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Low-dose subcutaneous ketamine for postoperative pain management in Rwanda: a dose-finding study

ConclusionAdding subcutaneous ketamine to standard analgesic measures resulted in decreases in postoperative pain scores without serious side effects. These data can be used to inform a randomized controlled trial to compare subcutaneous ketamine plus standard care with placebo plus standard care for reducing postoperative pain.
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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In recent conflicts, advances in acute pain management have been pushed to the forefront of battlefield medical care. With dramatic improvements in battlefield resuscitation, mortality rates have significantly decreased, as a result significant numbers of patients sustaining severe polytraumatic injuries must now be transported from the site of injury and, eventually, to stateside military treatment facilities. A variety of transport platforms are utilized to facilitate this mission. Continued analgesia (especially regional anesthetic techniques) during transport is a critical component of battlefield care as it decreases ...
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Symposium Source Type: research
Painful medical procedures are common. Topical anesthetics are easily applied, rapid onset, inexpensive, and avoid injection pain and needlestick injury. The aims of this study, using patient and health care provider questionnaires, were to answer the following questions: (1) Does vapocoolant spray decrease venipuncture pain? (2) Would patients be satisfied with and use a vapocoolant spray in the future? (3) Would providers be satisfied with and use a vapocoolant spray in the future? Adults (18-80  years) in a hospital emergency department (ED) were randomly assigned to sterile water placebo spray (S) (N = 5...
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-na ïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use. Patients underwent surgery with routine perioperative care, and were followed up at 90 to 120 days after surgery to determine opioid use. Factors associated with opioid use were assessed with logistic regress...
Source: Anaesthesia and Intensive Care - Category: Anesthesiology Source Type: research
We report a 69-year-old woman with bilateral diaphragmatic paralysis who underwent a laparoscopic hernia repair and an open laparotomy for reversal of a Hartmann procedure under general anesthesia. Postoperative analgesia was provided by intravenous opioid and epidural local anesthetic and opioid, respectively. The patient’s trachea was successfully extubated at the end of both surgical procedures. Epidural analgesia was associated with better pain control and shorter intensive care unit stay.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports: Case Report Source Type: research
The therapeutic effect of postherpetic neuralgia (PHN) is often disappointing and challenging. The role of intra-cutaneous injection of local anesthetic and steroids in preventing PHN remains unknown. The purpose of this study was to investigate the effect of a single intra-cutaneous injection of ropivacaine plus methylprednisolone on acute thoracic herpes zoster (HZ) pain intensity and duration, eruptive duration, and PHN incidence. A total of 97 patients with acute thoracic HZ diagnosed 1-7  days after the onset of the rash were randomly assigned to receive either 15 mL of 37.5 mg ropivacaine plus 40 mg methylpre...
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
Conclusions Foot drop is very rare after spinal anesthesia. Any suspected patient must undergo emergent neurological consultation and magnetic resonance imaging to exclude major finding and need for early surgical intervention.
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
We describe a rare case and novel management strategy of painful trigeminal neuropathy caused by an arachnoid cyst confined to Meckel ’s cave. A 57-year-old female presented with several years of progressive trigeminal pain and signs of trigeminal deafferentation, including sensory loss, corneal anesthesia and mastication muscle atrophy. Medical treatment with carbamazepine provided partial and temporary pain control. Surgical t reatment was eventually performed by aspiration of the arachnoid cyst through the foramen ovale using a percutaneous approach. The patient experienced relief of pain and improvement of numbne...
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
CONCLUSIONS: The ESP block may be a promising alternative to other interventional procedures in the management of chronic shoulder pain and deserves further study. PMID: 29134518 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Abstract PURPOSE: Postoperative pain control is often inadequate in low-income countries such as Rwanda, prompting the search for an inexpensive improvement. A randomized controlled trial was conducted to study the use of subcutaneous ketamine for the management of postoperative pain in patients undergoing major surgery in Kigali, Rwanda. METHODS: Fifty-nine patients undergoing major abdominal, head and neck, plastic, or gynecological surgeries were studied. In addition to standard care, patients received five subcutaneous injections of ketamine 1 mg·kg(-1) (ketamine group, n = 30) or normal saline (pl...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Conclusion: A TDB patch (10 μg/hour) applied 24 hours before surgery can be used as a postoperative analgesic for lumber fixation surgery without any drug-related adverse effect.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
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