Regional analgesia techniques for pain management in patients admitted to the intensive care unit.
Regional analgesia techniques for pain management in patients admitted to the intensive care unit. Minerva Anestesiol. 2019 Apr 02;: Authors: Rubio-Haro R, Morales-Sarabia J, Ferrer-Gomez C, De Andrés J Abstract Controlling pain should be a priority in the clinical practice of intensive care units (ICUs). Monomodal analgesic approaches, such as the administration of opioids, are widely employed; however, the widespread use of opioids has catastrophic consequences, given their multiple side effects and the development of dependence. Regional analgesia (RA), with single or continuous dosing using neuraxial and peripheral catheters, can play an important role in multimodal analgesia for management of pain in critical care patients. RA provides superior pain control, as compared to systemic treatments, and is associated with a lower rate of side effects. Nevertheless, RA remains underused in ICUs. Many critically ill, post-surgical or traumatically injured patients would benefit from these techniques. For these reasons, we aim to establish a set of potential indications integrating the use of RA in analgesia protocols routinely used in ICUs. We performed a review of literature sources with contrasted evidence levels to present RA techniques and their potential applications in ICU patients. PMID: 30945513 [PubMed - as supplied by publisher]
Condition: Pain, Postoperative Interventions: Procedure: saphenous nerve block; Procedure: popliteal plexus block; Drug: Plain bupivacaine; Drug: 0.05 mg epinephrine Sponsor: Fayoum University Hospital Not yet recruiting
Background: Many of those aging with HIV suffer from distal neuropathic pain (DNP) due to HIV-associated sensory neuropathy (HIV-SN). Prior studies have linked chronic pain conditions to a variant of the catechol-O-methyltransferase (COMT), Val158Met. This variant confers reduced enzymatic activity and results in higher synaptic dopamine levels. Here we examined the role of Val158Met as a predictor of DNP in HIV-SN. Methods: In 1044 HIV-infected individuals enrolled in CNS HIV Antiretroviral Therapy Effects Research, an observational study across six US institutions, we characterized the relationship between Val158Met...
Written by Pendell MeyersA female in her mid 60s with history of SVT and HTN presented with sudden onset 3/10 chest tightness while lying in bed in the early morning. She had nausea and diaphoresis with this event, as well as tightness between her scapula, and a loose bowel movement.Here is her initial ECG at presentation to the ED at time zero (no prior available):What do you think?Sinus rhythm with significant downsloping STD in V1-V3, maximal in V1-V2. There is also subtle STE in V6 with large-area T-wave with straight/convex ST segment morphology. The T-waves in the inferior leads could be large if a prior ECG wer...
ConclusionsTo date the methods of placebo/sham control and blinding in RCTs have been poorly reported, leading to concerns about the validity and replicability of the findings. Important aspects that need to be clearly reported in the design of placebo ‐/sham‐controlled RCTs of SCS include the transparent reporting of stimulation programming parameters, patient position during perception threshold measurement, management of the patient handheld programmer, frequency of recharging, and assessment of the fidelity of blinding.
ConclusionIn this pioneering attempt, the document lays down structured, expert consensus-based statements to guide and align practitioners on the appropriate use of IAHA in the Indian setting.FundingDr. Reddy ’s Laboratories Ltd.
Fear of pain resonates with most people, in particular in relation to dying. Despite this, there are still people dying with unrelieved pain.
People with metastatic cancers experience poor quality of life (QoL), fatigue, and decreased physical function. Exercise improves these symptoms in the curative setting, but the efficacy and safety of exercise in the metastatic setting is uncertain.
ConclusionsOur scoping review found the majority of published articles described chiropractic services in the active duty military in the US setting. Recent RCTs suggest a benefit of including chiropractic care to usual medical care in managing back pain in active duty military. Yet despite reported benefits in Australia, Canada, and the US, there is a need for further qualitative, descriptive, and clinical trial data worldwide to inform the role of chiropractic services in active duty military.
ConclusionThe evidence obtained shows LLLT has a positive effect in controlling diabetic neuropathic pain.