Methods of PAIN relief that may be used with or in place of ANALGESICS.
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.
The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.
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).
Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.
Pain during the period after surgery.
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.
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.
A widely used local anesthetic agent.
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.
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.
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)
Compounds capable of relieving pain without the loss of CONSCIOUSNESS.
Procedure in which an anesthetic is injected into the epidural space.
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.
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.
An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.
An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.
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.
Introduction of therapeutic agents into the spinal region using a needle and syringe.
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).
A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.
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)
Procedure in which an anesthetic is injected directly into the spinal cord.
A narcotic analgesic proposed for severe pain. It may be habituating.
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.
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.
A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.
Extraction of the FETUS by means of abdominal HYSTEROTOMY.
Emesis and queasiness occurring after anesthesia.
Amount of stimulation required before the sensation of pain is experienced.
Injection of ANALGESICS; LOCAL ANESTHETICS; or NARCOTICS into the PLEURAL CAVITY between the two pleural membranes.
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.
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.
Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.
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)
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)
Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.
An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.
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.
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.
Epidural anesthesia administered via the sacral canal.
An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.
Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.
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.
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.
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.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.
Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.
A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.
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.
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.
Agents inhibiting the effect of narcotics on the central nervous system.
The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.
Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.
Surgical incision into the chest wall.
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.
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.
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)
An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.
An IBUPROFEN-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis.
Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.
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.
Analogs or derivatives of morphine.
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.
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.
A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.
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.
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.
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)
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)
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.
Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.
Excision of the uterus.
A family of hexahydropyridines.
The relationship between the dose of an administered drug and the response of the organism to the drug.
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.
Persistent pain that is refractory to some or all forms of treatment.
A semisynthetic derivative of CODEINE.
The process by which PAIN is recognized and interpreted by the brain.
The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.
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.
Process of administering an anesthetic through injection directly into the bloodstream.
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)
A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.
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 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.
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.
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.
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 made into a vein for therapeutic or experimental purposes.
Extraction of the fetus by means of obstetrical instruments.
A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE.
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.
A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.
Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.
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.
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.
Methods of delivering drugs into a joint space.
An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.
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)
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.
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.
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.
Interventions to provide care prior to, during, and immediately after surgery.
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)
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.
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.
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.
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.
The period of emergence from general anesthesia, where different elements of consciousness return at different rates.
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.
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.
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.
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.
An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.
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.
That portion of the body that lies between the THORAX and the PELVIS.
Elements of limited time intervals, contributing to particular results or situations.
Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.
A semisynthetic analgesic used in the study of narcotic receptors.
Drugs that selectively bind to and activate alpha adrenergic receptors.
Sensing of noxious mechanical, thermal or chemical stimuli by NOCICEPTORS. It is the sensory component of visceral and tissue pain (NOCICEPTIVE PAIN).
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.
Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.
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.
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.
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.
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.
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.
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)
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.
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.
Surgery performed on the female genitalia.
The observable response an animal makes to any situation.
A range of methods used to reduce pain and anxiety during dental procedures.
Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.
Trained lay women who provide emotional and/or physical support during obstetric labor and the postpartum period for mothers and their partners.
The period of OBSTETRIC LABOR that is from the complete dilatation of the CERVIX UTERI to the expulsion of the FETUS.
A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.
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.
Designated locations along nerves or organ meridians for inserting acupuncture needles.
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).
Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.
Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.
Injections into the cerebral ventricles.
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)
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.
Space between the dura mater and the walls of the vertebral canal.
The period following a surgical operation.
Replacement of the knee joint.
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)
A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.
The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.
The action of a drug that may affect the activity, metabolism, or toxicity of another drug.
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.
Compounds that bind to and activate ADRENERGIC ALPHA-2 RECEPTORS.
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.
Endoscopic examination, therapy and surgery of the joint.
A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.
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.
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.
Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.
The forcible expulsion of the contents of the STOMACH through the MOUTH.
Drugs used to prevent NAUSEA or VOMITING.
Therapy with two or more separate preparations given for a combined effect.
Strong dependence, both physiological and emotional, upon morphine.
The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.
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.
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.
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.
The surgical removal of a tooth. (Dorland, 28th ed)
A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.
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.
Presence of warmth or heat or a temperature notably higher than an accustomed norm.
Surgical removal of a tonsil or tonsils. (Dorland, 28th ed)
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.
The period during a surgical operation.
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.
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.
The action of a drug in promoting or enhancing the effectiveness of another drug.
Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
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.
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 ...
Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study Yao Tsung Lin,1 Kuo Mao Lan,1 Li-Kai Wang,1 Chin-Chen Chu,1 Su-Zhen Wu,1 Chia-Yu Chang,2 Jen-Yin Chen1,3 1Department of Anesthesiology, 2Department of Neurology, Chi Mei Medical Center, 3Department of the Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Background: Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited. Objective: We aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA. Methods: A prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged ≥60 years. POD was measured by the Nursing Delirium Screening Scale (NuDESC; 0&ndash
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
Patient-controlled analgesia Patient-controlled analgesia (PCA) is any method of allowing a person in pain to administer their own pain relief. Additional
St. Josephs/Candler Hospitals reduced opioid-related events with patient-controlled analgesia (PCA) pumps. The hospitals are error-free since using smart PCA pumps with integrated capnography.. by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety). St. Josephs/Candler Hospitals (SJ/C) in Savannah, Georgia, are two of the oldest continuously operating hospitals in the US. About 10 years ago, SJ/C had three opioid-related events with patient-controlled analgesia (PCA) with serious outcomes over a two-year period.. Fortunately, none of these adverse events resulted in deaths, says Carolyn Williams, RPh, Medication Safety Specialist at SJ/C.. Since using smart PCA pumps with integrated capnography, SJ/C has been error-free. Read More →. ...
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) ...
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 ...
By Michael Wong. This is the question that I have been asking myself ever since Centers for Medicare & Medicaid Services (CMS) recently announced proposed quality measures it is considering for adoption through rulemaking for the Medicare program. One of the measures under consideration by CMS (proposed quality measure #3040) calls for appropriate monitoring of patients receiving PCA [patient-controlled analgesia].. ...
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.
Masterlock 503RED Latch Tight Group Lockout Station available to buy online at Caulfield Industrial - We are the leading broadline industrial distributor in Ireland
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...
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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 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 ...
A patient-driven control strategy for Functional Electrical Stimulation (FES), which amplifies volitionally-initiated shoulder abductions, is proposed to improve stroke patients rehabilitation. Based on the measured abduction angle, a FES-induced muscle recruitment is generated that yields a pre-specified percentage of this angle - yielding arm weight relief. To guarantee the correct recruitment also under fatigue and uncertain muscle activation we employ feedback control of the recruitment level determined by filtering the FES-evoked electromyogram. Filter parameters are user-optimized to obtain a linear relation between filter output and angle with a good signal-to-noise ratio. The auto-tuned recruitment controller (RC) was tested on five healthy subjects and compared to direct stimulation (DS) while muscle fatigue progressively occurred. Results showed a more linear relation between recruitment level and angle than between non-controlled stimulation intensity and angle (R2=0.93 vs. R2=0.79, angular
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From here on out, Im just going to refer to LOCKOUT by my preferred title of SPACE PRISON, if you dont mind too much. LOCKOUT sounds like a G.I. Joe code name, and a movie as brashly, brutishly high-concept as this one demands to be named as on-the-snout as possible.. Now, I am aware of the growing internet groundswell choosing to refer to SPACE PRISON as SPACE JAIL, but A) us hardened ex-cons know theres a big difference between prison and jail and we hope decent people like you never need to learn it, and B) Im glad to see people discovering this movie via its current status on Netflix Instant, but I still have my ticket stub from paying hard-earned cash to see it in the theaters. Thats after seeing it at a press screening. Twice on the big screen. In other words: Fuck you, I was here first.. I loved the movie, by the way. Its the right kind of stupid. I know it can get confusing, but when I call a movie stupid its not always a putdown (or a lockout.). In local parlance here in the ...
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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 ...
As Canadians face the possibility of being alone with their partner for the foreseeable future, some say that marital discord is more likely than the kind of intimacy that would lead to a baby boom in nine months.. Disasters sometimes bring people together - pregnancy rates increased slightly after September 11, and after the well documented blackout in New York in 1977, the city experienced a small increase in the birth rate.. But its unlikely to happen here, said Tom McCormack, a business economist from Metro Economics in Burlington, Ontario, who assesses recent and future economic and demographic changes in the metropolitan area.. I think the coup that happened in a very, very old way in 1977 was very, very small. It was barely traceable but that made good news, said McCormack in an interview.. However, many wonder if additional lockout time will result in a new generation of coronials or baby Zoomers.. Online hashtags have appeared, including #infectiouslycute and #madeinquarantine, ...
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This new safety lock out prevents accidental shifting into reverse in the same fashion as the stock lock out system. The module is the most simple and elegant way to hookup your reverse lock-out solenoid pigtail. Learn more about it in the official release below.. Official Release: Reverse lock out control module for Magnum or T56 6-speed. Having six gears is a joy. But stacking all those gears in a transmission case means sometimes there are compromises. Fifth gear and Reverse on T-56 and Magnum transmissions are really close. Its important to use a safety lockout to avoid accidentally shifting into reverse on the freeway!. Historically, this lockout is achieved by intercepting the brake light wire, telling the solenoid you are stepping on the brake and energizing the lockout to open the gate. The problem is that sometimes you step on your brake at speed and could easily put your car into reverse on the road.. This module eliminates that problem by using the VSS speed sensor in the ...
NFL players voted to OK a final deal Monday, days after the owners approved a tentative agreement, and the sides finally managed to put an end to the 4 1/2-month lockout, the longest work stoppage in league history.
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...
Here we are, just about three weeks before the September 15th expiration of the NHL s collective bargaining agreement. If you listen to the Canadian press and the hockey media all across North America, an owner lockout is almost a guarantee...
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The NHL has made a new proposal to the NHL Players Association with time ticking toward a canceled season, according to an unidentified player cited by Pierre LeBrun of The player said that the league made a new offer to the NHLPA on Thursday, one which moved on the term limit for player
A Govt report shows India lost 13.75 mn man-days and Rs 181.82 cr as production-linked losses in Jan-Sept 06, reports Sutirtho Patranobis.
While the Jets have told their non-football employees to expect some unpaid time off next month if there is no new Collective Bargaining Agreement - the team will have its employees take one furloughe
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Back when the lockout of the NHL had all hockey lovers chomping at the bit for its return, the one. Continue reading2008 Stanley Cup = Parity?. ...
Tliba, O., Damera, G., Banerjee, A., Gu, S., Baidouri, H., Keslacy, S. and Amrani, Y. (2008) Cytokines induce an early steroid resistance in airway smooth muscle cells Novel role of interferon regulatory factor-1. American Journal of Respiratory Cell and Molecular Biology, 38, 463-472. Epub 18 October 2007. doi10.1165/rcmb.2007-0226OC
Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic ... Patient-controlled analgesia (PCA) is any method of allowing a person in pain to administer their own pain relief. The infusion ... Intravenous fentanyl patient-controlled analgesia for perioperative treatment of neuropathic/ischaemic pain in haemodialysis ... "Patient-controlled analgesia system (PCA)". Clinical Reference Systems. Vol. 10. McKesson Health Solutions. 2010. Pearce, ...
Simopoulos TT, Smith HS, Peeters-Asdourian C, Stevens DS (January 2002). "Use of meperidine in patient-controlled analgesia and ... Stone PA, Macintyre PE, Jarvis DA (November 1993). "Norpethidine toxicity and patient controlled analgesia". British Journal of ... McHugh GJ (June 1999). "Norpethidine accumulation and generalized seizure during pethidine patient-controlled analgesia". ... "Conversion Factors for Controlled Substances". Diversion Control Division. Drug Enforcement Administration (DEA), U.S. ...
... inventor of patient-controlled analgesia Abraham Sinkov - mathematician; NSA (National Security Agency) cryptology pioneer ... American arms control expert Guillermo Linares 1975 - first Dominican-American New York City Council member Colin Powell - ...
... inventor of patient-controlled analgesia Joshua Lederberg (1940) - genetics; 1957 United States National Academy of Sciences, ...
... inventor of patient-controlled analgesia (PCA) Abraham Sinkov - mathematician; National Security Agency cryptology pioneer ... American arms control expert Albert L. Lewis - conservative rabbi, president of international Rabbinical Assembly Samuel A. ...
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) Archived 2016-04-17 at ...
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. With a formula of ... Patients who stop taking this drug abruptly may experience withdrawal symptoms, which may start within hours of taking the last ... Clonidine is a non-opioid adjunct, which may be used in situations where opioid use is not desired, such as in patients with ...
For more severe crises, most patients require inpatient management for intravenous opioids; patient-controlled analgesia ... If not treated, patients may die within 1-2 hours due to circulatory failure. Management is supportive, sometimes with blood ... Most patients can be managed supportively; some need a blood transfusion. Haemolytic crises are acute accelerated drops in ... Patients benefit today from routine vaccination for S. pneumoniae. Stroke, which can result from a progressive narrowing of ...
"Acute dystonia by droperidol during intravenous patient-controlled analgesia in young patients". J. Korean Med. Sci. 17 (5): ... Anesthesia and Analgesia. 88 (6): 1370-9. doi:10.1213/00000539-199906000-00032. 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 ... Anesthesia and Analgesia. 79 (5): 983-6. doi:10.1213/00000539-199411000-00028. PMID 7978420. Calver, Leonie; Page, Colin; ...
It is common in cancer patients who often have background pain that is generally well-controlled by medications, but who also ... Cancer Control. 8 (1): 15-24. doi:10.1177/107327480100800103. PMID 11176032. Selbst SM, Fein JA (2006). "Sedation and analgesia ... Experimental subjects challenged by acute pain and patients in chronic pain experience impairments in attention control, ... Such patients report that they have pain but are not bothered by it; they recognize the sensation of pain but suffer little, or ...
"Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain". The Cochrane ... or by the patient using patient-controlled analgesia (PCA). PCA has been shown to provide slightly better pain control and ... in-patient/out-patient) and the individual.: 2757 Pain management is classified into either pre-emptive or on-demand. On-demand ... For instance, an operation on a person who is between the ages of 60-79 years old places the patient at 2.3 times greater risk ...
It is commonly used in patient-controlled analgesia (PCA) units. The usual starting dose is 5-10 mg given every 3-5 hours. ... Nicomorphine is regulated in much the same fashion as morphine worldwide but is a Schedule I controlled substance in the United ... Koopman-Kimenai PM, Vree TB, Booij LH, Dirksen R (December 1994). "Rectal administration of nicomorphine in patients improves ...
He was the inventor of patient-controlled analgesia (PCA), now commonly used post-operatively. Sechzer graduated from New ...
"Comparison of analgesic efficacy of oxycodone and morphine in postoperative intravenous patient-controlled analgesia". Acta ... Patients with chronic (rather than acute) pain may respond to analgesia differently. Repeated administration of a medication is ... Some patients request to be switched to a different narcotic due to stigma associated with a particular drug (e.g. a patient ... Patient variables such as sex, age, and organ function may also influence the effect of the drug on the system. These variables ...
... double-blind randomised crossover study with patient-controlled analgesia". The Lancet. 339 (8806): 1367-1371. doi:10.1016/0140 ... Randomized Controlled Trials: A User's Guide. London: BMJ Publishing Group, 1998 Jadad AR, Enkin MW. Randomized Controlled ... The neurosurgical patient: anesthetic and intensive care: Copilito Press, 1989 [Original title in Spanish: El paciente ... During this time, he also led the development of virtual clinical tools to transform the encounter between patients and health ...
For children, intravenous patient-controlled analgesia (IV-PCA) can be used when parenteral administration is preferred. IV-PCA ... It is not clear from clinical trials if it is more effective to provide pain control around the clock or provide pain relief as ... It is recommended to use the lowest dose and shortest duration possible to control pain. NSAIDs are not approved for infants ... Treatment such as surgery and injections can also lead to significant pain for the patient. If untreated, the pain can suppress ...
This course covers hand hygiene, wound care, CPR, health checkup, CADD pump and Patient-controlled analgesia (PCA). The series ...
Alon's fields of research and investigation are obstetric anesthesia, patient-controlled analgesia, regional anesthesia, and ...
"Epidural analgesia versus intravenous patient-controlled analgesia following minimally invasive pectus excavatum repair: a ... Patients who receive a diagnosis of cardiac disease are more apt to have acute pain. This pain often awakes them from sleep or ... Trauma can also be a cause for chest pain and has been found to be associated with the pain in 5% of the patients. Children can ... A small study in Turkey evaluated patients and found that 59% complained of pain that they had had for more than one month in ...
... known as the inventor of patient-controlled analgesia. Bernard Slicher van Bath, 94, Dutch social historian. Shobha Gurtu, 79, ...
"Nimodipine-enhanced opiate analgesia in cancer patients requiring morphine dose escalation: a double-blind, placebo-controlled ... A] number of studies, however, have also reported inadequate pain control in 40%-70% of patients, resulting in the emergence of ... Santillán R, Maestre JM, Hurlé MA, Flórez J (July 1994). "Enhancement of opiate analgesia by nimodipine in cancer patients ... to be prescribed only as a last resort for dying patients. The Controlled Substances Act of 1970 eventually relaxed the ...
... in a manner that foreshadowed the patient-controlled analgesia infusion pumps of today. The Analgizer inhaler was withdrawn in ... All vital signs remain normal in obstetric patients, newborns, and injured patients. The Analgizer was widely utilized for ... it was easy for patients to self-administer the drug and rapidly achieve a level of conscious analgesia which could be ... and for dressing changes on burn patients. When used for labor analgesia, the Analgizer allows labor to progress normally and ...
Topics covered include: heparin overdose, misdiagnosis, hospital-acquired infection, patient-controlled analgesia (PCA) pump, ... According to Institute of Medicine (IOM) and Institute for Healthcare Improvement (IHI), as many as 98,000 patient deaths occur ...
... double-blind study with gynaecological patients using intravenous patient-controlled analgesia". Pain. 62 (3): 313-320. doi: ... 2010). "DEA controls tramadol as a schedule IV controlled substance effective August 18, 2014". FDA Law Blog. 2 July 2014. ... The UK classified tramadol as a Class C, Schedule 3 controlled drug on 10 June 2014, but exempted it from the safe custody ... US patent 6254887, Miller RB, Leslie ST, Malkowska ST, Smith KJ, Wimmer S, Winkler H, Hahn U, Prater DA, "Controlled Release ...
... pain control is usually dependent on the setting and patient characteristics but commonly involves local analgesia with either ... Patients who are experiencing a miscarriage or who have a fetus diagnosed with severe congenital anomalies may prefer an intact ... Patients who have recently undergone an intact D&E are monitored for signs of coagulopathy, uterine perforation, uterine atony ... This may present a psychological problem for the patient who wishes to view the remains, or make a comprehensive autopsy ...
Audioanalgesia Electroanalgesia Pain management Patient-controlled analgesia Pain in babies Congenital analgesia (insensitivity ... Girard P, Chauvin M, Verleye M (January 2016). "Nefopam analgesia and its role in multimodal analgesia: A review of preclinical ... Topical analgesia is generally recommended to avoid systemic side-effects. Painful joints, for example, may be treated with an ... Patients starting morphine may experience nausea and vomiting (generally relieved by a short course of antiemetics such as ...
And Placebo-controlled Study in Hemorrhoidectomy Patients". Clin J Pain. 33 (5): 429-434. doi:10.1097/AJP.0000000000000417. ... "Sebacoyl Dinalbuphine Ester Extended-release Injection for Long-acting Analgesia: A Multicenter, Randomized, Double-Blind, ... Narver HL (March 2015). "Nalbuphine, a non-controlled opioid analgesic, and its potential use in research mice". Lab Anim (NY ... is a non-controlled opioid analgesic which is used as a 7-day long-acting injection in the treatment of moderate to severe ...
... and the Laryngeal Tube Airway in Paralyzed Anesthetized Adult Patients Undergoing Pressure-Controlled Ventilation". Anesthesia ... Anesthesia and Analgesia. 95 (4): 1094-7, table of contents. doi:10.1097/00000539-200210000-00057. PMID 12351302. Wrobel, M; ... Asai, T.; Shingu, K.; Cook, T. (1 August 2003). "Use of the laryngeal tube in 100 patients". Acta Anaesthesiologica ... during anaesthesia with controlled ventilation". British Journal of Anaesthesia. 91 (5): 678-683. doi:10.1093/bja/aeg239. PMID ...
The infusion of local anesthetic can be programmed to be a continuous flow or patient-controlled analgesia. In some cases, ... Combined Selective Nerve Blockade and Local Infiltration Analgesia in a Total Shoulder Arthroplasty Patient With Chronic Pain ... They described their technique with the patient in the sitting position or in the supine position with a pillow between the ... However it may be associated with a shorter performance time and less procedure-related pain for the patient. The axillary ...
She studied the impact of cannabis plant extract during surgery, leading a placebo-controlled study with patients suffering ... The group presented a report documenting sex and gender differences in pain and analgesia. In the 1990s Holdcroft became ... She went on to investigate cannabis as a pain management strategy for patients with HIV Holdcroft was the first researcher to ... Principles and practice of obstetric anaesthesia and analgesia Core Topics in Pain 2005 Sex and Gender Differences in Pain ...
A cut is made in the patient's abdomen and then in the uterus to remove the baby. A C section may be the best option when the ... Epidural analgesia is a generally safe and effective method of relieving pain in labour, but has been associated with longer ... Different measures for pain control have varying degrees of success and side effects to the woman and her baby. In some ... Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an ...
Dr Mark Bloch - Dr Bloch was an enthusiastic anaesthetist and prehospital physician with a patient for patient care and medical ... Scotl; Ambulance, 's Charity Air; Tower, The Control; Airport, Perth; Scone; Perthshire; Tel: 0300 123 1111, PH2 6PL View on ... analgesia and prolonged field care. BASICS Scotland aims to undertake annual teaching for medical students; having previously ... The medical centre was successful at managing a high percentage of patients at the conference and avoiding unnecessary burdens ...
In a separate filing, Purdue claims that controlled-release oxycodone "provides pain relief in said patient for at least 12 ... "Pharmacological characterization of noroxymorphone as a new opioid for spinal analgesia". Anesthesia and Analgesia. 106 (2): ... Under the Controlled Substances Act, oxycodone is a Schedule II controlled substance whether by itself or part of a multi- ... Oxycodone is a controlled substance under Schedule I of the Controlled Drugs and Substances Act (CDSA). In February 2012, ...
Most patients present with headache, vomiting, seizures and focal signs such as hemiplegia or dysphasia, but a minority of ... A possible complication of epidural analgesia. British Medical Journal 285: 972 only. name="Cambridge 2017, p56-58." Shoib S, ... because this can lead to long term control and elimination of the disease. The opportunities come under the heading of clinical ... But these patients can also develop acute and recurrent psychoses, even as early as the puerperium. Hyponatraemia (which leads ...
A male horse is often gelded to make him better-behaved and easier to control. Gelding can also remove lower-quality animals ... Veterinary Anaesthesia and Analgesia 34.1:23-30. Hanrath, M., and Rodgerson, D.H. (2002). "Laparoscopic Cryptorchidectomy Using ... risk for surgeon and patient". For simple castration of normal animals, the advantages to recumbent castration are that the ... horse is prone, better asepsis (sterile environment) can be maintained, and better haemostasis (control of bleeding) is ...
This enables a patient to take adequate quantities of medications (especially levodopa), thus leading to better control of ... "Stimulation-induced analgesia". In Sykes N, Bennett MI & Yuan C-S (ed.). Clinical pain management: Cancer pain (2nd ed.). ... "pending determination of patient selection criteria and the outcome of carefully controlled clinical trials, a cautious ... of epilepsy patients are drug-resistant. These patients are at risk for significant morbidity and mortality. In cases where ...
Patients are instructed to call immediately for pain that cannot be controlled with over the counter pain medication or if ... Due to the higher risks associated with bulbar blocks, topical analgesia with mild sedation is becoming more common. Rarely ... The first trial to do so is the TAGS randomised controlled trial which investigated if eye drops or trabeculectomy is more ... A Cochrane review sought to compare the effectiveness of fornix-based versus limbal-based conjunctival flaps for patients ...
Gate control theory led to the valuable discovery of endorphins and enkephalins, the body's natural opiates. He is also noted ... After studying for his Ph.D. in 1954 with Hebb at McGill University in Montreal, he began to work with patients who suffered ... for work on stress-induced analgesia, phantom-limb pain and the theory of neuromatrix. He proposes that we are born with a ... In 1965 at MIT, Melzack and Wall developed the gate control theory of pain which states that pain is "gated" or modulated by ...
Patients are recommended to sit upon the edge of the bed and walk short distances several times a day. Moving is mandatory, and ... Anderson M, Collins E (November 2008). "Analgesia for children with acute abdominal pain and diagnostic accuracy". Archives of ... a case control study". Surgical Infections. 8 (1): 55-62. doi:10.1089/sur.2005.04250. PMID 17381397. Burkitt DP (September 1971 ... After surgery, the patient will be transferred to a postanesthesia care unit, so his or her vital signs can be closely ...
... some patients might prefer an alternative to epidural analgesia because of epidural-related side effects. Epidural analgesia ... provide better pain control than subcutaneous wound catheters after abdominal surgery. After being placed, the catheter is ... "The influence of race and socioeconomic factors on patient acceptance of perioperative epidural analgesia". Anesthesia and ... and need for preoperative placement in awake patients, considered as cumbersome by many patients, sometimes leading to refusal ...
... is the practice of a surgical patient abstaining from eating or drinking ("nothing by mouth") for some ... Gastroparesis (delayed gastric emptying) may occur and is due to metabolic causes (e.g. poorly controlled diabetes mellitus), ... Analgesia. 123 (6): 1463-1468. doi:10.1213/ANE.0000000000001590. PMID 27644057. S2CID 13452428. (Webarchive template wayback ... The following are the recommended guidelines for nil by mouth prior to surgery in healthy patients: When anaesthesia is ...
They carried out a case-control study in 1950, which compared lung cancer patients with matched control and also began a ... Anesthesia and Analgesia. 121 (4): 1043-51. doi:10.1213/ANE.0000000000000861. PMID 26378704. S2CID 19333613. Eldridge SM, ... These are controlled for by the inclusion of patients who receive only a placebo. Subjects are assigned randomly without ... In this kind of study, all patients are given both placebo and active doses in alternating periods. Placebo-controlled: The use ...
... and dose-dependent analgesia and antianalgesia in patients with postoperative pain". Pain. 83 (2): 339-45. doi:10.1016/S0304- ... Butorphanol is used for sedation and mild to moderate pain control in dogs and cats. It is not considered adequate pain control ... "Conversion Factors for Controlled Substances". DEA Diversion Control Division. United States Drug Enforcement Administration. ... ISBN 978-0-9548037-0-4. Sladky KK (2014). "Chapter 18: Analgesia". In Mader DR, Divers SJ (eds.). Current therapy in reptile ...
Safety and efficacy has not been established in patients under the age of 18. Patients over the age of 65 may have heightened ... The exact mechanism of analgesia is unknown. Acetaminophen is a non-opioid, non-salicylate analgesic. The specific mechanism of ... Benzhydrocodone is a schedule II-controlled substance. Like other opioids, benzhydrocodone has the potential to be abused. ... Benzhydrocodone/APAP is mainly excreted through the kidneys; therefore, geriatric patients with impaired renal function may ...
1983 "A controlled trial to improve care for seriously ill hospitalized patients: the Study to Understand Prognoses and ... More specific living wills may include information regarding an individual's desire for such services such as analgesia (pain ... In the Netherlands, patients and potential patients can specify the circumstances under which they would want euthanasia for ... Conclusions Patient-designated and next-of-kin surrogates incorrectly predict patients' end-of-life treatment preferences in ...
International Narcotics Control Board (August 2003). "List of psychotropic substances under international control" (PDF). incb. ... detection of risk situations to the patient safety in a brazilian teaching hospital". Journal of Patient Safety. 5 (2): 69-74. ... Mencía SB, López-Herce JC, Freddi N (May 2007). "Analgesia and sedation in children: practical approach for the most frequent ... Patients with renal dysfunction may exhibit prolongation of elimination half-life for both the parent drug and its active ...
Sympathetic control of blood flow to the skin involves the system of noradrenergic vasoconstriction as well as an active ... Frozen peas, on the other hand, have been observed to produce skin temperatures sufficient to induce localized skin analgesia ( ... Furthermore, the timing of hypothermia treatments are a crucial consideration to be made when dealing with patients suffering ... Skin temperature also plays an important role in controlling cooling when exposed to high ambient temperatures. At a given core ...
Most cognitive experiments are done in a lab instead of a social setting; this is done mainly to provide maximum control of ... Experimenters use these when doing an experiment on analgesia. An olfactometer is any device that is used to measure the sense ... They may also study patients with focal brain damage or neurologic disease (see cognitive neuropsychology) or use brain ... A two-group design typically consists of an experimental group (a group that receives treatment) and a control group (a group ...
The massager provides two vibration rates-5,000 and 6,000 rpm, which are equivalent to 83 Hz and 100 Hz-that are controlled by ... They wrote that extension of muscles and sensory clues worked together to provide regional perception of the patient's upper ... "The Efficacy of Mechanical Vibration Analgesia for Relief of Heel Stick Pain in Neonates: A Novel Approach". Journal of ... He stated he recommended the device to female patients with difficulty achieving orgasm to use in masturbation. Kaminetsky ...
"Effect of nitrous oxide on folate and vitamin B12 metabolism in patients". Anesthesia and Analgesia. 71 (6): 610-7. doi:10.1213 ... "Controlled Substances " Inhalants: Legal consequences". Salerno, Rob (25 June 2013). "Health Canada cracks down ... Most inhalant solvents and gases are not regulated under drug laws such as the United States Controlled Substances Act. However ... plays a man who takes up building remote-controlled airplanes as a hobby to give him an excuse to sniff the fuel in the wake of ...
In private hospitals, patients will be seen as soon as a week after discharge for a complete check up. They will have follow up ... Center for Disease Control and Prevention. "North America :: Mexico - The World Factbook - Central Intelligence Agency". www. ... Women often laboring in these hospitals will have epidurals or other forms of analgesia, if deemed necessary. Family members ... with rates of pharmaceutical analgesia being higher in institutional births. This is further outlined in the section regarding ...
... epidural analgesia or paravertebral blockade have shown to be the most effective methods for post-thoracotomy pain control. ... These tubes are used to drain air and fluid until the patient heals enough to take them out (usually a few days). Complications ... Comparing thoracic epidural analgesia and paravertebral blockade, paravertebral blockade reduced the risks of developing minor ... Ökmen K (April 2019). "Efficacy of rhomboid intercostal block for analgesia after thoracotomy". Korean J Pain. 32 (2): 129-132 ...
Dentists use a simpler machine which only delivers an N 2O/O 2 mixture for the patient to inhale while conscious. The patient ... On the other hand, since 38% or more of the N 2O entering the atmosphere is the result of human activity, control of nitrous ... "Nitrous Oxide Analgesia for Childbirth". Archived from the original on 25 May 2011. O'Connor RE; Brady W; Brooks ... The first time nitrous oxide was used as an anaesthetic drug in the treatment of a patient was when dentist Horace Wells, with ...
This system operates by connecting both ventilators to a master control unit, allowing for synchrony between the two ... "Lung isolation techniques for patients with difficult airway". Current Opinion in Anesthesiology. 23 (1): 12-7. doi:10.1097/ACO ... de Menezes Lyra R. Glottis simulator. Anesth Analg. 1999 Jun;88(6 ... Clinical Experience With 1,170 Patients" (PDF). Journal of Cardiothoracic and Vascular Anesthesia. 17 (3): 289-98. doi:10.1016/ ...
"List of psychotropic substances under international control". International Narcotics Control Board. International Narcotics ... Dronabinol is used to stimulate appetite and therefore weight gain in patients with HIV/AIDS and cancer. It is also used to ... Burns TL, Ineck JR (February 2006). "Cannabinoid analgesia as a potential new therapeutic option in the treatment of chronic ... United States federal law currently registers dronabinol as a Schedule III controlled substance, but all other cannabinoids ...
Wagner AM (July 1998). "Pain control in the pediatric patient". Dermatol Clin. 16 (3): 609-17. doi:10.1016/s0733-8635(05)70256- ... June 2010). "(June 2010). "Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic ... Walco GA, Cassidy RC, Schechter NL (1994). "Pain, Hurt and Harm: The ethics of pain control in infants and children". N Engl J ... In babies treated with Sensorial Saturation, a reduction in crying time and pain score were noted, with respect to a control ...
This can lead to a reduction in the amount of opiates needed for pain control. The advantages of nerve blocks over general ... Since it is a unilateral block, it may be chosen over epidurals for patients who can't tolerate the hypotension that follows ... Studies in humans indicate improved onset time and increased duration of analgesia. The duration of the nerve block depends on ... Therapeutic blocks may be used for acute pain patients, diagnostic blocks are used to find pain sources, prognostic blocks are ...
A midline incision may be preferred as well when the fetus lies transversely across the patient's uterus or if the placenta ... Some professionals will say that the sharp expansion allows for a more controlled entry into the uterus and a faster delivery ... requiring more post-operative analgesia. Return of bowel function was faster with in situ repair. It was found that between ... Soskin PN, Yu J (May 2019). "Resuscitation of the Pregnant Patient". Emergency Medicine Clinics of North America. Obstetric and ...
Read medical definition of Patient controlled analgesia ... Definition of Patient controlled analgesia. *Medical Editor: ...
A patient-controlled analgesia (PCA) pump lets you give yourself pain medicine when you need it. This gives you more control of ... A patient-controlled analgesia (PCA) pump lets you give yourself pain medicine when you need it. This gives you more control of ... post a link to Pain Management: Patient-Controlled Analgesia (PCA) Pump information on Facebook. ... post a link to Pain Management: Patient-Controlled Analgesia (PCA) Pump information on Twitter. ...
Patient Controlled Analgesia (PCA) pumps were developed to address the problem of undermedication. They are used to permit the ... Patient Controlled Analgesia Pumps: 5 Sources of Dangers - Part 2. Aug 09, 2012 by ArtiModi ... Patient Controlled Analgesia Pumps: 4 Sources of Dangers Part 1. Aug 06, 2012 by ArtiModi ... These pumps are typically used primarily in the hospital for pain control. The premise behind the pumps is that the patient is ...
S44-7 Comparative analysis of patient- controlled analgesia versus traditional intramuscular injection in Chinese women ... 81.10 more per patient.. 3. Although they experienced more nausea, patients receiving patient-controlled analgesia were ... 1. Women on patient-controlled analgesia used significantly larger amounts of morphine than those given intramuscular analgesia ... 2. Although patient-controlled analgesia is a more effective means of managing pain post-abdominal hysterectomy, it costs HK$ ...
We evaluated the potential benefits of adding magnesium sulphate (MgSO4) to ketamine (K) in a patient controlled analgesia (PCA ... Effect of low-dose ketamine regimen with or without magnesium sulphate adjunct in tramadol patient controlled analgesia in a ... Effect of low-dose ketamine regimen with or without magnesium sulphate adjunct in tramadol patient controlled analgesia in a ... Effect of low-dose ketamine regimen with or without magnesium sulphate adjunct in tramadol patient controlled analgesia in a ...
Patient-controlled analgesia (PCA) is a type of pain management that allows you to decide when you will get a dose of pain ... Health ProfessionalsRefer a PatientTransfer a PatientNursingInfection Control Officer. Francesca Torriani, MD. Medical Director ... Patients & VisitorsBilling & InsuranceFinancial AssistanceMedical RecordsAppointmentsWalk-in ClinicsQualityInternational ... COVID-19 updates, including vaccine information, for our patients and visitors Learn More ...
This study focuses on Patient Controlled Analgesia (PCA), which is a delivery system for pain medication. This study proposes ... The sample in this study included 1099 patients. Every patient was described by 280 attributes, including the class attribute. ... We analyzed PCA patient data and conducted several experiments to evaluate the potential of applying machine-learning ... We used decision tree-based learning algorithms to predict analgesic consumption and PCA control readjustment based on the ...
... patient-controlled analgesia after a craniotomy has been shown to be both safe and effective compared with conventional as- ... Patient-Controlled Analgesia Safe, Effective in Postcraniotomy Pain Management - Medscape - Feb 04, 2008. ... February 4, 2008 (Honolulu) - Intravenous patient-controlled analgesia (PCA) is safe and effective for managing pain after ... the nurses in our ICU were hoping that the patients would be in the PCA arm of the study," he said. "Patients were more ...
Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a ... Adult patients, affiliated to social security. Yes for Adult patients, affiliated to social security inclusion criteria 1 ... a Randomized Controlled Trial. (QETAL) * ... No for Adult patients, affiliated to social security inclusion ... The rate of epidural analgesia during labor is about 85% in France. In addition to the comfort provided, epidural analgesia ...
Patient control analgesia case project. October 12, 2018. /in Uncategorized /by admin. ... Patient control analgesia case project.. Part I: Case Description. Our case occurred at an urban, academic medical center with ... Standard post-operative orders include a patient-controlled analgesia (PCA) for his type of surgery. In the PACU, the RN ... The patient was stable, and the RN was busy with discharge teaching for a non-English speaking patient (no interpreter was on ...
Bolus patient-controlled analgesia leads to decreases in length of stay, opioid use, hypoxia, and acute chest syndrome in ... patient-controlled analgesia], methadone can provide acute pain control. Superiority of the bolus-only [patient-controlled ... Bolus-only patient-controlled analgesia is successful in managing vaso-occlusive crises, the authors said. "In patients with ... Demand-only patient-controlled analgesia for treatment of acute vaso-occlusive pain in sickle cell disease. Pediatr Blood ...
In a randomized controlled study of adult ED patients, Sener et al found that the incidence of recovery agitation was ... Procedural sedation and analgesia (PSA) is intended to result in a depressed level of consciousness that allows the patient to ... Patient Education and Consent. Consent should be obtained from the patient or family member. [57, 58] The reason the procedure ... Patients (n=62) requiring procedural sedation and analgesia for deep traumatic lacerations and reduction of bone fractures were ...
A patient-controlled analgesia (PCA) pump lets you give yourself pain medicine when you need it. This gives you more control of ... A patient-controlled analgesia (PCA) pump lets you give yourself pain medicine when you need it. This gives you more control of ... A patient-controlled analgesia (PCA) pump lets you give yourself pain medicine when you need it. This gives you more control of ... Pain Management: Patient-Controlled Analgesia (PCA) Pump. Overview. Pain medicine works better when the pain first starts, ...
... interruption of medication infusion decreases ventilator days and hospital length of stay in critically ill trauma patients. ... After exclusions, 61 patients were in the control group and 58 in the protocol group. The median duration of mechanical ... An analgesia-delirium-sedation protocol for critically ill trauma patients reduces ventilator days and hospital length of stay ... Results: A total of 143 patients were included. Patients who died during their hospitalization were excluded except in the ...
Patient controlled analgesia using ketorolac prevented respiratory failure in a child after cardiac surgery. Annals of Cardiac ... Patient controlled analgesia using ketorolac prevented respiratory failure in a child after cardiac surgery. ...
Patient controlled analgesia. *Joint injection. *Epidural block. *Epidurography epidural adhesiolysis. *Neurolytic blocks for ... It is a common belief that a patient in pain has to undergo some sort of surgery or other costly treatment. ...
... analgesia-specific dosing for Dilaudid, Exalgo(hydromorphone), frequency-based adverse effects, comprehensive interactions, ... Patient-controlled analgesia. *Usual concentration, 0.2 mg/mL; demand dose, 0.1-0.2 mg; dose range is 0.05-0.4 mg ... Critically ill patients (opiate-naive patients): 0.2-0.6 mg q1-2hr PRN given slowly over 2-3 minutes; patients with previous ... Controlled-release formulation should only be used when continuous analgesia is required over an extended period of time; not ...
Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients: a meta-analysis ... Patient-controlled intravenous analgesia (PCIA) is a recommended solution, where oxycodone has depicted unique advantages in ... Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for pos ... patients satisfaction (ORâ =â 1.13, 95% CI 0.88-1.44; Pâ =â 0.33; I2â =â 72%) and drug consumption (MDâ =â -5.55, 95% CI - ...
This is called patient controlled analgesia (PCA).. You will then be switched to pain pills that you take by mouth, or you may ...
Patient-controlled analgesia pump. *PIC line. Authority control: National libraries *Israel. *United States ... New safety controls were designed on disposable needles to ensure the safety of medical workers in particular. These controls ... It also occurs with patients who have asthma or other severe allergies. Such patients may need to take desensitization ... In the latter case, such patients often carry a syringe loaded with epinephrine (e.g. EpiPen),[23] diphenhydramine (e.g. ...
The choice of opioids administered by patient-controlled intravenous analgesia (PCIA) for thoracoscopic lung surgery is unclear ... Of 555 enrolled patients, 184 patients in group O, 186 in group H and 184 in group S were included in the final analysis. The ... Patients in groups O and H had lower pain scores when coughing on the second day after surgery than those in group S, both with ... oxycodone or hydromorphone is superior to sufentanil for achieving SAME as a supplement to multimodal analgesia in patients ...
Patient Controlled Analgesia * PALLIATIVE AND END-OF-LIFE CARE * 0 1 2 3 4 ... WOMENS HEALTH/MATERNAL-INFANT CARE: Care of Patient With * 0 1 2 3 4 ... WOUND/SKIN CARE MANAGEMENT: Care of Patient With * 0 1 2 3 4 ... PEDIATRICS: Care of Patient With * 0 1 2 3 4 Broncho Pulmonary ...
Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and ... Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and ...
From: Effect of droperidol addition to fentanyl-based intravenous patient-controlled analgesia on postoperative nausea and ...
Subcutaneous or intravenous opioid administration by patient-controlled analgesia in cancer pain: a systematic literature ... Subcutaneous or intravenous patient-controlled analgesia (PCA) with opioids is an appropriate and safe form of treatment for ... Subcutaneous or intravenous opioid administration by patient-controlled analgesia in cancer pain: a systematic literature ... the published studies on opioids administered by subcutaneous and intravenous patient-controlled analgesia for patients with ...
The authors describe and analyze the errors associated with the use of IV patient-controlled analgesia at a large medical ... CE: Original Research: Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective ... ketamine may be an ideal agent for adjunctive analgesia in burn patients. The authors of this study evaluated the efficacy and ... CE: Original Research: Patient Handling and Mobility Course Content: A National Survey of Nursing Programs. Powell-Cope, Gail; ...
Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial Pain ... Epidural analgesia is considered to be the most effective method of pain relief and recommended as first choice. However its ... To determine whether patients with placenta previa who delivered preterm have an increased risk for recurrent spontaneous ... Determinants of unwanted pregnancies in India using matched case-control designs In India, while the total fertility rate has ...
patient-controlled analgesia: A method that allows a person to control, within limits, the amount and timing of pain medication ... locus ceruleus: An area of the brain stem that helps control the brains alertness, responses to certain stimuli, and stress ... mitral valve: The valve that controls the one-way flow of blood from the left atrium to the left ventricle. ... parathyroid hormone: A hormone that controls levels of calcium and phosphorous in the blood and influences bone loss and growth ...
  • This study supports the notion that some opioids, and presumably other potent analgesics, can and should be used in these patients," Dr. Gelb told Medscape Critical Care . (
  • According to Dr. Gelb, further study is needed regarding the relative role of regional or local analgesia vs systemic opioids as well as the effect of postoperative neurological impairment on patient outcomes in this setting. (
  • Bolus patient-controlled analgesia with opioids leads to reduced rates of hypoxia, acute chest syndrome, opioid utilization, and a decreased length of stay in the hospital in adolescents with sickle cell disease (SCD), a new study published in Pediatric Blood & Cancer found. (
  • Opioids are often used to manage pain caused by vaso-occlusive crises in patients with SCD, however, dosing usually depends on the provider, and these drugs can have serious short- and long-term side effects. (
  • Subcutaneous or intravenous patient-controlled analgesia (PCA) with opioids is an appropriate and safe form of treatment for postoperative pain but studies on this form of administration are sparse in the setting of cancer pain despite widespread use. (
  • OBJECTIVE: To evaluate the published studies on opioids administered by subcutaneous and intravenous patient-controlled analgesia for patients with cancer pain. (
  • Studies based on original data with a focus on intravenous or subcutaneous PCA administration of opioids in patients suffering from cancer-related pain were selected. (
  • Therapy with opioids should be administered cautiously in patients with gastrointestinal obstruction, constipation, inflammatory bowel disease, or recent gastrointestinal tract surgery. (
  • Therapy with opioids should be avoided or administered cautiously in patients with infectious diarrhea, particularly that due to pseudomembranous enterocolitis or enterotoxin-producing bacteria or if accompanied by high fever, pus, or blood in the stool. (
  • The use of opioids in the ICU and the post-operative period is common, with patients often receiving opioids even after simple surgeries. (
  • In an article published in ICU Management and Practice , Dr. Xavier Capdevila, Head of the Department of Anesthesia and Critical Care Medicine at Lapeyronie University Hospital, France, outlines the concept of multimodal analgesia as an alternative to administering solely opioids to patients. (
  • A French study showed that the use of multimodal analgesia in mechanically ventilated critically ill patients decreases sedation and delirium while avoiding the need for opioids. (
  • Patients given multimodal analgesia were also more likely to have fewer organ failures compared to patients who received opioids alone (Payen et al. (
  • A study published in Anesthesia and Analgesia compared patients with a paravertebral blockade with rib fractures who received only sedation and opioids to similar patients who also received regional anesthesia. (
  • The patients who received regional analgesia experienced an optimized rehabilitation with a decreased use of opioids. (
  • Through the proper application of multimodal analgesia, ICU clinicians can effectively manage patient pain while reducing the need for opioids and heavy sedation. (
  • The clinical effect of an opioid depends on additional patient factors, including the presence or absence of pain, health status of the animal, concurrent drugs administered (eg, tranquilizers), and individual sensitivity to opioids. (
  • Though effective, opioids may contribute to serious adverse effects particularly in old age patients. (
  • Even though opioids are considered as the primary analgesic therapy in moderate to severe postoperative pain, these drugs do not provide optimum patient satisfaction as they are associated with dose-related adverse effects such as sedation, respiratory depression, postoperative nausea and vomiting, pruritus, and urinary retention [ 3 , 4 ]. (
  • Ketamine is often added to opioids in patient-controlled analgesia devices. (
  • Only opioids could be used for labor analgesia in these situations, as they do not decrease systemic vascular resistance. (
  • Clinical and genetic factors associated with nausea and vomiting in cancer patients receiving opioids. (
  • Impact of genetic factors on severity of side effects of opioids in patients after major surgical interventions]. (
  • Opioids are often used to provide pain control after surgery. (
  • COCA is excited to partner with CDC's National Center for Injury Prevention and Control to offer this call series on CDC Guideline for Prescribing Opioids for Chronic Pain. (
  • Alvimopan is contraindicated in opioid tolerant patients (ie, those who have taken therapeutic doses of opioids for >7 consecutive days immediately prior to taking alvimopan). (
  • Patients recently exposed to opioids are expected to be more sensitive to the effects of alvimopan and therefore may experience abdominal pain, nausea and vomiting, and diarrhea. (
  • Tramadol is not recommended for patients who are dependent on opioids. (
  • Tramadol should be used with caution and in reduced dosages when administering to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, phenothiazines, tranquilizers or sedative hypnotics. (
  • In such patients, methadone dosages are adjusted or combined with other opioids as adjuvant treatments to enhance response to analgesic interventions. (
  • February 4, 2008 (Honolulu) - Intravenous patient-controlled analgesia (PCA) is safe and effective for managing pain after major intracranial surgery compared with conventional as-needed (PRN) therapy, according to research presented here at the 37th Critical Care Congress of the Society of Critical Care Medicine. (
  • Ismail S, Afshan G, Monem A, Ahmed A. Postoperative analgesia following caesarean section: intravenous patient controlled analgesia versus conventional continuous infusion. (
  • The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption , the Ramsay sedation scale, patients ' satisfaction and side effects. (
  • Multimodal analgesia is simultaneous administration of 2 or more analgesic drugs (pain medications) affecting different parts of the pain pathway, simultaneously. (
  • The aim of this randomized control trial was to compare the analgesic efficacy of two commonly prescribed medications, mefenamic acid (Ponstan™ Forte) and lysine clonixinate (Dorixina®) in patients undergoing dental implant surgery. (
  • When anti-inflammatory drugs are contraindicated in patients undergoing implant treatment, LC can be safely prescribed with the same analgesic efficacy of an AINS. (
  • Individualize dosing based on severity of pain, patient response, prior analgesic experience, and risk factors for addiction, abuse and misuse. (
  • We have been administering continuous sciatic nerve block (CSNB) for patients with CLI whose pain could not be relieved by other analgesic tools. (
  • The analgesic effect of CSNB was greater in patients with older age and hemodialysis. (
  • Pre-emptive analgesia is a treatment whereby a preoperative analgesic regimen is introduced to reduce noxious stimuli in the surgical process. (
  • Pain scores, patient satisfaction scores, time to first demand of rescue analgesic, the total number of doses, and total consumption of rescue analgesic along with side effects were recorded. (
  • Conclusion: We concluded that low-dose IV ketamine infusion was associated with significantly lower pain scores, reduced rescue analgesic requirement along with better patient satisfaction so that it could be used as a useful adjunct to multimodal postoperative analgesia. (
  • Relief of PAIN , without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. (
  • Therefore, the purpose of this contemporary investigation is to determine whether lidocaine administration has any analgesic effect on reducing maternal pain during amniocentesis when contrasted with a control treatment. (
  • Nitrous oxide has a sedative and analgesic (pain- controlling) effect. (
  • In Dentistry, three drug groups are commonly employed to control pain: local anesthetics, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, and analgesic drugs of central and/or peripheral action 14 . (
  • Comparison of the analgesic effect of a corticosteroid and paracetamol in patients with pain after oral surgery. (
  • Rescue analgesia was given to 67% (10/15) of the cats in each group.Conclusion: The administration of lidocaine at ST-36 and SP-6 acupuncture points did not provide significant perioperative analgesic benefits in healthy cats undergoing ovariohysterectomy. (
  • Methadone is an analgesic used in cancer patients or other terminally ill patients and in chronic pain pathologies. (
  • Methadone is an alternative in treating patients with opioid tolerance as they may not respond to traditional analgesic regimens. (
  • PCA in the setting of postoperative supratentorial craniotomy pain appeared to be safe and showed a trend toward improvement in sedation and Glasgow coma scores, indicating increased lucidity and comfort of patients. (
  • The American College of Emergency Physicians (ACEP) defines procedural sedation as "a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function. (
  • Procedural sedation and analgesia (PSA) is intended to result in a depressed level of consciousness that allows the patient to maintain oxygenation and airway control independently. (
  • Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. (
  • Sedation and analgesia introduces an independent risk factor for morbidity and mortality in addition to the procedure itself. (
  • Understanding the various depths of sedation is essential to provide safe and effective procedural sedation and analgesia. (
  • Additionally, clinicians must recognize procedures performed outside of the operating room that may require monitored anesthesia care (MAC) with an anesthesia provider overseeing the sedation and monitoring of the patient. (
  • Implementation of an Analgesia-Delirium-Sedation (ADS) Protocol using objective assessments with a goal of maintaining an awake and comfortable patient may obviate the need for daily interruption of infusions in critically ill trauma patients. (
  • and follow patients for signs and symptoms of respiratory depression and sedation. (
  • This study tried to assess the desirable and adverse effects of sodium thiopental-fentanyl (TF) with ketamine-propofol (KP) for procedural sedation and analgesia in the emergency department. (
  • Methods After signing written consent, patients were enrolled in this randomised double-blind trial to receive either KP or TF to reach the desired sedation level. (
  • Multimodal analgesia also reduces the need for total sedation. (
  • The practice of analgosedation in the ICU (using analgesia before sedation) is becoming increasingly common. (
  • One study demonstrated that patients who received more fentanyl and fewer benzodiazepines or more dexmedetomidine and less propofol required lower sedation (Faust et al. (
  • Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia or to some it is referred to as "Twilight Sedation" for their dental treatment. (
  • The μ-opioid receptors, located in the CNS (e.g., brainstem, locus coeruleus, periaqueductal gray matter) and parts of the gastrointestinal tract, act to modulate various neurochemical activities involved in analgesia, euphoria, and sedation. (
  • To evaluate the efficacy of lidocaine local analgesia on maternal pain reduction during amniocentesis. (
  • The inclusion criteria comprised ( a ) patients: Females undergoing amniocentesis, ( b ) intervention: Local analgesia using lidocaine, ( c ) comparison: Placebo or no treatment, ( d ) outcome: Pain perception, ( e ) study design: RCTs. (
  • EXPAREL is indicated for single-dose infiltration in adults to produce postsurgical local analgesia and as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia. (
  • The addition of epidural analgesia to general anesthesia was also associated with long-term survival. (
  • Regional anesthetic techniques, alone or as a supplement to general anesthesia, provide outstanding analgesia with less nausea or other adverse effects. (
  • Helmy N, Badawy AA, Hussein M, Reda H. Comparison of the preemptive analgesia of low dose ketamine versus magnesium sulfate on parturient undergoing cesarean section under general anesthesia. (
  • TKA may be performed with the patient under regional or general anesthesia. (
  • Which of these is used depends partly on the medical condition of the patient, though cardiovascular outcomes, cognitive function, and mortality rates associated with regional and general anesthesia have not been proved to be significantly different. (
  • A patient may choose general anesthesia for simple procedures depending on their level of anxiety. (
  • Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia. (
  • The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. (
  • Analgesics and sedatives are required to maintain a calm and comfortable mechanically ventilated injured patient. (
  • Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who have sustained injuries to the eye. (
  • Patients placed on opiate analgesics should be cautioned not to drive or operate machinery. (
  • Do not abruptly discontinue oxycodone hydrochloride tablets in a physically dependent patient because rapid discontinuation of opioid analgesics has resulted in serious withdrawal symptoms, uncontrolled pain, and suicide. (
  • Low-dose intravenous (IV) ketamine infusion has been considered to be an effective postoperative analgesia and resurged again as a substitute of opioid analgesics. (
  • No significant interaction is expected with concurrent use of opioid analgesics and alvimopan in patients who received opioid analgesics for 7 or fewer consecutive days prior to alvimopan. (
  • The objective of this prospective, double-blinded, randomized, controlled trial was to assess the effect of preemptive low-dose epidural ketamine in addition to preemptive thoracic epidural analgesia on the incidence of chronic post-thoracotomy pain. (
  • The researchers note that "scalp acupuncture can serve as a preemptive analgesia technique and increase effectiveness of epidural morphine analgesia. (
  • To evaluate the effect of preemptive analgesia of paracetamol and dipyrone in vital teeth professionally whitened in office. (
  • Dipyrone 500 mg exhibited higher effectiveness than Paracetamol 500 mg in the study population, as a technique of preemptive analgesia in tooth whitening procedure. (
  • An adjuvant therapy is the preemptive analgesia, which is a drug regimen prior to the nociceptive stimulus, aiming at preventing hyperalgesia and the subsequent pain amplification 1 . (
  • Pharmacological agents, such as epidural anesthesia, intraspinal anesthesia, intrapleural anesthesia, or patient-controlled analgesia (PCA), are effective in relieving postoperative pain in most patients. (
  • A total of 60 patients that received intestinal cancer surgery under combined general/epidural anesthesia were treated and evaluated in this study. (
  • For the control group patients, combined general/epidural anesthesia was administered during the operation, while morphine was administered for patient-controlled epidural analgesia after the operation. (
  • Patients who have epidural anesthesia have been shown to develop fewer perioperative deep vein thromboses (DVTs). (
  • They evaluated the effect of a clinical practice guideline, which eliminates basal infusion dosing for patient-controlled analgesia upon admission to the hospital. (
  • 2016). Clinical evidence shows that epidural analgesia can decrease mortality, complications, and morbidity after surgery. (
  • Patient demographics, neurological history, complications, and subjective evaluation of the effectiveness of CSNB were investigated from their clinical records. (
  • Although several clinical options, including nonsteroidal anti-inflammatory medications (NSAIDs), narcotic medications, epidural analgesia, and spinal stimulations, are reported to relieve pain due to CLI [1], the application of these options may be limited because of side effects or possible complications. (
  • Background: A randomized, pilot, placebo-controlled clinical trial was conducted with the aim of evaluating the effectiveness of a cream based on Bach flower remedies (BFR) on symptoms and signs of carpal tunnel syndrome. (
  • Guangdong Provincial Hospital of Traditional Chinese Medicine researchers combined scalp acupuncture with epidural morphine analgesia in a controlled clinical trial. (
  • note, "The addition of acupuncture therapy to epidural morphine analgesia in a clinical setting can reduce the total dosage of morphine and correspondingly eliminate the medication-induced side effect rate. (
  • Global initiatives are required to address complex clinical problem-solving for patients with refractory angina. (
  • Impact of genetic and non-genetic factors on clinical responses to prochlorperazine in oxycodone-treated cancer patients. (
  • Safety of the Combination of PERC and YEARS Rules in Patients With Low Clinical Probability of Pulmonary Embolism: A Retrospective Analysis of Two Large European Cohorts. (
  • We performed a retrospective analysis of two European cohorts of emergency patients with low gestalt clinical probability of PE (PROPER and PERCEPIC). (
  • In this multicenter, double-blind, parallel-group, active- and placebo-controlled clinical trial, 412 patients undergoing unilateral simple bunionectomy with a lidocaine Mayo block were randomized to 1 of the following 3 treatment groups in a 3:3:2 ratio (respectively): Zynrelef 60 mg/1.8 mg, bupivacaine HCl 50 mg, or saline placebo. (
  • Said H , Nee J , Iturrino J, Rangan V , Singh P, Lembo A , Ballou S . Clinical Characteristics of Patients Presenting With Bloating as a Predominant Symptom. (
  • A clinical diagnosis of acute herpes zoster on the left ophthalmic branch of the trigeminal nerve was confirmed by a dermatologist, and the patient was treated with acyclovir (400 mg, five times a day) and non-steroidal anti-inflammatory drugs for 1 week. (
  • 1992) proposed, for veterinary cardiac patients, a method for assessment which is based on information from the patient's clinical status, that is easy to implement and can be widely used. (
  • Besides the subjectivity inherent to this way to collect data, the clinical course of a disease may be different for some patients with the same diagnosis. (
  • The purpose of this study protocol is to compare the short-term effects of DN versus acupoint DN on wrist flexor spasticity and upper extremity function in patients with stroke.Methods: A double-blind, randomized clinical trial will be conducted to include patients with stroke and upper extremity spasticity and functional disability. (
  • [5] However, in pediatric populations, the use of opioid medications for analgesia is considered off-label due to scant clinical data to elaborate on the harms versus benefits in this population. (
  • The mixed use of sedative agents with opiates coupled with regional anesthesia helped improve patient rehabilitation in the postoperative period (Malekpour et al. (
  • Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (
  • Specific recommendations have been formulated for pregnant women, patients requiring surgery while receiving long-term oral anticoagulant treatment, and patients undergoing regional anesthesia and/or analgesia. (
  • In the present study, a team of researchers led by Deepa Manwani, MBBS, from the Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine in Bronx, New York examined the efficacy of demand-only patient-controlled analgesia in adolescents with SCD. (
  • We performed a literature search in PubMed , Embase, the Cochrane Central Register of Controlled Trials, Web of Science , Chinese National Knowledge Infrastructure , Wanfang, and VIP databases up to December 2020 to select specific randomized controlled trials (RCTs) comparing the efficacy of oxycodone with sufentanil in PCIA. (
  • However, its efficacy in postoperative pain control is inconclusive and health economic evaluation is limited. (
  • A randomized, sham-controlled, patient- and- assessor-blind trial is designed to evaluate the efficacy and safety of acupuncture in managing postoperative pain following abdominal surgery of gynecological diseases. (
  • The practice of these pumps has been encouraged over the manually driven flow control method to provide accurate and exact delivery of the fluid and achieve therapeutic efficacy. (
  • The aim of this retrospective study was to investigate the efficacy and safety of CSNB for patients with CLI. (
  • In humans, the potential efficacy of marijuana for controlling pain has led several states to pass legislation allowing medical use. (
  • Efficacy, safety and tolerability of meropenem as empiric antibiotic therapy in hospitalized pediatric patients. (
  • The efficacy of acetaminophen-caffeine compared to ibuprofen in the control of postoperative pain after periodontal surgery: A crossover pilot study. (
  • Patient satisfaction scores with labor analgesia were measured on the 11-point Likert scale. (
  • It was conducted at a single center, so labor and labor analgesia management may differ from other institutions. (
  • Laboring patients must be educated about the different available methods of labor analgesia. (
  • Many pharmacological and nonpharmacological methods of labor analgesia have been adopted over the years. (
  • Different ways to administer these drugs also can be included in multimodal analgesia (pain relief). (
  • Other methods of pain control can also add to the multimodal definition. (
  • As a result, multimodal analgesia can reduce postoperative pain (Jin and Chung 2001). (
  • 2013). Dexmedetomidine, an alpha 2 antagonist and a potent anxiolytic, is another drug that ICU clinicians should consider within the multimodal analgesia approach. (
  • Dr. Capdevila concludes multimodal analgesia optimizes pain management and decreases organ dysfunction while demonstrating a positive impact on the long-term mortality in patients after major surgeries. (
  • Our Anesthesiology Service works closely with the other specialists in providing multimodal pain control and anesthetic protocols tailored for each patient. (
  • Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a Randomized Controlled Trial. (
  • We included five RCTs totaling 1004 women (lidocaine arm n=502 patients and control arm n=502 patients). (
  • There was no noteworthy change concerning maternal pain perception between the lidocaine and control arms. (
  • Several randomized controlled trials (RCTs) explored the capacity of lidocaine-mediated pain relief among pregnant women undergoing amniocentesis (5,6,7,8,9) . (
  • The hypothesis is that the lidocaine administration will correlate with better maternal analgesia than the control treatment during amniocentesis. (
  • Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. (
  • Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. (
  • The control group did not receive lidocaine (Control group). (
  • Zynrelef is specifically indicated in adults for soft tissue or periarticular instillation to produce postsurgical analgesia for up to 72 hours after bunionectomy, open inguinal herniorrhaphy, and total knee arthroplasty. (
  • Zynrelef is also approved for use in adults for soft tissue or periarticular instillation to produce postsurgical analgesia for up to 72 hours after foot and ankle, small-to-medium open abdominal, and lower extremity total joint arthroplasty surgical procedures. (
  • All mechanically ventilated trauma patients receiving infusions of narcotic, propofol, or benzodiazepine were included. (
  • After decontamination is performed on patients with chemical burns affecting a significant portion of the body, administer standard IV fluid and narcotic therapy as used for thermal burns. (
  • Morphine sulfate is the drug of choice for narcotic analgesia because of its reliable and predictable effects, safety profile, and ease of reversibility with naloxone. (
  • Nonsteroidal anti-inflammatory drugs may be sufficient to manage the pain in some patients, but others do not respond to these and require opioid treatment or hospitalization to treat severe episodes. (
  • At 23:30, the night shift RN came in to greet her patient and noticed that Mr. S was very difficult to arouse with a low respiratory rate. (
  • IMSEAR at SEARO: Patient controlled analgesia using ketorolac prevented respiratory failure in a child after cardiac surgery. (
  • The respiratory and haemodynamic complications, nausea and vomiting, recovery agitation, patient recall and satisfaction, provider satisfaction and recovery time were compared. (
  • Sections on the prevention of bacterial pneumonia in mechanically ventilated and/or critically ill patients, care of respiratory-therapy devices, prevention of cross-contamination, and prevention of viral lower respiratory tract infections (e.g., respiratory syncytial virus {RSV} and influenza infections) have been expanded and updated. (
  • Traditional preventive measures for nosocomial pneumonia include decreasing aspiration by the patient, preventing cross-contamination or colonization via hands of personnel, appropriate disinfection or sterilization of respiratory-therapy devices, use of available vaccines to protect against particular infections, and education of hospital staff and patients. (
  • It may also cause respiratory depression and is contraindicated for patients with cardiopulmonary disease. (
  • We tested whether in surgical patients, ketamine added to an opioid patient-controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of. (
  • Therefore, tramadol should be administered cautiously in patients at risk for respiratory depression. (
  • This article-winner of the 2021 Nurse Faculty Scholars/AJN Mentored Writing Award-describes an evidence-based practice project in which nurses used structured yoga sessions for patients with psychiatric illness as a means of providing stress relief, promoting relaxation, reducing anxiety, and improving quality of care. (
  • Il s'agissait d'une revue exhaustive de la littérature (Pubmed, Medline, cochrane library) concernant les méta-analyses, revues de la littérature et essais randomisés publiés sur le sujet et en anglais de 2003 à 2021. (
  • Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. (
  • Ijichi K, Nijima K, Iwagaki T, Irie J, Uratsuji Y. A randomized double-blind comparison of epidural versus intravenous tramadol infusion for postoperative analgesia. (
  • The author reviews current device therapies for heart failure and uses a composite case to demonstrate how bedside nurses can help patients understand treatment options, potential complications of implantation, and post-op care. (
  • When our patients' pain is treated more completely we can see fewer complications as well as faster recoveries! (
  • Patients who received epidural analgesia exhibited fewer complications than patients who received only analgosedation (Bardia et al. (
  • Epidural analgesia also limits the need for opiates, thereby decreasing opioid-related complications (Pöpping et al. (
  • It also helps control blood pressure in women with preeclampsia by alleviating labor pain, and it blunts the hemodynamic effects of uterine contractions and the associated pain response in patients with other medical complications. (
  • however, with the numbers of both prescriptions and consumption of over-the-counter (OTC) NSAIDs increasing every year, so do the numbers of overdoses and NSAID-related complications reported to poison control centers around the country. (
  • It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. (
  • The overall objective of the Polish guidelines for the prevention and treatment of venous thromboembolism is to increase patient benefit and safety by appropriate prevention and treatment of deep vein thrombosis and pulmonary embolism as well as proper management of the complications associated with antithrombotic and thrombolytic therapy. (
  • PCA pumps not only control pain but also have other benefits. (
  • Both physicians and nurses can contribute to errors that harm patients receiving PCA pumps. (
  • These pumps are typically used primarily in the hospital for pain control. (
  • Patient Controlled Analgesia (PCA) pumps were developed to address the problem of undermedication. (
  • Consider the use of patient-controlled analgesia pumps. (
  • These are designed based on the specialized functions such as enteral feeding pumps to deliver nutrients, insulin pumps to deliver insulin, and patient controlled analgesia (PCA) pumps for delivery of pain medications. (
  • Factors such as the recurrent use of accessories & consumables and the increasing adoption of infusion pumps for the delivery of medications in a controlled manner are responsible for the large share and high growth of this segment. (
  • Ambulatory infusion pumps are wearable or portable, whereas infusion pumps aid in the exact distribution of fluids such as medications, antibiotics, and nutrition throughout the body in a controlled setting. (
  • Adding a low dose of K or MgSO 4 to T in post-operative major abdominal surgery did not improve analgesia but the combination of both had a statistical sparing effect on T consumption. (
  • When patients received an IV injection of 2 g propacetamol, reduction of morphine consumption up to 46% has been reported. (
  • The aims of the review is to assess the evidence for the effectiveness of paracetamol compared to placebo or no treatment, for postoperative pain relief, in terms of opioid consumption in patients undergoing orthopaedic surgery. (
  • In 7 trials (495 patients), cumulative 24 hours morphine consumption was decreased by 28% with ketamine (weighted mean difference -12.9 mg [-22.4 to -3.35], P = 0.002). (
  • Association of mu-opioid receptor gene polymorphism (A118G) with variations in morphine consumption for analgesia after total knee arthroplasty. (
  • 19 demonstrated that dipyrone use prior to surgical incision reduces the consumption of morphine per hour, evaluated through the method of analgesia controlled by the patient. (
  • While PCA is efficacious and has become well-accepted in many settings, use of analgesia following intracranial surgery has been controversial due to potential adverse neurological effects and the perception that it may not be necessary," said senior author Allan Gottschalk, MD, PhD, from Johns Hopkins Hospital, Baltimore, Maryland. (
  • Managing acute postoperative pain is challenging for anesthesiologists , surgeons , and patients , leading to adverse events despite making significant progress. (
  • Oxycodone improves postoperative analgesia and causes fewer adverse effects , and could be recommended for PCIA, especially after abdominal surgeries. (
  • Individually titrate oxycodone hydrochloride tablets to a dose that provides adequate analgesia and minimizes adverse reactions. (
  • 2,3] Over 30% of tramadol is excreted unchanged in the urine, which means patients with CKD are at higher risk for toxicity and adverse effects. (
  • Additionally, adverse events related to drug interactions, or exposure to vulnerable patients with disease states that predispose patients to NSAID toxicity, are common and may result in significant morbidity and mortality. (
  • This activity will highlight the mechanism of action, adverse effect profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for members of the healthcare team in the management of patients with opioid use disorder and chronic pain. (
  • Standard post-operative orders include a patient-controlled analgesia (PCA) for his type of surgery. (
  • The correlation between post-operative fentanyl requirements and µ-opioid receptor gene A118G polymorphism in patients undergoing radical gastrectomy. (
  • Post operative abdominal-surgical patients. (
  • Seizures are generally tonic-clonic, occur within 24 hours of initiation, and are more common in patients taking other serotonergic agents, alcohol or medications that reduce the seizure threshold like bupropion. (
  • Description of Technique Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. (
  • An infusion system consists of a pump (device) and associated disposables for delivering fluids, such as nutrients and medications, into a patient's body in controlled amounts. (
  • Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. (
  • Effectiveness of a radiofrequency detection system as an adjunct to manual counting protocols for tracking surgical sponges: a prospective trial of 2,285 patients. (
  • Of 220 patients admitted to the surgical ICU who had a nasogastric tube for more than 24 hours, 68 case patients received oral metoclopramide (10 mg every 8 hours) and 152 control patients did not. (
  • Gastric aspiration was common, and, without antibiotics, even if the patient survived the actual procedure, the risk of dying from postoperative surgical site infection or aspiration pneumonitis was great. (
  • From 1922 to 2022, we have made tremendous advances in the anesthetic and perioperative management of the surgical patient. (
  • Postoperative pain management is one of the most challenging jobs in orthopedic surgical population as it comprises of patients from extremes of ages and with multiple comorbidities. (
  • Methods: Forty-three patients with mild to moderate carpal tunnel syndrome during their 'waiting' time for surgical option were randomized into 3 parallel groups: Placebo (n = 14), blinded BFR (n = 16), and nonblinded BFR (n = 13). (
  • The Lancet Commission and the Global Surgery Founda- plines without specialist training, with little or no support tion in 2015 highlighted the urgent need to improve the from a perioperative multidisciplinary team(MDT), no access gap to safe surgery and anesthesia for essential access to a perioperative nurse coordinator and a lack of surgical services in low- and middle-income countries quality patient outcomes data. (
  • The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient's level of apprehension. (
  • Intraoperatively, fentanyl was given to control cardiovascular responses to surgical stimulation. (
  • These guidelines apply to adult trauma, cancer, surgical, and medical patients as well as those at increased risk of venous thromboembolism. (
  • 3. Although they experienced more nausea, patients receiving patient-controlled analgesia were significantly more satisfied than those receiving intramuscular pain management. (
  • Study of the OPRM1 A118G genetic polymorphism associated with postoperative nausea and vomiting induced by fentanyl intravenous analgesia. (
  • We evaluated the potential benefits of adding magnesium sulphate (MgSO 4 ) to ketamine (K) in a patient controlled analgesia (PCA) model with tramadol (T) on postoperative pain and cognitive function in major abdominal surgery. (
  • 10 Animal and human studies have demonstrated that subjects with OIH who were administered ketamine, an NMDA receptor antagonist, scored better during controlled pain-stimulus testing. (
  • Kaur S, Saroa R, Aggarwal S. Effect of intraoperative infusion of low-dose ketamine on management of postoperative analgesia. (
  • Benefit and harm of adding ketamine to an opioid in a patient-controlled analgesia device for the control of postoperative pain: systematic review and meta-analyses of randomized controlled trials with trial sequential analyses. (
  • Furthermore, fentanyl administration was significantly higher in the PCA group ( P = .005), indicating a high pain intensity experienced by patients after the procedure. (
  • Patients are usually sedated for the procedure itself and throughout surgery. (
  • Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: a controlled interrupted time series. (
  • Today, modern anesthesia allows an operation like a simple mastectomy, which could be fatal in 1822 and even 1922, to be performed as a routine outpatient procedure with little or no risk to the patient. (
  • Description of Technique The patient remains totally conscious throughout the procedure. (
  • Data collection was conducted by using two instruments: a record of research evaluation and visual analog scale (VAS), in which the patient was asked to score a value to the pain experienced before, during, 1 hour and 6 hours after the whitening procedure. (
  • Methods We conducted a 1:1 case-control study with women who delivered at our institution from January 2015 to December 2019. (
  • Methods for controlling nitrous-oxide (10024972) (N2O) exposure during administration to patients as an anesthetic gas by dental workers were discussed. (
  • An illustration of an N2O anesthetic delivery and scavenging system, a step by step approach for controlling N2O, and a list of sampling methods for N2O were provided. (
  • Patients and methods. (
  • Pharmacokinetics of caspofungin in pediatric patients [abstract M-896]. (
  • Have not provided adequate analgesia or are not expected to provide adequate analgesia. (
  • For control of chronic pain, administer oxycodone hydrochloride tablets on a regularly scheduled basis, at the lowest dosage level to achieve adequate analgesia. (
  • Adequate hydration and analgesia are essential in this time of high physical stress. (
  • There are no adequate and well-controlled studies in pregnant women. (
  • Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials were searched until July 2022. (
  • Researchers conclude that acupuncture increases the effectiveness of epidural morphine analgesia for the relief of pain after intestinal cancer surgery. (
  • 4] In the Guangdong Provincial Hospital of Traditional Chinese Medicine study, acupuncture increases the effectiveness of epidural morphine analgesia by improving VAS and BCS scores and facilitates the postoperative recovery of gastrointestinal function. (
  • Although there are many different strategies for provision of palliative care to patients with cancer, little is known about the effectiveness of these modalities. (
  • Bolus-only patient-controlled analgesia is successful in managing vaso-occlusive crises, the authors said. (
  • In patients with intractable pain unresponsive to a bolus [patient-controlled analgesia], methadone can provide acute pain control. (
  • Superiority of the bolus-only [patient-controlled analgesia] approach needs to be further evaluated in a randomized prospective study. (
  • There is a lack of evidence to guide emergency physicians regarding selection of patients for oral versus intravenous antibiotic therapy. (
  • After supratentorial craniotomy, 44 patients were randomly assigned to receive fentanyl either via PCA, 0.5 µg/kg every 6 minutes, at a maximum of 10 doses per hour (n = 18), or PRN, 25 to 50 µg every 30 minutes (n = 26). (
  • Transdermal fentanyl in the long-term treatment of cancer pain: a prospective study of 50 patients with advanced cancer of the gastrointestinal tract or the head and neck region. (
  • Effects of OPRM1 A118G polymorphism on epidural analgesia with fentanyl during labor: a meta-analysis. (
  • Human µ-opioid receptor A118G polymorphism affects epidural patient-controlled analgesia with fentanyl]. (
  • Effect of CYP3A4*18B polymorphisms and interactions with OPRM1 A118G on postoperative fentanyl requirements in patients undergoing radical gastrectomy. (
  • surgery contributes to chronic pain in 23% of patients in outpatient pain clinics [ 1 ]. (
  • While thoracic epidural analgesia has become the mainstay for managing acute post-thoracotomy pain, its effect on the chronic post-thoracotomy pain seems questionable. (
  • A growing number of patients, particularly those with advanced, chronic coronary artery disease, experience symptoms of angina that are refractory to treatment with β-blockers, calcium-channel blockers, and long-acting nitrates, despite revascularization. (
  • Explain the importance of collaboration and communication amongst the interprofessional team to improve patient outcomes affected by opioid use disorder and chronic pain. (
  • Before starting methadone for noncancer chronic pain, the patient should undergo an evaluation of risk factors that can lead to drug misuse or diversion and establish that benefit of therapy overweighs the harms. (
  • They enable the delivery of solutions in a predetermined and controlled manner and are thus helpful in managing chronic diseases and associated pain. (
  • Laboratory-induced dyspnea (breathing discomfort) in healthy subjects is widely used to study perceptual mechanisms, yet the relationship between laboratory-induced dyspnea in healthy volunteers and spontaneous dyspnea in patients with chronic lung disease is not well established. (
  • Patients with chronic pain who have had dry needling report significant pain improvement. (
  • A recent study showed high prevalence common, can become chronic (duration 3 months) of anxiety, depression and sleep disturbances in patients and are resource-consuming, especially in industrialized with chronic shoulder pain ( 9 ). (
  • Effective postoperative pain control after abdominal surgery is particularly important for patient recovery, mobility, and satisfaction. (
  • Although there are many studies involving various aspects of the postoperative pain control, there is no previous study about administration of CPNB to control severe pain due to CLI. (
  • Abstinence rates from opioid use are better when patients undergo long-term versus short-term methadone treatment. (
  • [3] Clinicians must evaluate the availability of methadone in pharmacies when referring patients to such programs, as licensing and availability can vary significantly across states. (
  • NIOSH hazard controls HC3 - Control of nitrous oxide in dental operatories. (
  • In addition, we will provide nitrous oxide analgesia if indicated. (
  • Nitrous oxide is safe, the patient receives 50-70% oxygen with no less than 30% nitrous oxide. (
  • Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients: a meta-analysis of randomized controlled trials. (
  • Meta-analyses randomized controlled trials (RCTs), prospective and retrospective cohort studies from both HIC's and LMIC's were considered for each perioperative item. (
  • The included randomized controlled trials (RCTs) were evaluated for the risk of bias via the Cochrane tool. (
  • Cancer patients require chemotherapy which is to be delivered to the patients in a continuous manner which can be achieved by using the pump. (
  • The paravertebral catheter remains in place at home, and a slow continuous infusion of local anesthetic through it allows the patient to sleep comfortably in her own bed. (
  • A continuous peripheral nerve block has been shown to provide effective analgesia for patients having lower limb surgery. (
  • A continuous peripheral nerve block (CPNB) of the lower limb has been shown to provide multiple benefits for patients having lower limb surgery [3,4]. (
  • Patient-controlled analgesia versus continuous infusion. (
  • At this early stage, the patient begins knee movement, sometimes using a continuous passive motion (CPM) machine and exercises. (
  • Shen's group argued that the potential effect on epidural analgesia during the second stage of labor "remains controversial," based on prior observational studies that did find the second stage of labor was longer, with higher rates of assisted vaginal delivery when women were given epidural analgesia. (
  • Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (
  • Screening results for gestational diabetes, as well as urinary controls and vaginal swabs for group B Streptococcus , were negative. (
  • In 2017, the Centers for Disease Control and Prevention (CDC) reported that drug overdose deaths in the United States more than tripled from 1999 to 2015. (
  • Twenty-four abdominal open surgery patients were included in a double-blind, randomized study. (
  • Our case occurred at an urban, academic medical center with patient Mr. S, who was sent to PACU after a routine surgery. (
  • It is a common belief that a patient in pain has to undergo some sort of surgery or other costly treatment. (
  • The acupuncture treatment protocol, if proven to be effective, can be implemented in routine settings to play a role in postoperative pain management for patients who have undergone abdominal surgery for gynecological diseases. (
  • A patient, whose pain is well controlled, usually does better after surgery. (
  • Is Outcome Post-surgery Improved by Epidural Anaesthesia/Analgesia? (
  • A study published in JAMA Surgery analyzed patients who received abdominal aortic aneurysm repair. (
  • Non-flammable agents allow the surgeon to use electrocautery to control intraoperative bleeding, so surgery no longer needs to be rushed. (
  • Postoperative pain is a major challenge in patients undergoing orthopedic surgery. (
  • Patients receiving both epidural morphine analgesia and scalp acupuncture in a combined pain management protocol after completion of intestinal cancer surgery showed significant improvements in visual analog scale (VAS) scores and Bruggman comfort scale (BCS) scores. (
  • 1 A major determinant of survival in patients undergoing cancer surgery is recurrence, with rates of 8-25% reported for colorectal cancer. (
  • Description of Technique A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist. (
  • Usual Indications Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. (
  • Moreover, less aggressive treatment options would be very useful in patients older than 70 years with comorbidities that make surgery a difficult and sometimes life-threatening treatment. (
  • The use of celecoxib and dexamethasone for the prevention and control of postoperative pain after periodontal surgery. (
  • An 82-year-old, 152 cm, 68 kg male patient had decompression surgery for cervical ossification of the posterior longitudinal ligament (C4/5 to C5/6) at a local hospital. (
  • 4. If intramuscular analgesia is used for pain management, closer adherence to prescription and administration protocols is needed to improve pain control. (
  • Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural after pectus excavatum repair with bar placement. (
  • Pain control is essential to quality patient care. (
  • Conclusions: CSNB provided good pain control for patients with severe pain caused by CLI. (
  • A recent Transatlantic Inter-Society Consensus [2] document on the management of peripheral arterial disease stresses the importance of optimizing pain control for all patients with CLI. (
  • Make the pain control options clear during and after hospitalization so that the patient will have realistic expectations. (
  • Dr. Hubbi specialized training in anesthetic and pain control ensures that your root canal treatment is completed with minimal discomfort. (
  • Subcutaneous or intravenous opioid administration by patient-controlled analgesia in cancer pain: a systematic literature review. (
  • Cognitive determinants in ICU patients are not modified by a low dose of K. (
  • 5 Tolerance can be overcome by increasing the opioid dose, whereas the same increase in a patient with OIH results in worsened pain. (
  • Moreover, according to the Centers for Disease Control and Prevention (CDC), in 2020, the prevalence of diabetes was estimated to be around 463 million cases worldwide and in the U.S., 34.2 million adults have diabetes which is 10.5% of the total population. (
  • Centers for Disease Control and Prevention. (
  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. (
  • The American Association of Poison Control Centers National Poison Data System (AAPCC NPDS) recorded 76,411 single exposures in 2019. (
  • I am Loretta Jackson-Brown and I am representing the Clinician Outreach and Communication Activity, COCA with the Emergency Risk Communication Branch at the Centers for Disease Control and Prevention. (
  • They would like to disclose that their employer the University of Washington received a contract payment from the Centers for Disease Control and Prevention. (
  • Dr. Dowell is the Senior Medical Advisor for the National Centers for Injury Prevention and Control at the Centers for Disease Control and Prevention. (