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https://www.readbyqxmd.com/read/29063665/a-retrospective-comparison-of-thoracic-epidural-infusion-and-multimodal-analgesia-protocol-for-pain-management-following-the-minimally-invasive-repair-of-pectus-excavatum
#1
Janice Y Man, Harshad G Gurnaney, Scott R Dubow, Theresa J DiMaggio, Gina R Kroeplin, N Scott Adzick, Wallis T Muhly
BACKGROUND: Pain management following minimally invasive repair of pectus excavatum is variable. We recently adopted a comprehensive multimodal analgesic protocol that standardizes perioperative analgesic management. We hypothesized that patients managed with this protocol would use more opioids postoperatively, have similar pain control, and shorter length of stay compared to patients managed with thoracic epidural infusion. AIMS: We retrospectively compared opioid consumption, pain scores, and length of stay between a cohort of patients managed with our multimodal analgesic protocol and a cohort managed with a thoracic epidural infusion...
October 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28979762/ketamine-for-pain
#2
REVIEW
Kelly Jonkman, Albert Dahan, Tine van de Donk, Leon Aarts, Marieke Niesters, Monique van Velzen
The efficacy of the N-methyl-D-aspartate receptor antagonist ketamine as an analgesic agent is still under debate, especially for indications such as chronic pain. To understand the efficacy of ketamine for relief of pain, we performed a literature search for relevant narrative and systematic reviews and meta-analyses. We retrieved 189 unique articles, of which 29 were deemed appropriate for use in this review. Ketamine treatment is most effective for relief of postoperative pain, causing reduced opioid consumption...
2017: F1000Research
https://www.readbyqxmd.com/read/29025089/oral-ketamine-for-acute-pain-management-after-amputation-surgery
#3
Asokumar Buvanendran, Jeffrey S Kroin, Arvind Rajagopal, Sherry J Robison, Mario Moric, Kenneth J Tuman
Objective: Intravenous ketamine has been shown to provide postoperative analgesia in many clinical trials, in particular to reduce opioid consumption. The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery. Methods: Three consented subjects (age 57-60 years) undergoing elective amputation of the lower extremity were included in the study (Institutional Review Board and Food and Drug Administration Investigational New Drug approved)...
September 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28984096/preventative-effect-of-ketamine-on-post-surgical-hyperalgesia-induced-at-a-body-part-remote-from-the-surgical-site-a-randomized-controlled-trial
#4
Young-Eun Moon, Mi-Hyun Kim, Hyung-Mook Lee, Hyo-Min Yoon, Young-Jae Jeon
BACKGROUND: It is known that pain hypersensitivity can be induced at a body part remote from a surgical site (tertiary hyperalgesia), leading to patient discomfort. Nevertheless, no reported study to date has investigated methods to attenuate such tertiary hyperalgesia. Ketamine is known to modulate hyperalgesia induced by central sensitization. Thus, we investigated whether intraoperative administration of ketamine could decrease post-surgical tertiary hyperalgesia in patients undergoing a laparoscopic hysterectomy...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28623471/the-effect-of-intravenous-lidocaine-infusion-on-bispectral-index-during-major-abdominal-surgery
#5
Patrick Bazin, James Padley, Matthew Ho, Jennifer Stevens, Erez Ben-Menachem
Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1...
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28782603/randomized-clinical-trial-of-epidural-compared-with-conventional-analgesia-after-minimally-invasive-colorectal-surgery
#6
RANDOMIZED CONTROLLED TRIAL
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
BACKGROUND: The effectiveness of thoracic epidural analgesia (EA) vs conventional IV analgesia (IA) after minimally invasive surgery is still unproven. We designed a randomized controlled trial comparing EA with IA after minimally invasive colorectal surgery. STUDY DESIGN: A total of 87 patients who underwent minimally invasive colorectal procedures at a single institution between 2011 and 2014 were enrolled. Eight patients were excluded and 38 were randomized to EA and 41 to IA...
November 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28670050/effects-of-epidural-analgesia-on-recovery-after-open-colorectal-surgery
#7
Ahmad Elsharydah, Leila W Zuo, Abu Minhajuddin, Girish P Joshi
The use of epidural analgesia (EA) has been suggested as an integral part of an enhanced recovery program for colorectal surgery. However, the effects of EA on postoperative outcomes and hospital length of stay remain controversial. Data from the American College of Surgeons National Surgical Quality Improvement Program database for 2014 and 2015 were queried for adult patients who underwent elective open colorectal surgery. We included only cases with general anesthesia as the main anesthetic. Cases with other types of anesthesia were excluded...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28677829/intravenous-lignocaine-in-colorectal-surgery-a-systematic-review
#8
REVIEW
Wiremu S MacFater, Jamie-Lee Rahiri, Melanie Lauti, Bruce Su'a, Andrew G Hill
BACKGROUND: Colorectal surgery leads to morbidity during recovery including pain and fatigue. Intravenous (IV) lignocaine (IVL) has both analgesic and anti-inflammatory effects that may improve post-operative pain and recovery. The aim of this review is to compare the effectiveness of IVL to other perioperative analgesia regimens for reducing pain and opioid consumption following colorectal surgery. METHODS: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a literature search was conducted to identify randomized clinical trials that compared IVL with IV placebo or epidural anaesthesia in open or laparoscopic colorectal surgery...
July 5, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28688514/pain-control-with-continuous-infusion-preperitoneal-wound-catheters-versus-continuous-epidural-analgesia-in-colon-and-rectal-surgery-a-randomized-controlled-trial
#9
Nicolas J Mouawad, Stefan W Leichtle, Christodoulos Kaoutzanis, Kathleen Welch, Suzanne Winter, Richard Lampman, Matt McCord, Kimberly A Hoskins, Robert K Cleary
OBJECTIVE: To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery. METHODS: An open-label equivalence trial randomizing patients to CPA or CEA. Primary outcomes were postoperative pain as determined by numeric pain scores and supplemental narcotic analgesia requirements. Secondary outcomes included incidence of complications and patient health status measured with the SF-36 Health Survey (Acute Form)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28656921/a-comparative-study-of-ketamine-gargle-and-lidocaine-jelly-application-for-the-prevention-of-postoperative-throat-pain-following-general-anaesthesia-with-endotracheal-intubation
#10
S O Aigbedia, K U Tobi, F E Amadasun
BACKGROUND: Postoperative throat pain is an established complication of general anaesthesia with endotracheal intubation. We thus sought to determine the incidence of postoperative throat pain and the efficacy of lidocaine jelly and ketamine gargle in the prevention of postoperative throat pain. MATERIALS AND METHOD: One hundred and fifty ASA I or II, male: female ratio of 1:2 patients, aged18 -64 year, scheduled for elective general surgery requiring general anaesthesia with endotracheal intubation were randomly recruited into two groups, ketamine (K group) and lidocaine (L group)...
June 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28663627/efficacy-of-low-dose-ketamine-as-sole-analgesic-agent-in-maintaining-analgesia-and-intraoperative-hemodynamics-during-laparoscopic-gynecological-surgeries
#11
Dipti Saxena, Atul Dixit, Naina Kumar, Bipin Arya, Sadhana Sanwatsarkar, Shilpa Bhandari
BACKGROUND: Ketamine, in low doses, is known to possess intense analgesic properties. The available literature shows wide variation regarding the time and dose of administration of ketamine during surgery. AIM: The aim of this study was to evaluate the effect of intraoperative administration of ketamine when used as sole analgesic in low doses, on hemodynamics and postoperative analgesia in patients undergoing laparoscopic gynecological surgery and compared on the basis of duration of surgery...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28691718/additive-and-antagonistic-antinociceptive-interactions-between-magnesium-sulfate-and-ketamine-in-the-rat-formalin-test
#12
Katarina Savić Vujović, Sonja Vučković, Dolika Vasović, Branislava Medić, Nick Knežević, Milica Prostran
Because ketamine and magnesium block NMDA receptor activation by distinct mechanisms of action, we hypothesized that in a model of inflammatory pain in rats the combination of ketamine and magnesium might be more effective than ketamine alone. Antinociceptive activity was assessed by the formalin test in male Wistar rats (200-250 g). Animals were injected with 100 μL of 2.5% formalin to the plantar surface of the right hind paw. Data were recorded as the total time spent in pain-related behavior after the injection of formalin or vehicle (0...
2017: Acta Neurobiologiae Experimentalis
https://www.readbyqxmd.com/read/28700455/perioperative-ketamine-for-analgesia-in-spine-surgery-a-meta-analysis-of-randomized-controlled-trials
#13
Arif Pendi, Ryan Field, Saifal-Deen Farhan, Martin Eichler, Stacey Samuel Bederman
STUDY DESIGN: Meta-analysis of randomized controlled trials. OBJECTIVE: To evaluate the effectiveness of perioperative supplemental ketamine to reduce postoperative opioid analgesic consumption following spine surgery. SUMMARY OF BACKGROUND DATA: Although low-dose supplemental ketamine has been known to reduce pain after surgery, there is conflicting evidence regarding whether ketamine can be effective to reduce opioid consumption following spine surgery...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/26649908/epidural-blockade-affects-the-pharmacokinetics-of-propofol-in-surgical-patients
#14
RANDOMIZED CONTROLLED TRIAL
Elske Sitsen, Erik Olofsen, Agnes Lesman, Albert Dahan, Jaap Vuyk
BACKGROUND: Neuraxial blockade reduces the dose requirements of sedative agents. It is unclear whether neuraxial blockade affects the pharmacokinetics and/or the pharmacodynamics of IV hypnotics. We therefore studied the influence of epidural blockade on the pharmacokinetics of propofol in patients scheduled for general surgery. METHODS: Twenty-eight patients were randomly divided into 4 groups, in a double-blind manner, to receive 0, 50, 100, or 150 mg epidural ropivacaine...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26901037/effects-of-intra-operative-total-intravenous-anaesthesia-with-propofol-versus-inhalational-anaesthesia-with-sevoflurane-on-post-operative-pain-in-liver-surgery-a-retrospective-case-control-study
#15
COMPARATIVE STUDY
Alfred Chor San Chan, Qiu Qiu, Siu Wai Choi, Stanley Sau Ching Wong, Albert Chi Yan Chan, Michael G Irwin, Chi Wai Cheung
BACKGROUND: Patients receiving total intravenous anesthesia (TIVA) with propofol have been shown to experience less postoperative pain. We evaluated the post-operative analgesic effects of propofol compared with sevoflurane maintenance of anesthesia in liver surgery. This study was registered at ClinicalTrials.gov (NCT02179437). METHODS: In this retrospective study, records of patients who underwent liver surgery between 2010 and 2013 were reviewed. Ninety-five patients anesthetized with propofol TIVA were matched with 95 patients anesthetized with sevoflurane...
2016: PloS One
https://www.readbyqxmd.com/read/28620916/ketamine-does-not-enhance-the-quality-of-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#16
E T Moro, I M P S S Feitosa, R G de Oliveira, G F P Saraiva, R Rosalino, V P Marossi, J A Bloomstone, L H C Navarro
BACKGROUND: Ketamine has been used as part of the multimodal analgesia technique in the acute perioperative period. The effect of perioperative intravenous small-dose ketamine on the quality of recovery from the patient point-of-view has not been assessed. We hypothesized that low-dose ketamine would enhance recovery following laparoscopic cholecystectomy under total intravenous anesthesia. METHODS: One hundred thirty five patients undergoing laparoscopic cholecystectomy were enrolled in this randomized, double-blind placebo-controlled trial...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28177939/a-narrative-review-of-the-evidence-on-the-efficacy-of-dexamethasone-on-postoperative-analgesic-consumption
#17
Chrysanthi Batistaki, Evagelia Kaminiotis, Thomas Papadimos, Georgia Kostopanagiotou
OBJECTIVES: The effect of dexamethasone on analgesic consumption has not been adequately studied. The aim of this review was to investigate recent literature regarding the possible effect of dexamethasone on postoperative analgesic consumption. METHODS: Critical review of randomized trials and prospective consecutive studies investigating the postoperative analgesic effect of dexamethasone was performed. Only studies published during 2006 to 2015 were included. RESULTS: Forty-one studies met the inclusion criteria; 33 in adults and 8 in children (9 in general surgery, 8 in gynecologic/breast surgery, 8 in orthopedic/spinal surgery, 8 in head/neck surgery, 7 in children's tonsillectomy, and 1 in children's orchiopexy)...
November 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27378709/a-retrospective-review-of-an-epidural-blood-patch-database-the-incidence-of-epidural-blood-patch-associated-with-obstetric-neuraxial-anesthetic-techniques-and-the-effect-of-blood-volume-on-efficacy
#18
J L Booth, P H Pan, J A Thomas, L C Harris, R D'Angelo
BACKGROUND: The optimal volume of blood required to treat post-dural puncture headache remains in question. In our institution a target volume of 30mL is used for an epidural blood patch unless the patient experiences pain during injection. METHODS: The institutional database was retrospectively reviewed for epidural blood patch and delivery statistics over a 15-year period to determine if the volume of blood administered during the procedure directly correlated with the number of epidural blood patches administered...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27693070/is-there-a-role-for-intravenous-subdissociative-dose-ketamine-administered-as-an-adjunct-to-opioids-or-as-a-single-agent-for-acute%C3%A2-pain-management-in-the-emergency-department
#19
REVIEW
Sergey Motov, Steven Rosenbaum, Gary M Vilke, Yuko Nakajima
BACKGROUND: Whether acute or chronic, emergency physicians frequently encounter patients reporting pain. It is the responsibility of the emergency physician to assess and evaluate, and if appropriate, safely and effectively reduce pain. Recently, analgesics other than opioids are being considered in an effort to provide safe alternatives for pain management in the emergency department (ED). Opioids have significant adverse effects such as respiratory depression, hypotension, and sedation, to say nothing of their potential for abuse...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27554227/effect-of-continuous-paravertebral-dexmedetomidine-administration-on-intraoperative-anesthetic-drug-requirement-and-post-thoracotomy-pain-syndrome-after-thoracotomy-a-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Vikas Dutta, Bhupesh Kumar, Aveek Jayant, Anand K Mishra
OBJECTIVES: To assess the effect of paravertebral administration of dexmedetomidine as an adjuvant to local anesthetic on the intraoperative anesthetic drug requirement and incidence of post-thoracotomy pain syndrome. DESIGN: Prospective, randomized, controlled, double-blind trial. SETTING: Single university hospital. PARTICIPANTS: The study comprised 30 patients who underwent elective thoracotomy and were assigned randomly to either the Ropin or Dexem group (n = 15 each)...
February 2017: Journal of Cardiothoracic and Vascular Anesthesia
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