Latest & greatest articles for acute pain

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Top results for acute pain

1. The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials Pregabalin is commonly used as an analgesic for neuropathic pain. But pregabalin as an adjunct to a multimodal analgesic regimen - although standard clinical protocol in some settings - has remained controversial. This meta-analysis was conducted to identify the efficacy of pregabalin for management of postoperative (...) drowsiness (OR: 8.61; 95% CI: 2.23-33.20; P=0.002), and less constipation (OR: 0.23; 95% CI: 0.09-0.59; P=0.002). There was no statistical differences in pain score on 7 days (MD:-0.77; 95% CI: -2.38 to 0.84; P=0.35), nausea (OR: 0.73; 95% CI: 0.42-1.26; P=0.26), and vomiting (OR: 0.83; 95% CI: 0.36-1.90; P=0.65).Pregabalin can prevent postoperative pain in thoracotomy and decrease incidence of neuropathic pain and morphine consumption. Pregabalin may be a valuable asset in management of acute

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2019 EvidenceUpdates

2. Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials

Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials Pregabalin (PGB) and gabapentin (GBP) are current and emerging drugs in the field of pre-emptive preoperative analgesia. However, the role of PGB or GBP in acute postoperative pain management still remains elusive.We conducted a comprehensive literature search of articles published by December 3, 2017. A total of 79 randomized controlled trials (...) with 6,201 patients receiving single-dose premedication were included. Through a network meta-analysis (NMA), we validated the analgesic effect and incidence of adverse events by using various doses of PGB or GBP administration.NMA results suggested that the analgesic effect may be dose related. For 24-hour opioid consumption, a consistent decrease was found with the increase in the dose of PGB or GBP. For 24-hour pain score at rest, a high dose (≥150 mg) of PGB was more effective in decreasing pain

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2019 EvidenceUpdates

3. Randomized Clinical Trial of Intravenous Acetaminophen as an Analgesic Adjunct for Older Adults With Acute Severe Pain

Randomized Clinical Trial of Intravenous Acetaminophen as an Analgesic Adjunct for Older Adults With Acute Severe Pain Older adults are at risk for undertreatment of pain. We examined intravenous (IV) acetaminophen as an analgesic adjunct to IV opioids in the care of older emergency department (ED) patients with acute severe pain.This was a randomized clinical trial conducted in two EDs in the Bronx, New York. Eligible adults aged 65 years and older with acute severe pain were randomized to 0.5 (...) in the hydromorphone + IV acetaminophen group wanted more analgesia at 60 minutes versus 29.1% in the hydromorphone + placebo group, for a difference of -0.4% (95% CI = -14.3% to 13.5%). These differences were neither clinically nor statistically significant. Safety profiles were similar in both groups.In this randomized clinical trial, the addition of IV acetaminophen to IV hydromorphone as an adjunctive analgesic for acute, severe, pain in older adults provided neither clinically nor statistically superior pain

2019 EvidenceUpdates

4. Perioperative intravenous ketamine for acute postoperative pain in adults. (PubMed)

Perioperative intravenous ketamine for acute postoperative pain in adults. Inadequate pain management after surgery increases the risk of postoperative complications and may predispose for chronic postsurgical pain. Perioperative ketamine may enhance conventional analgesics in the acute postoperative setting.To evaluate the efficacy and safety of perioperative intravenous ketamine in adult patients when used for the treatment or prevention of acute pain following general anaesthesia.We searched (...) . Studies compared ketamine with placebo, or compared ketamine plus a basic analgesic, such as morphine or non-steroidal anti-inflammatory drug (NSAID), with a basic analgesic alone.Two review authors searched for studies, extracted efficacy and adverse event data, examined issues of study quality and potential bias, and performed analyses. Primary outcomes were opioid consumption and pain intensity at rest and during movement at 24 and 48 hours postoperatively. Secondary outcomes were time to first

2018 Cochrane

5. Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies.Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials. The relative risk and weighted mean difference (WMD) were used to analyze the outcomes (...) . Random-effects model was used for meta-analysis.Compared with the normal saline group, patients using DEX showed a significantly decreased pain intensity within 6 hours [WMD=-0.93; 95% confidence interval (CI), -1.34 to -0.53) and at 24 hours after surgery (WMD=-0.47; 95% CI, -0.83 to -0.11). DEX usage significantly reduced the cumulative opioids consumption at 24 hours after surgery (WMD=-6.76; 95% CI, -10.16 to -3.35), decreased the rescue opioids consumption in postanesthesia care unit (WMD=-3.11

2018 EvidenceUpdates

6. Efficacy of preemptive analgesia on acute postoperative pain in children undergoing major orthopedic surgery of the lower extremities (PubMed)

Efficacy of preemptive analgesia on acute postoperative pain in children undergoing major orthopedic surgery of the lower extremities Children undergoing major orthopedic surgery of the lower extremities can experience severe postoperative pain; yet, the ideal postoperative pain management strategy is unknown. Thus, in this patient population, we investigated the effect of intraoperative epidural infusion of local anesthetic on acute postoperative pain and analgesic consumption.Patients (N=50 (...) , 3-12 years) randomly received either ropivacaine 0.15% (preemptive group) or normal saline (control group) as an initial bolus of 0.2 mL/kg, followed by continuous infusion of 0.15 mL/kg/h throughout surgery. Following surgery, patient-controlled epidural analgesia with ropivacaine 0.1% was provided. The main study outcomes were the revised Face, Legs, Activity, Cry, and Consolability pain scores, epidural ropivacaine consumption, and additional analgesic requirements during the first 48 hours

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2018 EvidenceUpdates

7. What Is the Utility of Coronary Computed Tomography Angiography Compared With Standard of Care for the Evaluation of Acute Chest Pain? (SRS diagnosis)

What Is the Utility of Coronary Computed Tomography Angiography Compared With Standard of Care for the Evaluation of Acute Chest Pain? (SRS diagnosis) TAKE-HOME MESSAGE Compared with existing standards of care for the evaluation of acute chest pain, coronary computed tomography (CT) angiography is associated with similar rates of major adverse events, but higher rates of revascularization. What Is the Utility of Coronary Computed Tomography Angiography Compared With Standard of Care (...) for the Evaluation of Acute Chest Pain? EBEM Commentators Michael Gottlieb, MD Chase Socha, MD Department of Emergency Medicine Rush University Medical Center Chicago, IL Results The search strategy identi?ed 648 articles, of which 10 trials (6,285 total participants) met the inclusion criteria. The studies were published between 2007 and 2016, and none were deter- mined to be at high risk of bias. Six studies were performed in the ED and 4 studies were per- formed in the inpatient setting. The mean age ranged

2018 Annals of Emergency Medicine Systematic Review Snapshots

8. Randomized Controlled Trial of Intravenous Acetaminophen Versus Intravenous Hydromorphone for the Treatment of Acute Pain in the Emergency Department

Randomized Controlled Trial of Intravenous Acetaminophen Versus Intravenous Hydromorphone for the Treatment of Acute Pain in the Emergency Department As clinicians look to nonnarcotic analgesics in the emergency department (ED), it is essential to understand the effectiveness and adverse effects of nonopioid medications in comparison with existing opioid treatments. Studies of intravenous acetaminophen for acute pain in the ED demonstrate mixed results and suffer from small sample sizes (...) and methodological limitations. This study compares intravenous hydromorphone with intravenous acetaminophen in adult ED patients presenting with acute pain.This was a prospective, randomized, clinical trial comparing 1 g intravenous acetaminophen with 1 mg intravenous hydromorphone for treatment of adults with severe, acute pain in the ED. The primary outcome was between-group difference in change in numeric rating scale from baseline to 60 minutes postadministration of study medication. Secondary outcomes

2018 EvidenceUpdates

9. Efficacy of hypnosis on pain, wound-healing, anxiety, and stress in children with acute burn injuries: a randomized controlled trial

Efficacy of hypnosis on pain, wound-healing, anxiety, and stress in children with acute burn injuries: a randomized controlled trial No randomized controlled trial has investigated the efficacy of hypnosis for reducing pain and improving wound-healing in children with burns. This randomized controlled trial aimed to investigate whether hypnosis decreases pain, anxiety, and stress and accelerates wound-healing in children undergoing burn wound procedures. Children (4-16 years) with acute burns (...) presenting for their first dressing change were randomly assigned to a Hypnosis Group who received hypnosis plus standard care or a Standard Care Group who received standard pharmacological and nonpharmacological intervention. Repeated measures of pain intensity, anxiety, stress, and wound-healing were taken at dressing changes until ≥95% wound re-epithelialization. Data for 62 children were analyzed on an intent-to-treat basis using Generalized Estimating Equations (n = 35 Standard Care Group; n = 27

2018 EvidenceUpdates

10. A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department Opioids are commonly prescribed in the emergency department (ED) for the treatment of acute pain. Analgesic alternatives are being explored in response to an epidemic of opioid misuse. Low-dose ketamine (LDK) is one opioid alternative for the treatment of acute pain in the ED.This systematic review and meta-analysis sought to quantify whether LDK is an effective and safe (...) opioid alternative for acute pain reduction in adults in the ED setting. (PROSPERO Registration Number CRD42017065303).This was a systematic review of randomized controlled trials comparing intravenous opioids to LDK for relief of acute pain in the ED. Studies where the control group initially received opioids prior to ketamine were excluded. A research librarian designed the electronic search strategy. Changes in visual analog scale or numeric rating scale pain scales were analyzed to determine

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2018 EvidenceUpdates

11. Single-dose intravenous diclofenac for acute postoperative pain in adults. (PubMed)

Single-dose intravenous diclofenac for acute postoperative pain in adults. Postoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) reduces patient opioid requirements and, in turn, reduces the incidence and severity of opioid-induced adverse events (AEs).To assess the analgesic efficacy and adverse effects of single-dose intravenous diclofenac, compared with placebo or an active comparator, for moderate to severe postoperative pain in adults.We searched the following (...) databases without language restrictions: the Cochrane Central Register of Controlled Trials (Cochrane Register of Studies Online), MEDLINE, and Embase on 22 May 2018. We checked clinical trials registers and reference lists of retrieved articles for additional studies.We included randomized trials that compared a single postoperative dose of intravenous diclofenac with placebo or another active treatment, for treating acute postoperative pain in adults following any surgery.We used standard

2018 Cochrane

12. Is oral orphenadrine beneficial for acute low back pain?

Is oral orphenadrine beneficial for acute low back pain? Is oral orphenadrine beneficial for acute low back pain? – Morsels of Evidence \t\t\t\r\n\t\t\t \t\t\t\r\n\t\t\t Like this: Like Loading... ","author":{"@type":"Person","name":"Michael Tam"},"image":["https:\/\/evidencebasedmedicine.com.au\/wp-content\/uploads\/2018\/08\/mo_2018-08_p46-7_cover.png"]} Toggle search form Toggle navigation Evidence-based medicine for general practitioners Aug 21 2018 Is oral orphenadrine beneficial for acute (...) low back pain? By in , Journal reference: Friedman BW, Cisewski D, Irizarry E, et al. A Randomized, Double-Blind, Placebo-Controlled Trial of Naproxen With or Without Orphenadrine or Methocarbamol for Acute Low Back Pain. Ann Emerg Med 2018 Mar;71(3):348-56 e5 Link: Published: March 2018 Evidence cookie says… Orphenadrine provides no benefit when used in addition to naproxen for acute low back pain the point estimate is close to zero, with the imprecision of the estimate well within the minimal

2018 Morsels of Evidence

13. Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial

Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol.Forty (...) observer's assessment of alertness/sedation score of 3 or 4. The cumulative amounts of fentanyl administered via intravenous patient-controlled analgesia were recorded at 24 and 48 hours postoperatively (primary outcome). The postoperative numerical rating scale for pain was assessed at 6, 12, 24, and 48 hours (secondary outcome). The postoperative use of additional rescue analgesic (ketoprofen) and antiemetic drugs was also compared between the 2 groups at 24 and 48 hours.Dexmedetomidine significantly

2018 EvidenceUpdates

14. Acute pain

Acute pain Top results for acute pain - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 (...) or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for acute pain The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence

2018 Trip Latest and Greatest

15. Cebranopadol: A Novel, First-in-Class, Strong Analgesic: Results from a Randomized Phase IIa Clinical Trial in Postoperative Acute Pain

Cebranopadol: A Novel, First-in-Class, Strong Analgesic: Results from a Randomized Phase IIa Clinical Trial in Postoperative Acute Pain Cebranopadol is a potent, first-in-class analgesic with a novel mechanistic approach combining nociceptin/orphanin FQ peptide (NOP) and opioid peptide receptor agonism.We aim to evaluate, for the first time, the analgesic efficacy, safety, and tolerability of cebranopadol in patients suffering from moderate to severe acute pain following bunionectomy.We (...) ) intake time-point.Cebranopadol doses of 400 µg and 600 µg were more effective in reducing postoperative acute pain compared to placebo, from 2 hours until approximately 22 hours after the first IMP intake time-point. No difference was observed between cebranopadol 200 µg and placebo. Per the subject global impression of the IMP assessment, patients who received cebranopadol 400 µg and 600 µg were more satisfied with the ability of the medication to treat their pain compared to those who received

2018 EvidenceUpdates

16. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management Consensus Guidelines on the Use of Intravenous Ketamine Infu... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account (...) Procite Reference Manager Save my selection doi: 10.1097/AAP.0000000000000806 REGIONAL ANESTHESIA AND ACUTE PAIN: SPECIAL ARTICLE Open Background Ketamine infusions have been used for decades to treat acute pain, but a recent surge in usage has made the infusions a mainstay of treatment in emergency departments, in the perioperative period in individuals with refractory pain, and in opioid-tolerant patients. The widespread variability in patient selection, treatment parameters, and monitoring

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2018 American Society of Regional Anesthesia and Pain Medicine

17. Low Back Pain, Adult Acute and Subacute

Low Back Pain, Adult Acute and Subacute Health Care Guideline: Adult Acute and Subacute Low Back Pain www.icsi.org Copyright © 2017 by Institute for Clinical Systems Improvement 1 Diagnosis Algorithm Text in blue in this algorithm indicates a linked corresponding annotation. Adult patient present with acute or subacute low back pain History and exam: • Pain characteristics • Sensory and strength changes • Prior treatment and response yes Complete assessment tools for pain and function (...) Incapacitating pain and/or advancing neurologic symptoms or other underlying pathology Consider re- evaluation, imaging or referral to specialist no Routine imaging is not recommended See Treatment Algorithm Acute 50) and failure to improve after one month had high false-positive rates. The authors concluded that red flags may be useful when combined or with a history of cancer, but by themselves will result in overtesting (Henschke, 2013). Fracture Single red flags that increase the likelihood of spinal

2018 Institute for Clinical Systems Improvement

18. Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial. (PubMed)

Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial. To assess whether percutaneous vertebroplasty results in more pain relief than a sham procedure in patients with acute osteoporotic compression fractures of the vertebral body.Randomised, double blind, sham controlled clinical trial.Four community hospitals in the Netherlands, 2011-15.180 participants requiring treatment for acute (...) opioids) decreased statistically significantly in both groups at all time points, with no statistically significant differences between groups. Two adverse events occurred in the vertebroplasty group: one respiratory insufficiency and one vasovagal reaction.Percutaneous vertebroplasty did not result in statistically significantly greater pain relief than a sham procedure during 12 months' follow-up among patients with acute osteoporotic vertebral compression fractures.ClinicalTrials.gov NCT01200277

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2018 BMJ

19. Acute Nonlocalized Abdominal Pain

Acute Nonlocalized Abdominal Pain Revised 2018 ACR Appropriateness Criteria ® 1 Acute Nonlocalized Abdominal Pain American College of Radiology ACR Appropriateness Criteria ® Acute Nonlocalized Abdominal Pain Variant 1: Acute nonlocalized abdominal pain and fever. No recent surgery. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT abdomen and pelvis with IV contrast Usually Appropriate ??? MRI abdomen and pelvis without and with IV contrast May Be Appropriate O US (...) Not Appropriate ???? Fluoroscopy contrast enema Usually Not Appropriate ??? Fluoroscopy upper GI series with small bowel follow-through Usually Not Appropriate ??? Variant 2: Acute nonlocalized abdominal pain and fever. Postoperative patient. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT abdomen and pelvis with IV contrast Usually Appropriate ??? MRI abdomen and pelvis without and with IV contrast May Be Appropriate O US abdomen May Be Appropriate O CT abdomen and pelvis

2018 American College of Radiology

20. Postoperative local incision analgesia for acute pain treatment in patients with hepatocellular carcinoma. (PubMed)

Postoperative local incision analgesia for acute pain treatment in patients with hepatocellular carcinoma. The present study aimed to investigate the analgesic effect and safety of using local incision analgesia to treat acute postoperative pain in patients with hepatocellular carcinoma (HCC).A cohort of 60 patients undergoing liver cancer resection was randomly divided into three groups (n=20 per group): local incision analgesia (LIA) group, which received local infiltration with ropivacaine (...) increased in LIA group compared with the control group (χ2=4.749; p=0.029).Local incision analgesia improves the analgesic effect, causes fewer adverse reactions and increases postoperative survival time. Our study demonstrated that local incision analgesia is a safe and effective method of postoperative pain management following hepatectomy.

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2018 Revista da Associacao Medica Brasileira (1992)