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Patient-controlled analgesia

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https://www.readbyqxmd.com/read/28448398/intrathecal-morphine-versus-extended-release-epidural-morphine-for-postoperative-pain-control-in-pediatric-patients-undergoing-posterior-spinal-fusion
#1
Mindy Cohen, Jeannie Zuk, Nancy McKay, Mark Erickson, Zhaoxing Pan, Jeffrey Galinkin
BACKGROUND: Posterior spinal fusion for scoliosis is one of the most painful elective pediatric surgeries. Good postoperative pain control allows early ambulation and return of ability to tolerate oral intake. Options for analgesia in this patient population are suboptimal. We hypothesized that extended-release epidural morphine (EREM) would provide better pain control and less adverse effects compared to intrathecal (IT) morphine. METHODS: The primary outcome was total IV morphine consumption during 0-48 hours postoperatively...
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28448390/comparison-of-postoperative-respiratory-monitoring-by-acoustic-and-transthoracic-impedance-technologies-in-pediatric-patients-at-risk-of-respiratory-depression
#2
Mario Patino, Megan Kalin, Allison Griffin, Abu Minhajuddin, Lili Ding, Timothy Williams, Stacey Ishman, Mohamed Mahmoud, C Dean Kurth, Peter Szmuk
BACKGROUND: In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. METHODS: Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia...
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28447227/the-efficacy-of-serratus-anterior-plane-block-in-analgesia-for-thoracotomy-a-retrospective-study
#3
Korgün Ökmen, Burcu Metin Ökmen
PURPOSE: A multimodal analgesic approach is necessary for post-thoracotomy pain, which can be severe. Intravenous access, central and peripheral nerve blocks are frequently used. The aim of this study was to evaluate the efficacy of serratus anterior plane block (SAPB) in the management of post-thoracotomy pain. METHODS: A total of 40 patients who underwent thoracotomy between January 2014 and January 2016 were retrospectively analyzed. The patients were divided into two groups: Group M (intravenous patient-controlled analgesia morphine; n = 20) and Group S (intravenous patient-controlled analgesia morphine + SAPB; n = 20)...
April 26, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28444652/-establishment-of-specialized-pediatric-palliative-home-care-in-the-medical-valley-of-the-european-metropolitan-area-nuremberg
#4
Steven Hébert, Chara Gravou-Apostolatou, Wolfgang Rascher
Background As part of the 2007 health reform in Germany the structure of outpatient palliative care for children and adolescents was adopted for the first time and then implemented in Erlangen-Nuremberg in 2009. Methods The introduction of Pediatric Palliative Home Care (PPHC) at the Hospital for Children and Adolescents at the University of Erlangen-Nuremberg was retrospectively analyzed between the years 2009 to 2014. Referring medical records (paper-based and electronic) were evaluated systematically. Results Considering 69 patients within this study, 44 (63...
March 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28442955/no-preemptive-analgesic-effect-of-preoperative-ketorolac-administration-following-total-abdominal-hysterectomy-a-randomized-study
#5
Beatriz Nistal-Nuño
BACKGROUND: Experimental models using short-duration noxious stimuli have led to the concept of preemptive analgesia. Ketorolac, a nonsteroidal anti-inflammatory drug, has been shown to have a postoperative narcotic-sparing effect when given preoperatively and alternatively to not have this effect. This study was undertaken to determine whether a single intravenous (IV) dose of ketorolac would result in decreased postoperative pain and narcotic requirements. METHODS: In a double-blind, randomized controlled trial, 48 women undergoing abdominal hysterectomy were studied...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28442931/postoperative-pain-and-patient-controlled-epidural-analgesia-related-adverse-effects-in-young-and-elderly-patients-a-retrospective-analysis-of-2-435-patients
#6
Jae Chul Koh, Young Song, So Yeon Kim, Sooyeun Park, Seo Hee Ko, Dong Woo Han
In this retrospective study, data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA) for pain relief after elective surgery under general or spinal anesthesia were reviewed. Differences in postoperative pain, incidence of patient-controlled analgesia (PCA)-related adverse effects, and risk factors for the need for rescue analgesics for 48 hours postsurgery in young (age 20-39 years) and elderly (age ≥70 years) patients were evaluated. Although there were no significant differences in postoperative pain intensity between the two groups until 6 hours postsurgery, younger patients experienced greater postoperative pain intensity compared with older patients 6-48 hours postsurgery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28442930/thoracic-epidural-analgesia-reduces-myocardial-injury-in-ischemic-patients-undergoing-major-abdominal-cancer-surgery
#7
Mohamad Farouk Mohamad, Montaser A Mohammad, Diab F Hetta, Eman Hasan Ahmed, Ahmed A Obiedallah, Alaa Ali M Elzohry
BACKGROUND AND OBJECTIVES: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA) on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery. PATIENTS AND METHODS: One hundred and twenty patients (American Society of Anesthesiologists grade II and III) of either sex were scheduled for elective upper gastrointestinal cancer surgeries...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28442852/perioperative-systemic-glucocorticoids-in-total-hip-and-knee-arthroplasty-a-systematic-review-of-outcomes
#8
REVIEW
Jeffrey Hartman, Vickas Khanna, Anthony Habib, Forough Farrokhyar, Muzammil Memon, Anthony Adili
BACKGROUND: Perioperative systemic glucocorticoids are frequently included in multimodal analgesia and antiemetic regimens administered to patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this systematic review was to evaluate the available randomized controlled trials (RCTs) to determine the effect of perioperative systemic glucocorticoids on postoperative nausea and vomiting (PONV), pain, narcotic consumption, antiemetic consumption, length of stay in hospital, and major complications in patients undergoing elective THA or TKA...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28442338/multicentre-evaluation-of-postoperative-pain-control-after-24hours-in-three-hospitals-of-colombia
#9
Jorge Enrique Machado-Alba, Manuel Enrique Machado-Duque, Javier Orlando Ramírez-Sarmiento
OBJECTIVE: To determine the intensity of pain in operated patients using a visual analogue scale and identify variables associated with lack of pain control in three cities in Colombia. METHOD: A cross-sectional study in patients over the age of 18 years, between January 1(st) and September 30(th) 2014, in 3 clinics in Colombia. The intensity of postoperative pain using a visual analogue scale at 24hours after surgery was recorded. Socio-demographic, clinical and pharmacological variables were taken into account...
April 22, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28441971/the-clinical-and-cost-effectiveness-of-stratified-care-for-patients-with-sciatica-the-scopic-randomised-controlled-trial-protocol-isrctn75449581
#10
Nadine E Foster, Kika Konstantinou, Martyn Lewis, Reuben Ogollah, Kate M Dunn, Danielle van der Windt, Ruth Beardmore, Majid Artus, Bernadette Bartlam, Jonathan C Hill, Sue Jowett, Jesse Kigozi, Christian Mallen, Benjamin Saunders, Elaine M Hay
BACKGROUND: Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work...
April 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28440034/role-of-transcranial-direct-current-stimulation-on-reduction-of-postsurgical-opioid-consumption-and-pain-in-total-knee-arthroplasty-double-randomized-clinical-trial
#11
E M Khedr, E S A Sharkawy, A M A Attia, N M Ibrahim Osman, Z M Sayed
BACKGROUND: Postoperative pain control is an important factor in determining recovery in total knee arthroplasty (TKA).The aim of the study was to assess the efficacy of 4 sessions of transcranial direct current stimulation (tDCS) over primary motor cortex (M1) in patients undergoing unilateral TKA. MATERIALS: Fifty patients undergoing TKA were included in the study. They were divided randomly into two groups (25 patients for each, using closed envelopes): real tDCS (2 mA, 20 min, with anodal stimulation applied over M1 postoperative for 4 consecutive days) and sham tDCS...
April 25, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28439445/ultrasound-guided-continuous-interpectoral-block-for-patient-undergoing-mastectomy-and-axillary-clearance
#12
Mario Fajardo-Pérez, Ece Yamak Altınpulluk, Javier García-Miguel, Borja Quintana-Gordon
Using a single dose of local anaesthetics has some disadvantages and provides limited analgesia depending on the pharmacokinetic characteristics of the local anaesthetic used. Nevertheless, the use of continuous perineural infusions allows sustained pain control. Ultrasound-guided interpectoral block followed by the placement of catheters in patients undergoing mastectomies with or without lymph node axillary dissections can result in sufficient pain control. We present a case of a 58-year-old woman undergoing mastectomy and axillary clearance who received ultrasound-guided continuous interpectoral block for postoperative analgesia...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28439156/diclofenac-transdermal-patch-a-potential-ingress-to-maxillofacial-surgery
#13
Anisha Perepa, Brig Ramen Sinha, Uday Kiran Uppada, Avss Subramanya Kumar
PURPOSE: To evaluate the analgesic efficacy of a diclofenac transdermal patch with diclofenac intra muscular injection in the immediate postoperative period in patients undergoing major oral surgical procedures. MATERIALS AND METHODS: Subjects who underwent bijaw surgeries for surgical correction of various dentofacial deformities were included. Sixty such patients who belonged to the above entity were randomly categorized into two groups from Jan 2012-Aug 2015...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28437264/magnesium-sulphate-improves-pulmonary-function-after-video-assisted-thoracoscopic-surgery-a-randomised-double-blind-placebo-controlled-study
#14
Hye-Min Sohn, Sang-Hoon Jheon, Sunwoo Nam, Sang-Hwan Do
BACKGROUND: Reduced lung volumes are unavoidable after lung resection surgery. Magnesium sulphate (MgSO4) administration has been reported to reduce the requirement for neuromuscular blocking drugs and postoperative analgesics in surgical patients. OBJECTIVE: To investigate the effect of MgSO4 on pulmonary function after video-assisted thoracoscopic surgery (VATS). DESIGN: A randomised, double-blind, placebo-controlled trial. SETTING: A university tertiary care centre...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#15
Stefan H Meyering, Ryan W Stringer, Matthew K Hysell
INTRODUCTION: Headaches represent over three million emergency department (ED) visits per year, comprising 2.4% of all ED visits. There are many proposed methods and clinical guidelines of treating acute headache presentations. However, data on intravenous acetaminophen usage in these settings are lacking. In this study, we sought to determine the efficacy of intravenous (IV) acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the ED with a chief complaint of "headache...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435273/an-innovative-nonpharmacological-intervention-combined-with-intravenous-patient-controlled-analgesia-increased-patient-global-improvement-in-pain-and-satisfaction-after-major-surgery
#16
Chia-Chun Chuang, Chien-Ching Lee, Li-Kai Wang, Bor-Shyh Lin, Wen-Ju Wu, Chung-Han Ho, Jen-Yin Chen
PURPOSE: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA). PATIENTS AND METHODS: This was a nonrandomized before-after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#17
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28430684/flurbiprofen-axetil-provides-effective-analgesia-without-changing-the-pregnancy-rate-in-ultrasound-guided-transvaginal-oocyte-retrieval-a-double-blind-randomized-controlled-trial
#18
Hong Zhao, Yi Feng, Yan Jiang, Qun Lu
BACKGROUND: In this prospective double-blind randomized study, we evaluated the analgesic effect and potential effect on pregnancy rate of the nonsteroidal anti-inflammatory drug flurbiprofen axetil in patients undergoing ultrasound-guided transvaginal oocyte retrieval under propofol-remifentanil anesthesia. METHODS: A total of 200 patients scheduled to undergo ultrasound-guided transvaginal oocyte retrieval were randomly allocated to receive 1.5 mg/kg of flurbiprofen axetil (FA group) or placebo (control group) 30 minutes before the procedure...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28428506/-a-new-therapeutic-approach-for-cancer-related-breakthrough-pain-focused-on-oral-transmucosal-fentanyl
#19
Kinomi Yomiya, Masayuki Kaneshima, Beni Kyosaka, Etsuko Warita, Rie Hosonuma, Shinnosuke Osato
In 2013, oral transmucosal fentanyl was first approved in Japan for reducing breakthrough pain(BTP). The development of BTP may contribute to less-effective analgesia, a reduced satisfaction with analgesia therapy, obstacles in daily life, mood disorders, and an increased use of healthcare resources. In most BTP, both the duration from BTP onset to its maximum intensity and the overall duration of BTP episodes are relatively short. The need for improved rapid pain relief for BTP in this setting has led to the development of rapid-onset opioids(ROOs), including oral transmucosal fentanyl citrate(OTFC)...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28425829/effects-of-dexmedetomidine-versus-midazolam-for-premedication-in-paediatric-anaesthesia-with-sevoflurane-a-meta-analysis
#20
Ji-Feng Feng, Xiao-Xia Wang, Yan-Yan Lu, Deng-Ge Pang, Wei Peng, Jian-Lan Mo
Background Dexmedetomidine (DEX), an α2-adrenergic receptor agonist, produces ideal sedation and early postoperative recovery for premedication in paediatric surgery, reducing preoperative anxiety and facilitating smooth induction of anaesthesia. We performed a meta-analysis to compare the effects of DEX and midazolam (MDZ) in paediatric anaesthesia with sevoflurane. Methods PubMed, Ovid, Web of Science, and Public Health Management Corporation were searched through December 2016 for randomized controlled trials (RCTs) that compared DEX and MDZ in children undergoing sevoflurane anaesthesia...
January 1, 2017: Journal of International Medical Research
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