Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Analgesia, Epidural: The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.Analgesia, Obstetrical: The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.Analgesia, Patient-Controlled: Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Pain, Postoperative: Pain during the period after surgery.Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Bupivacaine: A widely used local anesthetic agent.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Acupuncture Analgesia: Analgesia produced by the insertion of ACUPUNCTURE needles at certain ACUPUNCTURE POINTS on the body. This activates small myelinated nerve fibers in the muscle which transmit impulses to the spinal cord and then activate three centers - the spinal cord, midbrain and pituitary/hypothalamus - to produce analgesia.Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Analgesics: Compounds capable of relieving pain without the loss of CONSCIOUSNESS.Anesthesia, Epidural: Procedure in which an anesthetic is injected into the epidural space.Meperidine: A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.Labor Pain: Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Labor, Obstetric: The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Anesthesia, Spinal: Procedure in which an anesthetic is injected directly into the spinal cord.Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Analgesics, Non-Narcotic: A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Postoperative Nausea and Vomiting: Emesis and queasiness occurring after anesthesia.Pain Threshold: Amount of stimulation required before the sensation of pain is experienced.Interpleural Analgesia: Injection of ANALGESICS; LOCAL ANESTHETICS; or NARCOTICS into the PLEURAL CAVITY between the two pleural membranes.Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.Receptors, Opioid, mu: A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Ketorolac: A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)Labor Stage, First: Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.Hydromorphone: An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.Pain Management: A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.Anesthesia, Caudal: Epidural anesthesia administered via the sacral canal.Clonidine: An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.Anesthesia and Analgesia: Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.Femoral Nerve: A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints.Receptors, Opioid: Cell membrane proteins that bind opioids and trigger intracellular changes which influence the behavior of cells. The endogenous ligands for opioid receptors in mammals include three families of peptides, the enkephalins, endorphins, and dynorphins. The receptor classes include mu, delta, and kappa receptors. Sigma receptors bind several psychoactive substances, including certain opioids, but their endogenous ligands are not known.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Pirinitramide: A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Butorphanol: A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.Nalbuphine: A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors.Narcotic Antagonists: Agents inhibiting the effect of narcotics on the central nervous system.Anesthetics, Combined: The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.Anesthesia, Conduction: Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.Thoracotomy: Surgical incision into the chest wall.Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the ENKEPHALINS, the DYNORPHINS, and the ENDORPHINS. Each of these families derives from different precursors, proenkephalin, prodynorphin, and PRO-OPIOMELANOCORTIN, respectively. There are also at least three classes of OPIOID RECEPTORS, but the peptide families do not map to the receptors in a simple way.Electroacupuncture: A form of acupuncture with electrical impulses passing through the needles to stimulate NERVE TISSUE. It can be used for ANALGESIA; ANESTHESIA; REHABILITATION; and treatment for diseases.Mepivacaine: A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.Ketoprofen: An IBUPROFEN-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis.Adjuvants, Anesthesia: Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion.Morphine Derivatives: Analogs or derivatives of morphine.Hyperalgesia: An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Periaqueductal Gray: Central gray matter surrounding the CEREBRAL AQUEDUCT in the MESENCEPHALON. Physiologically it is probably involved in RAGE reactions, the LORDOSIS REFLEX; FEEDING responses, bladder tonus, and pain.Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.Pentazocine: The first mixed agonist-antagonist analgesic to be marketed. It is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (From AMA Drug Evaluations Annual, 1991, p97)Postoperative Care: The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)Dexmedetomidine: A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.Ambulatory Surgical Procedures: Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.Hysterectomy: Excision of the uterus.Piperidines: A family of hexahydropyridines.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Pain, Intractable: Persistent pain that is refractory to some or all forms of treatment.Oxycodone: A semisynthetic derivative of CODEINE.Pain Perception: The process by which PAIN is recognized and interpreted by the brain.Injections, Epidural: The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.Anesthesia, Intravenous: Process of administering an anesthetic through injection directly into the bloodstream.Anesthetics, Dissociative: Intravenous anesthetics that induce a state of sedation, immobility, amnesia, and marked analgesia. Subjects may experience a strong feeling of dissociation from the environment. The condition produced is similar to NEUROLEPTANALGESIA, but is brought about by the administration of a single drug. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed)Prilocaine: A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.Nociceptors: Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.Delivery, Obstetric: Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.Obstetric Labor Complications: Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.Nociceptive Pain: Dull or sharp aching pain caused by stimulated NOCICEPTORS due to tissue injury, inflammation or diseases. It can be divided into somatic or tissue pain and VISCERAL PAIN.Injections, Intravenous: Injections made into a vein for therapeutic or experimental purposes.Extraction, Obstetrical: Extraction of the fetus by means of obstetrical instruments.Dipyrone: A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE.Anti-Inflammatory Agents, Non-Steroidal: Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions.They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.Spinal Cord: A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Subarachnoid Space: The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.Narcotics: Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.Injections, Intra-Articular: Methods of delivering drugs into a joint space.Codeine: An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.Nefopam: Non-narcotic analgesic chemically similar to ORPHENADRINE. Its mechanism of action is unclear. It is used for the relief of acute and chronic pain. (From Martindale, The Extra Pharmacopoeia, 30th ed, p26)Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.Buprenorphine: A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.Perioperative Care: Interventions to provide care prior to, during, and immediately after surgery.Heroin: A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed)Apgar Score: A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.Preanesthetic Medication: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Administration, Rectal: The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few - MORPHINE; CODEINE; and PAPAVERINE - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic.Anesthesia Recovery Period: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Receptors, Opioid, kappa: A class of opioid receptors recognized by its pharmacological profile. Kappa opioid receptors bind dynorphins with a higher affinity than endorphins which are themselves preferred to enkephalins.Receptors, Opioid, delta: A class of opioid receptors recognized by its pharmacological profile. Delta opioid receptors bind endorphins and enkephalins with approximately equal affinity and have less affinity for dynorphins.ThiazinesInfusion Pumps: Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (INSULIN INFUSION SYSTEMS is also available), and other disorders.beta-Endorphin: A 31-amino acid peptide that is the C-terminal fragment of BETA-LIPOTROPIN. It acts on OPIOID RECEPTORS and is an analgesic. Its first four amino acids at the N-terminal are identical to the tetrapeptide sequence of METHIONINE ENKEPHALIN and LEUCINE ENKEPHALIN.Enkephalin, Ala(2)-MePhe(4)-Gly(5)-: An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Abdomen: That portion of the body that lies between the THORAX and the PELVIS.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Injections, Intramuscular: Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.Dihydromorphine: A semisynthetic analgesic used in the study of narcotic receptors.Adrenergic alpha-Agonists: Drugs that selectively bind to and activate alpha adrenergic receptors.Nociception: Sensing of noxious mechanical, thermal or chemical stimuli by NOCICEPTORS. It is the sensory component of visceral and tissue pain (NOCICEPTIVE PAIN).Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla.Infusions, Parenteral: The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the PRO-OPIOMELANOCORTIN precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; OPIOID PEPTIDES is used for the broader group.Propofol: An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.Anesthetics, Intravenous: Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)Midazolam: A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.Morphinans: Compounds based on a partially saturated iminoethanophenanthrene, which can be described as ethylimino-bridged benzo-decahydronaphthalenes. They include some of the OPIOIDS found in PAPAVER that are used as ANALGESICS.Gynecologic Surgical Procedures: Surgery performed on the female genitalia.Behavior, Animal: The observable response an animal makes to any situation.Anesthesia, Dental: A range of methods used to reduce pain and anxiety during dental procedures.Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.Doulas: Trained lay women who provide emotional and/or physical support during obstetric labor and the postpartum period for mothers and their partners.Labor Stage, Second: The period of OBSTETRIC LABOR that is from the complete dilatation of the CERVIX UTERI to the expulsion of the FETUS.Tolmetin: A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.Piroxicam: A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (NSAID) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily.Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles.Respiration: The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).Orthopedic Procedures: Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.Injections, Intraventricular: Injections into the cerebral ventricles.Oxymorphone: An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)Hypnosis, Anesthetic: Procedure in which an individual is induced into a trance-like state to relieve pain. This procedure is frequently performed with local but not general ANESTHESIA.Epidural Space: Space between the dura mater and the walls of the vertebral canal.Postoperative Period: The period following a surgical operation.Arthroplasty, Replacement, Knee: Replacement of the knee joint.Droperidol: A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593)Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.Heart Rate, Fetal: The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Adrenergic alpha-2 Receptor Agonists: Compounds that bind to and activate ADRENERGIC ALPHA-2 RECEPTORS.Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.Arthroscopy: Endoscopic examination, therapy and surgery of the joint.Cyclohexanecarboxylic AcidsSingle-Blind Method: A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.Hernia, Inguinal: An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.Transcutaneous Electric Nerve Stimulation: The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.Injections, Subcutaneous: Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.Vomiting: The forcible expulsion of the contents of the STOMACH through the MOUTH.Antiemetics: Drugs used to prevent NAUSEA or VOMITING.Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Morphine Dependence: Strong dependence, both physiological and emotional, upon morphine.Parity: The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.Epinephrine: The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.Tooth Extraction: The surgical removal of a tooth. (Dorland, 28th ed)Enkephalin, D-Penicillamine (2,5)-: A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.Ketorolac Tromethamine: A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity.Hot Temperature: Presence of warmth or heat or a temperature notably higher than an accustomed norm.Tonsillectomy: Surgical removal of a tonsil or tonsils. (Dorland, 28th ed)Intraoperative Care: Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.Intraoperative Period: The period during a surgical operation.Enkephalin, Leucine: One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.Receptors, Adrenergic, alpha-2: A subclass of alpha-adrenergic receptors found on both presynaptic and postsynaptic membranes where they signal through Gi-Go G-PROTEINS. While postsynaptic alpha-2 receptors play a traditional role in mediating the effects of ADRENERGIC AGONISTS, the subset of alpha-2 receptors found on presynaptic membranes signal the feedback inhibition of NEUROTRANSMITTER release.Drug Synergism: The action of a drug in promoting or enhancing the effectiveness of another drug.Catheterization, Peripheral: Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.Reaction Time: The time from the onset of a stimulus until a response is observed.

Dextromethorphan and pain after total abdominal hysterectomy. (1/379)

Dextromethorphan is an N-methyl-D-aspartate (NMDA) receptor antagonist which has been shown to inhibit the development of cutaneous secondary hyperalgesia after tissue trauma. We studied 60 ASA I-II patients undergoing total abdominal hysterectomy in a randomized, double-blind, placebo-controlled study. Patients received either dextromethorphan 27 mg capsules, two doses before operation and three doses in the first 24 h after operation, or placebo. Visual analogue pain scores (VAS) at 24 and 48 h were assessed at rest, on coughing and on sitting up, and were not significantly different between groups. Morphine consumption from a patient-controlled analgesia (PCA) device was also not significantly different between groups. Evidence of secondary hyperalgesia was assessed with von Frey hairs 10 cm above the Pfannenstiel incision. Both groups of patients exhibited evidence of secondary hyperalgesia after 24 and 48 h but there were no significant differences between groups. There was also no difference between groups in VAS scores at 1 month.  (+info)

Effects of prophylactic nalmefene on the incidence of morphine-related side effects in patients receiving intravenous patient-controlled analgesia. (2/379)

BACKGROUND: Opioid-related side effects associated with intravenous patient-controlled analgesia can be reduced by a low-dose naloxone infusion. The influence of nalmefene, a pure opioid antagonist with a longer duration of action, on opioid-related side effects has not been evaluated. This study was designed to determine the dose-response relation for nalmefene for the prevention of morphine-related side effects in patients receiving intravenous patient-controlled analgesia. METHODS: One hundred twenty women undergoing lower abdominal surgery were enrolled in the study. General anesthesia was induced using thiopental and rocuronium and maintained with desflurane, nitrous oxide, and fentanyl or sufentanil. All patients received neostigmine and glycopyrrolate to reverse residual neuromuscular blockade. No prophylactic antiemetics were administered. At the end of surgery, patients were randomized to receive saline, 15 microg nalmefene, or 25 microg nalmefene intravenously. The need for antiemetic and antipruritic drugs and the total consumption of morphine during the 24-h study were recorded. The incidences of postoperative nausea, vomiting, pruritus, and pain were recorded 30 min after patients were admitted to the postanesthesia care unit. In addition, patient remembrance of these side effects was noted at 24 h after operation. RESULTS: The need for antiemetic and antipruritic medications during the 24-h study period was significantly lower in the patients receiving nahmefene compared with those receiving placebo. However, the need to treat side effects was similar in the two nahmefene groups. Prophylactic administration of nalmefene reduced the patients remembrance of nausea and itching as assessed 24 h after operation. Although the total consumption of morphine during the 24-h study period was similar in the three groups, retrospectively patients who received nalmefene characterized their pain as less severe in the previous 24 h. CONCLUSION: Compared with placebo, prophylactic administration of nalmefene significantly decreased the need for antiemetics and antipruritic medications in patients receiving intravenous patient-controlled analgesia with morphine.  (+info)

Continuous epidural infusion of ropivacaine for postoperative analgesia after major abdominal surgery: comparative study with i.v. PCA morphine. (3/379)

We have compared the quality of three regimens of postoperative analgesia (continuous epidural administration of ropivacaine (Ropi. group), epidural ropivacaine and patient-controlled analgesia (PCA) with i.v. morphine (Ropi. + PCA group) and PCA morphine alone (PCA group)) during the first postoperative 24 h in a multicentre, randomized, prospective study. Postoperative analgesia was studied in 130 patients after major abdominal surgery performed under general anaesthesia. The ropivacaine groups received 20 ml of epidural bolus ropivacaine 2 mg ml-1 via the epidural route at the end of surgery, followed by continuous infusion of 10 ml h-1 for 24 h. The Ropi. + PCA group also had access to i.v. PCA morphine 1 mg, with a 5-min lockout. The PCA group received morphine as the sole postoperative pain treatment. The two ropivacaine groups had lower pain scores (P < 0.01) than the PCA group. Morphine consumption was higher in the PCA group (P < 0.05) than in the two ropivacaine groups. The quality of pain relief was rated as good or excellent in 79-85% of patients in the three groups. The percentage of patients without motor block increased between 4 and 24 h from 61% to 89% in the Ropi. group, and from 51% to 71% in the Ropi. + PCA group.  (+info)

Prospective, randomized comparison of epidural versus parenteral opioid analgesia in thoracic trauma. (4/379)

OBJECTIVE: To evaluate systemic versus epidural opioid administration for analgesia in patients sustaining thoracic trauma. SUMMARY BACKGROUND DATA: The authors have previously shown that epidural analgesia significantly reduces the pain associated with significant chest wall injury. Recent studies report that epidural analgesia is associated with a lower catecholamine and cytokine response in patients undergoing elective thoracotomy compared with patient-controlled analgesia (PCA). This study compares the effect of epidural analgesia and PCA on pain relief, pulmonary function, cathechol release, and immune response in patients sustaining significant thoracic trauma. METHODS: Patients (ages 18 to 60 years) sustaining thoracic injury were prospectively randomized to receive epidural analgesia or PCA during an 18-month period. Levels of serum interleukin (IL)-1beta, IL-2, IL-6, IL-8, and tumor necrosis factor-alpha (TNF-alpha) were measured every 12 hours for 3 days by enzyme-linked immunosorbent assay. Urinary catecholamine levels were measured every 24 hours. Independent observers assessed pulmonary function using standard techniques and analgesia using a verbal rating score. RESULTS: Twenty-four patients of the 34 enrolled completed the study. Age, injury severity score, thoracic abbreviated injury score, and length of hospital stay did not differ between the two groups. There was no significant difference in plasma levels of IL-1beta, IL-2, IL-6, or TNF-alpha or urinary catecholamines between the two groups at any time point. Epidural analgesia was associated with significantly reduced plasma levels of IL-8 at days 2 and 3, verbal rating score of pain on days 1 and 3, and maximal inspiratory force and tidal volume on day 3 versus PCA. CONCLUSIONS: Epidural analgesia significantly reduced pain with chest wall excursion compared with PCA. The route of analgesia did not affect the catecholamine response. However, serum levels of IL-8, a proinflammatory chemoattractant that has been implicated in acute lung injury, were significantly reduced in patients receiving epidural analgesia on days 2 and 3. This may have important clinical implications because lower levels of IL-8 may reduce infectious or inflammatory complications in the trauma patient. Also, tidal volume and maximal inspiratory force were improved with epidural analgesia by day 3. These results demonstrate that epidural analgesia is superior to PCA in providing analgesia, improving pulmonary function, and modifying the immune response in patients with severe chest injury.  (+info)

Epidural analgesia during labor and maternal fever. (5/379)

BACKGROUND: In recent observational studies, epidural analgesia during labor at patient request has been associated with maternal fever. The authors report a secondary analysis of fever in women who were randomized to receive either epidural or patient-controlled intravenous analgesia during labor. METHODS: Maternal tympanic temperature was measured during spontaneous labor in 715 women at term who were randomized to either epidural analgesia with bupivacaine and fentanyl or to patient-controlled intravenous analgesia with meperidine. Intent-to-treat analysis of women with fever (temperature > or = 38.0 degrees C) versus those without was performed using Student t test and Fisher exact test to determine statistical significance (P < 0.05). RESULTS: Epidural analgesia was associated with maternal fever (odds ratio = 4.0; 95% confidence interval = 2.0-7.7), as was nulliparity (odds ratio = 4.1; 95% confidence interval = 1.8-9.1) and labor longer than 12 h (odds ratio = 5.4; 95% confidence interval = 2.9-9.9). These factors were all independent variables for maternal fever when analyzed using logistic regression. CONCLUSIONS: Epidural analgesia is associated with maternal fever. However, nulliparity and dysfunctional labor are also significant cofactors in the fever attributed to epidural analgesia.  (+info)

Influence of bolus size on efficacy of postoperative patient-controlled analgesia with piritramide. (6/379)

We have examined the influence of bolus size on efficacy, opioid consumption, side effects and patient satisfaction during i.v. patient-controlled analgesia (PCA) in 60 patients (ASA I-II, aged 32-82 yr) after abdominal surgery. Patients were allocated randomly, in a double-blind manner, to receive PCA with a bolus dose of either piritramide 0.75 mg or 1.5 mg (lockout 5 min) for postoperative pain control. Mean 24 h piritramide consumption differed significantly between groups (11.4 (SD 5.8) mg vs 22.5 (18.3) mg; P = 0.001). There were no significant differences in the number of applied bolus doses, pain scores, pain relief (VAS), sedation, nausea, pruritus and patient satisfaction. We conclude that a PCA regimen with a bolus dose of piritramide 0.75 mg and a lockout time of 5 min was effective in the treatment of postoperative pain, but did not reduce the occurrence of side effects.  (+info)

Nocturnal hypoxaemia and respiratory function after endovascular and conventional abdominal aortic aneurysm repair. (7/379)

Respiratory function, assessed by pre- and postoperative spirometry, and overnight pulse oximetry recordings, was compared prospectively in patients undergoing infrarenal abdominal aortic aneurysm repair by endovascular or conventional surgery. Episodic hypoxaemia was common in both groups before operation and up to the fifth night after operation. The frequency and severity of hypoxaemia were greater in the conventional group (P < 0.05). FEV1 and FVC decreased significantly on the third and fifth days after operation in both groups (P < 0.05); decreases in FVC were greater in patients undergoing conventional surgery. On the fifth day after operation, FVC had recovered to 86% and 64% of preoperative values in the endovascular and conventional groups, respectively (P < 0.05). Duration of surgery was greater (P < 0.05) and duration of postoperative artificial ventilation significantly less (P < 0.05) after endovascular repair. Postoperative PCA morphine consumption and duration of use were significantly greater (P < 0.05) in patients undergoing conventional abdominal aortic aneurysm surgery.  (+info)

Comparison of midwife top-ups, continuous infusion and patient-controlled epidural analgesia for maintaining mobility after a low-dose combined spinal-epidural. (8/379)

We studied 133 women given a combined spinal-epidural for analgesia in labour. The initial intrathecal dose contained bupivacaine 2.5 mg with fentanyl 25 micrograms. When the mothers were comfortable, they were allocated randomly to one of three groups: continuous infusion (group Cl, n = 46), midwife top-ups (group MW, n = 43) or patient-controlled epidural analgesia (group PCEA, n = 44), to maintain analgesia throughout labour. All epidural solutions contained 0.1% bupivacaine and fentanyl 2 micrograms ml-1. Motor block was assessed by the mother's ability to straight leg raise (SLR). Four hours after combined spinal-epidural analgesia, 88.1% of women could SLR in group MW, 83.7% in group PCEA and 57.8% in group Cl (P = 0.002). Total use of bupivacaine was highest in group Cl (mean 11.3 (SD 3.3) mg h-1) compared with group MW (7.5 (3.1) mg h-1) and group PCEA (9.1 (2.1) mg h-1) (P < 0.001). Analgesia was similar between groups and overall satisfaction was equally high.  (+info)

Abstract. Background: This study was investigated the effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on pain attenuation in patients undergoing open gastrectomy in comparison with conventional thoracic epidural patient-controlled analgesia (E-PCA) and IV-PCA.. Methods: One hundred seventy-one patients who planned open gastrectomy were randomly distributed into one of the 3 groups: conventional thoracic E-PCA (E-PCA group, n = 57), dexmedetomidine in combination with fentanyl-based IV-PCA (dIV-PCA group, n = 57), or fentanyl-based IV-PCA only (IV-PCA group, n = 57). The primary outcome was the postoperative pain intensity (numerical rating scale) at 3 hours after surgery, and the secondary outcomes were the number of bolus deliveries and bolus attempts, and the number of patients who required additional rescue analgesics. Mean blood pressure, heart rate, and adverse effects were evaluated as well.. Results: One hundred fifty-three ...
Effect of patient-controlled epidural analgesia versus patient-controlled intravenous analgesia on postoperative pain management and short-term outcomes after gastric cancer resection: a retrospective analysis of 3,042 consecutive patients between 2010 and 2015 Liping Wang, Xuan Li, Hong Chen, Jie Liang, Yu Wang Department of Anaesthesiology, Harbin Medical University Cancer Hospital, Harbin, China Background: Effective postoperative analgesia is essential for rehabilitation after surgery. Many studies have compared different methods of postoperative pain management for open abdominal surgery. However, the conclusions were inconsistent and controversial. In addition, few studies have focused on gastric cancer (GC) resection. This study aimed to determine the effects of patient-controlled epidural analgesia (PCEA) on postoperative pain management and short-term recovery after GC resection compared with those of patient-controlled intravenous analgesia (PCIA). Methods: We analyzed retrospectively
The Comparison of Postoperative Pain After Lumbar Fusion Surgery in Intravenous Patient-controlled Analgesia Between Conventional Mode and Optimizing B.I Mode With PAINSTOP ...
Patient-Controlled Analgesia Pumps Patient-controlled analgesia (PCA) is a type of pain management that lets you decide when you will get a dose of pain medicine. In some situations, PCA may be a better way of providing pain relief than calling for someone (typically a nurse) to give you pain medicine. With PCA you dont need to wait for a nurse. And you can get smaller doses of pain medicine more often. With this type of pain treatment, a needle attached to an IV (intravenous) line is placed into 1 of ...
RATIONALE: Giving pain medication into the space between the wall of the spinal canal and the covering of the spinal cord or giving it into a vein may help lessen pain caused by cancer surgery. It is not yet known whether epidural analgesia is more effective than patient-controlled analgesia in controlling pain in patients who have undergone surgery for gynecologic cancer.. PURPOSE: This randomized clinical trial is studying epidural analgesia to see how well it works compared to patient-controlled analgesia in treating patients who have undergone surgery for gynecologic cancer. ...
TY - JOUR. T1 - Epidural, intrathecal, and patient-controlled analgesic use in a University Medical Center. AU - Erstad, B. L.. AU - Snyder, B. A.. AU - Kramer, T. H.. PY - 1993/1/1. Y1 - 1993/1/1. N2 - Objective: To determine the number and profile of surgical patients receiving epidural, intrathecal, and patient-controlled analgesia. Design: Two-month audit of epidural, intrathecal, and patient-controlled analgesia. Setting: A 300-bed, tertiary care, university medical center. Patients: All patients undergoing surgery and receiving epidural, intrathecal, or patient- controlled analgesia. Results: Of 1123 operations performed during the two- month audit, 185 patients (16 percent) received one of the three forms of analgesia studied. Sixty-three percent of the 185 patients received patient- controlled analgesia and 33 percent received epidural injections for pain control. The most common types of surgery associated with the use of these specialized pain-control techniques were ...
Problem: After a 72-year-old woman underwent cancer surgery, her surgeon prescribed patient-controlled analgesia (PCA) with a 2-mg morphine loading dose and 1 mg every 10 minutes as needed, for a maximum of 6 mg/hour. Initially, the patient was restless and agitated in the post-anesthesia care unit, but she remained obtunded (not alert) after surgery. Despite her inability to verbalize her pain, nurses pushed the PCA button and delivered frequent doses of morphine over the next 48 hours. Subsequently, the patient suffered a cardio-respiratory arrest and seizure, leading to hypoxic encephalopathy. She died several months later without ever having regained consciousness.. Several safety features exist with PCA to ensure that patients do not receive too much analgesia. These include a lockout interval that specifies the minimum amount of time between each dose and a maximum allowable amount that may be administered during a set time interval. buy kamagra. Another often-overlooked "built-in" safety ...
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...
Patients were sent to the surgical room without any premedication 30 min before the surgery. Standard monitoring consisted of five-lead electrocardiography (ECG), oxygen saturation (SpO2) and non-invasive blood pressure measurements. The anesthesiologist administering the anesthetic prepared a 50-ml syringe containing 4 μg/ml of DEX. A 20-gauge intravenous cannula was inserted in the dorsum of each patients left hand; 0.6 μg/kg of DEX was administered, and was changed to 0.4 μg/kg/h for maintenance after 15 min. Preoxygenation with 100% oxygen was administered before induction, which was delivered through a facial mask for no less than 3 min. After the arterial line was inserted under local anesthesia, general anesthesia was induced with 0.3 mg/kg of etomidate, 0.5 μg/kg of sufentanil and 1.2 mg/kg of rocuronium. Manual facemask ventilation was continued for no less than 4 min until the jaw was relaxed and the Bispectral Index Monitoring (BIS) was less than 50 to allow the double-lumen tube ...
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The primary objective of this study is to determine the safety and efficacy of single doses of intramuscular NALDEBAIN on patients scheduled to undergo
... (PCA) is any method of allowing a person in pain to administer their own pain relief. Additional
Surgeries accompanied by an extensive tissue trauma are associated with intense postsurgical pain and major perioperative homeostatic disorders. Both hyper-inflammatory and immuneparalytic reactions can be observed, what can negatively effect the postoperative course. To realise an effective and safe analgesia, epidural procedures are used to an increasing degree as an alternative method to the therapy with intravenous opioids. In this prospective, randomized, double-blinded trial we compared the patient-controlled epidural analgesia and the patient-controlled intravenous analgesia with respect to the analgesic efficiency and the influence on the postoperative immune competence. 54 patients received until the morning of the fourth postoperative day either ropivacaine plus sufentanil through an intraoperatively placed epidural catheter (PCEA-group) or intravenous morphine (PCIA-group). Cortisol, populations of leukocytes and lymphocytes, cell-surface molecules of monocytes and the soluble ...
To control pain after surgery, doctors recommend intravenous patient-controlled analgesia, patient-controlled epidural analgesia, nerve blocks or oral pain medications, according to Cleveland Clinic....
All 3 groups had similar values of TUG test on postoperative day (POD) 2 (46 [36-62], 45 [33-61], and 52 [41-69]; P = 0.166) as well as other short-term and 3-month functional outcomes. Patients in group 3 showed a favorable analgesic profile as evidenced by 3 positive secondary outcomes. These positive outcomes were lower pain scores 12 hours postoperatively both at rest (4 [2-6.3], 4 [2.3-6], and 3 [1-4]; P = 0.007) and on movement (6 [4-8], 6 [3-8], and 4 [2-6]; P = 0.002), a lower incidence of "rescue" intravenous patient-controlled analgesia (42%, 34%, and 20%; P = 0.031), and the lowest cumulative opioid requirements for the first 48 hours postoperatively (86 ± 71, 68 ± 46, and 59 ± 39; P , 0.005, group 3 compared with group 1).. CONCLUSIONS ...
PCA-related device events are three times as likely to result in injury or death. As Tim Ritter (Senior Patient Safety Analyst, Pennsylvania Patient Safety Authority) reminds us,
Physician-Patient Alliance for Health & Safety nominates the respiratory care department of St. Josephs/Candler Hospitals in Savannah, Georgia for RT Magazines
Epidurals are better pain relievers during labor than patient-controlled doses of a fast-acting painkiller called remifentanil, new research suggests. The Dutch
1. How Should Opioids Be Started and Titrated in Routine Outpatient Settings? -- 2. How Should Opioids Be Started and Titrated in Hospital or Inpatient Settings? -- 3. How Should Patient-Controlled Analgesia Be Used in Patients With Serious Illness and Those Experiencing Postoperative Pain? -- 4. How Should Opioids Be Used to Manage Pain Emergencies? -- 5. What Principles Should Guide Oral, Transcutaneous, and Intravenous Opioid Dose Conversions? -- 6. Which Opioids Are Safest and Most Effective in Renal Failure? -- 7. How Should Methadone Be Started and Titrated in Opioid-Naïve and Opioid-Tolerant Patients? -- 8. What Special Considerations Should Guide the Safe Use of Methadone? -- 9. When Should Corticosteroids Be Used to Manage Pain? -- 10. When Should Nonsteroidal Antiinflammatory Drugs Be Used to Manage Pain? -- 11. What Is Neuropathic Pain? How Do Opioids and Nonopioids Compare for Neuropathic Pain Management? -- 12. Should Bisphosphonates Be Used Routinely to Manage Pain and Skeletal ...
1. How Should Opioids Be Started and Titrated in Routine Outpatient Settings? -- 2. How Should Opioids Be Started and Titrated in Hospital or Inpatient Settings? -- 3. How Should Patient-Controlled Analgesia Be Used in Patients With Serious Illness and Those Experiencing Postoperative Pain? -- 4. How Should Opioids Be Used to Manage Pain Emergencies? -- 5. What Principles Should Guide Oral, Transcutaneous, and Intravenous Opioid Dose Conversions? -- 6. Which Opioids Are Safest and Most Effective in Renal Failure? -- 7. How Should Methadone Be Started and Titrated in Opioid-Naïve and Opioid-Tolerant Patients? -- 8. What Special Considerations Should Guide the Safe Use of Methadone? -- 9. When Should Corticosteroids Be Used to Manage Pain? -- 10. When Should Nonsteroidal Antiinflammatory Drugs Be Used to Manage Pain? -- 11. What Is Neuropathic Pain? How Do Opioids and Nonopioids Compare for Neuropathic Pain Management? -- 12. Should Bisphosphonates Be Used Routinely to Manage Pain and Skeletal ...
The complaint continues that in mid afternoon on April 1, 2007, Ms. Stewart told "one or more of the Defendants that her abdominal pain was 8 or higher and her knee pain was 3. The health care provider replied that he was not concerned with her abdominal pain". When a family member asked a nurse to contact a doctor, the nurse informed her ,"…the team responsible for decedents care was aware of the abdominal issues, that the pain was being caused by ileus and that two doctors, Defendants Stuffman and Hamman, had been contacted and they had taken a course of no action other than palliative medical treatment". Despite repeated requests from Ms. Stewart and family members, that she be examined and evaluated by a doctor, they were informed by the nurse … "that their job was to manage the pain and not to do anything else and directed Decedent to use the Patient-Controlled Analgesia or PCA device to administer pain medication". All this time, family members were assured that the "decedent was ...
OTC pain relievers e.g., codeine, psychiatric viagra nhs medicines e.g., amitriptyline, desipramine. Half a second, add a quarter cup of Frosted Shredded Wheat viagra nhs Spoonsize = 4 grams of fiber. Alternative Therapies Patient-controlled analgesia PCA is another option.
Thybo KH, Hägi-Pedersen D, Dahl JB, Wetterslev J, Nersesjan M, Jakobsen JC, Pedersen NA, Overgaard S, Schroder HM, Schmidt H, Bjorck JG, Skovmand K, Frederiksen R, Buus-Nielsen M, Vos Sorensen C, Kruuse LS, Lindholm P, Mathiesen O. Effect of combination of paracetamol (acetaminophen) and ibuprofen vs either alone on patient-controlled morphine consumption in the first 24 hours after total hip arthroplasty. The PANSAID randomized clinical trial. JAMA 2019;321:12 de febrero. [Ref.ID 103023 ...
A review and metaregression of 25 trials, totalling 763 patients, looked at efficacy and safety of different techniques for PVB to determine whether LA dose influenced the quality of analgesia from PVB. Use of higher doses of bupivacaine was found to predict lower pain scores at all time points up to 48 h and was predictive of faster recovery of pulmonary function by 72 h. CI of LA predicted lower pain scores compared with intermittent boluses and the use of adjuvant clonidine or fentanyl, pre-emptive PVB, and the addition of patient-controlled opioids to PVB did not improve analgesia (Kotzé et al. 2009, n=762, LoE 1 ...
Lockout Tagout LOTO Definition - The term lockout tagout (LOTO) refers to a safety procedure that ensures that dangerous machines and energy sources are...
Another day, another day without any developments in the lockout of the NFL officials. Per a source with knowledge of the situation, no negotiations have occurred between the NFL and the NFL Referees Association.
are people just nowfiguring out that i have no interest in talking about things that i agree with everyone on if i wanted to do that there are thousands of threads that i could pollute with quot exactly quot and quot quot yes if im talking about something my opinion is going to be made clear and yes i argue a point that i dont exactly hold in some cases this is probably one of those im not on the players side im definitely against people who are on the owners side though
Remember how David Stern said that if a deal wasnt reached by Monday that the first two weeks of the regular season would be cancelled? Well, were pretty much there. CBSSports.
He wanted to sell a business that Forbes had valued at 4.9 Billion for 3.5 Million and decided that it was a great enough idea that it was worth...
The European Survey of Enterprises on New and Emerging Risks (ESENER) asks managers and workers health and safety representatives about how health and safety risks are managed at their workplace, with a particular focus on the newer psychosocial risks, such as work-related stress, violence and harassment. This summary highlights a selection of the main results from a first analysis of the data, which is drawn from 36,000 interviews carried out in 31 countries.
BACKGROUND: The role of electroacupuncture in postthoracotomy pain control is uncertain. We conducted a pilot study to evaluate the role of electroacupuncture in the management of early postthoracotomy wound pain. METHODS: A total of 27 patients with operable non-small cell lung carcinoma who received thoracotomy were recruited and randomized to receive either electroacupuncture or sham acupuncture in addition to routine oral analgesics and patient-controlled intravenous analgesia for postoperative pain control. All patients received acupuncture twice daily with visual analog pain score recorded for the first 7 postoperative days. Specific chest acupoints (LI 4, GB 34, GB 36, and TE 8) were targeted. Patient-controlled analgesia was used for the first 3 postoperative days in all patients, and the cumulative dosage used was recorded. RESULTS: Two patients were excluded after randomization because of complications unrelated to acupuncture. Interventions and data collection were completed for the ...
TY - JOUR. T1 - Effects of postoperative pain management on immune function after laparoscopic resection of colorectal cancer. T2 - A randomized study. AU - Kim, So Yeon. AU - Kim, Nam Kyu. AU - Baik, Seung Hyuk. AU - Min, Byung Soh. AU - Hur, Hyuk. AU - Lee, Jinae. AU - Noh, Hyun Young. AU - Lee, Jong Ho. AU - Koo, Bon Neyo. PY - 2016/1/1. Y1 - 2016/1/1. N2 - There has been a rising interest in the possible association between perioperative opioid use and postoperative outcomes in cancer patients. Continuous surgical wound infiltration with local anesthetics is a nonopioid analgesic technique that can be used as a postoperative pain management alternative to opioid-based intravenous patient-controlled analgesia (IV PCA). The aim of this study was to compare the effects of an opioid-based analgesic regimen versus a local anesthetic wound infiltration-based analgesic regimen on immune modulation and shortterm cancer recurrence or metastasis in patients undergoing laparoscopic resection of ...
PATIENT CARE: The patient is prepared for surgery according to protocol. Aspirin or other medications that may cause postoperative hemorrhage are withheld. The patient and family are assured that, in most instances, the body will adapt to functioning with only one kidney. Postoperatively, vital signs are checked frequently; analgesics are administered (often by intravenous or epidural patient-controlled analgesia); and excessive bleeding is reported. Dressings are changed according to the surgeons directions or agency protocol. Fluid intake and output, body weight, and electrolytes are carefully monitored. Hemodynamics are monitored closely; the patient is assessed for evidence of postoperative complications such as stroke, myocardial infarction, pneumonia, or atelectasis. The patient is encouraged to breathe deeply (using incentive spirometry) and to cough to prevent atelectasis and other pulmonary complications. Oral hygiene is provided, and early fluid and food intake encouraged. ...
In a study to be presented on Feb. 7 at 1:30 p.m. CST, at the Society for Maternal-Fetal Medicines annual meeting, The Pregnancy Meeting, in New Orleans, researchers will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, pain appreciation scores, and overall satisfaction in women who request for pain relief during labor.
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A loading dose is an optional clinician bolus given postoperatively or during a pain crisis to bring the pain down to a manageable level. A loading dose may be larger than subsequent on-demand bolus doses such as morphine 2.5 mg, hydromorphone 0.4 mg, or fentanyl 25 mcg.12. A bolus dose should provide clinically significant analgesia, but it should not exceed accepted starting doses if the patient is opioid-naïve. There is no validated method of anticipating opioid requirements in opioid-naïve patients, so close follow-up is essential to determine whether dose titration is necessary. Elderly patients generally require a lower dose of opioid and are at greater risk for respiratory depression compared with younger patients, so they should initially receive conservative starting doses.13 Accepted starting bolus doses include morphine 1 mg, hydromorphone 0.2 mg, and fentanyl 20 mcg.12 One of the main advantages of on-demand bolus doses is that some degree of safety is afforded by a negative ...
In 1968, Robert Wexler of Abbott Laboratories developed the Analgizer, a disposable inhaler that allowed the self-administration of methoxyflurane vapor in air for analgesia.[9] The Analgizer consisted of a polyethylene cylinder 5 inches long and 1 inch in diameter with a 1 inch long mouthpiece. The device contained a rolled wick of polypropylene felt which held 15 milliliters of methoxyflurane. Because of the simplicity of the Analgizer and the pharmacological characteristics of methoxyflurane, it was easy for patients to self-administer the drug and rapidly achieve a level of conscious analgesia which could be maintained and adjusted as necessary over a period of time lasting from a few minutes to several hours. The 15 milliliter supply of methoxyflurane would typically last for two to three hours, during which time the user would often be partly amnesic to the sense of pain; the device could be refilled if necessary.[10] The Analgizer was found to be safe, effective, and simple to administer ...
In 1968, Robert Wexler of Abbott Laboratories developed the Analgizer, a disposable inhaler that allowed the self-administration of methoxyflurane vapor in air for analgesia.[9] The Analgizer consisted of a polyethylene cylinder 5 inches long and 1 inch in diameter with a 1 inch long mouthpiece. The device contained a rolled wick of polypropylene felt which held 15 milliliters of methoxyflurane. Because of the simplicity of the Analgizer and the pharmacological characteristics of methoxyflurane, it was easy for patients to self-administer the drug and rapidly achieve a level of conscious analgesia which could be maintained and adjusted as necessary over a period of time lasting from a few minutes to several hours. The 15 milliliter supply of methoxyflurane would typically last for two to three hours, during which time the user would often be partly amnesic to the sense of pain; the device could be refilled if necessary.[10] The Analgizer was found to be safe, effective, and simple to administer ...
Health,Phoenix Arizona November 15 2004 - Researchers have reported that I...This research is a subanalysis of a broader head-to-head study publis...Researchers reported no statistically-significant differences between ... In 2002 there were more than a million gynecologic surgeries perform...,Subanalysis,finds,patient-controlled,,transdermal,pain,management,system,may,be,comparable,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Definition of patient-controlled anesthesia. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and definitions.
METHODS: Ninety patients of either sex undergoing elective spine surgery and requiring urinary catheterization were randomly assigned into three groups to receive oral solifenacin 5 mg (Group S), darifenacin 7.5 mg (Group D) and placebo (Group C) 1 hour prior to induction of anesthesia. Anesthesia technique was identical in all the groups. Catheter-related bladder discomfort (CRBD) was evaluated in 4-point scale (1 = no discomfort, 2 = mild discomfort, 3 = moderate discomfort, 4 = severe discomfort), on arrival (0 hour) and at 1, 2, and 6 hours postoperatively. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief ...
Extradural clonidine, injected in the following ways, was studied: bolus injection alone, bolus followed by continuous infusion; bolus followed by patient-controlled analgesia infusion; bolus injection of a mixed solution followed by continuous solution; a mixed solution combining clonidine with fentanyl, local anaesthetics, two or more of these drugs, and continuous infusion of clonidine and morphine. Clonidine-bolus doses ranged from 75 to 800 micrograms, and from 1 to 8 micrograms/kg, and continuous infusions ranged from 0.3 to 2.0 micrograms/kg/hour and from 10 to 50 micrograms/hour. Administration was either intra-operatively, a few minutes after induction of anaesthesia, at the beginning of the surgical procedure, 30 minutes before the end of the surgical procedure, or post-operatively on arrival in the recovery room, 1-hour after surgery, or at the patients first complaint of pain. Extra-dural catheters were inserted either thoracically or at the high and/or the low lumbar level. ...
BACKGROUND: This study was designed to compare the efficacy of prophylactic ramosetron and ondansetron in preventing postoperative vomiting in children who received fentanyl by patient-controlled analgesia after orthopedic surgery. METHODS: Two hundr
HSCT or H&NRT. We reviewed 20 studies examining We reviewed 3 discrete studies testing zinc supplementa- the use of the mucosal coating agent sucralfate in various tion in patients receiving H&NRT, all of which found a settings. The evidence supported recommendations positive effect. A new suggestion was developed in favor of against the use of sucralfate for the prevention or treat- zinc in patients with oral cancer undergoing RT or che- ment of oral mucositis in patients receiving chemotherapy moradiation.36,37 However, there is some evidence indi- and also in patients receiving H&NRT. No guideline was cating that the use of antioxidants in smokers during possible for any anesthetic agent reviewed due to inad- H&NRT may reduce the efficacy of the RT.38 The evi- equate evidence. Guidelines were developed in favor of dence reviewed supported the continuation of a recom- the use of patient-controlled analgesia with morphine, mendation against the use of intravenous glutamine for transdermal ...
This trial is a randomised, single-centre, open-label, parallel trial with target sample size of 52 in total. Eligible participants will be randomly allocated to the PCRA group (group R) or the PCIA group (group I) after admission. Participants in group R will receive ultrasound-guided subgluteal sciatic catheterisation, followed by continuous PCRA infusion (0.2% ropivacaine 15 mL as loading dose, 8 mL/hour as background with a patient-controlled bolus of 6 mL). Participants in group I will receive PCIA (morphine is given in boluses of 1 mg as needed, background infusion at 1 mg/hour). Data will be collected at baseline (T0), 2 hours before revascularisation treatment (T1) and 2 hours before discharge (T2). The primary outcomes include the Numerical Rating Scale pain score at T1 and T2. The secondary outcomes include the perioperative transcutaneous oxygen pressure, the Tissue Haemoglobin Index, Hospital Anxiety and Depression Scale at T1 and T2; the Patient Global Impression of Change and ...
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Organising Secretary-Dr Suneet Kathuria said that Management of postoperative pain relieves suffering and leads to earlier mobilisation, shortened hospital stay, reduced hospital costs, and increased patient satisfaction. Pain control regimens should be tailored to the needs of the individual patient, taking into account medical, psychological, and physical conditions including age, level of fear or anxiety, surgical procedure, personal preference and response to agents given ...
The NFL lockout has produced all sorts of crazy rumors in the past week, but heres a doozy for you. The pregnant wife of an NFL player allegedly...
As such, it happens automatically (though there are exceptions in some disease states) and does not need conscious control or ... However, breathing can be consciously controlled or interrupted (within limits). Breathing allows oxygen (which humans and a ...
Volz HP, Kieser M (1997). "Kava-kava extract WS 1490 versus placebo in anxiety disorders--a randomized placebo-controlled 25- ...
Patient-controlled analgesia pump. *PIC line. Retrieved from "https://en.wikipedia.org/w/index.php?title=Intravenous_therapy& ... A patient with a right-to-left shunt is vulnerable to embolism from smaller amounts of air. Fatality by air embolism is rare, ... A rapid infuser can be used if the patient requires a high flow rate and the IV access device is of a large enough diameter to ... If a patient needs frequent venous access, the veins may scar and narrow, making any future access extremely difficult or ...
Patient-controlled analgesia pump. *PIC line. Retrieved from "https://en.wikipedia.org/w/index.php?title=Oxygen_mask&oldid= ... The quantity of oxygen delivered from the storage tank to the oxygen mask is controlled by a valve called a regulator. Some ... The vast majority of patients having an operation will at some stage wear an oxygen mask; they may alternatively wear a nasal ... Oxygen in these higher percentages is classified as a drug with too much oxygen being potentially harmful to a patient's health ...
Patient-controlled analgesia pump. *PIC line. Retrieved from "https://en.wikipedia.org/w/index.php?title=Jet_injector&oldid= ... In 1988 a podiatry clinic used a jet injector to deliver local anaesthetic into patients' toes. Eight of these patients ... A new method of drug administration". Current Researches in Anesthesia and Analgesia. 26 (6): 221-230. PMID 18917536.. ... The part which touches the patient's skin is single-use and can be replaced easily. It can be powered from a large compressed ...
"KALÉO ANNOUNCES U.S. AVAILABILITY AND PRICING TO PATIENTS OF AUVI-Q® (Epinephrine Injection, USP) AUTO-INJECTOR". Multivu. ... Carly Helfand for FiercePharma Mar 1, 2016 FDA swats down Teva's EpiPen copy, putting Mylan in cruise control ... In response to criticism, Mylan increased financial assistance available for some patients to purchase EpiPens,[93] a gesture ... "Why Mylan's 'savings card' won't make EpiPen cheaper for all patients". Washington Post. Washington Post. ...
Patient-Controlled Analgesia pump. *PIC line. This pharmacology-related article is a stub. You can help Wikipedia by expanding ...
A patient with a right-to-left shunt is vulnerable to embolism from smaller amounts of air. Fatality by air embolism is rare, ... An infusion pump allows precise control over the flow rate and total amount delivered. The volume to be infused (VTBI) of the ... A rapid infuser can be used if the patient requires a high flow rate and the IV access device is of a large enough diameter to ... If a patient needs frequent venous access, the veins may scar and narrow, making any future access extremely difficult or ...
Patient-Controlled Analgesia pump. *PIC line. *. Category. *. WikiProject. *. Pharmacy portal. This medical treatment-related ...
Patient-Controlled Analgesia pump. *PIC line. *. Category. *. WikiProject. *. Pharmacy portal. Retrieved from "https://en. ...
Lozenge-effects a metred and patient-controlled-rate combination of sublingual, buccal, and oral administration, as with the ...
Patient-Controlled Analgesia pump. *PIC line. *. Category. *. WikiProject. *. Pharmacy portal. *v. *t ...
Kang BK; Chon SK; Kim SH; Jeong SY; Kim MS; Cho SH; Lee HB; Khang G (November 2004). "Controlled release of paclitaxel from ... Yi T; Wan J; Xu H; Yang X (August 2008). "Controlled poorly soluble drug release from solid self-microemulsifying formulations ... J Control Release. 105 (1-2): 23-31. PMID 15908031. doi:10.1016/j.jconrel.2005.03.017.. ...
This process can be desired, if controlled in its extent, to tune physical properties of emulsions such as their flow behaviour ... Controlling cluster size and interaction strength". Food Research International. 122: 537-547. doi:10.1016/j.foodres.2019.04. ...
"Centers for Disease Control and Prevention. 6 September 2019.. This article incorporates text from this source, which is in the ... For patients, a study found that smoking cannabis sativa reduced daily pain by 34%, a statistically significant amount.[57] ... "Tobacco Control. 23 (5): 375-384. doi:10.1136/tobaccocontrol-2013-051122. ISSN 0964-4563. PMC 4520227. PMID 24259045.. ... "Tobacco Control. 23 (Supplement 2): ii11-ii17. doi:10.1136/tobaccocontrol-2013-051482. ISSN 0964-4563. PMC 3995255. PMID ...
Davis MP, Walsh D, LeGrand SB, Naughton M (2002). "Symptom control in cancer patients: the clinical pharmacology and ... "Anesthesia-analgesia.org. 1999-06-22. Retrieved 2010-08-19.. *^ a b "Crystal Meth: The Effects". Fenway Community Health. ... patients are taught to self-inject, such as SC injection of insulin in patients with insulin-dependent diabetes mellitus. As ... Condition of the patient.. In acute situations, in emergency medicine and intensive care medicine, drugs are most often given ...
A prospective, single-blind, randomized controlled trial of petroleum jelly/Vaseline for recurrent paediatric epistaxis. Clin ... A verified medicinal use is to protect and prevent moisture loss of the skin of a patient in the initial post-operative period ... but this was only ever reported in one patient.[10] However, petroleum jelly is used extensively by otolaryngologists-ear, nose ...
This would be used when administration by mouth was not possible because of the condition of the patient.[6] The Murphy drip ... From this can a tube extends which is inserted in the rectum of the patient to whom the proctoclysis is administered. It was ... the Murphy drip and hypodermoclysis were the prime routes to administer fluids such as for replacement when patients could not ... Patient-controlled analgesia pump. *PIC line. Retrieved from "https://en.wikipedia.org/w/index.php?title=Murphy_drip&oldid= ...
Patient controlled. Single shot interscalenic analgesia is preferably used during minor arthroscopic surgery because of its ... Post-operative analgesiaEdit. Shoulder replacement can cause severe to very severe pain especially during shoulder mobilization ... The metal ball takes the place of the patient's humeral head and is anchored via a stem, which is inserted down the shaft of ... The plastic socket is placed over the patient's glenoid and is typically secured to the surrounding bone via cement.[8] ...
Ferrante FM, Lu L, Jamison SB, Datta S (1991). "Patient-controlled epidural analgesia: demand dosing". Anesth. Analg. 73 (5): ... in patients who had patients with uncomplicated minor rib fractures. The researchers found that TENS therapy given twice a day ... sensation that alters the perception of pain by the patient. A small number of patients, especially those with severe pain from ... Essentially, the gate control theory states that sensory fibers carry their signal faster than pain fibers, and thus make their ...
... toxicity and patient controlled analgesia. British Journal of Anaesthesia. 1993 Nov;71(5):738-40. Holmberg L, Odar ... Use of meperidine in patient-controlled analgesia and the development of a normeperidine toxic reaction. Archives of Surgery. ... Norpethidine accumulation and generalized seizure during pethidine patient-controlled analgesia. Anaesthesia and Intensive Care ... It is a Schedule II Narcotic controlled substance in the United States and has an ACSCN of 9233. The 2014 annual manufacturing ...
It is often used in Patient Controlled Analgesia units. Dihydromorphine and morphine are also used alongside each other in ... Under the Controlled Substances Act, dihydromorphine is listed as a Schedule I substance along with heroin. In the United ... 216 Costantino CM, Gomes I, Stockton SD, Lim MP, Devi LA (2012). "Opioid receptor heteromers in analgesia". Expert Rev Mol Med ... Single Convention on Narcotic Drugs, 1961 - Page 40 of 44 Controlled Substances (in alphabetical order) - Page 5 of 12 DEA ...
May 1996). "A multidimensional comparison of morphine and hydromorphone patient-controlled analgesia". Anesth Analg. 82 (5): ... Patients with compromised kidney function and older patients are at higher risk for metabolite accumulation. Hydromorphone is ... Patients with renal abnormalities must exercise caution when dosing hydromorphone. In those with renal impairment, the half- ... Hydromorphone is a rapid acting pain killer, however some formulations can last up to several hours, patients who stop taking ...
"Acute dystonia by droperidol during intravenous patient-controlled analgesia in young patients". J. Korean Med. Sci. 17 (5): ... Anesthesia and Analgesia. 79 (5): 983-6. doi:10.1213/00000539-000000000-00000. PMID 7978420. Park CK, Choi HY, Oh IY, Kim MS ( ... Anesthesia and Analgesia. 88 (6): 1370-9. doi:10.1097/00000539-000000000-00000. PMID 10357347. Kao LW, Kirk MA, Evers SJ, ... generally in cases of severe agitation in a psychotic patient who is refusing oral medication. Its use in intramuscular ...
... or by the patient using patient-controlled analgesia (PCA). PCA has been shown to provide slightly better pain control and ... "Patient controlled opioid analgesia versus conventional opioid analgesia for controlling postoperative pain". Cochrane Database ... in-patient/out-patient) and the individual patient. Pain management is classified into either pre-emptive or on-demand. On- ... Patients typically wake within minutes of an anesthetic being terminated and regain their senses within hours. One exception is ...
Anichini M, Cesaretti S, Lepori M, Maddali Bongi S, Maresca M, Zoppi M (Jan 1997). "Substance P in the serum of patients with ... Bonham AC (Sep 1995). "Neurotransmitters in the CNS control of breathing". Respiration Physiology. 101 (3): 219-30. doi:10.1016 ... analgesia and aggression in mice lacking the receptor for substance P". Nature. 392 (6674): 394-7. doi:10.1038/32904. PMID ... Michaels LA, Ohene-Frempong K, Zhao H, Douglas SD (Nov 1998). "Serum levels of substance P are elevated in patients with sickle ...
... control group for comparison. Pain scores (VAS), supplemental analgesia, and side effects were recorded in the recoveryroom, 4 ... The patients were prospectively randomized into 4 groups: 1) interscalene brachial plexus block, 2) suprascapular nerve block, ... The LA group had significantly lower pain scores at rest in the postanesthesia care unit than the control group (p = 0.046) and ... and the control group (p = 0.0313). The same results were seen 4 hours follow-up. ...
Except for patients with severe chronic obstructive pulmonary disease, nitrous oxide/oxygen inhalation is a safe and acceptable ... Six patients in the benzodiazepine/opiate group had oxygen desaturation, whereas none did in the nitrous oxide/oxygen group. ... or patient pain scores between the group receiving the nitrous oxide/oxygen mixture (n = 30) and those managed with ... In the patients studied, no significant differences were noted in number of pain episodes, need for additional intravenous ...
Patient-controlled analgesia and urinary retention following lower limb joint replacement: A prospective audit and logistic ... SPRIX® group = 455 patients; placebo group = 245 patients). In these same controlled clinical trials, seven patients (N=455, ... For patients ≥ 65 years of age, renally impaired patients, and patients , 50 kg (110 lbs.): ... In ambulatory acute pain settings, use of SPRIX® will allow patients who need to remain alert to receive effective pain control ...
Patient-controlled analgesia. A patient-controlled analgesia infusion pump, configured for epidural administration of fentanyl ... Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic ... A patient-controlled analgesia infusion pump, configured for intravenous administration of morphine for postoperative analgesia ... Patient-controlled analgesia (PCA[1]) is any method of allowing a person in pain to administer their own pain relief.[2] The ...
Definition Patient-controlled analgesia (PCA) is a means for the patient to self-administer analgesics (pain medications) ... Patient-controlled analgesia. Definition. Patient-controlled analgesia (PCA) is a means for the patient to self-administer ... Patient-Controlled Analgesia. Definition. Patient-controlled analgesia (PCA) is a system of providing pain medication that ... Patient-controlled analgesia. Definition. Patient-controlled analgesia (PCA) is a system of providing pain medication that ...
Patient Controlled Analgesia (PCA) FAQs Patient Controlled Analgesia (PCA) means that you will have some control of your pain ... The pump has safeguards that will not give you more medicine than is percribed and is very safe as long as only the patient ... If you do the doctor can give you another medicine that will control the sick feeling or itching. Tell you nurse right away ... Clinical trial testing vitamin and steroid combination in sepsis patients underway at Emory. October 08, 2018 ...
... (PCA) is any method of allowing a person in pain to administer their ... Patient-controlled epidural analgesia (PCEA). Patient-controlled epidural analgesia (PCEA) is a related term describing the ... This situation has the patient in control, and is in fact the most common patient-controlled analgesia. As pain is a ... Patients who use PCAs report better analgesia and lower pain scores than those patients who have to request analgesia from the ...
... Revenues by 2026 - published on openPR.com ... Patient-Controlled Analgesia (PCA) Pump Market Report 2018 Patient-Controlled Analgesia (PCA) Pump Market Report 2018: ... Global Patient-Controlled Analgesia Pumps Market: Dynamics. The growth of the global patient-controlled analgesia pumps market ... PCA or patient-controlled analgesia pumps is a way with which analgesic can be self-administered by the patient as and when ...
Patient-controlled analgesia. What is patient-controlled analgesia (PCA)?. Analgesia means pain relief. Through the use of the ... Start a patient referral, request a consultation or second opinion.. Call 612-343-2121 or 1-866-755-2121 ... We depend upon the generosity of people like you to help us improve pediatric health and enhance the patient care experience. ... Studies have shown that children can be kept very comfortable when they control their own pain relief. ...
Intravenous patient controlled analgesia(IV-PCA) has been widely used to control postoperative pain. The increase in stress ... Hypokalemia and Intravenous Patient Controlled Analgesia. The safety and scientific validity of this study is the ... The researchers divided the patients undergoing laparoscopic cholecystectomy into two groups of IV-PCA group and control group ... patient-reported VAS score during postoperative period checking fourtimes. ; one hour after the end of surgery (T3), at 8:00 A. ...
A comparison of variable-dose patient-controlled analgesia with fixed-dose patient-controlled analgesia. Anesth Analg. 1996;83: ... Use of patient-controlled analgesia for pain control for children receiving bone marrow transplant. J Pain Symptom Manage. 1995 ... Postoperative patient-controlled analgesia: meta-analyses of initial randomized control trials. J Clin Anesth. 1993;5:182-193. ... Patient-controlled analgesia (PCA) refers to the delivery of analgesics immediately upon patient demand. The most commonly ...
... will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, ... Patient-controlled analgesia not as effective as epidural for labor pain Study finds remifentanil patient-controlled analgesia ... titled Remifentanil patient controlled analgesia versus epidural analgesia in labor; a randomized controlled equivalence trial ... study-finds-remifentanil-patient-controlled-analgesia-not-as-effective-as-epidural-analgesia-in-managing-pain-relief-during- ...
Patient-Controlled Analgesia Pumps Patient-controlled analgesia (PCA) is a type of pain management that lets you decide when ... Patient-Controlled Analgesia Pumps. Patient-controlled analgesia (PCA) is a type of pain management that lets you decide when ... Patient Information. Sinai Hospital Patient Information. Accommodations. Campus Map. Dining - Patient Room Menus. Dining - ... Patient Information. Accommodations. Campus Map. Dining - Patient Room Menus. Dining - Retail. Directions. FAQs. Gift Shop. ...
Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia].. [Article ... In our study, patient controlled epidural analgesia (PCEA) and patient controlled intravenous remifentanil analgesia (PCIVA) ... We set 5 ml/h basal infusion, 5 ml patient-controlled bolus and 20 min lock time. We prepared 2 mg remifentanil in 100 ml ... PCEA is the gold standard in labor analgesia. However, we believe that PCIVA is a good alternative to epidural analgesia in ...
Patient-controlled analgesia using butorphanol for postoperative pain relief: an open-label study.. Wermeling DP1, Foster TS, ... Patient-controlled analgesia (PCA) has been studied extensively for the treatment of postoperative pain using narcotic ... The role of butorphanol in the management of postoperative pain should be expanded to include patient-controlled drug delivery. ... Twenty-five patients undergoing general abdominal surgery and general anesthesia used a PCA device with butorphanol as the ...
Research shows that patients with higher pain scores have significantly higher levels of atelectasis (failure of the lungs to ... Analgesia following any thoracic surgery is important to reduce the risk of pulmonary and cardiovascular complications. ... Research shows that patients with higher pain scores have significantly higher levels of atelectasis (failure of the lungs to ... Analgesia following any thoracic surgery is important to reduce the risk of pulmonary and cardiovascular complications. ...
Birnbaum A, Schechter C, Tufaro V, Touger R, Gallagher EJ, Bijur P. Efficacy of patient-controlled analgesia for patients with ... The aims of this study are to assess efficacy and safety of patient-controlled analgesia (PCA) when applied to the Emergency ... Safety and Efficacy of Patient Controlled Analgesia in the Emergency Department. This study has been completed. ... Device: Patient-controlled analgesia Intravenous morphine delivered via Curlin painsmart PCA device ...
Ed Gentile, has created a simple path to optimal acute pain control in the ED. I heard this lecture on the EM:RAP podcast and ... Patient Controlled Analgesia by Edward Gentile. EMCrit Podcast 26 - Patient Controlled Analgesia by Edward Gentile. May 11, ... Patient Controlled Analgesia, PCA, podcasts. Cite this post as:. Scott Weingart. EMCrit Podcast 26 - Patient Controlled ... Patient Controlled Analgesia without the Pump. by Ed Gentile, MD. Need for an effective and efficient process is self evident . ...
This study aimed to compare patient-controlled paravertebral analgesia (PCPA) and intravenous patient-controlled analgesia ( ... followed by a 3 mL/h continuous infusion with patient-controlled analgesia (2 mL bolus, 10-minute lockout interval, 25 mL/4 h ... lobectomy.Patients and methods: The prospective randomized trial study was carried out on 60 patients who underwent VATS ... lobectomy (randomly allocated 30 patients in each group). In the PCPA group, an initial dose of 0.3 mL/kg of 0.125% bupivacaine ...
Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects , IntechOpen, Published on: 2017-05-24. ... Patientcontrolled analgesia. Anesth Analg 2005;101:S44-61.. 12 - Viscusi ER. Patientcontrolled drug delivery for acute ... Patientcontrolled Analgesia. Boston: Blackwell Scientific Publications; 1990, pp. 3-9.. 17 - Ferrante FM. Patientcontrolled ... Efficacy of postoperative patientcontrolled and continuous infusion epidural analgesia versus intravenous patientcontrolled ...
Patient controlled analgesia actuator Download PDF Info. Publication number. USD405525S. USD405525S US29089263 US08926398F ... US29089263 1998-06-11 Patient controlled analgesia actuator Expired - Lifetime USD405525S (en) Publications (1). Publication ... We claim the ornamenal design for a patient controlled analgesia actuator, as shown and described. ... 1 is a perspective view of said patient controlled analgesia actuator displaying our design; ...
Intravenous patient-controlled analgesia (PCA) equipment and opioid cost analyses on specific procedures are lacking. This ... patient-controlled analgesia, intravenous, total knee arthroplasty, total hip arthroplasty, abdominal surgery, cost ... Aggregated mean intravenous PCA equipment and opioid cost per patient were $196 (THA), $204 (TKA), and $243 (abdominal surgery ... Of 11,805,513 patients, 272,443 (2.3%), 139,275 (1.2%), and 195,062 (1.7%) had TKA, THA, and abdominal surgery, respectively, ...
Clinicians have started to recognize the importance of capnography monitoring for patients on PCA pumps for pain management ... Patient-controlled analgesia by proxy. December 20, 2004.. *The Joint Commission, Sentinel Event Alert, Issue 33: Patient- ... for patients on patient-controlled analgesia (PCA) pumps for pain management post-operatively. ... Maddox RR, Williams CK, Oglesby H, Butler B, Colclasure B. Clinical experience with patient-controlled analgesia using ...
BackgroundAdministering nurse/patient controlled analgesia (N/PCA) to children requires complex dose calculations and multiple ... Sources and magnitude of error in preparing morphine infusions for nurse-patient controlled analgesia in a UK paediatric ... Current practice of preparing morphine infusions for nurse/patient controlled analgesia in a UK paediatric hospital: healthcare ... Background Administering nurse/patient controlled analgesia (N/PCA) to children requires complex dose calculations and multiple ...
i] Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis.. van der Vyver M et ... This technique is similar to IV patient controlled analgesia, the difference being that the mother self-administers small ... optimal analgesia with minimal side-effects, high patient satisfaction and a reduced demand on professional time. PCEA has ... If analgesia is inadequate, the bolus dose and lockout interval can be adjusted, and/or extra local anaesthetic can be given. ...
  • While younger patients exhibited greater incidence of numbness, motor weakness, and discontinuation of PCA postsurgery, elderly patients exhibited greater incidence of hypotension, nausea/vomiting, rescue analgesia, and antiemetic administration. (altmetric.com)
  • abstract = "This feature presents information for patients in a question and answer format. (elsevier.com)
  • The findings showed that both groups could provide adequate analgesia. (nih.gov)
  • The present protocol must be refined further to provide analgesia adequate to cover mobilization as well. (diva-portal.org)
  • With the same objective, this study applies learning algorithms to predict (1) the postoperative analgesic requirement and (2) the need for PCA setting readjustment (e.g., lockout) based on patient physical states and the first few hours of PCA treatment data. (biomedcentral.com)
  • noted, however, that the magnitude of the observed differences between PCA and conventional intramuscular analgesia often is modest in view of the immense popularity of PCA. (asahq.org)
  • [ 14 , 15 ] A likely mechanism is the dural hole acts as a conduit to enhance epidural medication translocation into the intrathecal space, allowing enhanced coverage of sacral nerve roots while avoiding the side effects associated with conventional combined spinal-epidural analgesia. (medscape.com)
  • 6 , 7 In addition, quality-of-care indicators for children with SCD include the receipt of parenteral analgesia within 30 minutes of triage in the ED or comparable setting to treat VOEs. (aappublications.org)
  • They have been associated with adverse events in a variety of settings, including in hospitalized patients and outpatients , and ensuring the safety of patients receiving anticoagulants is a National Patient Safety Goal for 2008. (ahrq.gov)