supportive medicines were prescribed alongside strong opiates. A previous pain audit found dosing of analgesia was appropriate but did not assess clinical management against pain scores. Our paediatric guideline does not currently stipulate guidance on appropriate time frames to administer analgesia and re-assess pain. Standards were developed with a multidisciplinary team to audit against...
September 2016: Archives of Disease in Childhood
Ahmad I Dimassi, Mohamad K Rahal, Mohamad M Iskandarani, Etwal P BouRaad
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed in the community pharmacy. Their systemic administration has been related to significant adverse effects. The aim of this study was to evaluate the efficacy of topical NSAIDs in managing mild to moderate musculoskeletal pain versus systemic administration or combination of both routes. METHODS: This was a prospective observational study conducted in a large Lebanese community pharmacy over a period of 5 months in 302 patients...
2016: SpringerPlus
Jariya Lertakyamanee
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Endre Soreide, Lars-Petter Granan, Geir A Hjorthaug, Birgitte Espehaug, Sigbjørn Dimmen, Lars Nordsletten
BACKGROUND: The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to patients undergoing anterior cruciate ligament reconstruction (ACLR) is controversial because it may impair tissue healing and clinical outcomes. PURPOSE: To assess the effect of NSAID administration on patients undergoing ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included patients were aged >15 years and were registered in the Norwegian Knee Ligament Registry from 2008 until 2013 after the primary ACLR...
August 5, 2016: American Journal of Sports Medicine
Matthew J Snyder, Lawrence M Gibbs, Tammy J Lindsay
Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses proximally from the feet and hands. Clinicians should carefully consider the patient's goals and functional status and potential adverse effects of medication when choosing a treatment for painful diabetic peripheral neuropathy...
August 1, 2016: American Family Physician
Helen Gaskell, Sheena Derry, Cathy Stannard, R Andrew Moore
BACKGROUND: This is an update of an earlier review that considered both neuropathic pain and fibromyalgia (Issue 6, 2014), which has now been split into separate reviews for the two conditions. This review considers neuropathic pain only.Opioid drugs, including oxycodone, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for oxycodone, at any dose, and by any route of administration...
2016: Cochrane Database of Systematic Reviews
Brandon Glenn, Melissa Drum, Al Reader, Sara Fowler, John Nusstein, Mike Beck
INTRODUCTION: Medical studies have shown some potential for infiltrations of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals, San Diego, CA), a slow-release bupivacaine solution, to extend postoperative benefits of numbness/pain relief for up to several days. Because the Food and Drug Administration has approved Exparel only for infiltrations, we wanted to evaluate if it would be effective as an infiltration to control postoperative pain. The purpose of this study was to compare an infiltration of bupivacaine with liposomal bupivacaine for postoperative numbness and pain in symptomatic patients diagnosed with pulpal necrosis experiencing moderate to severe preoperative pain...
September 2016: Journal of Endodontics
Naama Levy-Cooperman, Kerri A Schoedel, Joseph L Reiz, David Thompson, Bijan Chakaraborty, Pierre Geoffroy, Kenneth J Michalko
OBJECTIVE: To assess the reduction in intravenous (IV) abuse potential of hydromorphone from different dose ratio combinations with naloxone in opioid-dependent drug users. DESIGN: Randomized, blinded, dose ratio escalation study. SETTING: Single center. PARTICIPANTS: Following conversion to a stable IV dose of hydromorphone, 12 non-treatment-seeking, opioid-dependent subjects were randomly assigned and received at least one dose of study drug; seven subjects received all five study treatments...
May 2016: Journal of Opioid Management
Ketan Gajjar, Pierre P L Martin-Hirsch, Andrew Bryant, Gemma L Owens
BACKGROUND: Pre-cancerous lesions of cervix (cervical intraepithelial neoplasia (CIN)) are usually treated with excisional or ablative procedures. In the UK, the National Health Service (NHS) cervical screening guidelines suggest that over 80% of treatments should be performed in an outpatient setting (colposcopy clinics). Furthermore, these guidelines suggest that analgesia should always be given prior to laser or excisional treatments. Currently various pain relief strategies are employed that may reduce pain during these procedures...
2016: Cochrane Database of Systematic Reviews
Agnieszka Kowalczyk, Patrycja Kleczkowska, Monika Rękawek, Kamila Kulik, Anna Lesniak, Anna Erdei, Attila Borics, Charlotte Martin, Karolina Pawlik, Andrzej W Lipkowski, Sándor Benyhe, Helena Makulska-Nowak, Steven Ballet, Magdalena Bujalska-Zadrozny
The design of novel drugs for pain relief with improved analgesic properties and diminished side effect induction profile still remains a challenging pursuit. Tolerance is one of the most burdensome phenomena that may hamper ongoing opioid therapy, especially in chronic pain patients. Therefore, a promising strategy of hybridizing two pharmacophores that target distinct binding sites involved in pain modulation and transmission was established. Previous studies have led to the development of opioid agonist/NK1 agonist hybrids that produce sufficient analgesia and also suppress opioid-induced tolerance development...
October 10, 2016: European Journal of Pharmaceutical Sciences
Abigail L Chua, Stephen Silberstein
INTRODUCTION: The inhalation of substances, both medicinally and recreationally, is a commonly used method of drug administration but has been underutilized in the treatment of neurologic disorders such as migraine. Three drugs have been studied as potential inhalable treatments for acute migraine: dihydroergotamine (MAP0004), prochlorperazine (Staccato prochlorperazine), and loxapine (Staccato loxapine). AREAS COVERED: This review discusses the available literature describing the pharmacokinetics, tolerability and efficacy of MAP0004, Staccato prochlorperazine and Staccato loxapine, including data from Phase II and Phase III clinical trials...
September 2016: Expert Opinion on Pharmacotherapy
Francesca Wuytack, Valerie Smith, Brian J Cleary
BACKGROUND: Many women experience perineal pain after childbirth, especially after having sustained perineal trauma. Perineal pain-management strategies are thus an important part of postnatal care. Non-steroidal anti-inflammatory drugs (NSAIDs) are a commonly used type of medication in the management of postpartum pain and their effectiveness and safety should be assessed. OBJECTIVES: To determine the effectiveness of a single dose of an oral NSAID for relief of acute perineal pain in the early postpartum period...
2016: Cochrane Database of Systematic Reviews
Chao Han, Xiao-Dan Li, Hong-Qiang Jiang, Jian-Xiong Ma, Xin-Long Ma
BACKGROUND: Pain management after total hip arthroplasty (THA) varies and has been widely studied in recent years. Gabapentin as a third-generation antiepileptic drug that selectively affects the nociceptive process has been used for pain relief after THA. This meta-analysis was conducted to examine the efficacy of gabapentin in THA. METHODS: An electronic-based search was conducted using the following databases: PubMed, EMBASE, Ovid MEDLINE,, and Cochrane Central Register of Controlled Trials (CENTRAL)...
2016: Journal of Orthopaedic Surgery and Research
Gitte S Jensen, Cassandra Drapeau, Miki Lenninger, Kathleen F Benson
The goal for this study was to evaluate safety regarding anticoagulant activity and platelet activation during daily consumption of an aqueous cyanophyta extract (ACE), containing a high dose of phycocyanin. Using a randomized, double-blind, placebo-controlled study design, 24 men and women were enrolled after informed consent, and consumed either ACE (2.3 g/day) or placebo daily for 2 weeks. The ACE dose was equivalent to ∼1 g phycocyanin per day, chosen based on the highest dose Generally Recognized as Safe (GRAS) by the U...
July 2016: Journal of Medicinal Food
Laizhu Zhang, Jianguo Wang, Huimin Chi, Shilei Wang
CONTEXT: Transdermal local anesthesia is one of the most applied strategies to avoid systemic adverse effects; there is an appealing need for a prolonged local anesthetic that would provide better bioavailability and longer pain relief with a single administration. OBJECTIVE: Layer by layer (LBL) technique was used in this study to explore a nanosized drug delivery system for local anesthetic therapy. MATERIALS AND METHODS: LBL coated lidocaine loaded nanostructured lipid nanoparticles (LBL-LA/NLCs) were prepared and characterized in terms of particle size, zeta potential, drug encapsulation efficiency (EE), in vitro skin permeation, and in vivo local anesthetic studies...
June 24, 2016: Drug Delivery
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