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Tonny Stone Luggya, Richard Nicholas Kabuye, Cephas Mijumbi, Joseph Bahe Tindimwebwa, Andrew Kintu
BACKGROUND: Surgery and anaesthesia cause shivering due to thermal dysregulation as a compensatory mechanism and is worsened by vasodilatation from spinal anaesthesia that redistributes core body heat. Due to paucity of data Mulago Hospital's post spinal shivering burden is unknown yet it causes discomfort and morbidity. METHODS: Ethical approval was obtained to perform the study among consenting mothers due for elective caesarean section from March to May 2011...
October 18, 2016: BMC Anesthesiology
Ali Solhpour, Alireza Jafari, Masoud Hashemi, Behnam Hosseini, Sajad Razavi, Gholamreza Mohseni, Maryam Vosoughian, Faranak Behnaz, Reza Amin Nejad, Mohamad Amin Pourhoseingholi, Fereshteh Soltani
STUDY OBJECTIVES: The aim of this study is to compare the efficacy of combination of meperidine and dexamethasone with that of placebo, meperidine alone, and the combination of ketamine and midazolam in preventing shivering during spinal anesthesia. DESIGN: This is a prospective, placebo-controlled study. SETTING: The setting is at an operating room of a university-based teaching hospital. PATIENTS: Two hundred American Society of Anesthesiologists I and II patients undergoing orthopedic and urologic surgery under spinal anesthesia were included...
November 2016: Journal of Clinical Anesthesia
Min Li, Xiaolan Hu, Yuan Tan, Baoping Yang, Kun Li, Zhenyu Tang
OBJECTIVES: Considerable controversy exists regarding the efficacy of ondansetron in preventing postanesthesia shivering (PAS). We performed a meta-analysis of randomized controlled trials to examine the controversy. MATERIALS AND METHODS: Randomized controlled trials assessing the effect of ondansetron on the prevention of PAS were identified from electronic databases (PubMed and EMBASE). The meta-analysis was performed with the fixed-effect model or random-effect model according to heterogeneity...
September 12, 2016: International Journal of Surgery
Sausan El Burai Félix, Karin A Mack, Christopher M Jones
OBJECTIVE: Limited information has been published about opioid prescribing practices in Puerto Rico. The objective of this study was to create baseline trends of opioids distributed over a period of fourteen years in Puerto Rico. METHODS: We examined data from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System (ARCOS) for the period 1999-2013. ARCOS data reflects the amount of controlled substances legally dispensed. Analyses include the distribution of opioids (in morphine milligram equivalent kg per 10,000 persons) by year and entity (pharmacy, hospital, practitioner)...
September 2016: Puerto Rico Health Sciences Journal
Ko-Eun Choi, Bomi Park, Asma M Moheet, Amanda Rosen, Shouri Lahiri, Axel Rosengart
Shivering is a common side effect of targeted temperature modulation and general anesthesia. Antishivering strategies often employ a stepwise approach involving both pharmacological and physical interventions. However, approaches to treat shivering are often empiric and vary widely across care environments. We evaluated the quality of published antishivering protocols and guidelines with respect to methodological rigor, reliability, and consistency of recommendations. Using 4 medical databases, we identified 4027 publications that addressed shivering therapy, and excluded 3354 due to lack of relevance...
September 12, 2016: Anesthesia and Analgesia
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
Jinhua Zhang, Yong Huang, Zhao Li, Jian Li, Kunpeng Liu, Chenghui Li
PURPOSE: To compare the efficacy and remifentanil with midazolam for conscious sedation during endoscopic retrograde cholangiopancreatography (ERCP). METHODS: 99 patients scheduled for ERCP were randomly allocated to be treated with either meperidine/midazolam (group C, n = 33), remifentanil (group R, n = 33), or the remifentanil plus midazolam (group RM, n = 33). In group C, intermittent intravenous meperidine and midazolam were administrated during the procedure; in group R, remifentanil was infused continuously at a rate of 0...
November 2016: International Journal of Clinical Pharmacology and Therapeutics
Brandon Stamper, Waseem Gul, Murrell Godfrey, Shahbaz W Gul, Mahmoud A ElSohly
Continuing our previous studies analyzing drugs of abuse in municipal wastewater, a method was developed for the analysis of miscellaneous drugs of abuse in wastewater samples using liquid chromatography coupled with tandem mass spectrometry (LC-MS-MS). Eight drugs and metabolites were analyzed including 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrolidine (EDDP), fentanyl, norfentanyl, meperidine, normeperidine, methadone, phencyclidine and tramadol. These drugs were chosen because of their widespread abuse. Wastewater samples were collected at both the Oxford Waste Water Treatment Plant in Oxford, Mississippi (MS) and the University Wastewater Treatment Plant in University, MS...
October 2016: Journal of Analytical Toxicology
Qianli Tang, Qiuyan Jiang, Suren R Sooranna, Shike Lin, Yuanyuan Feng, Qi Zhang, Meili Wang, Yu Wang
To observe the effects of electroacupuncture on pain threshold of laboring rats and the expression of norepinephrine transporter and α2 adrenergic receptor in the central nervous system to determine the mechanism of the analgesic effect of labor. 120 pregnant rats were divided into 6 groups: a control group, 4 electroacupuncture groups, and a meperidine group. After interventions, the warm water tail-flick test was used to observe pain threshold. NE levels in serum, NET, and α2AR mRNA and protein expression levels in the central nervous system were measured...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Guillermo Alberto Keller, María Cecilia Villa Etchegoyen, Nicolás Fernández, Nancy Mónica Olivera, Patricia Noemí Quiroga, Roberto Alejandro Diez, Guillermo Di Girolamo
: A prolongation of the QTc-interval has been described for several opioids, including pethidine (meperidine). OBJECTIVE: To evaluate in the clinical setting the frequency and risk factors associated with the QT-interval prolongation induced by meperidine. RESEARCH DESIGN AND METHODS: We recruited patients requiring meperidine administration and recorded their medical history and comorbidities predisposing to QT-interval prolongation. Ionograms and electrocardiograms (ECGs) were performed at baseline and during treatment; QT was corrected using the Bazzet, Fridericia, Framinghan, and Hogdes formulas...
August 11, 2016: International Journal of Clinical Pharmacology and Therapeutics
Hong-Qi Lin, Dong-Lin Jia
The pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience visceral pain after the former surgery. The aim of this study was to determine the effects of preemptive ketamine on visceral pain in patients undergoing gynecological laparoscopic surgery. Ninety patients undergoing gynecological laparoscopic surgery were randomly assigned to one of three groups. Group 1 received placebo. Group 2 was intravenously injected with preincisional saline and local infiltration with 20 mL ropivacaine (4 mg/mL) at the end of surgery...
August 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Vaibhav Wadhwa, Danny Issa, Sushil Garg, Rocio Lopez, Madhusudhan R Sanaka, John J Vargo
BACKGROUND & AIMS: Even though propofol use for gastrointestinal endoscopic procedures has increased over the past decade, there is a perception that it causes a higher rate of cardiopulmonary adverse events. The aim of this study was to compare the sedation-related adverse events associated with use of propofol vs nonpropofol agents for endoscopic procedures. We also wanted to determine the influence of duration or complexity of the procedures and endoscopist-directed (gastroenterologist) vs non-gastroenterologist-directed sedation on the outcomes...
July 21, 2016: Clinical Gastroenterology and Hepatology
Emel Ünal Bilge, Menşure Kaya, Gülçin Özalp Şenel, Süheyla Ünver
OBJECTIVE: In this study, we aimed to determine the risk factors and the incidence of delirium in patients who were followed postoperatively in our surgical intensive care unit for 24 h using the confusion assessment method (CAM). METHODS: After obtaining approval from the ethics committee, 250 patients were included in the study. Patients who were operated under general anaesthesia or regional anaesthesia and followed in the surgical intensive care unit were evaluated by the Ramsay Sedation Scale on the first postoperative day...
August 2015: Turk J Anaesthesiol Reanim
Chih-Peng Lin, Chih-Hung Hsu, Wen-Mei Fu, Ho-Min Chen, Ying-Hui Lee, Mei-Shu Lai, Yu-Yun Shao
BACKGROUND: Opioids are crucial in cancer pain management. We examined the nationwide prescription patterns of opioids in Taiwan cancer patients to find the potential concerns. METHODS: We reviewed the claims database of the National Health Insurance of Taiwan for patients diagnosed with cancer from 2003 to 2011. The use and cost of analgesics were analyzed. Opioids were classified into recommended strong opioids (morphine and transdermal fentanyl), recommended weak opioids (tramadol, buprenorphine, and codeine), and unrecommended opioids (propoxyphene, nalbuphine, and meperidine)...
June 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Hala Saad Abdel-Ghaffar, Sahar Abd-Elbaky Mohamed, Khaled M Fares, Mohamed Abdel-Kadr Osman
BACKGROUND: The optimum dose of dexmedetomidine for shivering control with the least hemodynamic derangements is still under research. OBJECTIVE: To compare the efficacy, hemodynamic and side effects of dexmedetomidine in 3 different doses with those of meperidine for the treatment of shivering in patients undergoing spinal anesthesia for minor elective lower abdominal surgery. STUDY DESIGN: Prospective double-blind randomized clinically controlled study...
May 2016: Pain Physician
Serhat Bilir, Bülent Serhan Yurtlu, Volkan Hancı, Rahşan Dilek Okyay, Gülay Erdoğan Kayhan, Hilal Peri Ayoğlu, Işıl Özkoçak Turan
OBJECTIVES: The aim of the present randomized, placebo-controlled study was to compare postoperative analgesic effects of peroperative paracetamol and lornoxicam administration. METHODS: Sixty adult patients with American Society of Anesthesiologists (ASA) risk classification I-II, who would undergo single-level lumbar discectomy under general anesthesia, were enrolled. Patients were administered either 1000 mg paracetamol (Group P), 8 mg lornoxicam (Group L), or saline (Group C) prior to induction of anesthesia (n=20 for all groups)...
April 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Kevin J Friesen, Jamie Falk, Shawn Bugden
BACKGROUND: Meperidine (pethidine) is an opioid analgesic that offers little advantage relative to other opioids and several disadvantages including limited potency, short duration of action, and the production of a neurotoxic metabolite (normeperidine) with a long half-life. Older adults are more sensitive to meperidine's side effects and may have diminished renal function which leads to the accumulation of normeperidine. The Institute for Safe Medication Practices has suggested avoiding meperidine in older adults, limiting its dose (≤600 mg/day) and duration of use (≤48 h)...
2016: BMC Geriatrics
Farnoush Farzi, Bahram Naderi Nabi, Ali Mirmansouri, Fereshteh Fakoor, Zahra Atrkar Roshan, Gelareh Biazar, Tayyebeh Zarei
BACKGROUND: Uncontrolled postoperative pain, characteristic to abdominal hysterectomy, results in multiple complications. One of the methods for controlling postoperative pain is preemptive analgesia. Gabapentin and tramadol are both used for this purpose. OBJECTIVES: This study aims to compare the effects of tramadol and gabapentin, as premedication, in decreasing the pain after hysterectomy. PATIENTS AND METHODS: This clinical trial was performed on 120 eligible elective abdominal hysterectomy patients, divided in three groups of 40, receiving tramadol, gabapentin and placebo, respectively...
February 2016: Anesthesiology and Pain Medicine
Bahman Hasannasab, Nadia Banihashem, Arash Khoshbakht
BACKGROUND: Postanaesthetic shivering is one of the most common unpleasant complications in patients. OBJECTIVES: The aim of this study was to compare the efficacy of doxapram, ketamine and meperidine in prevention of shivering after anaesthesia. PATIENTS AND METHODS: In this randomized, double-blind clinical trial, 120 patients aged between 20 - 45 years old under general anaesthesia were enrolled. The patients were randomly allocated into one of three groups: group M received 20 mg meperidine (n = 40), group K received 0...
February 2016: Anesthesiology and Pain Medicine
Xu Fang, Ling-Ling Zhu, Sheng-Dong Pan, Ping Xia, Meng Chen, Quan Zhou
Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011...
2016: Therapeutics and Clinical Risk Management
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