Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 17.647
Filtrar
1.
Med Gas Res ; 12(2): 41-43, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34677150

RESUMO

Cytokine storm in coronavirus disease 2019 (COVID-19) patients leads to acute lung injury, acute respiratory distress syndrome, multiorgan dysfunction, shock, and thrombosis thus contributing to significant morbidity and mortality. Several agents like steroids, ascorbic acid, vitamins (C, D, E), glutathione, N-acetylcysteine have been used and several studies are underway to identify its efficacy in addressing undesirable effects due to COVID-19 illness. Among several experimental modalities based on expert opinion and anecdotal data, melatonin is one molecule that appears promising. Owing to its anti-inflammatory, anti-oxidant, and immunomodulatory properties, melatonin can be an important agent used as a component of multimodal analgesia in COVID-19 patients, suspected patients, and patients with exposure to positive patients undergoing emergency or urgent surgeries. Further research is required to know the optimal time of initiation, dose, and duration of melatonin as an adjunct.


Assuntos
Analgesia , COVID-19 , Melatonina , Síndrome da Liberação de Citocina , Humanos , Melatonina/uso terapêutico , SARS-CoV-2
2.
Am J Clin Hypn ; 64(1): 12-19, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34748465

RESUMO

Many medical conditions are claimed to benefit when hypnosis is incorporated into their treatment. For some conditions, the claims are largely anecdotal, but the treatment of pain stands out in two ways. First, there is a strong body of evidence that hypnosis can produce clinically useful analgesic effects. Second, since innocuous pain can be induced in the laboratory, the process can be explored rigorously. This idea assumes that experimentally induced pain and clinical pain behave identically. We describe using experimentally induced pain in patients already suffering from temporomandibular disorders. Scanning results indicate that the pain and its amelioration are the same in the two circumstances. Moreover, the absence of any impact upon a nociceptive trigemino-facial reflex implies that the impact of hypnosis is purely cortical. Finally, we address the observation that clinical success correlates poorly with hypnotic susceptibility scores. It is proposed that a painful experimental situation induces anxiety. This, like hypnosis, has been associated with an emphasis on right hemisphere activity. Thus, clinical anxiety may render a person more responsive to hypnosis than would be indicated by a susceptibility test delivered in stress-free circumstances.


Assuntos
Analgesia , Hipnose , Transtornos da Articulação Temporomandibular , Humanos , Hipnóticos e Sedativos , Dor , Medição da Dor , Transtornos da Articulação Temporomandibular/terapia
3.
Pain Manag ; 12(1): 105-116, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34551582

RESUMO

Total knee arthroplasty (TKA) is a common orthopedic surgery performed with a projected 3.5 million procedures to be done by 2030. Current postoperative pain management for TKA is insufficient, as it results in extensive opioid consumption and functional decline postoperatively. This study identifies the best practices for postoperative TKA pain management through a literature review of the last three years. Studies utilizing interventional techniques (local infiltration analgesia, nerve blocks) and pharmacologic options were reviewed on PubMed, Embase, Ovid Medline and Scopus. Primary outcomes analyzed were the effect of different analgesic approaches on pain reduction, opioid use reduction and improvements in functional mobility or quadriceps strength postoperatively. Additionally, this paper explores the use of cooled radiofrequency ablation, a minimally invasive therapy, for preoperative and postoperative TKA pain management.


Assuntos
Analgesia , Artroplastia do Joelho , Bloqueio Nervoso , Analgésicos Opioides/uso terapêutico , Artroplastia do Joelho/efeitos adversos , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle
4.
Rev. colomb. anestesiol ; 49(4): e501, Oct.-Dec. 2021. tab
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341246

RESUMO

Abstract Introduction: The use of intravenous lidocaine infusion has increased over the past decade as part of a multimodal approach to analgesia in adults; however, information about its safety and tolerability in the pediatric population is limited. Methods: Acute pain management using lidocaine infusion in eleven patients treated in the pediatric intensive care unit. Results: Five cases of postoperative abdominal pain and six cases of non-operative abdominal pain. Two cases were cancer patients affected by neutropenic colitis. Analgesic control achieved was good. Conclusion: Lidocaine infusions are apparently a safe option for the management of acute pain, either post-operative or not, in the pediatric population.


Resumen Introducción: El uso de la infusión de lidocaína endovenosa ha aumentado en la última década como parte de un enfoque analgésico multimodal en los adultos; sin embargo, se dispone de información limitada sobre su seguridad y tolerabilidad en la población pediátrica. Métodos: Se presentan once casos de manejo de dolor agudo con lidocaína en infusión tratados en unidad de cuidado intensivo pediátrico. Resultados: Cinco casos fueron postoperatorio abdominal y seis casos tenían dolor abdominal no postoperatorio. Dos pacientes tenían cáncer y cursaban con colitis neutropénica. El control analgésico alcanzado fue bueno. Conclusión: Las infusiones de lidocaína parecen ser una opción segura para el manejo del dolor agudo ya sea posquirúrgico o no en la población pediátrica.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Anestesia Intravenosa , Lidocaína , Cuidados Pós-Operatórios , Unidades de Terapia Intensiva Neonatal , Dor Aguda , Analgesia
5.
Rev. colomb. anestesiol ; 49(4): e500, Oct.-Dec. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341245

RESUMO

Abstract Introduction Hip fracture pain is frequently acute and disabling and increases perioperative complications in the patient; hence it requires a multimodal analgesia approach. This case series describes the continuous erector spinae plane block at the lumbar level for hip fracture analgesia. Methods A search was conducted of patients with hip fracture referred to the pain service of Hospital Universitario San Vicente Fundación (HUSVF) from August 2019 to March 2020, who had undergone continuous erector spinae plane block as part of their analgesic regimen. Results A total of 6 patients, 4 females and 2 males with an average age of 75 years were identified. A reduction in pain intensity from acute to mild or absent was observed in every case, up to 24 hours after the initial injection. 66 % experienced a relapse of severe pain after 24 hours and 2 patients the catheter functionality failed after 24 hours. One patient underwent dermatome pinprick assessment. Conclusions The continuous erector spinae plane block with a single injection provided analgesic efficacy similar to other single injection peripheral blocks, although continuous analgesia for more than 24 hours was not achieved. Some variations in the block technique described may improve the analgesic effectiveness in patients with hip fracture pain.


Resumen Introducción El dolor de la fractura de cadera suele ser fuerte e incapacitante y aumenta las complicaciones perioperatorias en el paciente, lo que hace indispensable el enfoque de analgesia multimodal. En esta serie de casos se describe la experiencia del bloqueo continuo del plano erector de la espina a nivel lumbar para analgesia en fractura de cadera. Métodos Se realizó una búsqueda de los pacientes con fractura de cadera remitidos al servicio de dolor del Hospital Universitario San Vicente fundación (HUSVF) desde agosto de 2019 hasta marzo de 2020, a quienes se les realizó bloqueo continuo del plano erector de la espina como parte de su esquema analgésico. Resultados Se encontraron 6 pacientes, 4 mujeres y 2 hombres, con una edad promedio de 75 años. Se observó reducción de la intensidad del dolor de fuerte a leve o ausente en todos los casos hasta las 24 horas posteriores a la inyección inicial. El 66 % tuvo recaída del dolor fuerte posterior a las 24 horas y en 2 pacientes no se logró funcionalidad del catéter por más de 24 horas. En un paciente se hizo evaluación dermatómica por pinprick (prueba de pinchazo). Conclusiones El bloqueo continuo del plano erector de la espina con inyección única ofreció eficacia analgésica similar a otros bloqueos periféricos en inyección única, aunque no se logró analgesia continua con el catéter por más de 24 horas. Ciertas variaciones en la técnica del bloqueo descrita podrían mejorar la efectividad analgésica en pacientes con dolor por fractura de cadera.


Assuntos
Humanos , Masculino , Feminino , Idoso , Dor , Fraturas do Quadril , Coluna Vertebral , Analgesia , Anestesia por Condução
6.
Rev. colomb. anestesiol ; 49(4): e201, Oct.-Dec. 2021. tab
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341237

RESUMO

Abstract Introduction Prostatectomy is the standard treatment for patients with clinically localized prostate cancer. Currently, robot-assisted radical prostatectomy (RARP) is widely used for its advantages, as it provides better visualization, precision, and reduced tissue manipulation. However, RARP requires a multidisciplinary approach in which anesthesia and analgesia management are especially important. Objective This study aims to describe our experience delivering anesthesia for the first cases of patients undergoing RARP in a teaching hospital in Bogotá, Colombia. Methodology An observational study was conducted. We included all patients undergoing RARP from September 2015 to December 2019 at Fundación Santa Fe de Bogotá. All patients with incomplete data were excluded. Patient demographics were recorded, and significant perioperative events were reviewed. Results A total of 301 patients were included. At our institution, the mean age for patients undergoing RARP was 61.4 ± 6.7 years. The mean operative time was 205 ± 43 min and mean blood loss was 300 [200400] mL. Only 6 (2%) patients required transfusion. Age and BMI were not associated with clinical outcomes. Conclusions An adequate perioperative approach in RARP is important to minimize complications, which in this study and in this institution were infrequent.


Resumen Introducción La prostatectomía es el tratamiento estándar para pacientes con cáncer de próstata localizado. Actualmente, la prostatectomía radical asistida por robot es ampliamente utilizada por sus ventajas en visualización, precisión y manipulación de los tejidos. Sin embargo, este abordaje requiere un manejo multidisciplinario, pues el enfoque analgésico y anestésico es fundamental para optimizar los desenlaces. Objetivo Describir los primeros casos de prostatectomía radical asistida por robot realizadas en un hospital universitario de cuarto nivel en Bogotá, Colombia. Metodología Estudio observacional en el cual se incluyeron todos los pacientes sometidos a prostatectomía radical asistida por robot (PRAR) en el hospital Fundación Santa Fe de Bogotá entre septiembre de 2015 y diciembre de 2019. Se excluyeron los pacientes con historia clínica incompleta. Se registraron los datos demográficos y se revisaron los eventos perioperatorios importantes. Resultados Se analizaron 301 pacientes. La edad media de pacientes sometidos a PRAR fue 61,4 ± 6,7 años. El tiempo quirúrgico promedio fue 205 ± 43 minutos y la pérdida sanguínea media fue 300 [200-400] mL. Solo 6 pacientes (2 %) requirieron transfusión. La edad y el IMC no mostraron una asociación relevante con los desenlaces clínicos. Conclusiones El adecuado abordaje perioperatorio en PRAR es importante para minimizar las complicaciones, las cuales en este estudio y en esta institución fueron infrecuentes.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia , Cirurgia Endoscópica por Orifício Natural , Procedimentos Cirúrgicos Robóticos , Anestesia Geral , Neoplasias da Próstata , Estudos Observacionais como Assunto , Analgesia
7.
Acta Ortop Mex ; 35(2): 169-173, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34731918

RESUMO

INTRODUCTION: Total knee arthroplasty (TKA) is one of the most successful orthopedic treatments, however, it has been associated with severe postsurgical pain in 30-60% of patients. We propose that infiltration of the articular capsule of the knee during surgery will decrease postsurgical pain. MATERIAL AND METHODS: Experimental, randomized, double-blind study in patients undergoing unilateral TKA between April 2018 and January 2019. Patients were divided into two groups, the first infiltration with placebo and the second with anesthetic solution and adjuvants (fentanyl, epinephrine and ketorolac). Pain was measured with the visual analog scale (VAS) at 4, 6, 8, 12, 18, 24, 36 and 48 hours postsurgical, as well as the consumption of opioid analgesics and antiemetics. RESULTS: 20 patients in each group, with a follow-up of 4 weeks. There were no significant differences in demographic characteristics between the two groups. Better control of postsurgical pain was observed in the group that received infiltration with anesthetic and adjuvant, as well as a decrease in the consumption of opioid analgesics and antiemetics. There was no difference in bleeding or in the incidence of infections between the two groups. CONCLUSION: Peri-capsular infiltration is a safe and effective method, as part of multimodal analgesia in total knee arthroplasty, as it decreases postsurgical pain, opioid and antiemetic use and does not increase postsurgical bleeding.


Assuntos
Analgesia , Artroplastia do Joelho , Analgésicos Opioides/uso terapêutico , Anestésicos Locais , Método Duplo-Cego , Humanos , Manejo da Dor , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle
8.
Acta Clin Croat ; 60(2): 309-313, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34744283

RESUMO

The ultrasound-guided erector spinae plane (ESP) block is a novel interfascial plane block technique providing analgesic effects in different localizations of the body, in accordance with the level of administration. Although ESP block is usually performed in the thoracic region in pediatric patients, it is possible to achieve ESP block in the lumbar region as well. Postoperative pain management is essential in patients undergoing operative hip treatment, one of the most common procedures in pediatric orthopedic surgery. We report on a case of effective intraoperative analgesia achieved by ultrasound-guided lumbar ESP block and another case of effective intra- and postoperative analgesia accomplished with perineural catheter placement in addition to lumbar ESP block, both performed in children surgically treated for developmental hip disorders.


Assuntos
Analgesia , Bloqueio Nervoso , Cateteres , Criança , Humanos , Dor Pós-Operatória/prevenção & controle , Músculos Paraespinais
9.
Rev Med Chil ; 149(6): 864-872, 2021 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-34751345

RESUMO

BACKGROUND: The appropriate use of analgesia, sedation, neuromuscular blockade and the diagnosis and prevention of delirium (ASBD) are associated with better outcomes in critically ill patients at Intensive Care Unit (ICUs). AIM: To know the practices about analgesia, sedation, delirium, and neuromuscular blockade use among healthcare professionals working in adult ICUs in Chile. MATERIAL AND METHODS: An electronic survey was sent to 812 professionals working in ICUs using a previously published instrument, which was adapted and authorized by the author. RESULTS: We received 278 surveys. Fifty two percent of respondents were physicians, 34% nurses and 11% physical therapists. Their age ranged between 30 and 39 years in 43% and was over 50 years in 9%. Eighty four percent evaluated pain routinely, but only 26% use a validated scale. Sedation was routinely evaluated with a validated scale and 73% referred to have a protocol. Neuromuscular block is seldom used, and little monitoring occurs (43%). Delirium is routinely evaluated by 48% of respondents, usually using the CAM-ICU scale. CONCLUSIONS: There is a heterogeneous adherence to the ASBD recommended practices. The main gaps are in the assessment of pain, monitoring of neuromuscular blockade and diagnosis of delirium through validated instruments.


Assuntos
Analgesia , Delírio , Bloqueio Neuromuscular , Adulto , Chile , Cuidados Críticos , Delírio/diagnóstico , Delírio/prevenção & controle , Humanos , Hipnóticos e Sedativos , Unidades de Terapia Intensiva , Bloqueio Neuromuscular/efeitos adversos , Dor
10.
Sports Med Arthrosc Rev ; 29(4): e71-e76, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730120

RESUMO

Pain is common among athletes at all levels and the treatment of pain can be a challenging and frustrating task. The team physician needs a fundamental knowledge of analgesic strategies as it relates to athletes. It is important to understand the mechanism of action, side effect profile/associated complications, incidence of and indications for use, as well as the controversies associated with the most common analgesic medications used in sports medicine. Several "in vogue" treatment modalities, including cannabidiol, are also becoming more commonly used and are worth discussion.


Assuntos
Analgesia , Medicina Esportiva , Atletas , Humanos , Dor , Manejo da Dor
11.
Trials ; 22(1): 800, 2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34774098

RESUMO

BACKGROUND: Postoperative pain is a common problem that occurs in pediatric patients following neurosurgery which may lead to severe complications. Dexmedetomidine is a commonly used adjuvant medicine in craniotomy owing to its sedative, amnestic, analgesic, and neuroprotective properties. Besides, studies suggest that lidocaine has similar effects on sedation, analgesia, and neuroprotection. Both two adjuvants can reduce postoperative pain after neurosurgery in adults. However, it is still unknown whether dexmedetomidine or lidocaine can reduce postoperative pain in children undergoing craniotomy, and if yes, which is a better medicine choice. Therefore, we aimed to compare the effect of dexmedetomidine vs. lidocaine on postoperative pain in pediatric patients after craniotomy. METHODS/DESIGN: We will perform a randomized (1:1:1), double-blind, placebo-controlled, single-center trial. Children aged 1-12 years scheduled for craniotomy will be eligible for inclusion. The 255 recruited participants will be stratified by age in two strata (1-6 years and 7-12 years), and then each stratum will be equally randomized to three groups: group D (infusion of dexmedetomidine [intervention group]), group L (infusion of lidocaine [intervention group]), and group C (infusion of normal saline [control group]). Patients will be followed up at 1 h, 2 h, 4 h, 24 h, and 48 h after surgery. The primary outcome will be total sufentanil consumption within 24 h after surgery. DISCUSSION: In this clinical trial, we expect to clarify and compare the postoperative analgesic effect of dexmedetomidine vs. lidocaine infusion on pediatric patients undergoing craniotomy. We believe that the results of this trial will provide more choices for postoperative analgesia for the pediatric population. TRIAL REGISTRATION: Chinese ClinicalTrials.gov ChiCTR1800019411 . Registered on 10 November 2018.


Assuntos
Analgesia , Analgésicos não Narcóticos , Dexmedetomidina , Adulto , Analgésicos não Narcóticos/efeitos adversos , Criança , Pré-Escolar , Craniotomia/efeitos adversos , Dexmedetomidina/efeitos adversos , Método Duplo-Cego , Humanos , Lactente , Lidocaína/efeitos adversos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Scand J Trauma Resusc Emerg Med ; 29(1): 161, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34794486

RESUMO

BACKGROUND: As pediatric patients are typically rare among helicopter emergency medical systems (HEMS), children might be at risk for oligo-analgesia due to the rescuer's lack of experience and the fear of side effects. METHODS: In this retrospective analysis, data was obtained from the ÖAMTC HEMS digital database including 14 physician staffed helicopter bases in Austria over a 12-year timeframe. Primary missions involving pediatric trauma patients (< 15 years) not mechanically ventilated on-site were included. Analgesia was assessed and compared between the age groups 0-5, 6-10 and 11-14 years. RESULTS: Of all flight missions, 8.2% were dedicated to children < 15 years. Analgetic drugs were administered in 31.4% of all primary missions (3874 of 12,324), wherefrom 2885 were injured and non-ventilated (0-5 yrs.: n = 443; 6-10 yrs.: n = 902; 11-14 yrs.: n = 1540). The majority of these patients (> 75%) suffered moderate to severe pain, justifying immediate analgesia. HEMS physicians typically chose a monotherapy with an opioid (n = 1277; 44.3%) or Esketamine (n = 1187; 41.1%) followed by the combination of both (n = 324; 11.2%). Opioid use increased (37.2% to 63.4%) and Esketamine use decreased (66.1% to 48.3%) in children < 6 vs. > 10 years. Esketamine was more often administered in extremity (57.3%) than in head (41.5%) or spine injuries (32.3%). An intravenous access was less often established in children < 6 years (74.3% vs. 90.8%; p < 0.001). Despite the use of potent analgesics, 396 missions (13.7%) were performed without technical monitoring. Particularly regarding patient data at handover in hospital, merely < 10% of all missions featured complete documentation. Therefore, sufficient evaluation of the efficacy of pain relief was not possible. Yet, by means of respiratory measures required during transport, severe side effects such as respiratory insufficiency, were barely noted. CONCLUSIONS: In the physician-staffed HEMS setting, pediatric trauma patients liberally receive opioids and Esketamine for analgesia. With regard to severe respiratory insufficiency during transport, the application of these potent analgesics seems safe.


Assuntos
Resgate Aéreo , Analgesia , Serviços Médicos de Emergência , Médicos , Aeronaves , Áustria/epidemiologia , Criança , Humanos , Recém-Nascido , Dor/tratamento farmacológico , Dor/epidemiologia , Dor/etiologia , Sistema de Registros , Estudos Retrospectivos
14.
Saudi Med J ; 42(10): 1065-1071, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34611000

RESUMO

OBJECTIVES: To compare the efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block with periarticular local infiltration analgesia (LIA) to assess postoperative pain control and enhanced recovery after total knee arthroplasty (TKA). METHODS: This research was carried out at King Saud University Medical City, Riyadh, Saudi Arabia, from September 2020 to March 2021. Eighty Patients scheduled for elective unilateral TKA were randomized to receive either iPACK or periarticular LIA along with adductor canal block under spinal anesthesia. The primary outcome was postoperative pain score, and secondary outcomes included physical rehabilitation, duration of surgery, length of post-anesthesia care unit stay, hemodynamics, and length of hospital stay. RESULTS: The pain score during activity in iPACK group was significantly lower compared to LIA group at 4 hours postoperatively, but no significant difference was observed at 24 or 48 hours. The timed up and go test took significantly longer for patients in LIA group at 4, 24, and 48 hours compared to those in iPACK group. No significant differences in knee range of motion were observed between the 2 groups at any point. CONCLUSION: Based on our findings, iPACK block is an effective technique in reducing pain in the immediate postoperative period without affecting motor function, resulting in enhanced recovery following primary TKA.


Assuntos
Analgesia , Artroplastia do Joelho , Bloqueio Nervoso , Humanos , Dor Pós-Operatória , Artéria Poplítea , Equilíbrio Postural , Estudos Prospectivos , Estudos de Tempo e Movimento
15.
A A Pract ; 15(10): e01540, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34673657

RESUMO

Pain management options in neonates after thoracotomy have traditionally been limited to intravenous opioids and caudal catheters. However, because of increasing familiarity with ultrasound imaging, erector spinae and paravertebral nerve blocks are being performed more frequently. For thoracic procedures, we describe a case series of 4 neonates involving ropivacaine infusion via an extrathoracic chest wall catheter placed by the surgeon. This technique requires less time, is less invasive, does not require ultrasound, and enabled us to accomplish tracheal extubation in the operating room immediately after surgery, and decreased postoperative opioid use in the neonatal intensive care unit.


Assuntos
Analgesia , Bloqueio Nervoso , Cirurgia Torácica , Parede Torácica , Anestésicos Locais , Cateteres , Humanos , Recém-Nascido , Manejo da Dor , Dor Pós-Operatória/tratamento farmacológico , Parede Torácica/cirurgia
17.
Niger Postgrad Med J ; 28(3): 187-192, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34708705

RESUMO

Background: The most common major obstetric procedure is caesarean section (CS) and one of the greatest concerns for women after CS is to have optimal pain relief. Aim: This study aims to compare the efficacy of pentazocine + diclofenac and paracetamol + diclofenac on post-operative analgesia after CS. Methodology: This was a single-blind, randomised trial. Pregnant women that had CS were randomized into two groups. Group A received intramuscular pentazocine + rectal diclofenac postoperatively. Group B received intramuscular paracetamol + rectal diclofenac postoperatively. Post-operative pain was assessed by numeric rating scale at 1 h after the surgery, at 6 h, 12 h and 24 h. The result obtained was analysed using SPSS Version 22 and P < 0.05 was considered statistically significant. Results: The median pain scores in both groups ranged from 2 to 3 across all periods of assessment. The pain relief was slightly better in the pentazocine + diclofenac group with no significant difference in the pain score between the two groups at all periods of assessment. The satisfaction level was good in 66.3% and 69.5% of the participants in the pentazocine + diclofenac and paracetamol + diclofenac group respectively but the difference was not statistically significant (χ2 = 4.14, P = 0. 12). Nausea, vomiting and drowsiness were significantly more in the pentazocine + diclofenac combination (P < 0.001). Conclusion: Both combination of analgesics provided adequate analgesia but pentazocine + diclofenac combination had better pain relief but was more associated with side effects.


Assuntos
Analgesia , Diclofenaco , Acetaminofen/uso terapêutico , Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Cesárea/efeitos adversos , Diclofenaco/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Nigéria , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Pentazocina/uso terapêutico , Gravidez , Método Simples-Cego
18.
J Healthc Eng ; 2021: 1418281, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34691371

RESUMO

The objective of this paper is to study the curative effect of music combined with hypnosis on labor pains during childbirth. Based on the algorithm of data mining, we randomly selected 100 women who delivered babies in obstetric units from October 2020 to June 2021, set the control group and the observation group, obtained the relevant clinical data through comparison, and analyzed the value of music combined with hypnotic analgesia midwifery in obstetrics. The results showed that the number of spontaneous delivery cases in the observation group was higher than that in the control group (P < 0.05) and the delivery time in the observation group was better than that in the control group (P < 0.05). It is proved that music combined with hypnosis can effectively improve the rate of natural childbirth and shorten the overall labor time, so as to guarantee the health of mother and child.


Assuntos
Analgesia , Hipnose , Trabalho de Parto , Música , Mineração de Dados , Feminino , Humanos , Recém-Nascido , Gravidez
19.
Adv Emerg Nurs J ; 43(4): 293-302, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34699418

RESUMO

There has been a great increase in the number of diagnostic and therapeutic procedures performed in the emergency department (ED) setting over the past several decades. Most of these procedures are unscheduled, unplanned, and much more likely to be successful and result in a positive outcome when the child's pain, fear, anxiety, and movement are controlled. To promote patient quality and safety, increase the effectiveness and efficiency of care, and improve patient and caregiver satisfaction, there has been a proportionate increase in the number of pediatric procedural sedations performed in the ED. With proper education and skills verification, pediatric procedural sedation can be safely and efficaciously performed in the ED. The purpose of this article is to present an overview of pediatric analgesia, anxiolysis, and sedation to promote compassionate, evidence-based emergency care of children and optimize procedural performance and outcomes.


Assuntos
Analgesia , Sedação Consciente , Criança , Serviço Hospitalar de Emergência , Humanos , Hipnóticos e Sedativos , Dor , Manejo da Dor
20.
J Opioid Manag ; 17(5): 389-396, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34714539

RESUMO

OBJECTIVE: We evaluated the effect of the addition of 100 ng of naloxone to fentanyl-bupivacaine mixture used in thoracic paravertebral block (PVB) on the duration and the quality of post-mastectomy analgesia. DESIGN: A randomized double-blinded trial. SETTING: Oncology surgery unit. PATIENTS AND PARTICIPANTS: This study included 135 patients, aged 40-60 years of either sex presented for elective unilateral-modified radical mastectomy. INTERVENTIONS: Patients were divided randomly into three groups: group I, received 0.3 mL/kg of 0.25 percent bupivacaine; group II, received 0.3 mL/kg of 0.25 percent bupivacaine, fentanyl 50 µg, and naloxone 100 ng; group III, received 0.3 mL/kg of 0.25 percent bupivacaine and fentanyl 50 µg. MAIN OUTCOME MEASURE(S): The visual analog scale was assessed immediately post-operative, every 2 hours till 12 hours, and then every 6 hours for 24 hours; the time of first and total amount of rescue analgesia and side effects during the first 24 hours were recorded. RESULTS: Group II showed a significant prolonged analgesia with a delayed first request of rescue analgesia and lower amount of morphine (592.1 ± 14.9 minutes and 7.28 ± 7.81 mg, respectively) than groups I (127.7 ± 35.1 minutes and 19.84 ± 2.56 mg, respectively) and III (232.2 ± 9.27 minutes and 13.52 ± 1.74 mg, respectively) as p < 0.001. CONCLUSION: Using naloxone as additives in PVB has been promising and effective in controlling post-mastectomy pain.


Assuntos
Analgesia , Neoplasias da Mama , Analgésicos Opioides , Anestésicos Locais , Neoplasias da Mama/cirurgia , Bupivacaína , Método Duplo-Cego , Feminino , Fentanila , Humanos , Mastectomia , Mastectomia Radical Modificada , Naloxona , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...