Academic literature on the topic 'Anesthesia and Analgesia'
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Journal articles on the topic "Anesthesia and Analgesia"
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Furumoto, Kayo, Kumi Ogita, Tomomi Kamisaka, Asami Kawasumi, Koushi Takata, Noritaka Maeta, Takamasa Itoi, Masakatsu Nohara, Kaori Saeki, and Teppei Kanda. "Effects of Multimodal Analgesic Protocol, with Buprenorphine and Meloxicam, on Mice Well-Being: A Dose Finding Study." Animals 11, no. 12 (November 30, 2021): 3420. http://dx.doi.org/10.3390/ani11123420.
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The anesthetic or analgesic agent of choice, route and frequency of anesthetic or analgesic administration, and stressors induce distress during the perioperative period. We evaluated a multimodal analgesic protocol using buprenorphine and meloxicam on the well-being of mice. Twenty-four Slc:ICR male mice were divided into control, anesthesia + analgesia, and surgery + anesthesia + analgesia groups. Tap water (orally: PO) and water for injection (subcutaneous: SC) were administered to the control group. Buprenorphine was administered twice (SC, 0.1 mg/kg/8 h) and meloxicam was administered thrice (PO, 5 mg/kg/24 h) to the anesthesia + analgesia and surgery + anesthesia + analgesia groups. The mice were subjected to laparotomy and assessed for several parameters. Even in absence of surgical pain, the anesthesia + analgesia group presented the same negative effects as the surgery + anesthesia + analgesia group. This multimodal analgesic protocol for mice was expected to have an analgesic effect on pain associated with laparotomy but was not sufficient to prevent food intake and weight decrease. This does not negate the need to administer analgesics, but suggests the need to focus on and care not only about the approach to relieve pain associated with surgery, but also other types of distresses to minimize negative side effects that may interfere with postoperative recovery in mice.
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Tkachenko, R. O. "Modern anesthesia in obstetrics as a component of the concept of safe anesthesia." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 280–82. http://dx.doi.org/10.32902/2663-0338-2020-3.2-280-282.
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Background. Anesthesia should be selected individually for each labor. Systemic analgesia of labor includes suggestive analgesia, narcotic analgesics, local infiltration and regional blockade, inhalation analgesia. It should be noted that there is no analgesic, sedative or local anesthetic that does not penetrate the placenta, affecting the fetus in any way.
Objective. To describe modern anesthesia in obstetrics.
Materials and methods. Analysis of literature sources on this issue.
Results and discussion. Three groups of antispasmodics are used for analgesia: neurotropic (atropine, scopolamine), myotropic (papaverine, drotaverine) and neuromyotropic (baralgin). The main non-steroidal anti-inflammatory drugs used for this purpose include metamizole sodium, ketorolac tromethamine, diclofenac sodium. Inhalation autoanalgesia with nitrous oxide (N2O) is effective only in 30-50 % of women. When the concentration of N2O exceeds 50 %, the sedative effect increases and oxygenation decreases, which leads to the loss of consciousness and protective laryngeal reflexes. Such analgesia is indicated for low-risk patients who have refused from regional anesthesia. Epidural anesthesia (EDA) is the gold standard of labor anesthesia. The advantages of EDA include the option to change the degree of analgesia, the ability to continue pain relief until the end of labor and the minimal impact on the condition of both child and mother. Before manipulation, be sure to determine the platelet count and heart rate of the fetus. It is recommended to start EDA in the latent stage of labor. In patients with uterine scarring, early EDA is a mandatory component of medical care. The woman’s wish is the main indication for EDA. Indications for early catheterization of the epidural space include the presence of twins, preeclampsia, obesity, respiratory tract with special features. Headache is the most common complication of EDA. The use of pencil-point spinal needles minimizes the frequency of this complication. Adequate analgesia for uncomplicated labor should be performed with minimal concentrations of anesthetics with the least possible motor block. Local anesthetics (lidocaine, bupivacaine (Longocaine, “Yuria-Pharm”), ropivacaine) are used for EDA). Combined spinal-epidural anesthesia provides a rapid effect and long-term analgesia. For this purpose, 0.25 % Longocaine heavy (“Yuria-Pharm”) 2 mg and fentanyl 20 μg are administered intrathecally, followed by 0.225 % Longocaine 10 mg and fentanyl 20 μg epidurally. The technique of epidural dural puncture is a modification of combined spinal-epidural anesthesia. This technique improves the caudal spread of analgesia compared to the epidural technique without the side effects seen with spinal-epidural anesthesia. The ideal local anesthetic should be safe for both mother and fetus, provide sufficient analgesia with minimal motor block, and not affect labor process. A single spinal injection of opioids may be effective, but it should be limited in time. The use of systemic opioids during labor increases the need for resuscitation of newborns and worsens the condition of their acid-base balance compared to basic regional anesthesia. Catheter techniques can be used in case of the increased labor duration. Nalbuphine (“Yuria-Pharm”), which eliminates the side effects of regional anesthesia, can also be successfully used. Analgesic effect of paracetamol (Infulgan, “Yuria-Pharm”) in case of intravenous administration exceeds the analgetic effect of tramadol, and the effect on the newborn condition according to the Apgar scale does not differ (Meenakshi et al., 2015). Paracetamol (Infulgan) is moderately effective for perineal pain on the first day after delivery. The possibility of use during lactation is an another advantage of paracetamol.
Conclusions. 1. Pain during labor is an extremely stressful factor, so women should have access to quality analgesia and anesthesia. 2. There is no analgesic, sedative or local anesthetic that does not penetrate the placenta, affecting the fetus. 3. EDA is the gold standard of labor anesthesia. 4. Combined spinal-epidural anesthesia provides rapid effect and long-term analgesia. 5. The use of systemic opioids during labor increases the need for resuscitation of newborns and worsens the condition of their acid-base balance. 6. Nalbuphine and Infulgan have been used successfully for labor pain relief.
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Sekulovski, M., B. Simonska, G. Mutafov, V. Alexandrov, and L. Spassov. "Bilateral ultrasound-guided abdominal peripheral block in tap plane, tap - block." Trakia Journal of Sciences 18, no. 4 (2020): 344–49. http://dx.doi.org/10.15547/tjs.2020.04.009.
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INTRODUCTION: Bilateral ultrasound-guided peripheral block (TAP - block) in the plane between the inner oblique abdominal muscle and the transversal abdominal muscle – TAP plane, is a regional anesthesia technique by infiltration of a local anesthetic, provides analgesia for operations involving the anterior abdominal wall. The analgesic effectiveness of the block decreases the consumption of opioid analgesics and non-steroidal anti-inflammatory drugs. AIM: In this study, we evaluated the intraoperative analgesic efficacy of bilateral TAP - block and the consumption of opioid analgesics in patients undergoing bilateral laparoscopic inguinal hernia repair. METHODS: The study was conducted with 35 patients, who were randomized into two groups. In the control group (group I), there are patients who received general anesthesia (GA), and experimental group (group II), were patients who have received general anesthesia and a bilateral tap block (GA + TAP). RESULTS: Patients with TAP-block (group II) have significantly lower fentanyl consumption compared to group I. CONCLUSION: Multimodal approach for the simultaneous administration of general anesthesia with a TAP block provides effective intraoperative analgesia and significantly reduces the perioperative consumption of opioid analgesics.
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Pulkina, O. N., V. P. Ivanov, V. I. Gurskaya, and E. V. Parshin. "Infiltrative analgesia of the skin flap in children with craniosynostosis after reconstructive surgery on skull bones." Messenger of ANESTHESIOLOGY AND RESUSCITATION 16, no. 6 (January 27, 2020): 37–45. http://dx.doi.org/10.21292/2078-5658-2019-16-6-37-45.
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The objective of the study is to evaluate the effectiveness of analgesia by infiltration of the skin flap with local anesthetic in children with craniosynostosis after reconstructive surgery.Materials and subjects. 50 children with craniosynostosis, who underwent reconstructive surgery on skull bones, were divided into two groups based on the method of postoperative anesthesia: in Group 1(experimental), the infiltration of the skin flap was used within multimodal anesthesia, while in Group 2, it was standard parenteral use of analgesic drugs. In the postoperative period, pain severity was assessed by FLACC scales, the amount of opioid and non-opioid analgesics consumed was assessed by the formalized Analgesiс Assessment Scale (FSA), and non-invasive hemodynamic monitoring (BP, HR) was performed.Results. The statistical analysis of the results revealed significant differences between groups in the assessment results of FSA and FLACC scales. In Group 1, the level of postoperative pain was significantly lower compared to Group 2. The amount of opioid and non-opioid analgesics consumed was also significantly lower in Group 1.Conclusion. The use of the infiltration of the skin flap as part of multimodal analgesia in children with craniosynostosis, after reconstructive surgery on skull bones significantly reduces the intensity of pain and the amount of opioid analgesics consumed in the postoperative period.
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Waechter, Fábio Luiz, José Artur Sampaio, Rinaldo Danesi Pinto, Mário Reis ÁLvares-Da-Silva, and Luiz Pereira-Lima. "A Comparison between Topical and Infiltrative Bupivacaine and Intravenous Meperidine for Postoperative Analgesia after Inguinal Herniorrhaphy." American Surgeon 67, no. 5 (May 2001): 447–50. http://dx.doi.org/10.1177/000313480106700513.
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The purpose of the present study is to compare postoperative analgesia offered by the simple instillation of local anesthetic on the surgical wound, its infiltration with the same local anesthetic, and the use of an intravenous opioid. Sixty patients were divided into the three analgesia groups to be studied: instillation of local anesthetic (Group I), injection of local anesthetic (Group II), and intravenous opioid (Group III). The pain was quantified using the visual analogue scale. It was observed that there was better analgesia in Groups I and II during the first 6 hours postoperatively as compared with Group III ( P < 0.0001). At the end of the 12 hours the three modes of analgesia proved comparable. However, after 24 hours there was better analgesic development in Group I, whereas Group II had greater postoperative morbidity. We conclude that the instillation of local anesthesia provides analgesia during the immediate postoperative period comparable to local infiltration using the same anesthetic. Both regional analgesia methods are more effective analgesics during the first 6 hours than are intravenous opioids. Furthermore the simple instillation of local anesthetic allows better analgesic evolution of the surgical wound after the first 24 hours considering the lower rate of resulting complications.
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Lisnyi, І. І. "Perioperative anesthesia." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 178–79. http://dx.doi.org/10.32902/2663-0338-2020-3.2-178-179.
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Background. Ensuring adequate analgesia is a prerequisite for rapid recovery after surgery. Improving the management of acute pain is important to ensure the safe and effective analgesia needed for early mobilization and for avoidance of organ dysfunction due to inadequate analgesia. For this purpose, multimodal analgesia (MMA) is used. It includes opioid analgesics, nonsteroidal anti-inflammatory drugs (NSAID), paracetamol or metamizole, local anesthetics and ancillary drugs.
Objective. To describe modern views on perioperative analgesia.
Materials and methods. Analysis of literature data on this issue.
Results and discussion. MMA involves an opioid-preserving approach (reducing the dose of opioids without reducing the quality of analgesia), procedure and patient specificity. The postoperative recovery improvement program includes several items, three of which have been associated with a reduction in treatment duration, namely, multimodal prevention of postoperative nausea and vomiting, perioperative NSAID use, and post-operative opioid protocol. The combined use of NSAID and paracetamol provides a better result than the use of each of these drugs alone. At the correct dose, paracetamol (Infulgan, “Yuria-Pharm”) is an effective non-opioid analgesic for the treatment of acute pain with minimal side effects for a long time. Pre- and intraoperative administration of paracetamol is recommended in a number of guidelines. Intravenous administration of local anesthetics is an another important component of MMA. The 2016 Cochrane review showed that long-term intravenous perioperative infusion of lidocaine significantly reduced the postoperative need for opioids. However, the meta-analysis of 10 randomized controlled trials found that perioperative intravenous lidocaine did not differ from placebo in post-operative pain assessed with the help of a visual analog scale and in opioid requirements (Rollins K.E., 2020). Similar results have been obtained in other studies in recent years. Inclusion of nefopam in MMA can reduce the dose of opioids. The use of nefopam, paracetamol and deksketoprofen makes it possible to dramatically reduce the use of morphine. Neither pain nor postoperative recovery can be adequately controlled with a single treatment due to the multifactorial nature of the problem. It is recommended to use MMA, but there are no recommendations for optimal combinations of analgesics for specific procedures. Administration of paracetamol and NSAID in combination with the use of regional techniques is a golden standard of MMA.
Conclusions. 1. After the surgery, the patient should be adequately anesthetized. 2. To achieve optimal, preferably non-opioid, analgesia, it is recommended to use MMA. 3. NSAID, paracetamol, nefopam and regional techniques are the important components of MMA.
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Ma, Xiaofan, Jiali Peng, Yelin Chen, Zeyi Wang, Qiang Zhou, Jia Yan, and Hong Jiang. "Esketamine Anesthetizes Mice With a Similar Potency to Racemic Ketamine." Dose-Response 21, no. 1 (January 2023): 155932582311575. http://dx.doi.org/10.1177/15593258231157563.
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Esketamine, the right-handed optical isomer of racemic ketamine, has recently become widely used for anesthesia and analgesia as a replacement for racemic ketamine. However, there are limited studies comparing the anesthetic and analgesic effects of esketamine and racemic ketamine in mice. This research was conducted to analyze the dose-dependent anesthetic and analgesic efficacy of esketamine in mice and to compare its potency with that of the racemate. We tested the anesthetic effects of different doses of esketamine and compared its potency with that of the racemate using righting reflex tests. Then, the acetic acid-induced pain model and formalin-induced pain model were used to investigate the analgesic effect. Compared with racemic ketamine, an equivalent dose of esketamine at 100 mg/kg was required to induce stable anesthesia. In contrast, 5 mg/kg esketamine was sufficient to provide analgesic effects similar to those of 10 mg/kg ketamine. Together, esketamine had a similar potency to racemic ketamine for anesthesia and a stronger potency for analgesia in mice.
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Hu, Chaojun, Shan Zhang, Qian Chen, and Rong Wang. "Effects of Different Anesthetic and Analgesic Methods on Cellular Immune Function and Stress Hormone Levels in Patients Undergoing Esophageal Cancer Surgery." Journal of Healthcare Engineering 2022 (March 12, 2022): 1–9. http://dx.doi.org/10.1155/2022/4752609.
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The change of perioperative immune function in patients with esophageal cancer is mainly caused by the joint action of surgical trauma and anesthesia. In our study, we aimed to investigate the effects of different anesthetic methods on the changes of T lymphocyte subsets and cytokines in peripheral blood of patients with esophageal cancer surgery. 50 patients with esophageal cancer were divided into the study group and the control group. Among them, the patients in the control group chose intravenous anesthesia and received self-controlled intravenous analgesia after surgery. Patients in the study group chose thoracic epidural anesthesia combined with general anesthesia, undergoing self-controlled epidural analgesia after surgery; serum interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) were measured by ELISA. Serum stress hormones GH and sIL-8 were measured by radioimmunoassay. Both groups of patients achieved significant postoperative analgesia, but the VAS score in the study group at the T2–T4 time point was lower than that in the control group. The serum GH concentration in the study group increased at T1 and reached its highest peak at T2, then decreased. The serum IL-8 concentration of the two groups showed a downward trend from T1 to T4. Thoracic epidural anesthesia combined with general anesthesia for postoperative epidural analgesia can relieve the degree of cellular immunosuppression during and after surgery. Moreover, the thoracic epidural block combined with general anesthesia for esophageal cancer surgery and epidural analgesia after surgery for patients are anesthetic and analgesic methods with clinically significant effects. Our research results have a positive effect on the promotion of postoperative rehabilitation in patients with malignant cell tumors.
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Fayziev, Otabek Ya, T. S. Agzamhodjaev, A. S. Yusupov, and I. A. Mamatkulov. "IMPROVEMENT OF COMBINED MULTIMODAL ANESTHESIA FOR ABDOMINAL SURGICAL INTERVENTIONS IN CHILDREN." Russian Pediatric Journal 21, no. 6 (April 30, 2019): 362–65. http://dx.doi.org/10.18821/1560-9561-2018-21-6-362-365.
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The aim of the study was to enhance the efficiency and safety of the combined methods of anesthesia using propofol and epidural anesthesia for the abdominal surgery in children by assessing the hemodynamic regulation of the heart rhythm and the clinical course of anesthesia. Materials and methods. We studied children aged of 1 to 14 years operated for diseases and malformations of the abdominal cavity. To ensure the anesthetic protection in 57% of affected children there was used combined epidural anesthesia by bupivacaine combined with propofol and fentanyl in cases from the 1 (main) group and in 43% of affected children there was applied the combined anesthesia by fentanyl and droperidol with lidocaine epidural anesthesia - 2 (control) groups. Results The results showed the relative stability of the patients providing adequate pain relief after the surgery in children. Use of a combination of drugs: early fentanyl analgesic effect develops, whereas propofol implements its action later, and provides a prolongation of analgesia. Propofol, fentanyl with epidural analgesia bupivacaine for analgesic effect appeared to be several times higher than methods of neuroleptanalgesia.
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Stojanović, Simona, Nikola Burić, Milos Tijanić, Kosta Todorović, Kristina Burić, Nina Burić, Marija Jovanović, and Vukadin Bajagić. "The Assessment of Prolonged Inferior Alveolar Nerve Blockade for Postoperative Analgesia in Mandibular Third Molar Surgery by a Perineural Addition of Dexamethasone to 0.5% Ropivacaine: A Randomized Comparison Study." International Journal of Environmental Research and Public Health 19, no. 3 (January 25, 2022): 1324. http://dx.doi.org/10.3390/ijerph19031324.
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Background: Perineurally adding dexamethasone to local anesthetics could enable postoperative analgesia. Our aim was to investigate the efficacy of 4 mg dexamethasone and 0.5% ropivacaine on the prolonged duration of mandibular anesthesia for postoperative analgesia during third molar surgery. Materials and method: The patients of both sexes, and in the age range of 17 to 50 yrs of age, received the Gow-Gates anesthesia. Group I received 4 mL of plain 0.5% ropivacaine, with perineurally added 1 mL/4 mg of dexamethasone; group II received 4 mL of plain 0.5% ropivacaine with perineurally added 1 mL of 0.9% saline; group III received 4 mL of plain 0.5 bupivacaine with perineurally added 1 mL of 0.9% saline. The prime anesthesia outcome was the duration of conduction anesthesia (DCA); the secondary outcome was the duration of analgesia (DAN) and analgesia before analgesic intake. Results: In 45 randomly selected subjects (mean age 27.06 ± 8.20), DCA was statistically longest in group I (n = 15) (592.50 ± 161.75 min, p = 0.001), collated with groups II (n = 15) and III (n = 15) (307.40 ± 84.71 and 367.07 ± 170.52 min, respectively). DAN was significantly the longest in group I (mean: 654.9 ± 198.4 min, p = 0.001), compared with group II (345.4 ± 88.0 min) and group III (413.7 ± 152.3 min), with insignificant adverse reactions. One-third of the operated patients absented from the use of analgesics. Conclusion: A amount 0.5% ropivacaine with dexamethasone usefully served as an analgesic with a success rate of 93.4% of the given anesthesia.
Dissertations / Theses on the topic "Anesthesia and Analgesia"
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Björnsson, Marcus. "Pharmacometric Models in Anesthesia and Analgesia." Doctoral thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-205580.
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Modeling is a valuable tool in drug development, to support decision making, improving study design, and aid in regulatory approval and labeling. This thesis describes the development of pharmacometric models for drugs used in anesthesia and analgesia. Models describing the effects on anesthetic depth, measured by the bispectral index (BIS), for a commonly used anesthetic, propofol, and for a novel anesthetic, AZD3043, were developed. The propofol model consisted of two effect-site compartments, and could describe the effects of propofol when the rate of infusion is changed during treatment. AZD3043 had a high clearance and a low volume of distribution, leading to a short half-life. The distribution to the effect site was fast, and together with the short plasma half-life leading to a fast onset and offset of effects. It was also shown that BIS after AZD3043 treatment is related to the probability of unconsciousness similar to propofol. In analgesia studies dropout due to lack of efficacy is common. This dropout is not at random and needs to be taken into consideration in order to avoid bias. A model was developed describing the PK, pain intensity and dropout hazard for placebo, naproxen and a novel analgesic compound, naproxcinod, after removal of a wisdom tooth. The model provides an opportunity to describe the effects of other doses or formulations. Visual predictive checks created by simultaneous simulations of PI and dropout provided a good way of assessing the goodness of fit when there is informative dropout. The performance of non-linear mixed effects models in the presence of informative dropout, with and without including models that describe such informative dropout was investigated by simulations and re-estimations. When a dropout model was not included there was in general more bias. The bias increased with decreasing number of observations per subject, increasing placebo effect and increasing dropout rate. Bias was relatively unaffected by the number of subjects in the study. The bias had, in general, little effect on simulations of the underlying efficacy score, but a dropout model would still be needed in order to make realistic simulations.
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McCarthy, Jennifer F. M. "Multimodal Analgesia in Children Following Dental Rehabilitation under General Anesthesia." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1242252421.
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Evangelista, Marina Cayetano. "Bloqueio dos nervos ciático e femoral em gatos: avaliação da dispersão da bupivacaína sob ressonância nuclear magnética e avaliação dos efeitos antinociceptivos." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/10/10137/tde-19092016-155909/.
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Os bloqueios perineurais são práticos, efetivos e amplamente utilizados para o manejo da dor perioperatória, porém os estudos em gatos são escassos. O objetivo do estudo era avaliar a dispersão da bupivacaína por meio do emprego da ressonância magnética (RM) em relação aos nervos ciático (NC) e femoral (NF) e avaliar a exequibilidade, eficácia e duração dos bloqueios dos mesmos, realizados com a bupivacaína isolada ou em associação com dexmedetomidina ou buprenorfina. Na primeira fase do estudo seis gatos adultos foram submetidos ao exame de RM sob anestesia geral com isoflurano. Foram obtidas imagens dos membros pélvicos nos planos sagital e transverso. Os bloqueios NC e NF guiados por um estimulador de nervos foram realizados com bupivacaína 0,5 % (0,1 mL/kg por ponto). As sequências da RM foram repetidas após cada bloqueio e as imagens analisadas de acordo com a distribuição (1; em contato com nervo ou 0; sem contato com o nervo alvo), localização da bupivacaína e presença ou ausência de hematoma e lesões nervosas. Na segunda fase do estudo, seis gatos adultos foram sedados com dexmedetomidina (25 µg/kg) e receberam os bloqueios NC e NF com 0,1 mL/kg de um dos tratamentos: salina 0,9% (CONTROLE), bupivacaína (0,46%; BUPI), bupivacaína e dexmedetomidina (1 µg/kg; BUPI-DEX) ou bupivacaína e buprenorfina (2,5 µg/kg; BUPI-BUPRE). A sedação foi revertida com atipamezole (250 µg/kg). Os escores de sedação, limiar de retirada do membro, capacidade de deambulação e resposta ao pinçamento digital foram avaliados até 24 horas após os bloqueios. De acordo com as imagens da RM, cinco de seis injeções do NC tiveram escore 1. O comprimento do NC em contato com a bupivacaína foi 25 ± 11 mm. Todas as injeções do NF tiveram escore 1. Em uma das injeções, a bupivacaína foi depositada distal à bifurcação do NF e do nervo safeno, apenas sobre o ramo motor do NF. Não foram observadas lesões nervosas e hemorragias. A técnica promoveu uma dispersão adequada e o volume foi considerado suficiente. Variações quanto à localização e distribuição do injetado poderiam explicar diferenças no bloqueio motor e sensitivo no contexto clínico. Todos os animais tratados com anestésico local demonstraram diminuição na função motora e alterações na antinocicepção. A capacidade de deambulação foi reduzida no tratamento BUPI de 30 min a 2 horas, no BUPI-DEX entre 1 e 2 horas e no BUPIBUPRE às 2h (p < 0,05). O bloqueio motor foi observado entre 1 e 3 horas. A analgesia, determinada pelo limiar de retirada do membro no tratamento BUPI foi maior de 1 a 6 horas em relação ao CONTROLE (p < 0,05) e atingiu valores acima de 2,4 N de 1 a 4 horas nos tratamentos BUPI-DEX e BUPI-BUPRE e de 1 a 8 horas nos animais que receberam o tratamento BUPI. As doses de buprenorfina e dexmedetomidina utilizadas como adjuvantes não aumentaram a magnitude e duração dos bloqueios dos NC e NF em gatosPeripheral nerve blocks are practic, effective and widely used for the perioperative pain management, however studies in cats are scarce. The aim of this study was to evaluate the distribution of bupivacaine after sciatic (ScN) and femoral nerve (FN) blocks in cats using magnetic resonance imaging (MRI) and to determine the feasibility, effectiveness and duration of antinociception after ScN and FN blocks using bupivacaine alone, or in combination with either dexmedetomidine or buprenorphine. In the first phase of the study, six adult cats were anesthetized with isoflurane and underwent MRI. Transverse and sagittal plan sequences of pelvic limbs were obtained. The ScN and FN blocks were performed using an electric nerve stimulator-guided technique and bupivacaine 0.5% (0.1 mL/kg per site). The MRI sequences were repeated after each block and the images were analyzed according to the distribution (1; in contact with the nerve or 0; not in contact with the target nerve), bupivacaine location and presence or absence of hematomas and nerve injuries. In the second phase of the study, six adult cats were sedated with dexmedetomidine (25 µg/kg) and received the ScN and FN blocks with 0.1 mL/kg of one of the treatments: saline 0.9% (CONTROL), bupivacaine (0.46%; BUPI), bupivacaine and dexmedetomidine (1 µg/kg; BUPI-DEX) or bupivacaine and buprenorphine (2.5 µg/kg; BUPI-BUPRE). Atipamezole (250 µg/kg) was administered for reversal of sedation. Sedation scores, paw withdrawal thresholds, ability to walk and response to toe pinch were evaluated up to 24 hours after the blocks. According to MRI, five out of six ScN injections had distribution score of 1. Mean ± SD length of the ScN in contact with bupivacaine was 25 ± 11 mm. All FN injections had distribution score of 1. In one injection (FN), bupivacaine was administered distal to the bifurcation between the femoral and saphenous nerve and over the motor branch of FN. Nerve injury or acute hemorrhage were not observed. Nerve stimulator-guided ScN and FN injections produced a reliable bupivacaine spread over the target nerves and the volume was considered sufficient. Individual variability in regards to the injectate location may explain differences in sensory and motor blockade in the clinical setting. All local anesthetic-treated animals had motor function impairment and changes in antinociception. Walking ability was impaired in BUPI from 30 min to 2 hours, in BUPI-DEX between 1 and 2 hours and in BUPI-BUPRE at 2h (p < 0.05). Motor blockade was observed between 1 and 3 hours. Analgesia, determined by paw withdraw threshold, was higher from 1 to 6 hours in BUPI compared to CONTROL (p < 0.05) and reached values greater than 2.4 N from 1 to 4 hours in BUPI-DEX and BUPI-BUPRE and from 1 to 8 hours in BUPI. The chosen doses of buprenorphine and dexmedetomidine as adjuvant drugs did not enhance the magnitude and duration of the ScN and NF blocks in cats
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Ramstad, Marsha. "The Relationship between Epidural Analgesia during Childbirth and Childbirth Outcomes." Thesis, North Dakota State University, 2004. https://hdl.handle.net/10365/28727.
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Epidural analgesia has increased in usage dramatically in the United States as a means
of comfort for labor pain. Prior studies have connected epidural analgesia to an increase in
cesarean birth rate, an increase in use of instrumentation, an increase in length of labor,
episiotomy rate, and maternal fever. Epidural analgesia has produced additional costs to
the patient and society. The purpose of this study is to examine the relationship between
epidural analgesia during childbirth and childbirth outcomes. The data for this study were obtained from a retrospective patient record review of 200
systematically selected labor patients who delivered in 2002 at a midwestern hospital. The
epidural analgesia rate was 72% at this facility in 2002, a signi?cant increase from the
previous 5 years. Using the Chi-square test of independence, 3 relationship was established
between epidural analgesia and four of the variables examined. A statistically signi?cant
relationship was found to exist between epidural analgesia and cesarean birth rate, pitocin
augmentation, and the ?rst and second stages of labor with the total sample. The results of
the study are important for healthcare providers who are relaying in?uential wellness
information to childbearing women and their partners. The results indicate a need for further education for healthcare providers on alternative methods of pain relief for their patients during childbirth.
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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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Araujo, Daniele Ribeiro de. "Desenvolvimento e avaliação farmacologica de formulações de liberação controlada com anestesicos locais amino-amidas ciclicos : bupivacaina, mepivacaina e ropivacaina." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/314147.
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Orientadores: Eneida de Paula, Angelica de Fatima de Assunção BragaTese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia
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Resumo: Dentre os fármacos usados para aliviar ou eliminar a dor, encontram-se os anestésicos locais (AL). Esses compostos, capazes de bloquear a excitação-condução em nervos periféricos, têm duração de ação relativamente curta e toxicidade para os sistemas nervoso central e cardiovascular. Com a finalidade de prolongar a duração de ação e reduzir a toxicidade sistêmica dos AL, pesquisas com diferentes tipos de sistemas carreadores têm sido desenvolvidas. Essas novas formulações, denominadas de liberação lenta, possibilitam a liberação controlada e evitam picos plasmáticos dos AL, prolongando a analgesia e reduzindo sua toxicidade. Neste trabalho objetivamos preparar, caracterizar (quanto a encapsulação ou complexação, estabilidade e liberação da droga) e avaliar in vitro (toxicidade celular) e in vivo, a atividade farmacológica (latência, intensidade, duração de ação e toxicidade local) de novas formulações anestésicas de liberação controlada, comparando-as com os fármacos disponíveis no mercado. Os AL de escolha foram as amino-amidas cíclicas: Bupivacaína (BVC), Mepivacaína (MVC) e Ropivacaína (RVC), bastante utilizadas em clínica médica e odontológica. Os sistemas carreadores de drogas adotados foram lipossomas unilamelares grandes (LUV de 400nm, compostos de fosfatidilcolina e colesterol) e as ciclodextrinas: ß-CD ou hidroxipropil ß-CD (HPß-CD). Ensaios de estabilidade física, por fluorescência, revelaram que os lipossomas mantêm o conteúdo encapsulado e que a presença do AL não interfere na permeabilidade dos mesmos, analisada em função do tempo e temperatura. O coeficiente de partição foi calculado e indicou o perfil esperado pelas substituições, i.e., MVC
Doutorado
Bioquimica
Doutor em Biologia Funcional e Molecular
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Souza, Marcio Antonio de. "Analgesia de parto : bloqueio combinado raqui-peridural versus bloquei peridural continuo em primigestas." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309851.
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Orientador: João Luiz de Carvalho Pinto e SilvaDissertação ( mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: JUSTIFICATIVA E OBJETIVOS: O trabalho de parto produz desconforto e dor intensa à maioria das parturientes. O método de eleição que seria ideal para produzir analgesia deveria reduzir ao máximo os inconvenientes e a dor provocados pelo trabalho de parto, permitindo que a mãe participasse ativamente e com prazer da experiência de dar à luz. A analgesia combinada raqui-peridural (ACRP) apresentaria, como vantagens, a possibilidade de instalação precoce, rápido início de ação analgésica, uso de baixas doses de anestésicos locais, associando-se a trabalhos de partos mais curtos, menor bloqueio motor e ofereceria maior satisfação à parturiente. A analgesia peridural contínua (APC) utilizaria doses maiores de anestésicos locais, produzindo maior bloqueio motor, mas deveria ser realizada em fases mais adiantadas do período de dilatação. O potencial atrativo da ACRP seria o de incorporar as vantagens da administração intratecal de fármacos de ação analgésica rápida, com a manutenção de acesso através de um cateter peridural, disponível continuamente para complementação com novas doses ou adição de outras drogas, minimizando as desvantagens apresentadas por ambas as técnicas. O estudo compara os desfechos maternos e perinatais com a utilização da ACRP e APC em parturientes primigestas. SUJEITOS E MÉTODOS Foi realizado um ensaio clínico aleatorizado com 128 gestantes primigestas em trabalho de parto, divididas em dois grupos de igual tamanho (grupo APC e grupo ACRP) admitidas no pré-parto de duas maternidades na cidade de Jundiaí - SP, sendo estudadas as seguintes variáveis: tempo de latência de instalação da analgesia, intensidade da dor ao longo da analgesia, tempo total decorrido até a completa dilatação do colo uterino, Índice de Apgar de primeiro e quinto minutos, tempo de resolução do parto, grau de bloqueio motor, efeitos adversos como náuseas, vômitos, prurido, hipotensão arterial e o grau de satisfação materna. ANÁLISE DOS DADOS: A análise dos dados foi feita através do teste de Mann-Whitney para as variáveis contínuas não paramétricas. Utilizou-se também teste exato de Fisher e teste qui-quadrado de Pearson para variáveis categóricas. RESULTADOS: Não houve diferenças entre os grupos em relação à velocidade de dilatação cervical, tempo para resolução do parto, parâmetros hemodinâmicos maternos, vitalidade do recémnascido, complementações analgésicas durante o trabalho de parto e parto. Ocorreu maior rapidez de instalação da analgesia no grupo da ACRP. Com relação ao bloqueio motor também se observou diferença estatística significativa entre os dois grupos, sendo menor no grupo de APC. CONCLUSÕES: As duas técnicas mostraram-se seguras e eficientes, porém a ACRP ofereceu uma analgesia mais rápida, com alívio mais precoce da dor. O bloqueio motor menos intenso no grupo APC proporcionou movimentação mais ativa no leito e uma colaboração mais efetiva das gestantes durante o período expulsivo. A grande maioria das mulheres (97,6%) referiu satisfação com a analgesia recebida. As doses de anestésicos locais e opióides utilizadas em ambas as técnicas analgésicas propostas não produziram efeitos adversos maternos significativos e tampouco alteraram a vitalidade dos recém-nascidos dos dois grupos. Ambas as técnicas não mostraram qualquer predomínio de efeitos adversos
Abstract: PROBLEM AND OBJECTIVES: The childbirth arouses distress and intense pain to most of the parturients. The ideal method of producing analgesia must reduce the labor's pain and inconveniences to the utmost level, allowing the mother to participate on the delivery experience in an active and pleasant manner. The Combined Spinal-Epidural (CSE) analgesia offers the advantages of an early insertion, fast onset of analgesia, small dose of local anesthetic and reduced degree of motor block, being thus associated to short-time labors and yielding greater satisfaction to the puerpera. Otherwise, the Continuous Epidural Analgesia (CEA) would require larger doses of local anesthetics and a larger motor block as well, but it would be applied only in advanced stages of dilatation. The CSE analgesia has an attractive prospect, since it incorporates the advantages of the intrathecal administration of rapid onset pharmaceuticals, preserving this access through an epidural catheter that is uninterruptedly available for the insertion of other drugs and, at the same time, reducing the disadvantages that these both anesthesia techniques present. This study compares the combined spinal-epidural analgesia with the continuous epidural analgesia in primiparous parturients, through maternal and perinatal outcomes. APPROACH AND METHOD: 128 primiparous parturients in labor were recruited for the study. They were separated into two equal groups (CEA group and CSE group) when they applied to two of the maternity hospitals in Jundiaí city, during the pre-labor stage. A random clinical rehearsal was accomplished and the following variables were analyzed: latency time for the analgesia onset, pain intensity after its onset, total time elapsed until the complete cervical dilation, Apgar Index at the 1st and 5th minutes, time for delivery conclusion, degree of motor block, level of sensitive block, adverse effects (such as nausea, vomiting, pruritus and arterial hypotension) and degree of motherly approval. Data Analysis: The analysis was performed through the Mann-Whitney non-parametric test for continuous variables. Fisher's exact test and Pearson's chi-square test were also employed. RESULTS: Concerning the compared variables on the speed of cervical dilation, time for delivery conclusion, maternal hemodynamic parameters, newborn's healthiness, complementary analgesia during labor and labor, there were no significant statistic differences between the two groups studied. However, the CSE group had a faster analgesia insertion. In relation to the motor block, a significant statistic difference was detected between the two groups, revealing a reduced motor block in the group that received the CEA. CONCLUSIONS: Both techniques were proved as safe and efficient, though the CSE analgesia offered a faster analgesia and sooner pain relief. Due to a less intense motor block, the parturients from the CEA group were able to accomplish an active movement and effective collaboration during the expulsion stage. The major part of the women (95,4%) expressed satisfaction with the analgesia that was applied. The doses of local anesthetics and opioids, contained in both analgesia techniques, did not cause considerable adverse effects on the mothers and did not either affect the newborns in any of the two groups
Mestrado
Tocoginecologia
Mestre em Tocoginecologia
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Rane, Lindgren Kerstin. "Intrathecal adenosine for treatment of acute pain : safety assessments and evaluation in experimental, surgical and labour pain /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-750-9.
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Gering, Ana Paula [UNESP]. "Avaliação de duas doses de lidocaína, administradas à altura da primeira vértebra lombar sobre a analgesia trans-cirúrgica e parâmetros cardiorrespiratórios em cadelas submetidas à ovariohisterectomia." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/88968.
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A anestesia epidural, quando comparada à anestesia geral, apresenta algumas vantagens como redução dos custos, minimização dos riscos anestésicos por ocasionar poucas alterações respiratórias e cardiovasculares. Mas tem sido utilizada basicamente para cirurgias no membro posterior e inguinais já que o anestésico local quando administrado no espaço compreendido entre a sétima vértebra lombar e a primeira vértebra sacral proporciona bloqueio máximo até a quarta vértebra lombar. Uma alternativa para bloqueios mais craniais é a utilização do cateter epidural. Tal estudo avaliou, comparativamente os efeitos de duas doses de lidocaína (4 e 6 mg/Kg) administradas por via epidural na altura da primeira vértebra lombar em cadelas submetidas à ovariohisterectomia. Foram utilizadas 16 cadelas SRD, pesando entre 4 e 20 Kg e entre 1 e 6 anos. Todas receberam butorfanol e etomidato, ambos por via intravenosa nas doses de 0,4 mg/Kg e 2 mg/Kg respectivamente. Foram avaliados parâmetros cardiovasculares, hemogasométricos, ventilometricos e relacionados à analgesia. Os parâmetros fisiológicos avaliados não apresentaram diferença entre os grupos em com o uso de diferentes doses de lidocaína. Relativamente à analgesia, 25% dos animais do G4 apresentaram escore de dor considerado insuficiente. Contudo conclui-se que as duas doses de lidocaína, depositadas na altura da primeira vértebra lombar, não interferem nos parâmetros ventilométricos, hemogasométricos e cardiovasculares. E a dose de 6 mg/Kg determina melhor analgesia que a de 4 mg/Kg
Epidural anesthesia compared to general anesthesia has some advantages such as reducing cost, minimizing the risks of anesthesia by causing fewer respiratory and cardiovascular changes. But it has been used primarily for surgery in the posterior limb and inguinal as the local anesthetic when administered in the space between the seventh lumbar and first sacral vertebra provides maximum block until the fourth lumbar vertebra. An alternative to more bloks cranial is the use of epidural catheter. This study evaluated the comparative effects of two doses of lidocaine (4 and 6 mg/Kg) administered epidurally at the time of the first lumbar vertebra en bitches submitted to ovariohisterectomy. !6 mongrel dogs were used, weighing between 4 and 20 Kg ande between 1 and 6 years old. All received butorphanos and etomidate, both intravenously ins doses of 0,4mg/Kg to 2 mg/Kg respectively. We assessed cardiovascular, blood gas ventilometric and analgesia. The physiological parameters evaluated did not differ between the groups using different doses of lidocaine. For analgesia, 25% of animals in G4 had a pain score considered insufficient. However, it is conclused that two doses os lidocaine, deposited at the time of the first lumbar vertebra, the parameters do not interfere ventilometric, blood gas and cardiovascular diseases. And the dose of 6 mg/Kg determines the better analgesia of 4 mg/Kg
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Silva, Bruno Monteiro da. "Avaliação cardiorrespiratória e analgésica da ropivacaína isolada e associada ao fentanil ou ao tramadol, administrados pela via peridural em cães /." Araçatuba : [s.n.], 2007. http://hdl.handle.net/11449/92199.
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Orientador: Valéria Nobre Leal de Souza OlivaBanca: Paulo Sérgio Patto dos Santos
Banca: Carmen Esther Grumadas Machado
Resumo: A anestesia peridural é amplamente difundida no meio veterinário, utilizando-se o anestésico local isolado ou associado aos opióides, capazes de promover aumento do efeito analgésico. A ropivacaína é um fármaco relativamente novo, ainda pouco utilizado em Veterinária. O fentanil é um opióide agonista e o tramadol é um opióide de ação mista. Neste experimento, oito cães foram tranqüilizados com acepromazina, submetidos à peridural com um dos protocolos a seguir: GR (ropivacaína), GRF (ropivacaína + fentanil), GRT (ropivacaína + tramadol), em volume total de 0,25 mL/kg. Durante o procedimento foram avaliados e comparados os seguintes parâmetros vitais (FC, f, temperatura retal, pressão arterial, e gasometria do sangue arterial), os bloqueios sensitivo e motor (latência e duração de ação), o grau de sedação, e a ocorrência de possíveis efeitos indesejáveis advindos da administração de ropivacaína isolada ou em associação. A diminuição mais intensa na FC ocorreu nos grupos GRF e GRT, e ocorreu hipotermia significativa nos animais do GRF. Todos os grupos apresentaram sedação, sendo severa nos grupos GRF e GRT. De maneira geral, o período de recuperação foi mais curto nos animais do grupo GRT do que nos demais. O GRT também foi o que apresentou bloqueio mais cranial. Foram observadas bradicardia, hipotermia e síndrome de Shiff- Sherrington no período trans-anestésico em animais de todos os grupos. Decorridas 24 horas de período pós-anestésico, não foram evidenciados efeitos indesejáveis, em nenhum dos grupos. GRF foi o grupo com maior duração de anestesia e analgesia, GRT apresentou a menor duração de anestesia com analgesia intermediária, e GR apresentou duração intermediária, com menor analgesia.
Abstract: Peridural anesthesia is broadly applied in the Veterinary field, using the isolated local anesthetic or in combination with opiates capable to increase the analgesic effect. The ropivacaine is a relatively new drug, not much used in the Veterinary field yet. The fentanil is an agonist opiate and tramadol is a mixed action opiate. In this experiment, eight dogs were sedated with acepromazine and subjected to the epidural anesthesia with one of the following protocols: GR (ropivacaine), GRF (ropivacaine + fentanyl), GRT (ropivacaine + tramadol), in 0,25mL/Kg of total volume. During the procedure, following vital signs were evaluated and compared (heart rate, respiratory rate, rectal temperature, blood pressure and gasometry of arterial blood), the sensory and motor blockade (latency and length of action), level of sedation and the occurrence of possible side effects due to administration of ropivacaine individually or in combination with other drugs. The highest decrease in the heart rate occurred in the following GRF and GRT and also significant hypothermia in animals of GRF. All groups presented sedation, even severe in the period of recovering was shorter in the animals belonging to GRT than in others. The GRT was also the one that presented the most cranial block. Bradycardia, hypothermia and Shiff- Sherrington syndrom were observed in the transanesthetic period in animals belonging to all of the groups. Twenty-four hours after the postanesthetic period, no side effects were observed, in none of the groups. The GRF was the one with higher length of anesthesia and analgesia, GRT presented the length of anesthesia with intermediate analgesia and, GR group presented intermediate length, with lower analgesia.
Mestre
Books on the topic "Anesthesia and Analgesia"
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G, Reves J., and Stanley Theodore H. 1940-, eds. Intravenous anesthesia and analgesia. Philadelphia: Lea & Febiger, 1988.
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Grimm, Kurt A., Leigh A. Lamont, William J. Tranquilli, Stephen A. Greene, and Sheilah A. Robertson, eds. Veterinary Anesthesia and Analgesia. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781119421375.
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Wayne, Hollingshead K., and McKelvey Diane, eds. Veterinary anesthesia and analgesia. 3rd ed. St. Louis, Mo: Mosby, 2003.
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M, Steele Susan, Nielsen Karen C, and Klein Stephen M, eds. Ambulatory anesthesia and perioperative analgesia. New York: McGraw-Hill, Medical Pub. Division, 2005.
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H, Sowray J., ed. Local analgesia in dentistry. 3rd ed. Bristol: Wright, 1987.
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author, D'Angelo Robert, and Paech Michael J. author, eds. Obstetric anesthesia. Oxford: Oxford University Press, 2011.
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Phillip, Lerche, and McKelvey Diane, eds. Anesthesia and analgesia for veterinary technicians. 4th ed. St. Louis, Mo: Mosby/Elsevier, 2010.
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Thomas, John A. Anesthesia and analgesia for veterinary technicians. 4th ed. St. Louis, Mo: Mosby/Elsevier, 2011.
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Doherty, Tom, and Alex Valverde, eds. Manual of Equine Anesthesia and Analgesia. Oxford, UK: Blackwell Publishing Ltd, 2006. http://dx.doi.org/10.1002/9780470753248.
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McConachie, Ian, ed. Controversies in Obstetric Anesthesia and Analgesia. Cambridge: Cambridge University Press, 2011. http://dx.doi.org/10.1017/cbo9780511734847.
Full textBook chapters on the topic "Anesthesia and Analgesia"
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de Maio, M. "Anesthesia and Analgesia." In Injectable Fillers in Aesthetic Medicine, 23–29. Berlin, Heidelberg: Springer Berlin Heidelberg, 2006. http://dx.doi.org/10.1007/3-540-32447-x_4.
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Duke, Marquinn D., and Juan C. Duchesne. "Analgesia and Anesthesia." In Surgical Critical Care and Emergency Surgery, 121–28. Chichester, UK: John Wiley & Sons, Ltd, 2018. http://dx.doi.org/10.1002/9781119317913.ch12.
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de Maio, Mauricio. "Anesthesia and Analgesia." In Injectable Fillers in Aesthetic Medicine, 61–68. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-45125-6_5.
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Sager, Jennifer K. "Anesthesia and Analgesia." In Veterinary Technician's Manual for Small Animal Emergency and Critical Care, 465–93. West Sussex, UK: John Wiley & Sons, Ltd., 2013. http://dx.doi.org/10.1002/9781118785690.ch20.
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Haskins, Steve C. "ANESTHESIA AND ANALGESIA." In Manual of Small Animal Emergency and Critical Care Medicine, 41–62. Chichester, UK: John Wiley & Sons, Ltd, 2017. http://dx.doi.org/10.1002/9781119421870.ch5.
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Mele, Michele, Valentina Bellussi, and Laura Felder. "Analgesia And Anesthesia." In Obstetric Evidence Based Guidelines, 137–51. 4th ed. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781003102342-12.
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Tranquilli, William J., Kurt A. Grimm, and Leigh A. Lamont. "Epidural Analgesia/Anesthesia." In Pain Management, 35–38. 2nd ed. New York: Teton NewMedia, 2022. http://dx.doi.org/10.1201/9780429172717-19.
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Mosley, Craig A. "Anesthesia Equipment." In Veterinary Anesthesia and Analgesia, 23–85. Chichester, UK: John Wiley & Sons, Ltd, 2017. http://dx.doi.org/10.1002/9781119421375.ch3.
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Livingston, Alex, and Deborah V. Wilson. "Analgesia." In Manual of Equine Anesthesia and Analgesia, 293–304. Oxford, UK: Blackwell Publishing Ltd, 2007. http://dx.doi.org/10.1002/9780470753248.ch20.
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Camorcia, Michela. "Postoperative Analgesia." In Anesthesia for Cesarean Section, 153–67. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-42053-0_11.
Full textConference papers on the topic "Anesthesia and Analgesia"
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Zhou, H., and E. An. "ESRA19-0207 The effect of transversus abdominis plane block combined with intravenous analgesia on perioperative analgesia and recovery in abdominal colorectal surgery patients." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.414.
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Bruhn, J. "ESRA19-0715 Multimodal analgesia in orthopaedic surgery: the way ahead!" In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.43.
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Pintarič, TS. "ESRA19-0628 Maternal anaesthesia/analgesia and fetal/neonatal drug uptake." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.7.
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Sakalauskaite, G., D. Gasiūnaitė, A. Kraujelytė, and J. Šipylaitė. "ESRA19-0351 Comparison of analgesic efficacy and postoperative pain localization of transversus abdominis plane block and regular postoperative analgesia after C-section." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.147.
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Parmar, J., A. Hassan, and N. Bedforth. "ESRA19-0349 Implementing a regional analgesia service for hip fracture patients." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.178.
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Roriz, D., D. Gonçalves, J. Brandão, R. Graça, J. Barros, S. Caramelo, and R. Abrunhosa. "ESRA19-0347 Charcot-marie-tooth and analgesia for labor- case report." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.203.
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Irigoyen, S., B. Esnaola, P. Romero, and S. Telletxea. "ESRA19-0164 Analgesia with an interfascial catheter after laparoscopic gastric surgery." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.435.
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Rudiger, J., A. Kapuscinska, T. Barnes, S. Goodge, S. O’Mant, A. Belgaumkar, and E. Syrrakou. "ESRA19-0330 Analgesia with abdominal wound catheters post laparotomy in adults." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.450.
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Kovalevska, K., A. Sandner-Kiesling, and GA Schittek. "B58 Concepts of analgesia and sedation for the pre-operative peripheral regional anesthesia." In ESRA Abstracts, 39th Annual ESRA Congress, 22–25 June 2022. BMJ Publishing Group Ltd, 2022. http://dx.doi.org/10.1136/rapm-2022-esra.133.
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Grimaud, O. "ESRA19-0511 Continuous spinal analgesia in trial for labour using wiley spinal." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.143.
Full textReports on the topic "Anesthesia and Analgesia"
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Zhang, Lulu, Buhuai Dong, Yanan Wei, Peng Liu, Yun Liang, and Shanshan Zhang. Acupoint acupuncture for postoperative analgesia after general anesthesia: a meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, March 2021. http://dx.doi.org/10.37766/inplasy2021.4.0075.
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Sandeep, Bhushan, Huang Xin, and Xiao Zongwei. A comparison of regional anesthesia techniques in patients undergoing of video-assisted thoracic surgery: A network meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0003.
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Review question / Objective: Although video-assisted thoracoscopic surgery is a minimally invasive surgical technique, the pain remains moderate to severe. We comprehensively compared the regional anesthesia methods for postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery. Eligibility criteria: All published full-article RCTs comparing the analgesic efficacy of investigated regional anesthesia technique or comparative blocks in adult patients undergoing any VATS were eligible for inclusion. There were no language restrictions. Moreover, we also excluded case reports, non-RCT studies, incomplete clinical trials, and any trials used multiple nerve blocks. We also excluded any conference abstracts which could not offer enough information about the study design, or by data request to the author.
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Zhu, Bo, Dixin Wang, Wei Long, Jia Liu, Huilin Cao, Hucheng Wen, Ling Liu, and Sandeep Bhushan. A comparison of regional anesthesia techniques for postoperative analgesia in patients undergoing liver surgery: A systematic review and network meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0090.
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Pang, Qianyun, Jingyun Wang, and Hongliang Liu. The analgesic efficacy of regional anesthesia using local anesthetic alone versus local anesthetic plus adjuvants for craniotomy: a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, March 2022. http://dx.doi.org/10.37766/inplasy2022.3.0044.
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Harris, Gregory, Brooke Hatchell, Davelin Woodard, and Dwayne Accardo. Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0010.
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Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.
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Acred, Aleksander, Milena Devineni, and Lindsey Blake. Opioid Free Anesthesia to Prevent Post Operative Nausea/Vomiting. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0006.
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Purpose The purpose of this study is to compare the incidence of post-operative nausea and vomiting (PONV) in opioid-utilizing and opioid-free general anesthesia. Background PONV is an extremely common, potentially dangerous side effect of general anesthesia. PONV is caused by a collection of anesthetic and surgical interventions. Current practice to prevent PONV is to use 1-2 antiemetics during surgery, identify high risk patients and utilize tracheal intubation over laryngeal airways when indicated. Current research suggests minimizing the use of volatile anesthetics and opioids can reduce the incidence of PONV, but this does not reflect current practice. Methods In this scoping review, the MeSH search terms used to collect data were “anesthesia”, “postoperative nausea and vomiting”, “morbidity”, “retrospective studies”, “anesthesia, general”, “analgesics, opioid”, “pain postoperative”, “pain management” and “anesthesia, intravenous”. The Discovery Search engine, AccessMedicine and UpToDate were the search engines used to research this data. Filters were applied to these searches to ensure all the literature was peer-reviewed, full-text and preferably from academic journals. Results Opioid free anesthesia was found to decrease PONV by 69%. PONV incidence was overwhelming decreased with opioid free anesthesia in every study that was reviewed. Implications The future direction of opioid-free anesthesia and PONV prevention are broad topics to discuss, due to the nature of anesthesia. Administration of TIVA, esmolol and ketamine, as well as the decision to withhold opioids, are solely up to the anesthesia provider’s discretion. Increasing research and education in the importance of opioid-free anesthesia to decrease the incidence of PONV will be necessary to ensure anesthesia providers choose this protocol in their practice.
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Duan, Yuanqiong, Xin Huang, Ailing Liang, Rutie Yin, and Mengpei Zhang. A comparison of the efficacy and feasibility of different regional anesthesia modes in cesarean section：A systematic review and network meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0093.
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Review question / Objective: To investigate the efficacy and feasibility of different regional anesthesia techniques in patients who received cesarean section. Condition being studied: The current study aims to perform a network meta-analysis to comprehensively compare the regional anesthesia methods for postoperative pain in patients scheduled for elective cesarean section and try to find an optimal method that can serve as a reference in clinical practice. Information sources: Two investigators (YY and SS) independently extracted the data. Information was extracted about participant characteristics (age, gestational week, American society of Anesthesiologist grade (ASA), body mass index(BMI), etc.), study design, anesthesia methods, and analgesic efficacy outcomes. The data were extracted from the text, tables, and graphs of each study.
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Schwieger, Alexandra, Kaelee Shrewsbury, and Paul Shaver. Dexmedetomidine vs Fentanyl in Attenuating the Sympathetic Surge During Endotracheal Intubation: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0007.
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Purpose/Background Direct laryngoscopy and endotracheal intubation after induction of anesthesia can cause a reflex sympathetic surge of catecholamines caused by airway stimulation. This may cause hypertension, tachycardia, and arrhythmias. This reflex can be detrimental in patients with poor cardiac reserve and can be poorly tolerated and lead to adverse events such as myocardial ischemia. Fentanyl, a potent opioid, with a rapid onset and short duration of action is given during induction to block the sympathetic response. With a rise in the opioid crisis and finding ways to change the practice in medicine to use less opioids, dexmedetomidine, an alpha 2 adrenergic agonist, can decrease the release of norepinephrine, has analgesic properties, and can lower the heart rate. Methods In this scoping review, studies published between 2009 and 2021 that compared fentanyl and dexmedetomidine during general anesthesia induction and endotracheal intubation of surgical patients over the age of 18 were included. Full text, peer-reviewed studies in English were included with no limit on country of study. The outcomes included post-operative reviews of decrease in pain medication usage and hemodynamic stability. Studies that were included focused on hemodynamic variables such as systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and use of opioids post-surgery. Result Of 2,114 results from our search, 10 articles were selected based on multiple eligibility criteria of age greater than 18, patients undergoing endotracheal intubation after induction of general anesthesia, and required either a dose of dexmedetomidine or fentanyl to be given prior to intubation. Dexmedetomidine was shown to effectively attenuate the sympathetic surge during intubation over fentanyl. Dexmedetomidine showed a greater reduction in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure than fentanyl, causing better hemodynamic stability in patients undergoing elective surgery.Implications for Nursing Practice Findings during this scoping review indicate that dexmedetomidine is a safe and effective alternative to fentanyl during induction of general anesthesia and endotracheal intubation in attenuating the hemodynamic response. It is also a safe choice for opioid-free anesthesia.
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Johnson, Corey, Colton James, Sarah Traughber, and Charles Walker. Postoperative Nausea and Vomiting Implications in Neostigmine versus Sugammadex. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0005.
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Purpose/Background: Postoperative nausea and vomiting (PONV) is a frequent complaint in the postoperative period, which can delay discharge, result in readmission, and increase cost for patients and facilities. Inducing paralysis is common in anesthesia, as is utilizing the drugs neostigmine and sugammadex as reversal agents for non-depolarizing neuromuscular blockers. Many studies are available that compare these two drugs to determine if neostigmine increases the risk of PONV over sugammadex. Sugammadex has a more favorable pharmacologic profile and may improve patient outcomes by reducing PONV. Methods: This review included screening a total of 39 studies and peer-reviewed articles that looked at patients undergoing general anesthesia who received non-depolarizing neuromuscular blockers requiring either neostigmine or sugammadex for reversal, along with their respective PONV rates. 8 articles were included, while 31 articles were removed based on our exclusion criteria. These were published between 2014 and 2020 exclusively. The key words used were “neostigmine”, “sugammadex”, “PONV”, along with combinations “paralytic reversal agents and PONV”. This search was performed on the scholarly database MEDLINE. The data items were PONV rates in neostigmine group, PONV rates in sugammadex group, incidence of postoperative analgesic consumption in neostigmine group, and incidence of postoperative analgesic consumption in sugammadex group. Results: Despite numerical differences being noted in the incidence of PONV with sugammadex over reversal with neostigmine, there did not appear to be any statistically significant data in the multiple peer-reviewed trials included in our review, for not one of the 8 studies concluded that there was a higher incidence of PONV in one drug or the other of an y clinical relevance. Although the side-effect profile tended to be better in the sugammadex group than neostigmine in areas other than PONV, there was not sufficient evidence to conclude that one drug was superior to the other in causing a direct reduction of PONV. Implications for Nursing Practice: There were variable but slight differences noted between both drug groups in PONV rates, but it remained that none of the studies determined it was statically significant or clinically conclusive. This review did, however, note other advantages to sugammadex over neostigmine, including its pharmacologic profile of more efficiently reversing non-depolarizing neuromuscular blocking drugs and its more favorable pharmacokinetics. This lack of statistically significant evidence found within these studies consequentially does not support pharmacologic decision-making of one drug in favor of the other for reducing PONV; therefore, PONV alone is not a sufficient rationale for a provider to justify using one reversal over another at the current time until further research proves otherwise.