An Effective Treatment in the Austere Environment? A Critical Appraisal into the Use of Intra-Articular Local Anesthetic to Facilitate Reduction in Acute Shoulder Dislocation
The objective of this systematic review of the literature was to determine if intra-articular local anesthetic (IAL) is an effective treatment that could have prehospital application. A methodical search of MEDLINE, PubMed, and EMBASE databases targeted publications from January 1, 1990 until January 1, 2017. Eligible articles compared IAL with other analgesic techniques in patients 16 years or older experiencing acute glenohumeral dislocation. Reduction success, complications, and patient-reported outcome measures underwent comparison. All identified publications originated from the hospital setting. Procedural success rates ranged widely among randomized control trials comparing IAL with intravenous analgesia and sedation (IAL 48–100%, intravenous analgesia and sedation 44–100%). A pooled risk ratio [RR] favored intravenous analgesia and sedation (RR 0.91, 95% confidence interval [CI] 0.84–0.98), but there was significant inconsistency within the analysis (I2 = 75%). IAL provided lower complication rates (4/170, 2%) than intravenous analgesia and sedation (20/150, 13%) (RR 1.11, 95% CI 1.04–1.19, I2 = 63%). One trial found a clinically relevant reduction in visual analogue pain scores when comparing IAL against no additional analgesia in the first minute (IAL 21±13 mm; control 49±15 mm; P<0.001) and fifth minute (IAL 10±10 mm; control 40±14 mm, P<0.001) after reduction. The results suggest that IAL is an effective in...
Does preoperative cannabinoid use have an impact on early postoperative pain in patients undergoing major orthopedic surgery?Anesthesia &Analgesia
Just wanted to give a shout out to the members of the anesthesia and pain management team at Cook County. Completed a rotation with them last month (August) and it was by far the best rotation experience I've had to date. The hands on experience and one-on-one with the residents had me feeling like I was a part of the team and actually useful (a feeling most of us can probably agree we don't often have as a medical student). Hours were good, team was great, and the experience overall was... Cook County Anesthesia elective
Conclusion: Intravenous dexmedetomidine infusion at ED50 (0.13 μg/kg) or ED95 (0.30 μg/kg) during induction for 10 min can prevent half or almost all EA after sevoflurane and remifentanil anesthesia during pediatric tonsillectomy and adenoidectomy.
Conditions: Daytime Operation; Nighttime Operation; Sleep Quality; General Anesthesia; Circadian Rhythm Sleep Disorder Intervention: Other: receiving operation during the day or at night Sponsor: Shengjing Hospital Recruiting
Conclusion. The addition of dexmedetomidine to preemptive ropivacaine wound infiltration provided a superior analgesic effect, reduced postoperative morphine consumption, and prolonged the time of the first analgesic demand with no serious side effects. Level of Evidence: 2
AbstractGlobally, chronic pain is a major therapeutic challenge and affects more than 15% of the population. As patients with painful terminal diseases may face unbearable pain, there is a need for more potent analgesics. Although opioid-based therapeutic agents received attention to manage severe pain, their adverse drug effects and mortality rate associated with opioids overdose are the major concerns. Evidences from clinical trials showed therapeutic benefits of cannabis, especially delta-9-tetrahydrocannabinol and cannabinoids reduced neuropathic pain intensity in various conditions. Also, there are reports on using co...
Back in May, Bruce Schoneboom wrapped up his appointment to the HHS Pain Management Best Practices Inter-Agency Task Force. The group determined best practices for managing chronic and acute pain—and addressed judicious prescribing of opioids. If you didn’t know: The CDC reports there are 192 overdose deaths in the U.S. every day. Forty percent of The post Dr. Bruce Schoneboom and the HHS Pain Task Force appeared first on Johns Hopkins Nursing Magazine.
In 1877, William Bates Kilbourne (1850 to 1924) of Auburn, Maine, was granted United States Patent No. 189,941 for coupling threaded hoses. A dozen years later, Kilbourne ’s trade card advertised his namesake “Pain Stop” by coupling the image of a melancholic clown, the face-painted Pierrot, with the pirouetting Columbina (upper image). The clown was forever losing his love interest, Columbina, to the unpictured trickster, Harlequin. Although Kilbourne ’s panacea was “good for internal use in small doses, and excellent for external use,” could even “Pain Stop” relieve Pierrot...
Conclusions The authors conclude that sympathetic blocks may be therapeutic in patients with complex regional pain syndrome regardless of preprocedure limb temperatures. The effects of sympathetic blocks do not predict the success of spinal cord stimulation.
Conclusions: With multiple options available for treatment of rectal prolapse, treatment recommendations remain surgeon-dependent and may be influenced by many factors. In our practice, robotic ventral mesh rectopexy was the most commonly recommended operation and was offered to carefully selected patients of advanced age. Although robotic surgery and ventral mesh rectopexy may not be accessible to all patients and surgeons, this represents a single surgeon's practice bias. This study reinforces the importance of perineal procedures for higher-risk individuals. PMID: 31525304 [PubMed - as supplied by publisher]