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 ...
The Comparison of Postoperative Pain After Lumbar Fusion Surgery in Intravenous Patient-controlled Analgesia Between Conventional Mode and Optimizing B.I Mode With PAINSTOP ...
Patient-Controlled Analgesia Pumps Patient-controlled analgesia (PCA) is a type of pain management that lets you decide when you will get a dose of pain medicine. In some situations, PCA may be a better way of providing pain relief than calling for someone (typically a nurse) to give you pain medicine. With PCA you dont need to wait for a nurse. And you can get smaller doses of pain medicine more often. With this type of pain treatment, a needle attached to an IV (intravenous) line is placed into 1 of ...
RATIONALE: Giving pain medication into the space between the wall of the spinal canal and the covering of the spinal cord or giving it into a vein may help lessen pain caused by cancer surgery. It is not yet known whether epidural analgesia is more effective than patient-controlled analgesia in controlling pain in patients who have undergone surgery for gynecologic cancer.. PURPOSE: This randomized clinical trial is studying epidural analgesia to see how well it works compared to patient-controlled analgesia in treating patients who have undergone surgery for gynecologic cancer. ...
TY - JOUR. T1 - Epidural, intrathecal, and patient-controlled analgesic use in a University Medical Center. AU - Erstad, B. L.. AU - Snyder, B. A.. AU - Kramer, T. H.. PY - 1993/1/1. Y1 - 1993/1/1. N2 - Objective: To determine the number and profile of surgical patients receiving epidural, intrathecal, and patient-controlled analgesia. Design: Two-month audit of epidural, intrathecal, and patient-controlled analgesia. Setting: A 300-bed, tertiary care, university medical center. Patients: All patients undergoing surgery and receiving epidural, intrathecal, or patient- controlled analgesia. Results: Of 1123 operations performed during the two- month audit, 185 patients (16 percent) received one of the three forms of analgesia studied. Sixty-three percent of the 185 patients received patient- controlled analgesia and 33 percent received epidural injections for pain control. The most common types of surgery associated with the use of these specialized pain-control techniques were ...
Problem: After a 72-year-old woman underwent cancer surgery, her surgeon prescribed patient-controlled analgesia (PCA) with a 2-mg morphine loading dose and 1 mg every 10 minutes as needed, for a maximum of 6 mg/hour. Initially, the patient was restless and agitated in the post-anesthesia care unit, but she remained obtunded (not alert) after surgery. Despite her inability to verbalize her pain, nurses pushed the PCA button and delivered frequent doses of morphine over the next 48 hours. Subsequently, the patient suffered a cardio-respiratory arrest and seizure, leading to hypoxic encephalopathy. She died several months later without ever having regained consciousness.. Several safety features exist with PCA to ensure that patients do not receive too much analgesia. These include a lockout interval that specifies the minimum amount of time between each dose and a maximum allowable amount that may be administered during a set time interval. buy kamagra. Another often-overlooked "built-in" safety ...
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...
Patients were sent to the surgical room without any premedication 30 min before the surgery. Standard monitoring consisted of five-lead electrocardiography (ECG), oxygen saturation (SpO2) and non-invasive blood pressure measurements. The anesthesiologist administering the anesthetic prepared a 50-ml syringe containing 4 μg/ml of DEX. A 20-gauge intravenous cannula was inserted in the dorsum of each patients left hand; 0.6 μg/kg of DEX was administered, and was changed to 0.4 μg/kg/h for maintenance after 15 min. Preoxygenation with 100% oxygen was administered before induction, which was delivered through a facial mask for no less than 3 min. After the arterial line was inserted under local anesthesia, general anesthesia was induced with 0.3 mg/kg of etomidate, 0.5 μg/kg of sufentanil and 1.2 mg/kg of rocuronium. Manual facemask ventilation was continued for no less than 4 min until the jaw was relaxed and the Bispectral Index Monitoring (BIS) was less than 50 to allow the double-lumen tube ...
PubMed Central Canada (PMC Canada) provides free access to a stable and permanent online digital archive of full-text, peer-reviewed health and life sciences research publications. It builds on PubMed Central (PMC), the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature and is a member of the broader PMC International (PMCI) network of e-repositories.
The primary objective of this study is to determine the safety and efficacy of single doses of intramuscular NALDEBAIN on patients scheduled to undergo
... (PCA) is any method of allowing a person in pain to administer their own pain relief. Additional
Surgeries accompanied by an extensive tissue trauma are associated with intense postsurgical pain and major perioperative homeostatic disorders. Both hyper-inflammatory and immuneparalytic reactions can be observed, what can negatively effect the postoperative course. To realise an effective and safe analgesia, epidural procedures are used to an increasing degree as an alternative method to the therapy with intravenous opioids. In this prospective, randomized, double-blinded trial we compared the patient-controlled epidural analgesia and the patient-controlled intravenous analgesia with respect to the analgesic efficiency and the influence on the postoperative immune competence. 54 patients received until the morning of the fourth postoperative day either ropivacaine plus sufentanil through an intraoperatively placed epidural catheter (PCEA-group) or intravenous morphine (PCIA-group). Cortisol, populations of leukocytes and lymphocytes, cell-surface molecules of monocytes and the soluble ...
To control pain after surgery, doctors recommend intravenous patient-controlled analgesia, patient-controlled epidural analgesia, nerve blocks or oral pain medications, according to Cleveland Clinic....
All 3 groups had similar values of TUG test on postoperative day (POD) 2 (46 [36-62], 45 [33-61], and 52 [41-69]; P = 0.166) as well as other short-term and 3-month functional outcomes. Patients in group 3 showed a favorable analgesic profile as evidenced by 3 positive secondary outcomes. These positive outcomes were lower pain scores 12 hours postoperatively both at rest (4 [2-6.3], 4 [2.3-6], and 3 [1-4]; P = 0.007) and on movement (6 [4-8], 6 [3-8], and 4 [2-6]; P = 0.002), a lower incidence of "rescue" intravenous patient-controlled analgesia (42%, 34%, and 20%; P = 0.031), and the lowest cumulative opioid requirements for the first 48 hours postoperatively (86 ± 71, 68 ± 46, and 59 ± 39; P , 0.005, group 3 compared with group 1).. CONCLUSIONS ...
PCA-related device events are three times as likely to result in injury or death. As Tim Ritter (Senior Patient Safety Analyst, Pennsylvania Patient Safety Authority) reminds us,
Physician-Patient Alliance for Health & Safety nominates the respiratory care department of St. Josephs/Candler Hospitals in Savannah, Georgia for RT Magazines
Epidurals are better pain relievers during labor than patient-controlled doses of a fast-acting painkiller called remifentanil, new research suggests. The Dutch
1. How Should Opioids Be Started and Titrated in Routine Outpatient Settings? -- 2. How Should Opioids Be Started and Titrated in Hospital or Inpatient Settings? -- 3. How Should Patient-Controlled Analgesia Be Used in Patients With Serious Illness and Those Experiencing Postoperative Pain? -- 4. How Should Opioids Be Used to Manage Pain Emergencies? -- 5. What Principles Should Guide Oral, Transcutaneous, and Intravenous Opioid Dose Conversions? -- 6. Which Opioids Are Safest and Most Effective in Renal Failure? -- 7. How Should Methadone Be Started and Titrated in Opioid-Naïve and Opioid-Tolerant Patients? -- 8. What Special Considerations Should Guide the Safe Use of Methadone? -- 9. When Should Corticosteroids Be Used to Manage Pain? -- 10. When Should Nonsteroidal Antiinflammatory Drugs Be Used to Manage Pain? -- 11. What Is Neuropathic Pain? How Do Opioids and Nonopioids Compare for Neuropathic Pain Management? -- 12. Should Bisphosphonates Be Used Routinely to Manage Pain and Skeletal ...
1. How Should Opioids Be Started and Titrated in Routine Outpatient Settings? -- 2. How Should Opioids Be Started and Titrated in Hospital or Inpatient Settings? -- 3. How Should Patient-Controlled Analgesia Be Used in Patients With Serious Illness and Those Experiencing Postoperative Pain? -- 4. How Should Opioids Be Used to Manage Pain Emergencies? -- 5. What Principles Should Guide Oral, Transcutaneous, and Intravenous Opioid Dose Conversions? -- 6. Which Opioids Are Safest and Most Effective in Renal Failure? -- 7. How Should Methadone Be Started and Titrated in Opioid-Naïve and Opioid-Tolerant Patients? -- 8. What Special Considerations Should Guide the Safe Use of Methadone? -- 9. When Should Corticosteroids Be Used to Manage Pain? -- 10. When Should Nonsteroidal Antiinflammatory Drugs Be Used to Manage Pain? -- 11. What Is Neuropathic Pain? How Do Opioids and Nonopioids Compare for Neuropathic Pain Management? -- 12. Should Bisphosphonates Be Used Routinely to Manage Pain and Skeletal ...
The complaint continues that in mid afternoon on April 1, 2007, Ms. Stewart told "one or more of the Defendants that her abdominal pain was 8 or higher and her knee pain was 3. The health care provider replied that he was not concerned with her abdominal pain". When a family member asked a nurse to contact a doctor, the nurse informed her ,"…the team responsible for decedents care was aware of the abdominal issues, that the pain was being caused by ileus and that two doctors, Defendants Stuffman and Hamman, had been contacted and they had taken a course of no action other than palliative medical treatment". Despite repeated requests from Ms. Stewart and family members, that she be examined and evaluated by a doctor, they were informed by the nurse … "that their job was to manage the pain and not to do anything else and directed Decedent to use the Patient-Controlled Analgesia or PCA device to administer pain medication". All this time, family members were assured that the "decedent was ...
OTC pain relievers e.g., codeine, psychiatric viagra nhs medicines e.g., amitriptyline, desipramine. Half a second, add a quarter cup of Frosted Shredded Wheat viagra nhs Spoonsize = 4 grams of fiber. Alternative Therapies Patient-controlled analgesia PCA is another option.
Thybo KH, Hägi-Pedersen D, Dahl JB, Wetterslev J, Nersesjan M, Jakobsen JC, Pedersen NA, Overgaard S, Schroder HM, Schmidt H, Bjorck JG, Skovmand K, Frederiksen R, Buus-Nielsen M, Vos Sorensen C, Kruuse LS, Lindholm P, Mathiesen O. Effect of combination of paracetamol (acetaminophen) and ibuprofen vs either alone on patient-controlled morphine consumption in the first 24 hours after total hip arthroplasty. The PANSAID randomized clinical trial. JAMA 2019;321:12 de febrero. [Ref.ID 103023 ...
A review and metaregression of 25 trials, totalling 763 patients, looked at efficacy and safety of different techniques for PVB to determine whether LA dose influenced the quality of analgesia from PVB. Use of higher doses of bupivacaine was found to predict lower pain scores at all time points up to 48 h and was predictive of faster recovery of pulmonary function by 72 h. CI of LA predicted lower pain scores compared with intermittent boluses and the use of adjuvant clonidine or fentanyl, pre-emptive PVB, and the addition of patient-controlled opioids to PVB did not improve analgesia (Kotzé et al. 2009, n=762, LoE 1 ...
Lockout Tagout LOTO Definition - The term lockout tagout (LOTO) refers to a safety procedure that ensures that dangerous machines and energy sources are...
Another day, another day without any developments in the lockout of the NFL officials. Per a source with knowledge of the situation, no negotiations have occurred between the NFL and the NFL Referees Association.
are people just nowfiguring out that i have no interest in talking about things that i agree with everyone on if i wanted to do that there are thousands of threads that i could pollute with quot exactly quot and quot quot yes if im talking about something my opinion is going to be made clear and yes i argue a point that i dont exactly hold in some cases this is probably one of those im not on the players side im definitely against people who are on the owners side though
Remember how David Stern said that if a deal wasnt reached by Monday that the first two weeks of the regular season would be cancelled? Well, were pretty much there. CBSSports.
He wanted to sell a business that Forbes had valued at 4.9 Billion for 3.5 Million and decided that it was a great enough idea that it was worth...
The European Survey of Enterprises on New and Emerging Risks (ESENER) asks managers and workers health and safety representatives about how health and safety risks are managed at their workplace, with a particular focus on the newer psychosocial risks, such as work-related stress, violence and harassment. This summary highlights a selection of the main results from a first analysis of the data, which is drawn from 36,000 interviews carried out in 31 countries.
BACKGROUND: The role of electroacupuncture in postthoracotomy pain control is uncertain. We conducted a pilot study to evaluate the role of electroacupuncture in the management of early postthoracotomy wound pain. METHODS: A total of 27 patients with operable non-small cell lung carcinoma who received thoracotomy were recruited and randomized to receive either electroacupuncture or sham acupuncture in addition to routine oral analgesics and patient-controlled intravenous analgesia for postoperative pain control. All patients received acupuncture twice daily with visual analog pain score recorded for the first 7 postoperative days. Specific chest acupoints (LI 4, GB 34, GB 36, and TE 8) were targeted. Patient-controlled analgesia was used for the first 3 postoperative days in all patients, and the cumulative dosage used was recorded. RESULTS: Two patients were excluded after randomization because of complications unrelated to acupuncture. Interventions and data collection were completed for the ...
TY - JOUR. T1 - Effects of postoperative pain management on immune function after laparoscopic resection of colorectal cancer. T2 - A randomized study. AU - Kim, So Yeon. AU - Kim, Nam Kyu. AU - Baik, Seung Hyuk. AU - Min, Byung Soh. AU - Hur, Hyuk. AU - Lee, Jinae. AU - Noh, Hyun Young. AU - Lee, Jong Ho. AU - Koo, Bon Neyo. PY - 2016/1/1. Y1 - 2016/1/1. N2 - There has been a rising interest in the possible association between perioperative opioid use and postoperative outcomes in cancer patients. Continuous surgical wound infiltration with local anesthetics is a nonopioid analgesic technique that can be used as a postoperative pain management alternative to opioid-based intravenous patient-controlled analgesia (IV PCA). The aim of this study was to compare the effects of an opioid-based analgesic regimen versus a local anesthetic wound infiltration-based analgesic regimen on immune modulation and shortterm cancer recurrence or metastasis in patients undergoing laparoscopic resection of ...
PATIENT CARE: The patient is prepared for surgery according to protocol. Aspirin or other medications that may cause postoperative hemorrhage are withheld. The patient and family are assured that, in most instances, the body will adapt to functioning with only one kidney. Postoperatively, vital signs are checked frequently; analgesics are administered (often by intravenous or epidural patient-controlled analgesia); and excessive bleeding is reported. Dressings are changed according to the surgeons directions or agency protocol. Fluid intake and output, body weight, and electrolytes are carefully monitored. Hemodynamics are monitored closely; the patient is assessed for evidence of postoperative complications such as stroke, myocardial infarction, pneumonia, or atelectasis. The patient is encouraged to breathe deeply (using incentive spirometry) and to cough to prevent atelectasis and other pulmonary complications. Oral hygiene is provided, and early fluid and food intake encouraged. ...
In a study to be presented on Feb. 7 at 1:30 p.m. CST, at the Society for Maternal-Fetal Medicines annual meeting, The Pregnancy Meeting, in New Orleans, researchers will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, pain appreciation scores, and overall satisfaction in women who request for pain relief during labor.
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A loading dose is an optional clinician bolus given postoperatively or during a pain crisis to bring the pain down to a manageable level. A loading dose may be larger than subsequent on-demand bolus doses such as morphine 2.5 mg, hydromorphone 0.4 mg, or fentanyl 25 mcg.12. A bolus dose should provide clinically significant analgesia, but it should not exceed accepted starting doses if the patient is opioid-naïve. There is no validated method of anticipating opioid requirements in opioid-naïve patients, so close follow-up is essential to determine whether dose titration is necessary. Elderly patients generally require a lower dose of opioid and are at greater risk for respiratory depression compared with younger patients, so they should initially receive conservative starting doses.13 Accepted starting bolus doses include morphine 1 mg, hydromorphone 0.2 mg, and fentanyl 20 mcg.12 One of the main advantages of on-demand bolus doses is that some degree of safety is afforded by a negative ...
In 1968, Robert Wexler of Abbott Laboratories developed the Analgizer, a disposable inhaler that allowed the self-administration of methoxyflurane vapor in air for analgesia.[9] The Analgizer consisted of a polyethylene cylinder 5 inches long and 1 inch in diameter with a 1 inch long mouthpiece. The device contained a rolled wick of polypropylene felt which held 15 milliliters of methoxyflurane. Because of the simplicity of the Analgizer and the pharmacological characteristics of methoxyflurane, it was easy for patients to self-administer the drug and rapidly achieve a level of conscious analgesia which could be maintained and adjusted as necessary over a period of time lasting from a few minutes to several hours. The 15 milliliter supply of methoxyflurane would typically last for two to three hours, during which time the user would often be partly amnesic to the sense of pain; the device could be refilled if necessary.[10] The Analgizer was found to be safe, effective, and simple to administer ...
In 1968, Robert Wexler of Abbott Laboratories developed the Analgizer, a disposable inhaler that allowed the self-administration of methoxyflurane vapor in air for analgesia.[9] The Analgizer consisted of a polyethylene cylinder 5 inches long and 1 inch in diameter with a 1 inch long mouthpiece. The device contained a rolled wick of polypropylene felt which held 15 milliliters of methoxyflurane. Because of the simplicity of the Analgizer and the pharmacological characteristics of methoxyflurane, it was easy for patients to self-administer the drug and rapidly achieve a level of conscious analgesia which could be maintained and adjusted as necessary over a period of time lasting from a few minutes to several hours. The 15 milliliter supply of methoxyflurane would typically last for two to three hours, during which time the user would often be partly amnesic to the sense of pain; the device could be refilled if necessary.[10] The Analgizer was found to be safe, effective, and simple to administer ...
Health,Phoenix Arizona November 15 2004 - Researchers have reported that I...This research is a subanalysis of a broader head-to-head study publis...Researchers reported no statistically-significant differences between ... In 2002 there were more than a million gynecologic surgeries perform...,Subanalysis,finds,patient-controlled,,transdermal,pain,management,system,may,be,comparable,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Definition of patient-controlled anesthesia. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and definitions.
METHODS: Ninety patients of either sex undergoing elective spine surgery and requiring urinary catheterization were randomly assigned into three groups to receive oral solifenacin 5 mg (Group S), darifenacin 7.5 mg (Group D) and placebo (Group C) 1 hour prior to induction of anesthesia. Anesthesia technique was identical in all the groups. Catheter-related bladder discomfort (CRBD) was evaluated in 4-point scale (1 = no discomfort, 2 = mild discomfort, 3 = moderate discomfort, 4 = severe discomfort), on arrival (0 hour) and at 1, 2, and 6 hours postoperatively. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief ...
Extradural clonidine, injected in the following ways, was studied: bolus injection alone, bolus followed by continuous infusion; bolus followed by patient-controlled analgesia infusion; bolus injection of a mixed solution followed by continuous solution; a mixed solution combining clonidine with fentanyl, local anaesthetics, two or more of these drugs, and continuous infusion of clonidine and morphine. Clonidine-bolus doses ranged from 75 to 800 micrograms, and from 1 to 8 micrograms/kg, and continuous infusions ranged from 0.3 to 2.0 micrograms/kg/hour and from 10 to 50 micrograms/hour. Administration was either intra-operatively, a few minutes after induction of anaesthesia, at the beginning of the surgical procedure, 30 minutes before the end of the surgical procedure, or post-operatively on arrival in the recovery room, 1-hour after surgery, or at the patients first complaint of pain. Extra-dural catheters were inserted either thoracically or at the high and/or the low lumbar level. ...
BACKGROUND: This study was designed to compare the efficacy of prophylactic ramosetron and ondansetron in preventing postoperative vomiting in children who received fentanyl by patient-controlled analgesia after orthopedic surgery. METHODS: Two hundr
HSCT or H&NRT. We reviewed 20 studies examining We reviewed 3 discrete studies testing zinc supplementa- the use of the mucosal coating agent sucralfate in various tion in patients receiving H&NRT, all of which found a settings. The evidence supported recommendations positive effect. A new suggestion was developed in favor of against the use of sucralfate for the prevention or treat- zinc in patients with oral cancer undergoing RT or che- ment of oral mucositis in patients receiving chemotherapy moradiation.36,37 However, there is some evidence indi- and also in patients receiving H&NRT. No guideline was cating that the use of antioxidants in smokers during possible for any anesthetic agent reviewed due to inad- H&NRT may reduce the efficacy of the RT.38 The evi- equate evidence. Guidelines were developed in favor of dence reviewed supported the continuation of a recom- the use of patient-controlled analgesia with morphine, mendation against the use of intravenous glutamine for transdermal ...
This trial is a randomised, single-centre, open-label, parallel trial with target sample size of 52 in total. Eligible participants will be randomly allocated to the PCRA group (group R) or the PCIA group (group I) after admission. Participants in group R will receive ultrasound-guided subgluteal sciatic catheterisation, followed by continuous PCRA infusion (0.2% ropivacaine 15 mL as loading dose, 8 mL/hour as background with a patient-controlled bolus of 6 mL). Participants in group I will receive PCIA (morphine is given in boluses of 1 mg as needed, background infusion at 1 mg/hour). Data will be collected at baseline (T0), 2 hours before revascularisation treatment (T1) and 2 hours before discharge (T2). The primary outcomes include the Numerical Rating Scale pain score at T1 and T2. The secondary outcomes include the perioperative transcutaneous oxygen pressure, the Tissue Haemoglobin Index, Hospital Anxiety and Depression Scale at T1 and T2; the Patient Global Impression of Change and ...
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Organising Secretary-Dr Suneet Kathuria said that Management of postoperative pain relieves suffering and leads to earlier mobilisation, shortened hospital stay, reduced hospital costs, and increased patient satisfaction. Pain control regimens should be tailored to the needs of the individual patient, taking into account medical, psychological, and physical conditions including age, level of fear or anxiety, surgical procedure, personal preference and response to agents given ...
The NFL lockout has produced all sorts of crazy rumors in the past week, but heres a doozy for you. The pregnant wife of an NFL player allegedly...
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...