collection
https://read.qxmd.com/read/29421247/-it-encourages-them-to-complain-a-qualitative-study-of-the-unintended-consequences-of-assessing-patient-reported-pain
#1
RANDOMIZED CONTROLLED TRIAL
Sangeeta C Ahluwalia, Karleen F Giannitrapani, Steven K Dobscha, Risa Cromer, Karl A Lorenz
UNLABELLED: The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain by encouraging routine pain assessment and management. In the Veterans Health Administration, routine pain screening has been practiced in primary care for more than a decade, but has not improved the quality of pain management measured using several process indicators, and some have expressed concerns of potentially fostering undesirable use of prescription opioids. We sought to evaluate the consequences of routine pain screening on clinical practice...
May 2018: Journal of Pain
https://read.qxmd.com/read/15157714/office-visits-and-analgesic-prescriptions-for-musculoskeletal-pain-in-us-1980-vs-2000
#2
COMPARATIVE STUDY
Margaret A Caudill-Slosberg, Lisa M Schwartz, Steven Woloshin
The treatment of pain has received increasing attention over the past decade promoted by national guidelines, the 'pain as the 5th vital sign' campaign and direct-to-consumer advertising. We examined national trends in office visits and analgesic treatment for musculoskeletal pain in the office setting, comparing data from 1980 and 2000. We analysed the National Ambulatory Medical Care Survey (NAMCS)--a nationally representative survey of visits to office-based physicians--using data from 1980-81 (n=89,000 visits) and 1999-2000 (n=45,000 visits)...
June 2004: Pain
https://read.qxmd.com/read/29643620/opioid-free-anesthesia-for-breast-cancer-surgery-an-observational-study
#3
JOURNAL ARTICLE
Swagata Tripathy, Satyajit Rath, Suresh Agrawal, P Bhaskar Rao, A Panda, T S Mishra, Sukdev Nayak
BACKGROUND AND AIMS: Opioids are associated with postoperative nausea, vomiting, drowsiness, and increased analgesic requirement. A nonopioid anesthesia technique may reduce morbidity, enable day care surgery, and possibly decrease tumor recurrence. We compared opioid-free, nerve block-based anesthesia with opioid-based general anesthesia for breast cancer surgery in a prospective cohort study. MATERIAL AND METHODS: Twenty four adult American Society of Anesthesiologists grade I-III patients posted for modified radical mastectomy (MRM) with axillary dissection were induced with propofol and maintained on isoflurane (0...
2018: Journal of Anaesthesiology, Clinical Pharmacology
https://read.qxmd.com/read/29624535/comparison-of-intraoperative-sedation-with-dexmedetomidine-versus-propofol-on-acute-postoperative-pain-in-total-knee-arthroplasty-under-spinal-anesthesia-a-randomized-trial
#4
JOURNAL ARTICLE
Hyun-Jung Shin, Sang-Hwan Do, Jae-Sung Lee, Tae-Kyun Kim, Hyo-Seok Na
BACKGROUND: In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol. METHODS: Forty-eight patients were enrolled and randomly assigned to either a dexmedetomidine group (n = 24), which received a loading dose of 1 μg/kg dexmedetomidine over 10 minutes, followed by a continuous infusion of 0...
April 5, 2018: Anesthesia and Analgesia
https://read.qxmd.com/read/29370902/opioid-free-anesthesia-with-bis-emg-monitored-propofol-ketamine
#5
EDITORIAL
B L Friedberg
No abstract text is available yet for this article.
May 2018: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/29333156/intravenous-magnesium-sulphate-for-analgesia-after-caesarean-section-a-systematic-review
#6
REVIEW
Andrew McKeown, Vyacheslav Seppi, Raymond Hodgson
OBJECTIVE: To summarise the evidence for use of intravenous magnesium for analgesic effect in caesarean section patients. BACKGROUND: Postcaesarean pain requires effective analgesia. Magnesium, an N -methyl-D-aspartate receptor antagonist and calcium-channel blocker, has previously been investigated for its analgesic properties. METHODS: A systematic search was conducted of PubMed , Scopus , MEDLINE , Cochrane Library , and Google Scholar databases for randomised-control trials comparing intravenous magnesium to placebo with analgesic outcomes in caesarean patients...
2017: Anesthesiology Research and Practice
https://read.qxmd.com/read/29225793/recent-advances-in-acute-pain-management-understanding-the-mechanisms-of-acute-pain-the-prescription-of-opioids-and-the-role-of-multimodal-pain-therapy
#7
REVIEW
Richa Wardhan, Jacques Chelly
In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the "opioid epidemic". In this regard, we propose that a fundamental principle in acute pain management is identifying patients who are most at risk and providing an "opioid free anesthesia and postoperative analgesia"...
2017: F1000Research
https://read.qxmd.com/read/29225750/opioid-free-anesthesia-using-continuous-dexmedetomidine-and-lidocaine-infusions-in-spine-surgery
#8
JOURNAL ARTICLE
David J Kim, Raheel Bengali, T Anthony Anderson
No abstract text is available yet for this article.
December 2017: Korean Journal of Anesthesiology
https://read.qxmd.com/read/29049119/a-review-of-opioid-sparing-modalities-in-perioperative-pain-management-methods-to-decrease-opioid-use-postoperatively
#9
REVIEW
Kanupriya Kumar, Meghan A Kirksey, Silvia Duong, Christopher L Wu
There is an epidemic of opioid use, abuse, and misuse in the United States, which results in significant morbidity and mortality. It may be difficult to reduce perioperative opioid use given known acute surgical trauma and resultant pain; however, the discrete and often limited nature of postoperative pain also may make management easier in part by utilizing nonopioid modalities, such as regional anesthesia/analgesia, and multimodal analgesia, which may decrease the need for powerful opioids. This article reviews the relevant literature describing the use of adjunct medications, regional anesthesia and analgesic techniques, and regional block additives in the context of providing adequate pain control while lessening opioid use...
November 2017: Anesthesia and Analgesia
https://read.qxmd.com/read/28922216/opioid-free-analgesia-in-the-era-of-enhanced-recovery-after-surgery-and-the-surgical-home-implications-for-postoperative-outcomes-and-population-health
#10
EDITORIAL
Nirav V Kamdar, Nir Hoftman, Siamak Rahman, Maxime Cannesson
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://read.qxmd.com/read/28626913/reply-to-sorbello-et-al-ponv-in-bariatric-surgery-time-for-opioid-free-anaesthesia
#11
LETTER
J Wallden, T A Halliday, M Hultin
No abstract text is available yet for this article.
August 2017: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/28626883/weighting-also-the-risk-of-post-operative-nausea-and-vomiting-in-bariatric-surgery-time-for-opioid-free-anesthesia
#12
LETTER
M Sorbello, G S Pulvirenti, E Panascia, I Di Giacinto
No abstract text is available yet for this article.
August 2017: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/28431750/opioid-free-general-anesthesia-a-paradigm-shift
#13
EDITORIAL
J Mulier
No abstract text is available yet for this article.
October 2017: Revista Española de Anestesiología y Reanimación
https://read.qxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#14
COMPARATIVE STUDY
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
September 1, 2017: Aesthetic Surgery Journal
https://read.qxmd.com/read/28251526/management-of-patients-on-abuse-deterrent-opioids-in-the-ambulatory-surgery-setting
#15
REVIEW
Nalini Vadivelu, Daniel Chang, Leandro Lumermann, Thomas Suchy, Matthew M Burg, Manuel L Fontes
PURPOSE OF REVIEW: The use of prescription opioids for acute and chronic pain has become more prevalent than ever, and concurrent with the increased prescribing of opioids, there has been a steady increase in opioid abuse. Abuse is commonly associated with physical or chemical manipulation of the original opiate to provide more rapid onset of the active ingredient. RECENT FINDINGS: This growing national public health concern has led to the development of various abuse-deterring opioids with the intent of decreasing the diversion of opioids from their prescribed use...
February 2017: Current Pain and Headache Reports
https://read.qxmd.com/read/28043841/non-opioid-pain-management-in-benign-minimally-invasive-hysterectomy-a-systematic-review
#16
REVIEW
Emily Blanton, Georgine Lamvu, Insiyyah Patanwala, Kenneth I Barron, Kathryn Witzeman, Frank F Tu, Sawsan As-Sanie
BACKGROUND: Less postoperative pain typically is associated with a minimally invasive hysterectomy compared with a laparotomy approach; however, poor pain control can still be an issue. Multiple guidelines exist for managing postoperative pain, yet most are not specialty-specific and are based on procedures that bear little relevance to a minimally invasive hysterectomy. OBJECTIVE: The purpose of this study was to determine whether there is enough quality evidence within the benign gynecology literature to make non-opioid pain control recommendations for women who undergo a benign minimally invasive hysterectomy...
June 2017: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/27636574/does-propofol-anesthesia-lead-to-less-postoperative-pain-compared-with-inhalational-anesthesia-a-systematic-review-and-meta-analysis
#17
REVIEW
Ke Peng, Hua-Yue Liu, Shao-Ru Wu, Hong Liu, Zhao-Cai Zhang, Fu-Hai Ji
BACKGROUND: Many studies have compared propofol-based anesthesia with inhalational anesthesia. Results from several studies have shown improved postoperative analgesia after propofol anesthesia, but other studies showed contradictory results. There are no large prospective studies that compare postoperative pain after propofol versus inhalational anesthesia. This meta-analysis was designed to focus on this question. METHODS: A systematic literature search for randomized controlled trials that compared propofol-based anesthesia with volatile agents-based anesthesia in adults undergoing surgery was conducted...
October 2016: Anesthesia and Analgesia
https://read.qxmd.com/read/27631259/opioid-free-general-anesthesia-in-patient-with-steinert-syndrome-myotonic-dystrophy-case-report
#18
JOURNAL ARTICLE
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
https://read.qxmd.com/read/27028535/ketamine-a-review-of-clinical-pharmacokinetics-and-pharmacodynamics-in-anesthesia-and-pain-therapy
#19
REVIEW
Marko A Peltoniemi, Nora M Hagelberg, Klaus T Olkkola, Teijo I Saari
Ketamine is a phencyclidine derivative, which functions primarily as an antagonist of the N-methyl-D-aspartate receptor. It has no affinity for gamma-aminobutyric acid receptors in the central nervous system. Ketamine shows a chiral structure consisting of two optical isomers. It undergoes oxidative metabolism, mainly to norketamine by cytochrome P450 (CYP) 3A and CYP2B6 enzymes. The use of S-ketamine is increasing worldwide, since the S(+)-enantiomer has been postulated to be a four times more potent anesthetic and analgesic than the R(-)-enantiomer and approximately two times more effective than the racemic mixture of ketamine...
September 2016: Clinical Pharmacokinetics
https://read.qxmd.com/read/27025133/-opioid-free-anesthesia-analgesia-and-sedation-in-surgery-of-head-and-neck-tumor
#20
JOURNAL ARTICLE
V V Balandin, E S Gorobec
62 adult patients had highly traumatic cancer head and neck surgery under multimodal non-opioid general anesthesia consisted of dexmedetomidine, lidocane, nefopam and sevoflurane. 18 patients had been intubatedwith fiber optic bronchoscope because of II-IV grade trismus. 10 patients with laryngeal stenosis had been tracheotomizedfor intubation. All these 28 patients had been sedated with dexmedetomidine, lidocane and small doses (10-20 mg) ketamine additionally to local anesthesia. All these patients maintained consciousness and breathed spontaneously...
November 2015: Anesteziologiia i Reanimatologiia
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