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Patient-controlled analgesia

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https://www.readbyqxmd.com/read/29241077/pectoral-nerve-blocks-to-improve-analgesia-after-breast-cancer-surgery-a-prospective-randomized-and-controlled-trial
#1
Neethu M, Ravinder Kumar Pandey, Ankur Sharma, Vanlalnghaka Darlong, Jyotsna Punj, Renu Sinha, Preet Mohinder Singh, Nandini Hamshi, Rakesh Garg, Chandralekha Chandralekha, Anurag Srivastava
STUDY OBJECTIVE: To evaluate the analgesic efficacy of ultrasound guided combined pectoral nerve blocks I and II in patients scheduled for surgery for breast cancer. DESIGN: Prospective, randomized, control trial. SETTING: Operating rooms in a tertiary care hospital of Northern India. PATIENTS: Sixty American Society of Anesthesiologists status I to II adult women, aged 18-70years were enrolled in this study. INTERVENTIONS: Patients were randomized into two groups (30 patients in each group), PECS (P) group and control (C) group...
December 11, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29240019/integrating-patient-controlled-analgesia-using-implanted-intrathecal-pumps-for-postoperative-pain-management-a-case-report
#2
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
December 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29239753/the-use-of-intranasal-analgesia-for-acute-pain-control-in-the-emergency-department-a-literature-review
#3
REVIEW
Billy Sin, Jennifer Wiafe, Christine Ciaramella, Luis Valdez, Sergey M Motov
BACKGROUND: Traditional routes for administration of pain medications include oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes are not feasible, the intranasal (IN) route may be considered. The objectives of this evidence-based review were: to review the literature which compared the safety and efficacy of IN analgesia to traditional routes and to determine if IN analgesia should be considered over traditional routes for acute pain control in the ED. METHODS: The MEDLINE and EMBASE databases from July 1970 to July 2017 were searched...
November 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29238167/comparison-of-dexmedetomidine-and-fentanyl-as-local-anesthetic-adjuvants-in-spinal-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
REVIEW
ShuJun Sun, JiaMei Wang, NaRen Bao, Ying Chen, Jun Wang
Purpose: To compare the effects of dexmedetomidine (Dex) and fentanyl as adjuvants to local anesthetics in spinal anesthesia. Methods: Two researchers independently searched the PUBMED, EMBASE, Cochrane library, and CBM for randomized controlled trials comparing the effects of Dex and fentanyl as adjuvants to local anesthetics for intrathecal injection. Results: A total of 639 patients from nine studies were included in this meta-analysis...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29234943/enhanced-recovery-care-versus-traditional-care-after-laparoscopic-liver-resections-a-randomized-controlled-trial
#5
Xiao Liang, Hanning Ying, Hongwei Wang, Hongxia Xu, Minjun Liu, Haiyan Zhou, Huiqing Ge, Wenbin Jiang, Lijun Feng, Hui Liu, Yingchun Zhang, Zhiying Mao, Jianhua Li, Bo Shen, Yuelong Liang, Xiujun Cai
BACKGROUND: Enhanced recovery after surgery (ERAS), with several evidence-based elements, has been shown to shorten length of hospital stay and reduce perioperative hospital costs in many operations. This randomized clinical trial was performed to compare complications and hospital stay of laparoscopic liver resection between ERAS and traditional care. METHODS: A randomized controlled trial was performed for laparoscopic liver resection from August 2015 to August 2016...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29233760/recovery-after-shoulder-arthroscopy-inpatient-versus-outpatient-management
#6
M Boissard, V Crenn, T Noailles, S Campard, F Lespagnol
INTRODUCTION: Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management.HypothesisThere is no difference in functional recovery between inpatient and outpatient management. MATERIALS AND METHOD: A single-center, single-operator prospective study was conducted. Both groups received patient-controlled analgesia via an interscalene catheter...
December 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29233569/continuous-adductor-canal-blocks-provide-superior-ambulation-and-pain-control-compared-to-epidural-analgesia-for-primary-knee-arthroplasty-a-randomized-controlled-trial
#7
Erdan Kayupov, Kamil Okroj, Adam C Young, Mario Moric, Timothy J Luchetti, Gilat Zisman, Asokumar Buvanendran, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Adductor canal blocks (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty. METHODS: Following institutional review board approval, 145 patients were randomized to 1 of 3 groups: combined spinal-epidural (CSE), spinal + continuous ACB (CACB), or general + CACB...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29232379/comparison-of-nalbuphine-and-sufentanil-for-colonoscopy-a-randomized-controlled-trial
#8
Chaoyi Deng, Xiao Wang, Qianmei Zhu, Yanming Kang, Jinlin Yang, Heng Wang
OBJECTIVES: Nalbuphine is as effective as morphine as a perioperative analgesic but has not been compared directly with sufentanil in clinical trials. The aims of this study were to compare the efficacy and safety of nalbuphine with that of sufentanil in patients undergoing colonoscopy and to determine the optimal doses of nalbuphine in this indication. METHODS: Two hundred and forty consecutive eligible patients aged 18-65 years with an American Society of Anesthesiologists classification of I-II and scheduled for colonoscopy were randomly allocated to receive sufentanil 0...
2017: PloS One
https://www.readbyqxmd.com/read/29232351/randomized-clinical-trial-of-lidocaine-analgesia-for-transurethral-bladder-catheterization-delivered-via-blunt-tipped-applicator-in-young-children
#9
Neil G Uspal, Bonnie Strelitz, Jesse Gritton, Kristin Follmer, Miranda C Bradford, Taryn L Colton, Paul A Merguerian, Eileen J Klein
OBJECTIVE: Transurethral bladder catheterization (TUBC) is a painful, frequently performed procedure for collecting sterile urine. We sought to determine if administration of intraurethral lidocaine before TUBC using a blunt tipped syringe decreases procedural pain in young children in the pediatric emergency department. METHODS: Randomized clinical trial of children 0 to 36 months old requiring TUBC for collection of urine in a pediatric emergency department was performed...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29231542/-clinical-research-of-electroacupuncture-on-the-analgesic-effect-of-thoracic-perioperative-stage
#10
Mintao Zhou, Yu Li, Xuechang Han, Qunzhi Xing, Yiyao Wang, Xu Dong, Junxiao Chang
OBJECTIVE: To discuss the clinical therapeutic effects of electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) on the analgesic effect of thoracic perioperative stage and its effect mechanism. METHODS: Sixty cases of esophageal cancer with elective radical resection under general anesthesia were divided into an observation group and a control group according to the operation sequence, 30 cases in each one. In the control group, the general anesthesia was simply applied and sufentanil was administered for patient controlled intravenous analgesia (PCIA) after operation...
July 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29231349/-effect-of-ear-point-embedding-on-plasma-and-effect-site-concentrations-of-propofol-remifentanil-in-elderly-patients-after-target-controlled-induction
#11
Xiaochun Zheng, Liling Wan, Fei Gao, Jianghu Chen, Wenshao Tu
OBJECTIVE: To observe the clinical effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients who underwent abdominal external hernia surgery at the time of consciousness and pain disappearing by target-controlled infusion (TCI) and bispectral index (BIS). METHODS: Fifty patients who underwent elective abdominal hernia surgery were randomly assigned into an observation group and a control group, 25 cases in each one...
August 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29229211/the-use-of-rapid-onset-fentanyl-in-children-and-young-people-for-breakthrough-cancer-pain
#12
Lucy Coombes, Kimberley Burke, Anna-Karenia Anderson
BACKGROUND AND AIMS: No published studies have looked at the dosing and use of rapid onset fentanyl preparations in children. The primary aim of this study was to assess whether there is a correlation between effective dose of rapid onset fentanyl and background oral morphine equivalent analgesia in children less than 18 years old. Secondary objectives included establishing whether there is a correlation between effective dose of rapid onset fentanyl and age and weight. Reported side effects were also reviewed...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29229039/analgesia-in-patients-with-trauma-in-emergency-medicine
#13
David Häske, Bernd W Böttiger, Bertil Bouillon, Matthias Fischer, Gernot Gaier, Bernhard Gliwitzky, Matthias Helm, Peter Hilbert-Carius, Björn Hossfeld, Christoph Meisner, Benjamin Schempf, Arasch Wafaisade, Michael Bernhard
BACKGROUND: Suitable analgesic drugs and techniques are needed for the acute care of the approximately 18 200-18 400 seriously injured patients in Germany each year. METHODS: This systematic review and meta-analysis of analgesia in trauma patients was carried out on the basis of randomized, controlled trials and observational studies. A systematic search of the literature over the 10-year period ending in February 2016 was carried out in the PubMed, Google Scholar, and Springer Link Library databases...
November 17, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29228438/analgesic-effect-of-dezocine-in-different-doses-on-elderly-patients-undergoing-abdominal-operation-under-general-anesthesia-and-its-influence-on-stress-response-to-postoperative-tracheal-extubation
#14
Z-Y Yao, Z Jia, Y-H Xie, L-L Zhang, H-S Zhang, W-Q Wu, C-K Zhang, L-J Gan
OBJECTIVE: To study the analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and to investigate the influence of dezocine on stress response to postoperative tracheal extubation. PATIENTS AND METHODS: A total of 76 elderly patients undergoing abdominal operation under general anesthesia and postoperative analgesia in our hospital from January 2015 to January 2016 were selected, and patients treated with fentanyl were selected as the control group (fentanyl: 10 μg/kg, n=19)...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29227351/impact-of-pectoral-nerve-block-on-postoperative-pain-and-quality-of-recovery-in-patients-undergoing-breast-cancer-surgery-a-randomised-controlled-trial
#15
Yoshinori Kamiya, Miki Hasegawa, Takayuki Yoshida, Misako Takamatsu, Yu Koyama
BACKGROUND: In recent years, thoracic wall nerve blocks, such as the pectoral nerve (PECS) block and the serratus plane block have become popular for peri-operative pain control in patients undergoing breast cancer surgery. The effect of PECS block on quality of recovery (QoR) after breast cancer surgery has not been evaluated. OBJECTIVES: To evaluate the ability of PECS block to decrease postoperative pain and anaesthesia and analgesia requirements and to improve postoperative QoR in patients undergoing breast cancer surgery...
December 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29226545/nitrous-oxide-oxygen-mixture-for-analgesia-in-adult-cancer-patients-with-breakthrough-pain-a-randomized-double-blind-controlled-trial
#16
Q Liu, L-L Gao, Y-L Dai, Y-X Li, Y Wang, C-F Bai, G-X Mu, X-M Chai, W-J Han, L-J Zhou, Y-J Zhang, L Tang, J Liu, J-Q Yu
BACKGROUND: The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. METHODS/DESIGN: A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen...
December 11, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29225744/a-comparison-between-ketorolac-and-nefopam-as-adjuvant-analgesics-for-postoperative-patient-controlled-analgesia-a-randomized-double-blind-prospective-study
#17
Ji-Seon Son, Aram Doo, Young-Jun Kwon, Young-Jin Han, Seonghoon Ko
Background: We compared the analgesic efficacy and side effects of ketorolac and nefopam that were co-administered with fentanyl via intravenous patient-controlled analgesia. Methods: One hundred and sixty patients scheduled for laparoscopic cholecystectomy were randomly assigned to ketorolac (Group K) or nefopam (Group N) groups. The anesthetic regimen was standardized for all patients. The analgesic solution contained fentanyl 600 µg and ketorolac 180 mg in Group K, and fentanyl 600 µg and nefopam 120 mg in Group N...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29224301/-application-of-bispectral-index-monitoring-in-sedation-and-analgesia-for-flexible-bronchoscopy
#18
S R Fang, Y J Liu, N J Su, Y Shu, W Gu
Objective: To investigate the feasibility of using bispectral index monitoring in sedation and analgesia for bronchoscopy. Methods: Totally 285 patients admitted to the Respiratory Medicine Department of Nanjing First Hospital for bronchoscopy between June 2016 and December 2016 were assigned, according to their own wishes, into a conscious sedation group (171 cases receiving local anesthesia and conscious sedation, 89 males, 82 females, mean age 59±10 years) and a control group (114 cases undergoing local anesthesia, 59 males, 55 females, average age 61±12 years)...
December 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29223694/atraumatic-versus-conventional-lumbar-puncture-needles-a-systematic-review-and-meta-analysis
#19
Siddharth Nath, Alex Koziarz, Jetan H Badhiwala, Waleed Alhazzani, Roman Jaeschke, Sunjay Sharma, Laura Banfield, Ashkan Shoamanesh, Sheila Singh, Farshad Nassiri, Wieslaw Oczkowski, Emilie Belley-Côté, Ray Truant, Kesava Reddy, Maureen O Meade, Forough Farrokhyar, Malgorzata M Bala, Fayez Alshamsi, Mette Krag, Itziar Etxeandia-Ikobaltzeta, Regina Kunz, Osamu Nishida, Charles Matouk, Magdy Selim, Andrew Rhodes, Gregory Hawryluk, Saleh A Almenawer
BACKGROUND: Atraumatic needles have been proposed to lower complication rates after lumbar puncture. However, several surveys indicate that clinical adoption of these needles remains poor. We did a systematic review and meta-analysis to compare patient outcomes after lumbar puncture with atraumatic needles and conventional needles. METHODS: In this systematic review and meta-analysis, we independently searched 13 databases with no language restrictions from inception to Aug 15, 2017, for randomised controlled trials comparing the use of atraumatic needles and conventional needles for any lumbar puncture indication...
December 6, 2017: Lancet
https://www.readbyqxmd.com/read/29220121/effects-of-rate-on-analgesia-in-kilohertz-frequency-spinal-cord-stimulation-results-of-the-proco-randomized-controlled-trial
#20
Simon J Thomson, Moein Tavakkolizadeh, Sarah Love-Jones, Nikunj K Patel, Jianwen Wendy Gu, Amarpreet Bains, Que Doan, Michael Moffitt
OBJECTIVE: The PROCO RCT is a multicenter, double-blind, crossover, randomized controlled trial (RCT) that investigated the effects of rate on analgesia in kilohertz frequency (1-10 kHz) spinal cord stimulation (SCS). MATERIALS AND METHODS: Patients were implanted with SCS systems and underwent an eight-week search to identify the best location ("sweet spot") of stimulation at 10 kHz within the searched region (T8-T11). An electronic diary (e-diary) prompted patients for pain scores three times per day...
December 8, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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