Latest & greatest articles for analgesia

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This page lists the very latest high quality evidence on analgesia and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

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Analgesia

Analgesic drugs are used to provide analgesia, the inability to feel pain. There are numerous groups of analgesics including simple analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. Analgesics types are prescribed differently depending on the severity of pain relief needed.

The most common type of analgesic generally known and used is non-steroidal anti-inflammatory drugs such as paracetamol, aspirin and ibuprofen. Opioid drugs include morphine, codeine, oxycodone, dihydromorphine and pethidine.

Research shows that analgesic drugs have an effect on the peripheral and central nervous system, relieving pain without the loss of consciousness. Opioids are highly effect pain relievers however case studies prove they can be highly addictive. Therefore use should be guided by the World Health Organization (WHO) pain ladder which specifies mild analgesics as its first step.

Clinical trials and studies carried out across all groups of analgesia have proven the drugs are highly effective painkillers, opioids in particular. However, years of research and clinical trials conclude that some groups have significant side effects such as addiction or cardiovascular side effects. Research evidence is broad including clinical guidelines, systematic reviews, randomised controlled trials, case studies etc. These can easily be found via a search of the Trip Database.

Top results for analgesia

181. The effect of manipulation of the programmed intermittent bolus time interval and injection volume on total drug use for labor epidural analgesia: a randomized controlled trial

The effect of manipulation of the programmed intermittent bolus time interval and injection volume on total drug use for labor epidural analgesia: a randomized controlled trial 21430035 2011 03 24 2011 05 16 2011 03 24 1526-7598 112 4 2011 Apr Anesthesia and analgesia Anesth. Analg. The effect of manipulation of the programmed intermittent bolus time interval and injection volume on total drug use for labor epidural analgesia: a randomized controlled trial. 904-11 10.1213/ANE.0b013e31820e7c2f (...) Programmed intermittent bolus administration of epidural anesthetic solution compared with continuous infusion results in decreased anesthetic consumption and increased patient satisfaction. In this randomized and blinded study, we evaluated bupivacaine consumption and other analgesic outcomes when the programmed intermittent bolus time interval and volume were manipulated during the maintenance of epidural labor analgesia. Healthy, term, nulliparous women in spontaneous labor had combined spinal

EvidenceUpdates2011

182. Local anaesthetic reduces need for analgesia after caesarean section

Local anaesthetic reduces need for analgesia after caesarean section PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They Local anaesthetic reduces need for analgesia after caesarean section Clinical question How effective are local anaesthetic agent wound infiltration/irrigation and/or abdominal nerve block on post-caesarean section pain and the mother's wellbeing and interaction with her baby (...) ? Bottom line In general, local anaesthetic wound infiltration was of benefit in women having a caesarean section requiring regional anaesthetics because of a reduction in the use of opioid analgesia compared to placebo (ranging from 22% to 52% across the 3 trials reviewed). Women undergoing general anaesthesia who had wound infiltration with local anaesthetics and peritoneal spraying required lower amounts of opioids in the first 24 hours post surgery compared to saline control. Those who had

Cochrane PEARLS2011

183. The effect of mixing 1.5% mepivacaine and 0.5% bupivacaine on duration of analgesia and latency of block onset in ultrasound-guided interscalene block

The effect of mixing 1.5% mepivacaine and 0.5% bupivacaine on duration of analgesia and latency of block onset in ultrasound-guided interscalene block 21156983 2011 01 24 2011 02 28 2016 11 25 1526-7598 112 2 2011 Feb Anesthesia and analgesia Anesth. Analg. The effect of mixing 1.5% mepivacaine and 0.5% bupivacaine on duration of analgesia and latency of block onset in ultrasound-guided interscalene block. 471-6 10.1213/ANE.0b013e3182042f7f Short- and long-acting local anesthetics are commonly (...) = 0.21 between all groups). The duration of motor block for the combination group (11.5 ± 4.7 hours) was between that of the bupivacaine (16.4 ± 9.4 hours) and mepivacaine (6.0 ± 4.2 hours) groups (P = 0.03 between bupivacaine and combination groups; P = 0.01 between mepivacaine and combination groups). Duration of analgesia was the shortest with mepivacaine (4.9 ± 2.4 hours), longest with bupivacaine (14.0 ± 6.2 hours), and intermediate with the combination group (10.3 ± 4.9 hours) (P < 0.001

EvidenceUpdates2011

184. Efficacy of thoracic epidural analgesia with or without intercostal nerve cryoanalgesia for postthoracotomy pain

Efficacy of thoracic epidural analgesia with or without intercostal nerve cryoanalgesia for postthoracotomy pain 21353017 2011 02 28 2011 05 05 2011 02 28 1552-6259 91 3 2011 Mar The Annals of thoracic surgery Ann. Thorac. Surg. Efficacy of thoracic epidural analgesia with or without intercostal nerve cryoanalgesia for postthoracotomy pain. 869-73 10.1016/j.athoracsur.2010.11.014 We evaluated effects of thoracic epidural analgesia combined with intercostal nerve cryoanalgesia or epidural (...) analgesia alone on acute and long-term pain after posterolateral thoracotomy. Forty-two elective thoracotomy patients were randomly assigned to two groups, epidural combined with cryoanalgesia or epidural alone. A thoracic epidural catheter was inserted before induction of anesthesia. At the end of the operation, cryoanalgesia was performed to 3 intercostals nerves: 1 at the level of the incision, 1 caudal, and 1 cranial. Cryoanalgesia was blinded to the investigating anesthetists and patients. To avoid

EvidenceUpdates2011

185. Superficial cervical plexus block for transitional analgesia in infratentorial and occipital craniotomy: a randomized trial

Superficial cervical plexus block for transitional analgesia in infratentorial and occipital craniotomy: a randomized trial 20878375 2010 11 22 2011 03 07 2013 11 21 1496-8975 57 12 2010 Dec Canadian journal of anaesthesia = Journal canadien d'anesthesie Can J Anaesth Superficial cervical plexus block for transitional analgesia in infratentorial and occipital craniotomy: a randomized trial. 1065-70 10.1007/s12630-010-9392-3 In this study, we compared the quality of transitional analgesia (...) of morphine after dural closure and a SCPB performed with 20 mL of a 1:1 mixture of 0.5% bupivacaine and 2% lidocaine at the end of the surgery). Postoperative pain was assessed at one, two, four, eight, 12, 16, and 24 hr using an 11-point (0-10) numerical rating scale (NRS). Analgesia was provided with subcutaneous codeine. Average NRS scores were similar between the two groups at each time interval over the study period. The average scores (with 95% confidence interval) were 3.9 (3.4-4.4) and 4.3 (3.8

EvidenceUpdates2011

186. Continuous interscalene analgesia with ropivacaine 0.2% versus ropivacaine 0.3% after open rotator cuff repair: the effects on postoperative analgesia and motor function

Continuous interscalene analgesia with ropivacaine 0.2% versus ropivacaine 0.3% after open rotator cuff repair: the effects on postoperative analgesia and motor function 20889941 2010 11 25 2011 01 07 2015 11 19 1526-7598 111 6 2010 Dec Anesthesia and analgesia Anesth. Analg. Continuous interscalene analgesia with ropivacaine 0.2% versus ropivacaine 0.3% after open rotator cuff repair: the effects on postoperative analgesia and motor function. 1543-7 10.1213/ANE.0b013e3181f94cac Interscalene (...) analgesia is a recognized technique for the management of postoperative pain after major shoulder surgery. The most effective local anesthetic concentration in this setting is still controversial. In this study, we compared the analgesia and side effects of a continuous infusion of ropivacaine 0.2% and 0.3% administered through an interscalene catheter for the first 48 hours after surgery. Eighty consecutive patients scheduled for elective open rotator cuff repair were randomized into 2 groups

EvidenceUpdates2011

187. Randomised controlled trial: The ?Ready for Child? structured antenatal training programme increases likelihood of mother's arriving at the maternity ward in active labour and decreases use of epidural analgesia

Randomised controlled trial: The ?Ready for Child? structured antenatal training programme increases likelihood of mother's arriving at the maternity ward in active labour and decreases use of epidural analgesia The ‘Ready for Child’ structured antenatal training programme increases likelihood of mother's arriving at the maternity ward in active labour and decreases use of epidural analgesia | Evidence-Based Nursing This site uses cookies. By continuing to browse the site you are agreeing (...) increases likelihood of mother's arriving at the maternity ward in active labour and decreases use of epidural analgesia Article Text Midwifery Randomised controlled trial The ‘Ready for Child’ structured antenatal training programme increases likelihood of mother's arriving at the maternity ward in active labour and decreases use of epidural analgesia Caroline SE Homer Statistics from Altmetric.com No Altmetric data available for this article. Commentary on: Maimburg RD , Vaeth M , Dürr J , et al

Evidence-Based Nursing (Requires free registration)2011

189. Quantitative study ? other: Nurse-initiated analgesia improves patients' pain experience: time for change?

Quantitative study ? other: Nurse-initiated analgesia improves patients' pain experience: time for change? Nurse-initiated analgesia improves patients' pain experience: time for change? | Evidence-Based Nursing This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Log in via your Society Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search (...) for this keyword Search for this keyword Main menu Log in via your Society Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Nurse-initiated analgesia improves patients' pain experience: time for change? Article Text Pain management Quantitative study – other Nurse-initiated analgesia improves patients' pain experience: time for change? Anne-Maree Kelly Statistics from Altmetric.com No Altmetric

Evidence-Based Nursing (Requires free registration)2011

190. Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review

Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review Wassen MM, Zuijlen J, Roumen FJ, Smits LJ, Marcus MA, Nijhuis JG CRD summary There was no increased risk of caesarean delivery or instrumental vaginal delivery (...) for women who received early epidural analgesia at cervical dilation of 3cm or less in comparison with late epidural analgesia. The results of this review reflect the evidence presented and can be taken as reliable. Authors' objectives To compare early versus late epidural analgesia for the risk of caesarian or instrumental delivery in nulliparous women. Searching PubMed, EMBASE and The Cochrane Library were searched to July 2010. Search terms were reported. There were no restrictions on publication

DARE.2011

191. Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial.

Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial. 21447587 2011 03 30 2011 05 25 2012 03 06 1756-1833 342 2011 Mar 29 BMJ (Clinical research ed.) BMJ Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial. d1491 10.1136/bmj.d1491 bmj.d1491 To compare long term recurrence of cancer and survival of patients having major abdominal surgery for cancer. Long term (...) and Perioperative Medicine, Alfred Hospital, Melbourne, Australia. p.myles@alfred.org.au Peyton Philip P Silbert Brendan B Hunt Jennifer J Rigg John R A JR Sessler Daniel I DI ANZCA Trials Group Investigators eng Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2011 03 29 England BMJ 8900488 0959-535X AIM IM BMJ. 2011;342:d1605 21447588 Abdominal Neoplasms mortality surgery Adult Aged Aged, 80 and over Analgesia, Epidural mortality Cause of Death Disease-Free

BMJ2011

192. American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients

American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients CHEST Consensus Statement 1342 Consensus Statement Executive Summary Performing Bronchoscopy With No Sedation There is an equal safety record of sedation 1. vs no sedation in bronchoscopy, but patients’ satisfaction and procedure tol- erance are signi? cantly improved with sedation. Sedation is suggested in all patients un- 2. dergoing (...) bronchoscopy unless contra- indications exist. The extent of sedation (minimal, mod- 3. erate, deep, or general anesthesia) used during bronchoscopy can vary based on American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients Momen M. W ahidi , MD, MBA, FCCP ; Prasoon Jain , MD, FCCP ; Michael Jantz , MD, FCCP ; Pyng Lee , MD, FCCP ; G. Burkhard Mackensen , MD, PhD ; Sally Y . Barbour , PharmD ; Carla

American College of Chest Physicians2011

193. Improving continuous wound infusion effectiveness for postoperative analgesia after cesarean delivery: a randomized controlled trial

Improving continuous wound infusion effectiveness for postoperative analgesia after cesarean delivery: a randomized controlled trial 20859153 2010 09 22 2010 10 22 2013 11 21 1873-233X 116 4 2010 Oct Obstetrics and gynecology Obstet Gynecol Improving continuous wound infusion effectiveness for postoperative analgesia after cesarean delivery: a randomized controlled trial. 893-900 10.1097/AOG.0b013e3181f38ac6 To evaluate in which anatomical layer (above the fascia or below the fascia) continuous (...) . No other systemic analgesics were used, except for rescue patient-controlled intravenous morphine. Evaluation by a blinded investigator included visual analog scale scores at rest and at movement, morphine consumption, patient satisfaction, residual pain at 1 and 6 months, and undesirable side effects. Continuous wound infusion below the fascia resulted in significantly reduced pain at rest and total postoperative morphine consumption (15.7 mg, 95% confidence interval 9.7-20.7 mg) compared with wound

EvidenceUpdates2010

194. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy

Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy 20705788 2010 09 27 2010 10 11 2013 11 21 1526-7598 111 4 2010 Oct Anesthesia and analgesia Anesth. Analg. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. 1004-10 10.1213/ANE.0b013e3181ee82fa (...) Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A). One hundred twenty-two patients with obstructive sleep apnea syndrome undergoing T&A, ages 2 to 10 years, completed this prospective, randomized, U.S. Food and Drug

EvidenceUpdates2010

195. Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults

Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults BestBets: Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults Report By: Lee Helliwell - SpR Emergency Medicine Search checked by Catherine Jackson - ST5, Emergency Medicine Institution: Lancashire Teaching Hospitals NHS Trust Current web editor: Richard Body - Clinical Research Fellow (...) . (fentanyl.mp. OR exp Fentanyl/OR exp Heroin/OR diamorphine.mp.) AND (exp Administration, Intranasal/OR intranasal.mp.) AND (morphine.mp. OR exp Morphine/OR exp Morphine Derivatives/) AND (exp Infusions, Intravenous/OR intravenous.mp. OR exp Injections, Intravenous/) AND (pain.mp. OR exp Pain/OR exp Pain Measurement/OR exp Analgesia/OR analgesi$.mp.) limit to all adult (19 plus years). Cochrane Library, accessed 22 March, 2010: (fentanyl OR diamorphine) AND intranasal. Search Outcome Six papers were

BestBETS2010

196. Transversus abdominis plane block does not provide additional benefit to multimodal analgesia in gynecological cancer surgery

Transversus abdominis plane block does not provide additional benefit to multimodal analgesia in gynecological cancer surgery 20547822 2010 08 24 2010 09 10 2016 11 25 1526-7598 111 3 2010 Sep Anesthesia and analgesia Anesth. Analg. Transversus abdominis plane block does not provide additional benefit to multimodal analgesia in gynecological cancer surgery. 797-801 10.1213/ANE.0b013e3181e53517 The transversus abdominis plane (TAP) block is a recently described technique involving injecting (...) local anesthetic between the internal oblique and transversus abdominis layers of the abdominal wall. It has been shown to be effective in reducing morphine consumption and improving postoperative pain relief in several clinical settings. We performed a randomized placebo-controlled trial comparing bilateral ultrasound-guided TAP blocks (2 x 20 mL 0.5% ropivacaine or 0.9% saline) in adult female patients undergoing midline laparotomy for known or presumed gynecological malignancy. Both groups

EvidenceUpdates2010

197. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty

A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty 20860447 2010 10 08 2010 10 14 2016 12 15 1745-3682 81 5 2010 Oct Acta orthopaedica Acta Orthop A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty. 606-10 10.3109/17453674.2010.519165 There have been few studies describing wound infiltration with additional intraarticular administration of multimodal (...) analgesia for total knee arthroplasty (TKA). In this study, we assessed the efficacy of wound infiltration combined with intraarticular regional analgesia with epidural infusion on analgesic requirements and postoperative pain after TKA. 40 consecutive patients undergoing elective, primary TKA were randomized into 2 groups to receive either (1) intraoperative wound infiltration with 150 mL ropivacaine (2 mg/mL), 1 mL ketorolac (30 mg/mL), and 0.5 mL epinephrine (1 mg/mL) (total volume 152 mL) combined

EvidenceUpdates2010 Full Text: Link to full Text with Trip Pro

198. The effect of intraoperative dexmedetomidine on postoperative analgesia and sedation in pediatric patients undergoing tonsillectomy and adenoidectomy

The effect of intraoperative dexmedetomidine on postoperative analgesia and sedation in pediatric patients undergoing tonsillectomy and adenoidectomy 20610555 2010 07 28 2010 08 26 2013 11 21 1526-7598 111 2 2010 Aug Anesthesia and analgesia Anesth. Analg. The effect of intraoperative dexmedetomidine on postoperative analgesia and sedation in pediatric patients undergoing tonsillectomy and adenoidectomy. 490-5 10.1213/ANE.0b013e3181e33429 The immediate postoperative period after tonsillectomy (...) and adenoidectomy, one of the most common pediatric surgical procedures, is often difficult. These children frequently have severe pain but postoperative airway edema along with increased sensitivity to the respiratory-depressant effects of opioids may result in obstructive symptoms and hypoxemia. Opioid consumption may be reduced by nonsteroidal antiinflammatory drugs, but these drugs may be associated with increased bleeding after this operation. Dexmedetomidine has mild analgesic properties, causes sedation

EvidenceUpdates2010

199. Postoperative analgesia in TKA: ropivacaine continuous intraarticular infusion

Postoperative analgesia in TKA: ropivacaine continuous intraarticular infusion 20049572 2010 04 13 2010 06 15 2014 12 04 1528-1132 468 5 2010 May Clinical orthopaedics and related research Clin. Orthop. Relat. Res. Postoperative analgesia in TKA: ropivacaine continuous intraarticular infusion. 1242-7 10.1007/s11999-009-1202-2 Postoperative pain control is a challenge in patients undergoing TKA due to side effects and technical limitations of current analgesic approaches. Local anesthetic (...) and over Amides administration & dosage Analgesia methods Anesthetics, Local administration & dosage Arthralgia drug therapy physiopathology Arthroplasty, Replacement, Knee Double-Blind Method Equipment Design Female Follow-Up Studies Humans Infusions, Parenteral instrumentation Knee Joint physiology Length of Stay Male Middle Aged Pain Measurement Pain, Postoperative drug therapy physiopathology Postoperative Care methods Prospective Studies Recovery of Function drug effects Treatment Outcome

EvidenceUpdates2010 Full Text: Link to full Text with Trip Pro

200. A randomized, double-blind, placebo-controlled trial of epidural morphine analgesia after vaginal delivery

A randomized, double-blind, placebo-controlled trial of epidural morphine analgesia after vaginal delivery 19910627 2009 12 21 2010 01 12 2013 11 21 1526-7598 110 1 2010 Jan 01 Anesthesia and analgesia Anesth. Analg. A randomized, double-blind, placebo-controlled trial of epidural morphine analgesia after vaginal delivery. 159-64 10.1213/ANE.0b013e3181c30f78 Pain after vaginal delivery can interfere with the activities of daily living. We hypothesized that epidural medication administered after (...) delivery would be of benefit for acute postpartum pain management. The objective of this study was to assess whether epidural morphine after vaginal delivery would reduce the analgesic requirements for perineal pain. This randomized, double-blind, placebo-controlled trial included 228 parturients who received epidural morphine, 2.5 mg, or epidural saline within 1 h of delivery. The primary outcome was the proportion of women who received additional analgesics in the first 24 h postpartum. We also

EvidenceUpdates2010