Pain management protocol implementation and opioid consumption in critical care: an interrupted time series analysis

RESUMO Objetivo: Avaliar o impacto de um protocolo de manejo da dor e redu ção do consumo de opioides no consumo geral de opioides e nos desfechos clínicos. Métodos: Estudo em centro único, quasi-experimental, retrospectivo, de coortes antes e depois. Utilizamos uma série temporal interrompida para analisar as alterações no nível e na tendência de utilização d e diferentes analgésicos. Foram usadas comparações bivariadas nas coortes antes e depois, regressão logística e regressão quantílica para estimativas ajustadas. Resultados: Incluímos 988 pacientes no período pré-intervenção e 1.838 no período pós-intervenção. O consumo de fentanil t eve ligeiro aumento gradual antes da intervenção ( β = 16; IC95% 7 - 25; p = 0,002), por ém diminuiu substancialmente em nível com a intervenção ( β = - 128; IC95% -195 - -62; p = 0,001) e, a partir de ent ão, caiu progressivamente ( β = - 24; IC95% -35 - -13; p
Source: Revista Brasileira de Terapia Intensiva - Category: Intensive Care Source Type: research

Related Links:

Abstract OBJECTIVES: To investigate racial differences in implementation of 11 evidence-based cancer pain management strategies in a matched sample of patients in hospice. SAMPLE & SETTING: 32 African American and 32 Caucasian American older adults (aged 65 years or older) with cancer pain receiving hospice care in the midwestern United States. METHODS & VARIABLES: Matched cohort secondary data analysis of postintervention data in a cluster randomized controlled trial was used. Main outcomes are the summative and individual Cancer Pain Practice Index scores. RESULTS: There were few statistic...
Source: Oncology Nursing Forum - Category: Nursing Authors: Tags: Oncol Nurs Forum Source Type: research
ConclusionMesenteric cysts represent a rare cause of intra-abdominal mass. Owing to low prevalence, literature is limited as is guidance on management. Careful pre-operative planning is essential so as to avoid operative complications. Imaging such as USS is of great importance; however Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) may be of more benefit, owing to the complex anatomical relations within which mesenteric cysts can present. Surgical excision is widely reported as the surgical treatment of choice for symptomatic cysts.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Surgery presents unique challenges in pain management for patients with chronic pain. A perioperative optimization program, starting at decision to surgery, is likely to yield the best results for this population. Perioperative optimization focuses on psychological, medical, and physical optimization. Psychological optimization includes cognitive behavior therapy, relaxation, and music therapy. Medical optimization focuses on the multimodal approaches of pharmacological adjustment and physical optimization focuses on prehabilitation and nutrition optimization. The ideal care model incorporates these optimization strategies...
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Symposium Source Type: research
CONCLUSIONS: These results support the potential of a new "opioid-sparing" approach for pain treatment, which combines CRAs with reduced doses of morphine. PMID: 32074321 [PubMed - in process]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Conclusion: CP following chest trauma is frequent and severe requiring preventive measures such as high risk patients screening, better management of acute pain, and a multidisciplinary approach for patients with diagnosed CP. PMID: 32071652 [PubMed - in process]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
In conclusion, 10 kHz SCS treatment resulted in significant pain relief in all the patients, decreased reliance on pain medication and improved lower limb sensory function in majority of patients. PMID: 32073352 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
(American Heart Association) Adding cilostazol, an antiplatelet medication for leg pain, to other drugs tended to prevent re-blockage of carotid artery stents within two years.This is the first trial to show potential effectiveness of medical management for prevention of in-stent restenosis after carotid artery stenting.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Conclusions: For one-level ACDF, the anchored cage with screws has some advantage compared to the stand-alone PEEK cage in avoiding dysphagia and restoring disc space height and cervical lordosis. We suggest the anchored spacer may be a good substitute for the stand-alone cage in one-level ACDF. Level of Evidence: Level II
Source: Current Orthopaedic Practice - Category: Orthopaedics Tags: Original Research Source Type: research
In this case study, we investigated the efficacy of mirror therapy and online counseling in the management of phantom limb pain. The patient was a 28-year-old woman who experienced phantom limb pain after a traumatic transhumeral amputation three and a half months before initiating therapy. After a 40-minute educational session with a nurse researcher experienced in pain management and surgical nursing, the patient practiced mirror therapy at home for four weeks and kept in contact with the nurse using a mobile chat application. The patient scored the intensity of her pain before and after each practice session on a 0-to-1...
Source: AJN - Category: Nursing Tags: Case in Point Source Type: research
Authors: Kushnarev M, Pirvulescu IP, Candido KD, Knezevic NN Abstract Introduction: Neuropathic pain is a chronic condition that significantly affects the quality of life of millions of people globally. Most of the pharmacologic treatments currently in use demonstrate modest efficacy and over half of all patients do not respond to medical management. Hence, there is a need for new, efficacious drugs. Evidence points toward voltage-gated sodium channels as a key target for novel analgesics.Area covered: The role of voltage-gated sodium channels in pain pathophysiology is illuminated and the preclinical and clinical ...
Source: Expert Opinion on Investigational Drugs - Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research
More News: Fentanyl | Intensive Care | Men | Pain | Pain Management | Study