Dissertations / Theses on the topic 'Analgesics Administration'
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Gregg, Elizabeth Dowing. "The relationship between analgesics administration and postoperative independence /." Staten Island, N.Y. : [s.n.], 1990. http://library.wagner.edu/theses/nursing/1990/thesis_nur_1990_gregg_relat.pdf.
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Persson, Jan. "Low dose ketamine : analgesia and side-effects in patients and volunteers /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3641-2/.
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Harmer, Michael. "The optimal mode of administration of traditional opioid analgesics for the relief of postoperative pain." Thesis, Queen Mary, University of London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300572.
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Eriksson-Mjöberg, Marianne. "Intravenous morphine after gynecological surgery : pain relief, endocrine and immune response /." Stockholm, 1997. http://diss.kib.ki.se/1997/19971107erik.
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Plesan, Aida. "Genetic factors and the role of the NMDA receptor in pain modulation and the effect of opioids /." Huddinge, 2000. http://diss.kib.ki.se/2000/91-628-4005-3/.
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Mamet, Wendy Ellen. "An examination of how critical care nurses' knowledge, attitudes, and concerns impact their administration of opoid analgesics /." Staten Island (M.S.) -- Wagner College, N.Y. : [s.n.], 1995. http://library.wagner.edu/theses/nursing/1995/thesis_nur_1995_mamet_exami.pdf.
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Crow, Lauren. "A Randomized Controlled Trial Comparing Preemptive Versus On Demand Administration of Analgesics After Mohs Surgery and Cutaneous Reconstruction." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/603591.
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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.BACKGROUND: Mohs Micrographic Surgery (MMS) affords a high cure rate for cutaneous carcinoma. OBJECTIVE: This study was designed to characterize the pain patients experience after MMS and reconstruction of the head and neck, and to determine if preemptive dosing of analgesics was superior to patient‐initiated dosing on an "as needed" basis. METHODS: A controlled trial of 200 subjects undergoing MMS and reconstruction of skin cancers on the head and neck were randomized to either receive acetaminophen at the time of discharge or to take it on an "as needed" basis. The two groups were evaluated for differences in peak pain, satisfaction with pain management, and the need for narcotic analgesic "rescue" postoperatively. RESULTS: Peak pain levels after surgery were surprisingly low and rated, on average, 2/10 using an analog pain scale. Peak pain occurred at four hours postoperatively for both subgroups and patients were satisfied with pain control 72.5% of the time. There was no significant difference in any of the parameters between the two dosing regimens. CONCLUSIONS: Mohs surgery peak pain typically occurs four hours postoperatively. Patient satisfaction with pain management was high with acetaminophen regardless of the dosing regimen. Preemptive analgesia with acetaminophen does not appear to be superior to "asneeded" regimens.
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Pimentel, Camilla B. "Use of Opioids for Pain Management in Nursing Homes: A Dissertation." eScholarship@UMMS, 2015. https://escholarship.umassmed.edu/gsbs_diss/773.
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Nursing homes are an essential yet understudied provider of cancer-related care for those with complex health needs. Nine percent of nursing home residents have a cancer diagnosis at admission, and it is estimated that one-third of them experience pain on a daily basis. Although pain management is an essential component of disease treatment, few studies have evaluated analgesic medication use among adults with cancer in this setting. Use of opioids, which are the mainstay of pain management in older adults because of their effectiveness in controlling moderate to severe pain, may be significantly related to coverage by the Medicare Part D prescription drug benefit. However, little is known about Medicare Part D’s effects on opioid use in this patient population. A limited body of evidence also suggests that despite known risks of overdose and respiratory depression in opioid-naïve patients treated with long-acting opioids, use of these agents may be common in nursing homes.
This dissertation examined access to appropriate and effective pain-related health care services among US nursing home residents, with a special focus on those with cancer. Objectives of this dissertation were to: 1) estimate the prevalence, and identify resident-level correlates, of pain and receipt of analgesic medications; 2) use a quasi-experimental research design to examine the relationship between implementation of Medicare Part D and changes in the use of fentanyl patches and other opioids; and 3) to estimate the prevalence, and identify resident-level correlates, of naïve initiation of long-acting opioids. Data on residents’ health status from the Resident Assessment Instrument/Minimum Data Set (versions 2.0 and 3.0) were linked with prescription drug transaction data from a nationwide long-term care pharmacy (January 2005–June 2007) and the Centers for Medicare and Medicaid Services (January–December 2011).
From 2006 to 2007, more than 65% of residents of nursing homes throughout the US with cancer experienced pain (28.3% on a daily basis), among whom 13.5% reported severe pain. More than 17% of these residents who experienced daily pain received no analgesics (95% confidence interval [CI]: 16.0–19.1%), and treatment was negatively associated among those with advanced age, cognitive impairment, feeding tubes, and restraints. These findings coincided with changing patterns in opioid use among residents with cancer, including relatively abrupt 10% and 21% decreases in use of fentanyl patches and other strong opioids, respectively, after the 2006 implementation of Medicare Part D. In the years since Medicare Part D was introduced, some treatment practices in nursing homes have not been concordant with clinical guidelines for pain management among older adults. Among a contemporary population of long-stay nursing home residents with and without cancer, 10.0% (95% CI: 9.4–10.6%) of those who began receiving a long-acting opioid after nursing home admission had not previously received opioid therapy. Odds of naïve initiation of these potent opioids were increased among residents with terminal prognosis, functional impairment, feeding tubes, and cancer.
This dissertation provides new evidence on pharmaceutical management of pain and on Medicare Part D’s impact on opioid use in nursing home residents. Results from this dissertation shed light on nursing home residents’ access to pain-related health care services and provide initial directions for targeted efforts to improve the quality of pain treatment in nursing homes.
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Pimentel, Camilla B. "Use of Opioids for Pain Management in Nursing Homes: A Dissertation." eScholarship@UMMS, 2004. http://escholarship.umassmed.edu/gsbs_diss/773.
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Nursing homes are an essential yet understudied provider of cancer-related care for those with complex health needs. Nine percent of nursing home residents have a cancer diagnosis at admission, and it is estimated that one-third of them experience pain on a daily basis. Although pain management is an essential component of disease treatment, few studies have evaluated analgesic medication use among adults with cancer in this setting. Use of opioids, which are the mainstay of pain management in older adults because of their effectiveness in controlling moderate to severe pain, may be significantly related to coverage by the Medicare Part D prescription drug benefit. However, little is known about Medicare Part D’s effects on opioid use in this patient population. A limited body of evidence also suggests that despite known risks of overdose and respiratory depression in opioid-naïve patients treated with long-acting opioids, use of these agents may be common in nursing homes.
This dissertation examined access to appropriate and effective pain-related health care services among US nursing home residents, with a special focus on those with cancer. Objectives of this dissertation were to: 1) estimate the prevalence, and identify resident-level correlates, of pain and receipt of analgesic medications; 2) use a quasi-experimental research design to examine the relationship between implementation of Medicare Part D and changes in the use of fentanyl patches and other opioids; and 3) to estimate the prevalence, and identify resident-level correlates, of naïve initiation of long-acting opioids. Data on residents’ health status from the Resident Assessment Instrument/Minimum Data Set (versions 2.0 and 3.0) were linked with prescription drug transaction data from a nationwide long-term care pharmacy (January 2005–June 2007) and the Centers for Medicare and Medicaid Services (January–December 2011).
From 2006 to 2007, more than 65% of residents of nursing homes throughout the US with cancer experienced pain (28.3% on a daily basis), among whom 13.5% reported severe pain. More than 17% of these residents who experienced daily pain received no analgesics (95% confidence interval [CI]: 16.0–19.1%), and treatment was negatively associated among those with advanced age, cognitive impairment, feeding tubes, and restraints. These findings coincided with changing patterns in opioid use among residents with cancer, including relatively abrupt 10% and 21% decreases in use of fentanyl patches and other strong opioids, respectively, after the 2006 implementation of Medicare Part D. In the years since Medicare Part D was introduced, some treatment practices in nursing homes have not been concordant with clinical guidelines for pain management among older adults. Among a contemporary population of long-stay nursing home residents with and without cancer, 10.0% (95% CI: 9.4–10.6%) of those who began receiving a long-acting opioid after nursing home admission had not previously received opioid therapy. Odds of naïve initiation of these potent opioids were increased among residents with terminal prognosis, functional impairment, feeding tubes, and cancer.
This dissertation provides new evidence on pharmaceutical management of pain and on Medicare Part D’s impact on opioid use in nursing home residents. Results from this dissertation shed light on nursing home residents’ access to pain-related health care services and provide initial directions for targeted efforts to improve the quality of pain treatment in nursing homes.
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Gallo, Maria L. "Nursing advocacy and the accuracy of intravenous to oral opioid conversion at discharge in the cancer patient." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003235.
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Dobrydnjov, Igor. "Perioperative effects of systemic or spinal clonidine as adjuvant during spinal anaesthesia /." Linköping : Univ, 2004. http://www.bibl.liu.se/liupubl/disp/disp2004/med859s.pdf.
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Espefält, Westin Ulrika. "Olfactory Transfer of Analgesic Drugs After Nasal Administration." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7829.
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Nasal administration of analgesics for achieving rapid pain relief is currently a topic of great interest. The blood-brain barrier (BBB) restricts access to the central nervous system (CNS) for several central-acting drugs, such as morphine and dihydroergotamine, which results in a substantial effect delay. Evidence for the olfactory transfer of drugs from the nasal cavity to the CNS after nasal administration, bypassing the BBB, is available for both animals and humans. The aims of this thesis were to study the olfactory transfer of morphine to the CNS after nasal administration, and to compare the nasal transport of analgesic drugs across nasal respiratory and olfactory mucosa. In vivo studies in rodents demonstrated that morphine is transferred via olfactory pathways to the olfactory bulbs and the longitudinal fissure of the brain after nasal administration. Further, olfactory transfer of morphine significantly contributed to the early high morphine brain hemisphere concentrations seen after nasal administration to rats. Olfactory transfer was tracked by collecting and analysing brain tissue and blood samples after right-sided nasal administration and comparing the results to the situation after i.v. administration. The olfactory transfer was also visualised by brain autoradiography. In vitro studies indicated that the olfactory mucosa should not be a major barrier to the olfactory transfer of dihydroergotamine or morphine, since transport of these drugs was no more restricted across the olfactory mucosa than across the nasal respiratory mucosa. The in vitro studies were performed using the horizontal Ussing chamber method. This method was further developed to enable comparison of drug transport across nasal respiratory and olfactory mucosa which cannot be achieved in vivo. In conclusion, these analgesic drugs showed potential for olfactory transfer, and access to the CNS by this route should be further investigated in humans, especially for the drugs with central effects that are currently under development for nasal administration.
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Espefält, Westin Ulrika. "Olfactory transfer of analgesic drugs after nasal administration /." Uppsala : Acta Universitatis Upsaliensis Acta Universitatis Upsaliensis, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7829.
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Miller, Gary L. "The Incidence of Postoperative Retching and Vomiting in the Adult Patient Undergoing Abdominal Surgery Following Intraoperative Administration of Droperidol." VCU Scholars Compass, 1985. https://scholarscompass.vcu.edu/etd/5234.
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The complication of postoperative nausea and vomiting is still one of the most common today. The potential for secondary complications associated with retching and vomiting such as aspiration pneumonitis strain of suture line with possible hemorrhage, and potential fluid and electrolyte imbalance makes prevention of retching and vomiting a primary concern in the management of the postoperative patient.
The use of antiemetic drugs to prevent or control postoperative nausea and vomiting is a long-standing practice. Droperidol, an antiemetic, routinely used since being introduced in 1963, has been found to be successful in treating postoperative nausea and vomiting. This study examines the effect of droperidol .018 mg/kg given intramuscularly one half hour prior to the end of anesthesia on postoperative emesis in the adult gynecological patient presenting for total abdominal hysterectomy.
Twelve patients were in this double-blind study, six acted as controls and six were in the experimental group. All subjects were premedicated with morphine sulfate 0.1 mg/kg and glycopyrrolate 0.2 mg, intramuscularly administered. All were induced with pentathol 4 mg/kg preceded by curare 3 mg and followed by succinylcholine 1.5 mg/kg for intubation. The subjects were maintained on isoflurane, sixty percent nitrous in oxygen, and pancuronium for relaxation. The subjects were of similar age and weight. Duration of anesthesia was similar with a mean of 2.93 hours overall.
The incidence of retching or vomiting was considered as the same result. The droperidol group had one subject retch only and another retch and vomit. This gave a 33 percent incidence of retching and vomiting. The control group had three subjects retch and vomit, giving a 50 percent incidence. The small sample size provided no statistical significance.
The results showed a trend of decreased vomiting in the adult subject presenting for total abdominal hysterectomy. The routine use of droperidol in this particular population cannot be recommended from these results.
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Galy, Alain. "La nalbuphine, pour l'analgésie post opératoire chez l'enfant, administration intra veineuse et intra rectale." Montpellier 1, 1991. http://www.theses.fr/1991MON11117.
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Hamilton, Stephanie Marie. "The Analgesic Effects of Epidural Ketamine in Dogs With a Chemically Induced Synovitis: A Comparison Between Pre - or Post - Injury Administration." Thesis, Virginia Tech, 2003. http://hdl.handle.net/10919/33143.
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The objective of this study was to determine if administering epidural ketamine before or after the induction of a sodium urate crystal synovitis provides analgesia in dogs.
In Part I, sixteen dogs were anesthetized with propofol (4 mg kg-1 intravenously). A sodium urate crystal synovitis was induced in the right stifle and allowed to develop for 12 hours. These dogs were again anesthetized with propofol and an epidural injection at the lumbosacral space of either ketamine (2 mg kg-1) or placebo (saline containing not more than 0.1 mg ml-1 benzethonium chloride) was performed. Analgesia was measured with a force platform and a numerical rating scale (NRS). Assessments were performed before and at 12, 14, 16, 18, 20 and 24 hours after the induction of synovitis. Vertical ground reaction forces were significantly decreased and numerical rating scale scores of total pain were significantly increased after the induction of synovitis in all dogs (p<0.05). No significant differences in ground reaction forces or total pain scores were measured between the ketamine and the control groups at any assessment period.
In Part II, synovitis was induced in the right stifle as described in Part I. Epidural injections at the lumbosacral space followed immediately. Analgesia was assessed at 2, 4, 6, 8, and 12 hours after the epidural injection and the induction of synovitis. Dogs that received ketamine had significantly lower NRS scores two hours after treatment (p < 0.05). NRS scores did not differ between the two treatment groups at any other evaluation. Vertical ground reaction forces did not significantly differ between treatment groups at any assessment period.
Results of this study indicate that ketamine, when administered epidurally at a dose of 2 mg kg-1 after the induction of a chemical synovitis, does not provide a significant level of analgesia. However, administration of ketamine immediately before the induction of synovitis resulted in a significantly decreased subjective pain score at two hours, but not at later evaluation periods.Master of Science
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CHAUSSERAY, GERALD. "Utilisation de la nalbuphine (nubain*) en analgesie post-operatoire pour la chirurgie viscerale pediatrique : administration controlee par le patient versus debit continu." Toulouse 3, 1993. http://www.theses.fr/1993TOU31528.
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Matthews, Ryan. "A description of practices of analgesia administration by advanced life support paramedics in the City of Cape Town." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/21187.
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Introduction: Emergency Medical Services (EMS) are ideally placed to provide relief of acute pain and discomfort. EMS frequently follow locally prescribed guidelines and have a variety of qualifications each with differing capabilities and scopes of practice. The objectives of this study are to describe prehospital pain management practices by EMS in the Western Cape, South Africa. Methods: A retrospective descriptive survey was undertaken of analgesic drug administration by advanced life support (ALS) paramedics. Patient care records (PCRs) generated in t he City of Cape Town during an 11 month period containing administrations of Morphine, Ketamine, Nitrates and 50% Nitrous Oxide/Oxygen were randomly sampled. Variables studied were drug dose, dose frequency, and route of administration, patient age, gender, disorder and call type as well as qualification and experience level of the provider. Results: A total of 530 PCRs were included (N=530). Morphine was administered in 70% (95% CI 66 - 74, n=371) of cases, Nitrates in 37 %(95% CI 33 - 41, n=197) and Ketamine in 1.7% (95% CI 1 - 3, n=9) of cases. A total of 5mg or less of Morphine was administered in 75% (95% CI 70 - 79, n=278), with the mean dose being 4mg (IQR 3 - 6). Single doses were administered in 72.2% (95% CI, 67 - 77, n=268) of Morphine administrations, 56% (95% CI, 21 - 86, n=5) of Ketamine administrations and 82% (95% CI, 76 - 87, n=161) of Nitrate administrations. Chest pain was the reason for pain management in 43% (n=226) of cases. ALS providers have a median experience level of 2 years (IQR2 - 4). Conclusion: ALS providers in the Western Cape appear to use low doses of Morphine, with most analgesia administered as a single dose. Chest pain is an important reason for drug administration in acute prehospital pain. Paramedics do not appear to be using a weight based nor a titration based strategy.
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Allen, Kellie. "The effect of timing of oral meloxicam administration on physiological responses in calves after dehorning with local anesthesia." Thesis, Kansas State University, 2013. http://hdl.handle.net/2097/15561.
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Master of ScienceDepartment of Clinical Sciences
Hans Coetzee
Dehorning is a painful husbandry procedure that is commonly performed in dairy calves. Parenteral meloxicam combined with local anesthesia mitigates the physiological and behavioral effects of dehorning in calves. The purpose of this study was to determine the influence of timing of oral meloxicam administration on physiological responses in calves after dehorning. Thirty Holstein bull calves 8- 10 weeks of age (28-70 kg) were randomly assigned to one of three treatment groups: placebo-treated control group (CONT) (n=10), calves receiving meloxicam administered orally (1 mg/kg) in powdered milk replacer 12 h prior to cautery dehorning (MEL-PRE) (n=10) and calves receiving meloxicam administered as an oral bolus (1 mg/kg) at the time of dehorning (MEL-POST) (n=10). Following cautery dehorning, blood samples were collected to measure cortisol, substance P (SP), haptoglobin, ex-vivo prostaglandin E2 (PgE2) production after lipopolysaccharide stimulation and meloxicam concentrations. Maximum ocular temperature (MOT) and mechanical nociceptive threshold (MNT) was also assessed. Data were analyzed using non-compartmental pharmacokinetic analysis and repeated measures ANOVA models. Mean peak meloxicam concentrations were 3.61 ± 0 .21 μg/mL and 3.27 ± 0.14 μg/mL with average elimination half-lives of 38.62 ± 5.87 h and 35.81 ± 6.26 h in the MEL-PRE and MEL-POST groups respectively. Serum cortisol concentrations were lower in meloxicam-treated calves compared with control calves at 4 h post-dehorning (P=0.0004). SP concentrations were significantly higher in control calves compared with meloxicam-treated calves at 120 h after dehorning (P=0.038). PgE2 concentrations were lower in meloxicam-treated calves compared with control calves (P=0.001). MNT was higher in control calves at 1 h after dehorning (P=0.02) but meloxicam-treated calves tended to have a higher MNT at 6 h after dehorning (P=0.07). There was no effect of timing of meloxicam administration on plasma cortisol concentrations (P= 0.69), SP concentrations (P=0.86), haptoglobin concentrations (P=0.86), MOT (P=0.90), or MNT (P=0.99). However, PgE2 concentrations in MEL-PRE calves were similar to CONT calves after 12h post-dehorning, while MEL-POST calves had lower PgE2 concentrations for 3 d post dehorning. These findings suggest that meloxicam reduced cortisol, SP and PgE2 after dehorning but only PgE2 production was significantly affected by the timing of meloxicam administration.
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Rennie, Anita Ellen. "Studies of chronic inflammatory pain in lambs after rubber ring castration and tail-docking : self-administration of analgesic and neurohistochemistry to validate behavioural assessment." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/29961.
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Following castration and tail-docking by rubber ring, lambs suffer from severe acute pain lasting up to 3 hours. The subsequent formation of inflammatory lesions, at the site of the ring, may be associated with chronic pain. Behaviour that has been used to assess acute pain in castrated lambs, has been associated with these lesions and validation of the use of these behaviours for assessment of chronic pain is necessary. Two approaches were used for validation. Firstly a model in which lambs could learn to self-administer analgesic was developed and used to indicate the presence of chronic pain. As lesions began to form after castration and tail-docking, lambs were given the opportunity to learn about the consequences of consuming a feed containing the non-steroidal anti-inflammatory, flunixin meglumine and an identical feed containing no drug. The lambs were then given the opportunity to choose between these feeds until the lesions healed. In the second part of this project, neurohistochemical evidence of chronic inflammatory pain was sought. In situ hybridisation histochemistry was used to seek evidence of a change in the expression of AVP and CRF mRNA in the paraventricular nucleus of the hypothalamus of lambs castrated and tail docked by rubber ring. The lesions produced in these studies were as severe as those found in lambs of the same ages in previous studies. Some evidence of ‘pain’ behaviours was found in castrated and tail-docked lambs. Despite this, no evidence that castrated and tail-docked lambs learned to self-administer analgesic was obtained despite trends observed in initial studies. In addition no neurohistochemical evidence of chronic inflammatory pain was found. This evidence suggests that any chronic pain associated with castration and tail-docking lesions is not sufficiently severe to provoke learning about the pain relieving properties of a drugged feed or to induce evidence of a chronic stress response in the HPA axis. However, it is argued that the damage to the tissue at the site of the rubber rings may have induced a local anti-inflammatory and analgesic response, which was sufficient to prevent any pain from the lesions.
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Binje, Bernard. "Analgésie par bloc axillaire continu dans les traumatismes graves de la main : auto-administration versus perfusion continue, étude prospective sur une population de 42 patients." Bordeaux 2, 1997. http://www.theses.fr/1997BOR23092.
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Steagall, Paulo Vinicius Mortensen [UNESP]. "Efeitos antinociceptivos dose-resposta e de diferentes vias de administração da buprenorfina em felinos domésticos." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/104001.
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O objetivo do estudo foi avaliar os efeitos antinociceptivos da buprenorfina em gatos, quando administrada em diferentes doses pela via intravenosa (IV), e também por diferentes vias de administração, por meio da mensuração do limiar nociceptivo térmico (LNT) e mecânico (LNM) num estudo cruzado, cego e aleatório. O estímulo nociceptivo térmico (LNT) foi realizado por meio de um dispositivo justaposto a um mangüito de pressão neonatal, posicionado ao redor do tórax do gato por uma cinta elástica. O estímulo nociceptivo mecânico foi realizado por meio de um bracelete de plástico, colocado ao redor do antebraço do gato. Na primeira fase, após as mensurações basais dos LNT e LNM, oito gatos (3,8±0,6kg) receberam buprenorfina (IV) nas doses de 0,01 (B1), 0,02 (B2) e 0,04 (B4) mg/kg. As mensurações foram feitas até 10h após cada tratamento. Na segunda fase, após as mensurações basais dos LNT, seis gatos (4,1±0,5kg) receberam buprenorfina (0,02 mg/kg) pelas vias IV, intramuscular (IM) e subcutânea (SC). As mensurações foram realizadas até 24h após cada tratamento. Na terceira fase, após as mensurações basais dos LNT e LNM, oito gatos (4,7±1,5kg) receberam buprenorfina (0,02 mg/kg) pela via epidural, por meio de uma via de acesso vascular implantada cirurgicamente antes do início do estudo. As mensurações foram realizadas até 24h após cada tratamento. Os dados foram analisados por ANOVA (P<0,05). Os LNT e LNM acima do intervalo de confiança de 95% (IC95%), gerados pelos valores basais, indicaram antinocicepção. Na primeira fase, os LNT e os LNM aumentaram significativamente entre 15min e 4h (LNT) após B1, entre 15min e 2h e aos 15 e 45min após B2, e entre 15min e 8h, exceto às 4h, e entre 30min e 2h, após B4, respectivamente. Aos 45min, os LNM foram significativamente maiores em B2 quando comparados a B1. As médias dos LNT e dos LNM ficaram...
The aim of this study was to evaluate the antinociceptive effects of buprenorphine in cats after intravenous (IV) administration of different doses and after different routes of administration, by means of measuring thermal (TT) and mechanical (MT) nociceptive thresholds, in a randomized, blinded and crossover study. Thermal stimulation was given via a probe, attached to an elasticated band and positioned around the cat’s thorax with an inflated modified neonatal cuff. Mechanical stimulation was given via a plastic bracelet with a modified neonatal cuff, taped around the cat’s antebrachium. In the first phase, after MT and TT baseline recordings, eight cats (3.8±0.6kg) were given 0.01 (B1), 0.02 (B2) and 0.04 (B4) mg/kg of buprenorphine IV. Thresholds were measured until 10h after administration of treatments. In the second phase, after TT baseline recordings, buprenorphine (0.02 mg/kg) was administered to six cats (4.1±0.5kg) by the IV, intramuscular (IM) and subcutaneous (SC) routes. Threshold measurements were performed up to 24h after treatments. In the third phase, after TT and MT baseline recordings, eight cats (4.7±1.5kg) received buprenorphine (0.02 mg/kg), through a vascular access port that had been surgically implanted in the epidural space. TT and MT were measured up to 24h after each treatment. Data were analyzed by ANOVA (P<0.05). A 95% confidence interval (IC95%) was generated by the baseline values. Thresholds above IC95% indicated antinociception. In the first phase, compared to baseline, TT were significantly increased between 15min and 4h after B1, between 15min and 2h after B2, and between 15min and 8h, expect at 4h, after B4. MT was significantly increased at 15 and 45min after B2 and between 30min and 2h after B4. At 45min, MT were significantly higher in B2 compared to B1. Mean TT were above the IC95% from 15min to 10h in all groups. Mean MT were... (Complete abstract click electronic access below)
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Gaume-Bonnemaison, Julie. "Intérêt de l'analgésie autocontrôlée à la morphine à la phase aigue͏̈ des traumatismes thoraciques." Bordeaux 2, 1998. http://www.theses.fr/1998BOR23027.
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Denoyer, Laurence. "L'analgésie par voie transdermique." Paris 5, 1998. http://www.theses.fr/1998PA05P030.
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Arantes, Viviana Moraes Neder. "Analgesia preemptiva do cetoprofeno e do parecoxibe em cirurgia para remoção de terceiros molares inclusos." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5152/tde-29012007-153432/.
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Este trabalho prospectivo, duplo-cego randomizado, avaliou o efeito da analgesia preemptiva do cetoprofeno e do parecoxibe. Sessenta pacientes foram submetidos à cirurgia para remoção de terceiros molares inferiores bilaterais inclusos, sendo operado um lado de cada vez. O paciente foi seu próprio controle. Os pacientes foram separados em dois grupos de 30 pacientes. No grupo parecoxibe, na primeira operação foi usado o parecoxibe ou placebo, endovenoso, 30 minutos antes da cirurgia e imediatamente após a operação foi feita a administração do placebo ou parecoxibe, garantindo ao paciente receber parecoxibe antes ou após a operação. O lado oposto foi operado após duas semanas da primeira cirurgia e o paciente que havia recebido parecoxibe antes e placebo depois da operação recebeu placebo antes e parecoxibe depois da operação e o que havia recebido placebo antes e parecoxibe depois recebeu parecoxibe antes e placebo depois. Nos 30 pacientes do grupo cetoprofeno, o modelo foi o mesmo, substituindo-se apenas o parecoxibe pelo cetoprofeno. O paciente pôde utilizar como medicação resgate a dipirona, sempre que necessário para controlar a dor pós-operatória. Após a operação foi fornecido para todos os pacientes um questionário, contendo a escala analógica visual (EAV), a escala descritiva de dor (EDD) e uma tabela para informar o consumo de medicação resgate. Foi avaliada a dor pós-operatória por meio da EAV, da EDD e pelo consumo de medicação resgate. Não houve diferença estatisticamente relevante quanto a intensidade da dor com o uso do parecoxibe ou do cetoprofeno antes ou depois do procedimento cirúrgico. Ao comparar a analgesia proporcionada pelo cetoprofeno e pelo parecoxibe os resultados mostraram que o parecoxibe administrado antes do procedimento cirúrgico foi mais eficaz do que o cetoprofeno no controle da dor na quarta hora do pós-operatório (p=0,041), mas foi menos eficaz após 24h (p=0,003). Quando se comparou a analgesia proporcionada por esses fármacos usados após a operação, o parecoxibe foi mais eficaz do que o cetoprofeno após 6 e 8h do procedimento (p=0,003 e 0,023, respectivamente).This is a prospective, double-blind randomized, cross over experiment, to evaluate the effect of the preemptive analgesia of ketoprofen and parecoxib. Sixity patients who had gone though surgery for removal of the impacted mandibular bilateral third molar teeth, having one side operated each time, were evaluated. The patients were separated in groups of 30, in the parecoxib group (P). On the first operation parecoxib or placebo were used 30 minutes before the surgery. Immediately after the operation, placebo or parecoxib were administred, so that the patient who had received parecoxib before the operation or after it. The opposite side was operated two weeks after the first surgery and the patients who received parecoxib before and placebo after operation received placebo before and parecoxib after operation and patients who received placebo before and parecoxib after received parecoxib before and placebo after, under the same method. In the group C (n= 30), the model was the same, using ketoprofen instead parecoxib. The patient could use dipyrone as rescue medication, in the event of postoperative pain. A questionnaire was provided to the patient after each surgery, containing a visual analogic scale, a descriptive pain scale and a table to inform the consum of rescue medication. The postoperative pain was evaluated by visual analogic scale, descriptive pain scale and rescue medicine consum. There was no statistically relevant difference as pain intensity with use of parecoxib or ketoprofen before or after the surgical procedure. Comparing ketoprofen analgesia against parecoxib analgesial, the results shown that the administration of parecoxib before the surgical procedure had a major efficacy than ketoprofen in pain control by the fourth hour post operatory (p=0,041), but was less efficient after 24 hours (p=0,003). When comparing the analgesic effect of both drugs after the operation, parecoxib was more effective than ketoprofen six and eight hours after the procedure (p=0,003 and 0,023, respectively).
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Steagall, Paulo Vinicius Mortensen. "Efeitos antinociceptivos dose-resposta e de diferentes vias de administração da buprenorfina em felinos domésticos /." Botucatu : [s.n.], 2009. http://hdl.handle.net/11449/104001.
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Orientador: Stelio Pacca Loureiro LunaBanca: André Leguthe
Banca: Renata Navarro Cassu
Banca: Juliana Brondani
Banca: Guilherme Barros
Resumo: O objetivo do estudo foi avaliar os efeitos antinociceptivos da buprenorfina em gatos, quando administrada em diferentes doses pela via intravenosa (IV), e também por diferentes vias de administração, por meio da mensuração do limiar nociceptivo térmico (LNT) e mecânico (LNM) num estudo cruzado, cego e aleatório. O estímulo nociceptivo térmico (LNT) foi realizado por meio de um dispositivo justaposto a um mangüito de pressão neonatal, posicionado ao redor do tórax do gato por uma cinta elástica. O estímulo nociceptivo mecânico foi realizado por meio de um bracelete de plástico, colocado ao redor do antebraço do gato. Na primeira fase, após as mensurações basais dos LNT e LNM, oito gatos (3,8±0,6kg) receberam buprenorfina (IV) nas doses de 0,01 (B1), 0,02 (B2) e 0,04 (B4) mg/kg. As mensurações foram feitas até 10h após cada tratamento. Na segunda fase, após as mensurações basais dos LNT, seis gatos (4,1±0,5kg) receberam buprenorfina (0,02 mg/kg) pelas vias IV, intramuscular (IM) e subcutânea (SC). As mensurações foram realizadas até 24h após cada tratamento. Na terceira fase, após as mensurações basais dos LNT e LNM, oito gatos (4,7±1,5kg) receberam buprenorfina (0,02 mg/kg) pela via epidural, por meio de uma via de acesso vascular implantada cirurgicamente antes do início do estudo. As mensurações foram realizadas até 24h após cada tratamento. Os dados foram analisados por ANOVA (P<0,05). Os LNT e LNM acima do intervalo de confiança de 95% (IC95%), gerados pelos valores basais, indicaram antinocicepção. Na primeira fase, os LNT e os LNM aumentaram significativamente entre 15min e 4h (LNT) após B1, entre 15min e 2h e aos 15 e 45min após B2, e entre 15min e 8h, exceto às 4h, e entre 30min e 2h, após B4, respectivamente. Aos 45min, os LNM foram significativamente maiores em B2 quando comparados a B1. As médias dos LNT e dos LNM ficaram... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The aim of this study was to evaluate the antinociceptive effects of buprenorphine in cats after intravenous (IV) administration of different doses and after different routes of administration, by means of measuring thermal (TT) and mechanical (MT) nociceptive thresholds, in a randomized, blinded and crossover study. Thermal stimulation was given via a probe, attached to an elasticated band and positioned around the cat's thorax with an inflated modified neonatal cuff. Mechanical stimulation was given via a plastic bracelet with a modified neonatal cuff, taped around the cat's antebrachium. In the first phase, after MT and TT baseline recordings, eight cats (3.8±0.6kg) were given 0.01 (B1), 0.02 (B2) and 0.04 (B4) mg/kg of buprenorphine IV. Thresholds were measured until 10h after administration of treatments. In the second phase, after TT baseline recordings, buprenorphine (0.02 mg/kg) was administered to six cats (4.1±0.5kg) by the IV, intramuscular (IM) and subcutaneous (SC) routes. Threshold measurements were performed up to 24h after treatments. In the third phase, after TT and MT baseline recordings, eight cats (4.7±1.5kg) received buprenorphine (0.02 mg/kg), through a vascular access port that had been surgically implanted in the epidural space. TT and MT were measured up to 24h after each treatment. Data were analyzed by ANOVA (P<0.05). A 95% confidence interval (IC95%) was generated by the baseline values. Thresholds above IC95% indicated antinociception. In the first phase, compared to baseline, TT were significantly increased between 15min and 4h after B1, between 15min and 2h after B2, and between 15min and 8h, expect at 4h, after B4. MT was significantly increased at 15 and 45min after B2 and between 30min and 2h after B4. At 45min, MT were significantly higher in B2 compared to B1. Mean TT were above the IC95% from 15min to 10h in all groups. Mean MT were... (Complete abstract click electronic access below)
Doutor
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Miao, Lei. "Synthesis of Amphibian Alkaloids and Development of Acetaminophen Analogues." ScholarWorks@UNO, 2009. http://scholarworks.uno.edu/td/985.
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The focus of these studies has been toward the development of new synthetic methods and procedures for the synthesis of novel compounds with unique biological properties. This research has led to the development of two new synthetic strategies for the construction of two novel amphibian alkaloids. In addition, the efforts have led to the large-scale process for the preparation of a novel analgesic compound. The regioselective ring opening of lactones (δ-valerolactone and γ-butyrolactone) with aryllithium reagents is reported for the construction of a series of δ-hydroxyarylketones and γ-hydroxyarylketones. Both the R and S enantiomers of the amphibian alkaloid noranabasamine were prepared in >30% overall yield with 80% ee and 86% ee, respectively. An enantioselective iridium-catalyzed N-heterocyclization reaction with either (R)- or (S)-1-phenylethylamine and 1-(5-methoxypyridin-3-yl)-1, 5-pentanediol was employed to generate the 2-(pyridin-3-yl)-piperidine ring system in 69-72% yield. A cis-2, 5-disubstitued pyrrolidine building block derived from (-)-Cocaine•HCl was prepared. We utilized this compound as a chiral building block for the formal synthesis of (+)-gephyrotoxin. Using this pyrrolidine building block, Kishi's intermediate was obtained enantiospecifically in 15 steps and 9.4% overall yield. A large-scale process for the preparation of the analgesic compounds SCP-123 and its sodium salt, SCP-123ss•monohydrate has been developed. The process for the preparation of SCP-123 required three synthetic steps with no chromatography, while the process for the preparation of SCP-123ss required four synthetic steps and no chromatography. The overall yields for both SCP-123 and SCP-123ss were 47% and 46%, respectively, and both compounds were obtained in exceptionally high purity (>99%).
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Oliveira, Carlos Augusto Cardim de. ""Prática de medicina baseada em evidências em um centro de tratamento intensivo pediátrico"." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-13082005-173825/.
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Objetivos: Estimar a concordância entre as práticas e as evidências disponíveis em uma unidade de terapia intensiva pediátrica. Métodos: Estudo retrospectivo de todos os pacientes internados durante 2001. As práticas foram classificadas em adequadas ou não-adequadas de acordo com recomendações. Esperava-se para as práticas recomendadas 90% de concordância, para as contra-indicadas, discordância de até 10% e para aquelas onde havia incertezas, 50%. Resultados: Foram selecionadas 114 publicações e avaliadas 253/275 internações (92%). O uso foi considerado apropriado para albumina em 47,6% (IC 95% 39% 55%); dopamina <3mg/kg/min 87,9% (83% 92%); sedação e analgesia 88,6% (87% 90%); transfusões de concentrado de hemácias 95,2% (92% 97%); profiliaxia de úlcera de estresse 89,7% (88% 91%).Objectives: Estimate the concordance between the practices and the evidence available in a pediatric intensive care unit. Methods: Retrospective study of all admitted patients during 2001. The practices were classified as adequate or non-adequate according to recommendations. It was expected 90% concordance for the recommended practices, while for non-adequate practices, discordance until 10% and for those where there was doubt, 50%. Results: 114 publications were selected and 253/275 admissions (92%) were evaluated. Use was considered appropriate for albumin in 47.6% (IC 95% 39% 55%); dopamine <3mg/kg/min 87.9% (83% 92%); sedation and analgesia 88.6% (87% 90%); red blood cell transfusions 95.2% (92% 97%); stress ulcer prophylaxis 89.7% (88% 91%).
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Sarment, Sylvie A. "A prospective comparison of the effects of preemptive administration of acetaminophen and ibuprofen on pain following orthodontic separation a thesis submitted in partial fulfillment ... for the degree of Master of Science in Orthodontics ... /." 2003. http://catalog.hathitrust.org/api/volumes/oclc/68962685.html.
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Wang, Mao-Hsien, and 王茂賢. "A Study of Patient Controlled Analgesia and Strategy for the Medical Administration." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/83477622487272369061.
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碩士國立臺灣大學
會計與管理決策組
99
Background: The national health insurance is a blessing for the people of Taiwan! However, it challenges the management of the medical administration. The national health insurance is based on the structure of the foregoing labor insurance system which is a history now. Under the previous system, the bureau began to manage the total budget of national health insurance with discount of the point value and decreasing the discrepancy of the drug’s price. The running of a regional hospital becomes much more difficult! In our opinion, searching for the medical market of self-expense is important for the lasting of national health insurance system and the quality of medical institution. Purpose: Patient controlled analgesia (PCA) is a self-expense medical service in Taiwan. PCA should utilize a specific machine and intravenous set bundled with. New machine of PCA increases the cost of the PCA system. By working on this issue, we have marked up the price of PCA service to maintain to profit. In this study, we would like to investigate the market share and probe into the behavior of the patient for the PCA system. By providing better medical service, we hope that we can have some discovery in this study. Methods: We have sampled 66 patients from a regional teaching hospital in northern Taiwan. The method of PCA is by intravenous route. All the patients are ASA class I or class II. The items of census include gender, insurance, residency, income, body weight, body height, surgery and functionary. The census is completed at pre-anesthetic consultation except visual analogue score (VAS). The VAS is evaluated at day 0 and day 1 after the surgical operation. Results: According to the results of the linear regression, PCA has strong relations with the decreasing VAS. It interprets that PCA is effective on postoperative pain control. The operations of joint replacement and thoracotomy have higher ratio of applying PCA than others. We conclude that patients received these operations should have a PCA service. Chi-Square shows no significance about gender, functionary, age, insurance, incomes and residency. Strategy: After mark-up of PCA service, we find that the number of service keeps the pace as usual. A strategy for the medical administration might be the following: Ongoing the current pricing strategy is possible. Statistically, thoracotomy is highly related with PCA. Enforce the PCA service for the patient receiving major operation should have the positive meaning for developing the intensive medicine. Strategically, the developing of intensive medicine should be encouraged by the promotion of PCA service. By promotion of PCA, we encourage the surgery of joint replacement. The patient will not be afraid of post-operative pain to reject the operation. It will be a win-win situation. We should discuss the cost of PCA to adjust the pricing respectively and hope to provide better medical service. After all, the best control of cost is higher quality of medical service.
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Patil, S. S., E. Venugopal, S. Bhat, K. R. Mahadik, and Anant R. Paradkar. "Microstructural elucidation of self-emulsifying system: effect of chemical structure." 2012. http://hdl.handle.net/10454/6124.
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PURPOSE: Self-emulsifying systems (SES) emulsify spontaneously to produce fine oil-in-water emulsion when introduced into aqueous phase. The self-emulsification process plays an important role during formation of emulsion. The objective of current work was to understand and explore the inner structuration of SES through controlled hydration and further to study the influence of additive on the same which ultimately governs performance of final formulation in terms of droplet size. METHODS: Droplet size of final formulations containing structural analogues of ibuprofen was determined. Microstructural properties of intermediate hydrated regimes of SES were investigated using techniques such as small angle X-ray scattering, differential scanning calorimetry and rheology. RESULTS: The current work established inverse relationship between droplet size of the formulations containing structural analogues of ibuprofen and their Log P values. Microstructural analysis of intermediate hydrated regimes of the prepared samples showed formation of local lamellar structure. Structural analogues of ibuprofen significantly altered microstructure of lamellae which was well correlated with the droplet size of final formulations. In vitro drug release study showed increase in dissolution rate of lipophillic drugs when formulated as SES. CONCLUSION: The current work emphasizes the fact that tailor-made formulations can be prepared by controlling the properties of intermediate regimes.