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Minerva Anestesiologica Aug 2016
Topics: Analgesia, Epidural; Analgesia, Patient-Controlled; Analgesics, Opioid; Humans; Pain, Postoperative
PubMed: 26883748
DOI: No ID Found -
Zoological Research Jan 2023
Topics: Animals; Pain; Analgesia; Sound
PubMed: 36594395
DOI: 10.24272/j.issn.2095-8137.2022.524 -
American Family Physician Nov 1998Epidural analgesia is a commonly employed technique of providing pain relief during labor. The number of parturients given intrapartum epidural analgesia is reported to... (Review)
Review
Epidural analgesia is a commonly employed technique of providing pain relief during labor. The number of parturients given intrapartum epidural analgesia is reported to be over 50 percent at many institutions in the United States. The procedure has few contraindications, the primary ones being patient refusal, maternal hemorrhage and coagulopathy. Induction of epidural analgesia in early labor remains controversial. However, many physicians induce analgesia as soon as the diagnosis of active labor has been established and the patient has requested pain relief. The most common complications occurring with epidural analgesia are maternal hypotension and postdural puncture headache. Retrospective studies have demonstrated an association between epidural analgesia and increases in duration of labor, instrumental vaginal delivery and cesarean section for labor. However, several recent prospective studies have concluded that epidural analgesia does not adversely affect the progress of labor or increase the rate of cesarean section. These remain controversial issues among practicing physicians.
Topics: Analgesia, Epidural; Analgesia, Obstetrical; Contraindications; Female; Humans; Labor, Obstetric; Patient Selection; Pregnancy; Time Factors
PubMed: 9835854
DOI: No ID Found -
Asian Journal of Anesthesiology Jun 2017Epidural catheters are used to provide effective intraoperative and postoperative analgesia. Standard epidural catheterization techniques rely on palpation of surface... (Review)
Review
Epidural catheters are used to provide effective intraoperative and postoperative analgesia. Standard epidural catheterization techniques rely on palpation of surface anatomy and the experience of the anesthesiologist. Failure to correctly place an epidural catheter can lead to inadequate analgesia and serious complications, such as dural puncture headache. Exciting new devices and techniques are being developed for identification of the epidural space and confirmation of catheter entry. This article reviews and describes the recent research findings. The devices and techniques are categorized into three sections: devices that modify the loss of resistance technique; visual confirmation using the epidural needle; and confirmation of placement of the epidural catheter.
Topics: Analgesia, Epidural; Catheterization; Epidural Space; Humans; Needles; Spectrum Analysis; Tomography, Optical Coherence; Ultrasonography
PubMed: 28971802
DOI: 10.1016/j.aja.2017.05.009 -
Anaesthesiology Intensive Therapy 2014Endoscopic procedures involving the gastrointestinal tract have been successfully developed in paediatric practice over the last two decades, improving both diagnosis... (Review)
Review
Endoscopic procedures involving the gastrointestinal tract have been successfully developed in paediatric practice over the last two decades, improving both diagnosis and treatment in many children's gastrointestinal diseases. In this group of patients, experience and co-operation between paediatricians/endoscopists and paediatric anaesthesiologists should help to guarantee the quality and safety of a procedure and should additionally help to minimise the risk of adverse events which are greater the smaller the child is. This principle is more and more important especially since the announcement of the Helsinki Declaration on Patient Safety in Anaesthesiology in 2010, emphasising the role of anaesthesiology in promoting safe perioperative care. The Helsinki Declaration has been endorsed by all European anaesthesiology institutions as well as the World Health Organisation's 'Safe Surgery Saves Lives' initiative including the 'Surgical Safety Checklist'. Although most of these procedures could be performed by paediatricians under procedural sedation and analgesia, children with congenital defects and serious coexisting diseases (ASA ≥ III) as well as the usage of anaesthetics (e.g. propofol) must be managed by paediatric anaesthesiologists. We have reviewed the specific principles employed during qualification and performance of procedural sedation and analgesia for gastrointestinal endoscopy in paediatrics. We have also tried to answer the questions as to how, with what, and by whom, procedural sedation for gastrointestinal endoscopy in children should be performed.
Topics: Age Factors; Analgesia; Anesthesia; Anesthesiology; Child; Endoscopy, Gastrointestinal; Humans; Hypnotics and Sedatives; Infant
PubMed: 24858971
DOI: 10.5603/AIT.2014.0021 -
Revista Brasileira de Anestesiologia 2012JUSTIFICATIONS AND OBJECTIVES: regional analgesia plays an important role in multimodal pain management in critically ill patients, minimizing patient discomfort and... (Review)
Review
UNLABELLED
JUSTIFICATIONS AND OBJECTIVES: regional analgesia plays an important role in multimodal pain management in critically ill patients, minimizing patient discomfort and reducing the associated physiological and psychological stress. Lower doses of systemic opioids reduce some of its side effects, such as withdrawal syndrome, possible psychological changes, and gastrointestinal dysfunction. Despite these benefits, its use is controversial, as patients in intensive care units often have contraindications, such as coagulopathy, hemodynamic instability, and difficulty in neurological assessment and implementation of regional technique.
CONTENT
The authors present a review of regional analgesia in intensive care, focusing on the main advantages and limitations of its use in critically ill patients, and describe the most commonly used regional techniques and its applicability.
Topics: Analgesia; Analgesia, Epidural; Critical Care; Humans; Pain Management
PubMed: 22999404
DOI: 10.1016/S0034-7094(12)70170-8 -
Revista Brasileira de Enfermagem Dec 2019To identify the procedures considered painful and stressful by health professionals from a neonatal intensive care unit and check the measures of analgesia.
OBJECTIVE
To identify the procedures considered painful and stressful by health professionals from a neonatal intensive care unit and check the measures of analgesia.
METHOD
Descriptive exploratory quantitative study with 65 health professionals, from November 2016 to February 2017.
RESULTS
The procedures considered painful were removal of adhesives, vein, arterial and lumbar puncture, phlebotomy, and thoracic drainage. Oral suctioning, intravenous catheter removal and tracheal extubation were considered stressful. Fentanyl was the most cited pharmacological measure, and restraint and nonnutritive suction were the most used nonpharmacological measures.
CONCLUSION
Professionals were able to classify the painful and stressful procedures; however, low use of measures for analgesia was evidenced.
Topics: Adult; Analgesia; Female; Health Personnel; Humans; Infant, Newborn; Male; Middle Aged; Pain; Pain Management; Pain Measurement; Perception; Stress, Psychological
PubMed: 31851250
DOI: 10.1590/0034-7167-2018-0326 -
Critical Care (London, England) 2008Analgesic and sedative medications are widely used in intensive care units to achieve patient comfort and tolerance of the intensive care unit environment, and to...
Analgesic and sedative medications are widely used in intensive care units to achieve patient comfort and tolerance of the intensive care unit environment, and to eliminate pain, anxiety, delirium and other forms of distress. Surveys and prospective cohort studies have revealed wide variability in medication selection, monitoring using sedation scales, and implementation of structured treatment algorithms among practitioners in different countries and regions of the world. Successful management of analgesia and sedation incorporates a patient-based approach that includes detection and management of predisposing and causative factors, including delirium; monitoring using analgesia and sedation scales and other instruments; proper medication selection, with an emphasis on analgesia-based drugs; and incorporation of structured strategies that have been demonstrated to reduce likelihood of excessive or prolonged sedation.
Topics: Analgesia; Analgesics; Conscious Sedation; Critical Illness; Humans; Hypnotics and Sedatives; Intensive Care Units; Monitoring, Physiologic; Pain Measurement; Patient-Centered Care
PubMed: 18495052
DOI: 10.1186/cc6147 -
Journal of the American Association For... Nov 2022Appropriate analgesia is a crucial part of rodent postoperative and postprocedural pain. Providing appropriate analgesia is an ethical obligation, a regulatory... (Review)
Review
Appropriate analgesia is a crucial part of rodent postoperative and postprocedural pain. Providing appropriate analgesia is an ethical obligation, a regulatory requirement, and an essential element of obtaining quality scientific results and conducting reproducible data. Meeting these requirements is facilitated by practical, efficient and safe delivery methods for providing analgesia. Over the last decade, long-acting analgesics have gained widespread use in research animal medicine to avoid or treat postoperative or postprocedural pain while minimizing handling-related time and stress. Long-acting formulations of analgesics suitable for rodents are available for opioids, NSAIDs, and local anesthetics. The goal of this review is to summarize the currently available long-acting formulations of analgesics for rodents and to provide recommendations to veterinarians and researchers regarding their use.
Topics: Rats; Mice; Animals; Analgesics; Analgesia; Pain Management; Pain; Analgesics, Opioid; Rodentia; Pain, Postoperative
PubMed: 36379476
DOI: 10.30802/AALAS-JAALAS-22-000061 -
Italian Journal of Pediatrics Feb 2023To date, pain and anxiety are the most common symptoms reported by children who refer to pediatric emergency department. Despite it is well known that the undertreatment... (Review)
Review
To date, pain and anxiety are the most common symptoms reported by children who refer to pediatric emergency department. Despite it is well known that the undertreatment of this condition has some negative consequences in a short term and long term of time, gaps in the management of pain in this setting still persist. This subgroup analysis aims to describe the current state of art of pediatric sedation and analgesia in Italian emergency departments and to identify existing gaps to solve. This is a subgroup analysis of a cross-sectional European survey of pediatric emergency departments sedation and analgesia practice undertaken between November 2019 and March 2020. The survey proposed a case vignette and questions addressing several domains, like the management of pain, availability of medications, protocols and safety aspects, staff training and availability of human resources around procedural sedation and analgesia. Italian sites responding to the survey were identified and their data were isolated and checked for completeness. Eighteen Italian sites participated to the study, the 66% of which was represented University Hospitals and/or Tertiary Care Centers. The most concerning results were an inadequate sedation to 27% of patients, lack of availability of certain medications like nitrous oxide, the lack of use of intranasal fentanyl and topical anesthetics at the triage, the rare use of safety protocols and preprocedural checklists, lack of staff training and lack of space. Furthermore, the unavailability of Child Life Specialists and hypnosis emerged. Despite procedural sedation and analgesia in Italian pediatric emergency departments is progressively more used than previously, several aspects still require an implementation. Our subgroup analysis could be a starter point for further studies and to improve and make the current Italian recommendations more homogeneous.
Topics: Child; Humans; Cross-Sectional Studies; Analgesia; Pain; Tertiary Care Centers; Emergency Service, Hospital
PubMed: 36793117
DOI: 10.1186/s13052-023-01426-7