Anesthesia Pain Palliative

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Ketamine is unique among anesthetics and analgesics. The drug is a rapid-acting general anesthetic that produces an anesthetic state characterized by profound analgesia, preserved pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression. Research has demonstrated the efficacy of its use on anesthesia, pain, palliative care, and intensive care. Recently, it has been used for postoperative and chronic pain, as an adjunct in psychotherapy, as a treatment for depression and posttraumatic stress disorder, as a procedural sedative, and as a treatment for respiratory and/or neurologic clinical conditions...

We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. Our primary outcomes were pain scores at different time intervals using the Visual Analog Scale (VAS). Our secondary outcomes were postoperative opioid consumption within 24 hours and postoperative nausea and vomiting incidence...

Palliative care is a comprehensive approach that includes medical, psychological, social, and spiritual support for patients to achieve the best quality of life for patients with incurable diseases and their relatives. Nurses are one of the main links that make up mobile palliative care teams they occupy an ideal position to provide quality care at the patient's bedside. However, the knowledge and skills of nurses remain at a low level and limiting high-quality palliative care. The purpose of this review is to study the problems of readiness of nursing staff to provide palliative care...

Ultrasound-guided interfascial plane blocks performed on the anterior and lateral thoracic wall have become an important adjuvant method to general anesthesia and an independent method of local anesthesia and pain management. These procedures diminish the harmful effects of anesthesia on respiratory function and reduce the risk of phrenic nerve paralysis or iatrogenic pneumothorax. In postoperative pain management, interfascial plane blocks decrease the dosage of intravenous drugs, including opioids. They can also eliminate the complications associated with general anesthesia when used as the sole method of anesthesia for surgical procedures...

BACKGROUND: Interventional radiology plays a major role in oncology both for curative and palliative treatment, but few reports address post-procedural pain. The purpose of this study was to quantify postoperative pain after interventional radiology procedures in oncology and to identify major pain-associated pre and intraoperative factors. METHODS: From 2015 to 2019, all patients treated with interventional radiology were included retrospectively in a cohort study...

Background: Cochrane systematic reviews (CSRs) have a section 'Implications for research' where authors make suggestions for improving future research. The authors of the present study assessed the prevalence and time dynamics of different recommendations in the CSRs about anesthesia and pain. Methods: The authors included all CSRs published by the Cochrane Anaesthesia Group and Cochrane Pain and Palliative Care Group before 17 July 2020. The authors analyzed recommendations for improving future research listed in the 'Implications for research' section of these CSRs and categorized recommendations for improvements...

In the context of end of life, palliative care offers support for the patient and his family, from a global perspective. This means paying attention to pain and difficult symptoms, but also to psychological, social and spiritual issues. Some situations confront healthcare teams with the difficulty of providing support to the end of life, not only in terms of relieving pain and suffering, but also when communication is impaired or even impossible. This is particularly the case with sedative practices. These situations involve providing comprehensive support by different evaluations of the patient’s pain and discomfort...

Aim: The study sought to evaluate the influence of anesthesia on chronic pain after total knee arthroplasty (TKA). Methods : This was a single-center, randomized controlled study, with patients receiving a spinal anesthetic (SP) alone or a general anesthetic (GA) with femoral block, with follow-up at 3 and at 6 months. The primary outcome was the WOMAC® score at 6 months. Results : 199 patients were enrolled. Group SP had better function (WOMAC: GA: 16.9 vs SP: 14.4, p = 0.015) and less pain (WOMAC pain: GA: 3...

Since their introduction into clinical use in the 1970s, aromatase inhibitors have been a cornerstone of therapy for estrogen-receptor positive breast cancer in postmenopausal women. Unfortunately, this therapy leads to estrogen depletion in the body, which can lead to unpleasant side effects such as menopausal symptoms like hot flashes, insomnia, slightly increased risk of ischemic heart disease, accelerated bone loss leading to higher osteoporosis risk, and most significantly, arthralgias. The joint pain induced by aromatase inhibitor therapy is frequently cited as the leading cause of premature discontinuation; approximately 50% of patients will report new onset or worsening joint pain 1 year after therapy initiation, approximately 30% of patients discontinue therapy after 1 year, and only 50%-68% of patients remain fully compliant with therapy after 3 years...

OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) techniques are commonly used for surgical procedures within the thoracic cavity with smaller incisions. There are very few regional anesthesia methods used to achieve this goal. This study aimed to investigate the effect of two fascial plane block technique rhomboid intercostal block (RIB) and serratus anterior plane block (SAPB) administered on pain scores after VATS. METHODS: A total of 90 patients who underwent VATS were included in this study...

Background: To date, there has been no investigation addressing the effects of vibration anesthesia during carboxytherapy. Aim: Investigate the analgesic effect of different vibratory devices during carboxytherapy for the treatment of cellulite. Materials & methods: A total of 78 women between 18 and 49 years of age with cellulite in the gluteal region will be randomly allocated to three groups: Group A (carboxytherapy and vibratory device A), Group B (carboxytherapy and vibratory device B) and control group...

Despite advances in cancer treatments, surgery remains one of the most important therapies for solid tumors. Unfortunately, surgery promotes angiogenesis, shedding of cancer cells into the circulation and suppresses anti-tumor immunity. Together this increases the risk of tumor metastasis, accelerated growth of pre-existing micro-metastasis and cancer recurrence. It was theorized that regional anesthesia could influence long-term outcomes after cancer surgery, however new clinical evidence demonstrates that the anesthesia technique has little influence in oncologic outcomes...

BACKGROUND: Postcesarean delivery pain leads to several adverse maternal outcomes. The primary objective of this study was to determine the incidence of moderate-to-severe pain after the use of spinal morphine for cesarean delivery. The secondary aim was to identify factors influencing moderate-to-severe pain. METHODS: This was a prospective observational study. The inclusion criteria were a patient age of ≥18 years, and undergoing elective cesarean delivery under spinal anesthesia with intrathecal morphine (200 mcg)...

BACKGROUND: Motor-sparing regional anesthesia modalities, such as periarticular infiltration (PAI) and pericapsular nerve group (PENG) block, have become the mainstay of multimodal approaches used during total hip arthroplasty (THA). We hypothesized that the postoperative analgesia of the PENG block was non-inferior to that of the PAI. METHODS: Sixty patients were randomly allocated into two groups. The PAI group were injected with 100 mL of cocktail solution (ropivacaine 20 mL, ketorolac 2 mL, and epinephrine 1 mL mixed with normal saline) in periarticular tissues directly by the surgeon...

This paper performs a review of current literature as well as uses our single-center experience to discuss pre-operative, intra-operative and, briefly, postoperative management for dorsal column stimulators (DCSs), dorsal root ganglion (DRG) stimulators, peripheral nerve stimulators (PNSs) and intrathecal pumps. Generally, pre-operative antibiotics are recommended with discontinuation within 24 h postoperatively. For dorsal column and DRG stimulation, monitored anesthesia care or general anesthesia with intra-operative neuromonitoring is recommended; for peripheral nerve stimulation and intrathecal pump implementation, monitored anesthesia care is preferred...

BACKGROUND: Orthodontists use mini-implants temporarily as an effective mode of skeletal anchorage devices. The placement of mini-implants can cause pain and discomfort to the patients. Patients often develop swelling, and the pain could interfere with their daily activities. Practitioners tend to prescribe antibiotics and pain medication for management. OBJECTIVES: The main objectives of this study are to evaluate the pain perception and discomfort due to mini-implant placement experienced by the patient and evaluate the interventions for pain management commonly practiced among orthodontists...

BACKGROUND: To observe the analgesic effect of different ultrasound-guided methods of serratus anterior plane block (SAPB) after surgery in patients who have undergone thoracoscopic lobectomy with general anesthesia combined with thoracic paravertebral nerve block. METHODS: A total of 120 patients aged 18-65 years old scheduled for video-assisted thoracoscopic surgery (VATS) were selected. Patients were randomly divided into 3 groups: patient-controlled intravenous analgesia (PCIA) group, serratus anterior plane block (SPB) group and continuous serratus anterior plane block (CSPB) group (n=40 each)...

Breast cancer has the greatest epidemiological impact in women. Opioids represent the most prescribed analgesics, both in surgical time and in immediate postoperative period, as well as in chronic pain management as palliative care. We made a systematic review analyzing the literature's evidence about the safety of opioids in breast cancer treatment, focusing our attention on the link between opioid administration and increased relapses. The research has been conducted using the PubMed database. Preclinical studies, retrospective and prospective clinical studies, review articles and original articles were analyzed...

INTRODUCTION: Angiosarcoma is a very rare malignancy, which varies based on the location and organ affected. A clinicopathological form of cutaneous angiosarcoma (CAS) involves the head: scalp, face, and neck. We report a 59-year-old female patient with CAS on the temporoparietal region of the scalp. CASE PRESENTATION: The patient presented with lesions in the head area, which appeared suddenly in the last 6 months, (before her surgery). Excision was performed under general anesthesia for bleeding as indicated on the right temporal region...