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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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Publication date: Available online 7 May 2018 Source:The Journal of Foot and Ankle Surgery Author(s): P. Andrew Crisologo, Erik K. Monson, Said A. Atway Postoperative pain is a problem that plagues physicians and has since the dawn of the surgical arts. Many interventions are available and used as the standard such as preoperative local anesthetic blocks, opiates, both oral and intravenous, and nonsteroidal antiinflammatory drugs. Although the temptation often exists to increase the postoperative opiate dose, opiate abuse is an increasing problem. This abuse has fueled the search for nonopiate pain adjuncts. Gabapentinoid...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
DiscussionDetermining whether ESWL is not inferior clinically and is cost-effective compared to ureteroscopic treatment as the initial management in adults with ureteric stones who are judged to require active treatment is relevant not only to patients and clinicians but also to healthcare providers, both in the UK and globally.Trial registrationISRCTN registry,ISRCTN92289221. Registered on 21 February 2013.
Source: Trials - Category: Research Source Type: clinical trials
Abstract BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epid...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSION: PAT performed in a clinic setting is both safe and efficacious with results comparative to that performed in theatre. There was no difference in post-operative complications or recurrence. Parental satisfaction to this procedure is excellent. There are significant financial advantages. Based on this data, our institution now performs all releases in an outpatient setting. PMID: 29771901 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
(Am J Obstet Gynecol. 2017;217(3):303–313) Preemptive analgesia, which may include multimodal pain management, is administered before surgery and is believed to prevent central sensitization. This can include narcotic or non-narcotic medications and may be administered in many ways. This systematic review used current studies of women receiving preemptive medication for abdominal hysterectomy, with a primary outcome of pain control. The aim was to determine the best method of pain control while decreasing narcotic consumption and adverse events.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Anesthesia Analgesia: Postoperative Analgesia Source Type: research
(Anaesthesia. 2017;72(8):1016–1028) Guidelines from both the American Society of Anesthesiologists (ASA) and the American College of Obstetricians and Gynecologists (ACOG) recommend epidural analgesia as the most effective and flexible analgesic option for labor pain management, but some laboring women have contraindications to neuraxial analgesia and others may prefer alternatives. This Cochrane systematic review analyzed the effectiveness of intravenous remifentanil patient-controlled analgesia (PCA) compared with other labor analgesia techniques as measured by patient satisfaction and adverse maternal or neonatal effects.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Editorials and Reviews Source Type: research
Patient-controlled epidural analgesia (PCEA), with or without background infusion, is commonly used to maintain labor analgesia.1 It results in greater maternal satisfaction when compared with a continuous infusion, presumably because women enjoy a certain level of control.2 Nevertheless, epidural analgesia has side effects and limiting the dose of local anesthetic (LA) may reduce some risks.3 Low concentrations of LA are now popular for epidural labor analgesia4 –6 and optimize obstetric outcomes.
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Creating a handbook for all of anesthesia is an undoubtedly daunting task. Cyprian Mendonca and Chandrashekar Vaidyanath should be congratulated for even attempting the feat with theirHandbook of Anaesthesia&Peri-operative Medicine. On one hand, it would have to cover incredibly broad topics with enough detail to be useful to a student, resident, or practicing physician. This book does cover huge swaths of content, with seven major sections totaling 37 chapters covering applied science, perioperative medicine, airway management, specialty-specific procedures, perioperative emergencies, critical care medicine, and pain ...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Neuroimaging research has demonstrated definitive involvement of the central nervous system in the development, maintenance, and experience of chronic pain. Structural and functional neuroimaging has helped elucidate central nervous system contributors to chronic pain in humans. Neuroimaging of pain has provided a tool for increasing our understanding of how pharmacologic and psychologic therapies improve chronic pain. To date, findings from neuroimaging pain research have benefitted clinical practice by providing clinicians with an educational framework to discuss the biopsychosocial nature of pain with patients. Future a...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Conclusions: The findings indicated that TENS was not superior to fentanyl for pain relief in laparoscopic surgery. It seems that the correct use of TENS parameters might merit further investigation. This trial is registered with: IRCT2016031216765N3. PMID: 29743962 [PubMed - in process]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
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