Framework to Explain the Progression of Pain in Obese or Overweight Children Undergoing Tonsillectomy.

Framework to Explain the Progression of Pain in Obese or Overweight Children Undergoing Tonsillectomy. J Perianesth Nurs. 2019 Jul 12;: Authors: Martin SD, John LD Abstract An estimated 100,000 obese (OB) and overweight (OW) children undergo tonsillectomy each year in the United States. Pain management in this population is particularly challenging because of weight-based dosing, clinician fears, potential for airway obstruction, and genetic differences. A framework is proposed to explain factors involved in the post-tonsillectomy pain (PTP) experience in OB and OW children. The tonsillectomy, the body's inflammatory state, and mechanical stressors comprise influencing factors in PTP progression. Clinician-delivered medication doses, genetic variants of drug metabolism, and soothing factors serve as mediating factors in the progression of PTP. Postanesthesia care unit (PACU) nurses may use this framework to better understand PTP progression in OB and OW children. PACU nurses may manipulate certain mediating factors discussed in this framework to moderate PTP progression in OB and OW children. Researchers may use this framework to support future research to improve PTP management in OB and OW children. PMID: 31307907 [PubMed - as supplied by publisher]
Source: Journal of Perianesthesia Nursing - Category: Nursing Authors: Tags: J Perianesth Nurs Source Type: research

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A 40-year-old man was treated with tonsillectomy and underwent early surgical exploration because of bleeding. Postoperative bleeding complications were treated with bronchoscopy. In addition to obesity, normal thyroid function, type 2 diabetes mellitus, and current tobacco abuse with severe obstructive sleep apnea syndrome, biochemistry revealed severe hypercholesterolemia (total cholesterol 572 mg/dL) and hypertriglyceridemia (1,220 mg/dL). During the postoperative period, low doses of propofol (up to 2 mg/kg/h for 10 hours), along with remifentanil (up to 0.0016 mg/kg/h for 20 hours), midazolam, and tramadol, were neede...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
An estimated 100,000 obese (OB) and overweight (OW) children undergo tonsillectomy each year in the United States. Pain management in this population is particularly challenging because of weight-based dosing, clinician fears, potential for airway obstruction, and genetic differences. A framework is proposed to explain factors involved in the post-tonsillectomy pain (PTP) experience in OB and OW children. The tonsillectomy, the body's inflammatory state, and mechanical stressors comprise influencing factors in PTP progression.
Source: Journal of PeriAnesthesia Nursing - Category: Nursing Authors: Tags: Continuing Education Source Type: research
Publication date: October 2018Source: Anaesthesia Critical Care &Pain Medicine, Volume 37, Issue 5Author(s): Florence Julien-Marsollier, Pierre Salis, Rachida Abdat, Thierno Diallo, Thierry Van Den Abbelle, Souhayl DahmaniAbstractIntroductionTonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy.Material and methodsThis is a retrospective single centr...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
A 14-year-old previously healthy adolescent male patient presented at Rady Children's Hospital (San Diego, CA, USA) in July, 2016, with a history of worsening snoring, recurrent nocturnal awakenings, and daytime somnolence over an 8-month period. Notably, the patient was not overweight or obese; by contrast, he had experienced a weight loss of 7 kg during the same time period. He did not complain of nausea, vomiting, diarrhoea, abdominal pain, dysphagia, or anorexia. Physical examination revealed enlarged tonsils (grade 4, with the left tonsil enlarged more than the right) with deviation of the uvula towards the right.
Source: The Lancet Oncology - Category: Cancer & Oncology Authors: Tags: Clinical Picture Source Type: research
Tonsillectomy, one of the most painful of pediatric surgeries, is performed in more than 0.5 million children each year in the United States. The estimated yearly number of obese or overweight (OB/OW) children who undergo tonsillectomy or adenotonsillectomy (T&A) approaches 200,000. Theoretically, OB/OW children could be at risk for longer episodes of uncontrolled post-tonsillectomy pain (PTP) in the Post anesthesia care unit (PACU) due to underlying genetic and physiological processes. PACU nurses provide PTP management for OB/OW children after surgery without clear guidelines to manage weight-based differences in PTP man...
Source: Journal of PeriAnesthesia Nursing - Category: Nursing Authors: Tags: ASPAN National Conference Abstract Source Type: research
DiscussionObstructive sleep apnea syndrome (OSAS) is defined as a “disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction (obstructive apnea) that disrupts normal ventilation during sleep and normal sleep patterns.” It is different than primary snoring which is snoring without apnea, sleep arousals, or problems with gas exchange. OSAS symptoms include snoring (often with snorts, gasps or pauses), disturbed sleep (often frequent arousals) and daytime neurobehavioral problems. Sleepiness during the day can occur but is less common in...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
The yearly number of obese or overweight (OB/OW) children in the United States undergoing tonsillectomy approaches 200,000. Weight-based risk for uncontrolled post-tonsillectomy pain (PTP) may exist due to underlying genetic and physiological processes and medication administration practices. It is unknown if OB/OW children are at risk for prolonged PTP in the post anesthesia care unit (PACU) and if there are weight-based variations in medication administration. A retrospective correlational cohort study design was used to examine associations between weight status and uncontrolled PTP.
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CHICAGO (AP) — The American Academy of Pediatrics has strengthened its warnings about prescribing codeine for children because of reports of deaths and risks for dangerous side effects including breathing problems. The academy’s advice, published in a report Monday in its medical journal, Pediatrics, mirrors warnings from the Food and Drug Administration about using codeine for kids’ coughs or pain. Studies suggest it is still commonly prescribed by doctors and dentists despite the risks and lack of evidence that it works to relieve coughs. Doctors and parents should choose another remedy when possible, i...
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Abstract: Tabata, S, Suzuki, Y, Azuma, K, and Matsumoto, H. Rhabdomyolysis after performing blood flow restriction training: a case report. J Strength Cond Res 30(7): 2064–2068, 2016—Rhabdomyolysis is a serious and potentially life-threatening condition related to resistance training. Despite numerous reports of low-intensity blood flow restriction (BFR) training inducing muscle hypertrophy and increasing strength, few reports of rhabdomyolysis related to BFR training have been published. Here, we report a 30-year-old obese Japanese man admitted to our hospital the day after his first BFR training session with ...
Source: Journal of Strength and Conditioning Research - Category: Sports Medicine Tags: Technical Report Source Type: research
Conclusions: IIH may manifest as intractable N/V in the absence of headache in adults. N/V can be an isolated clinical manifestation of IIH and should be excluded when symptoms do not improve with standard therapy. A high degree of suspicion is needed to diagnose IIH without headache.Disclosure: Dr. Bouges has nothing to disclose. Dr. AlSaid has nothing to disclose. Dr. Chaudhry has nothing to disclose. Dr. Hassan has nothing to disclose. Dr. Cupler has received personal compensation for activities with Novartis and Genzyme.
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