Latest & greatest articles for analgesia

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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

41. A Randomized Non-Inferiority Trial of Adductor Canal Block for Analgesia After Total Knee Arthroplasty: Single Injection Versus Catheter Technique

A Randomized Non-Inferiority Trial of Adductor Canal Block for Analgesia After Total Knee Arthroplasty: Single Injection Versus Catheter Technique 29198872 2017 12 04 1532-8406 2017 Nov 16 The Journal of arthroplasty J Arthroplasty A Randomized Non-Inferiority Trial of Adductor Canal Block for Analgesia After Total Knee Arthroplasty: Single Injection Versus Catheter Technique. S0883-5403(17)31023-9 10.1016/j.arth.2017.11.018 Adductor canal blocks (ACBs) provide effective analgesia following (...) AN Department of Anesthesia and Perioperative Care, Vancouver General Hospital, Vancouver, British Columbia, Canada. Tang Raymond R Department of Anesthesia and Perioperative Care, Vancouver General Hospital, Vancouver, British Columbia, Canada. eng Journal Article 2017 11 16 United States J Arthroplasty 8703515 0883-5403 TKA analgesia adductor canal block dexamethasone peri-neural catheters regional anesthesia 2017 09 08 2017 10 25 2017 11 08 2017 12 5 6 0 2017 12 5 6 0 2017 12 5 6 0 aheadofprint 29198872

EvidenceUpdates2018

42. Continuous Adductor Canal Blocks Provide Superior Ambulation and Pain Control Compared to Epidural Analgesia for Primary Knee Arthroplasty: A Randomized, Controlled Trial

Continuous Adductor Canal Blocks Provide Superior Ambulation and Pain Control Compared to Epidural Analgesia for Primary Knee Arthroplasty: A Randomized, Controlled Trial 29233569 2017 12 13 1532-8406 2017 Nov 13 The Journal of arthroplasty J Arthroplasty Continuous Adductor Canal Blocks Provide Superior Ambulation and Pain Control Compared to Epidural Analgesia for Primary Knee Arthroplasty: A Randomized, Controlled Trial. S0883-5403(17)30986-5 10.1016/j.arth.2017.11.013 Adductor canal blocks (...) (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty. Following institutional review board approval, 145 patients were randomized to 1 of 3 groups: combined spinal-epidural (CSE), spinal + continuous

EvidenceUpdates2018

43. Combination Analgesia for Neonatal Circumcision: A Randomized Controlled Trial

Combination Analgesia for Neonatal Circumcision: A Randomized Controlled Trial 29150457 2017 12 11 2017 12 11 1098-4275 140 6 2017 Dec Pediatrics Pediatrics Combination Analgesia for Neonatal Circumcision: A Randomized Controlled Trial. e20171935 10.1542/peds.2017-1935 There is no consensus on the most effective pain management for neonatal circumcision. We sought to compare different modalities. This is a double-blinded randomized controlled trial comparing 3 combination analgesics used during (...) circumcision (EMLA + sucrose; EMLA + sucrose + dorsal penile nerve block [DPNB]; EMLA + sucrose + ring block [RB]) with the traditional topical analgesic cream EMLA alone. The trial was set in the normal nursery of a teaching hospital. The sample included 70 healthy male newborns, randomly assigned to intervention and control groups at a 2:1 ratio. Infants were videotaped (face and torso) during the procedure for assessment of pain by 2 blinded, independent reviewers. The primary outcome measure

EvidenceUpdates2018

44. Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial

Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial 29289579 2018 02 07 1836-9561 64 1 2018 Jan Journal of physiotherapy J Physiother Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial. 33-40 S1836-9553(17)30145 (...) -5 10.1016/j.jphys.2017.11.014 Among women in labour, does sequential application of non-pharmacological interventions relieve labour pain, shorten labour, and delay pharmacological analgesia use? Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Eighty women admitted in labour at the end of a low-risk pregnancy. Participants in the experimental group received three interventions for up to 40minutes each in particular stages of labour: exercise on

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

45. Can early oral prolonged-release oxycodone with or without naloxone reduce the duration of epidural analgesia after cystectomy? A 3-arm, randomized, double-blind, placebo-controlled trial

Can early oral prolonged-release oxycodone with or without naloxone reduce the duration of epidural analgesia after cystectomy? A 3-arm, randomized, double-blind, placebo-controlled trial 29189517 2017 12 12 1872-6623 2017 Nov 20 Pain Pain Can early oral prolonged-release oxycodone with or without naloxone reduce the duration of epidural analgesia after cystectomy? A 3-arm, randomized, double-blind, placebo-controlled trial. 10.1097/j.pain.0000000000001112 Thoracic epidural analgesia (TEA (...) ) enhances recovery after bowel surgery. Early postoperative prolonged-release oral formulation of oxycodone or oxycodone/naloxone is potentially useful as a second analgesic step to reduce the duration of TEA. We hypothesized that oxycodone would decrease the duration of TEA and combined with naloxone preserve gastrointestinal function. Ninety patients undergoing open cystectomy and urinary diversion were enrolled in this randomized double-blind, three-arm, parallel-group, placebo-controlled single

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

46. Efficacy of Magnesium Sulfate Added to Local Anesthetic in a Transversus Abdominis Plane Block for Analgesia Following Total Abdominal Hysterectomy: A Randomized Trial

Efficacy of Magnesium Sulfate Added to Local Anesthetic in a Transversus Abdominis Plane Block for Analgesia Following Total Abdominal Hysterectomy: A Randomized Trial 29149143 2017 11 17 2150-1149 20 7 2017 Nov Pain physician Pain Physician Efficacy of Magnesium Sulfate Added to Local Anesthetic in a Transversus Abdominis Plane Block for Analgesia Following Total Abdominal Hysterectomy: A Randomized Trial. 641-647 Major abdominal surgeries are associated with severe pain, which can affect (...) respiratory and cardiac functions if insufficiently treated; this increases postoperative morbidity. We aim at evaluating the efficacy of magnesium sulfate as an adjuvant to local anesthetic in an ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in total abdominal hysterectomy. A prospective, randomized, double-blinded clinical trial. An academic medical center. This study is registered at https://clinicaltrials.gov (no.: NCT02930707). This randomized, double-blinded

EvidenceUpdates2018

47. Optimization of Postoperative Intravenous Patient-Controlled Analgesia with Opioid-Dexmedetomidine Combinations: An Updated Meta-Analysis with Trial Sequential Analysis of Randomized Controlled Trials

Optimization of Postoperative Intravenous Patient-Controlled Analgesia with Opioid-Dexmedetomidine Combinations: An Updated Meta-Analysis with Trial Sequential Analysis of Randomized Controlled Trials 29149140 2017 11 17 2150-1149 20 7 2017 Nov Pain physician Pain Physician Optimization of Postoperative Intravenous Patient-Controlled Analgesia with Opioid-Dexmedetomidine Combinations: An Updated Meta-Analysis with Trial Sequential Analysis of Randomized Controlled Trials. 569-596 It is still (...) a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. A systematic review and meta-analysis. Randomized controlled trials that compared opioid-DEX

EvidenceUpdates2018

48. Effect of oxycodone patient-controlled intravenous analgesia after cesarean section: a randomized controlled study

Effect of oxycodone patient-controlled intravenous analgesia after cesarean section: a randomized controlled study 29180891 2017 12 19 1178-7090 10 2017 Journal of pain research J Pain Res Effect of oxycodone patient-controlled intravenous analgesia after cesarean section: a randomized controlled study. 2649-2655 10.2147/JPR.S142896 Oxycodone is a semisynthetic μ-opioid receptor agonist with a potentially good analgesic efficacy in visceral pain. This study aims to compare the efficacy (...) of oxycodone with sufentanil patient-controlled intravenous analgesia (PCIA). One hundred and twenty primiparas undergoing elective cesarean section were randomized into four groups by different drugs of PCIA: group S (sufentanil 100 μg), group OS1 (sufentanil 70 μg, oxycodone 30 mg), group OS2 (sufentanil 50 μg, oxycodone 50 mg), and group O (oxycodone 100 mg). Ramosetron 0.3 mg was added to each group. In all groups, drugs were diluted to 100 mL and managed with a continuous infusion of 1 mL·h-1, a bolus

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

49. Efficacy of Postoperative Analgesia of Local Ketamine Wound Instillation Following Total Thyroidectomy: A Randomized, Double-blind, Controlled Clinical Trial

Efficacy of Postoperative Analgesia of Local Ketamine Wound Instillation Following Total Thyroidectomy: A Randomized, Double-blind, Controlled Clinical Trial 28591084 2017 12 04 1536-5409 34 1 2018 Jan The Clinical journal of pain Clin J Pain Efficacy of Postoperative Analgesia of Local Ketamine Wound Instillation Following Total Thyroidectomy: A Randomized, Double-blind, Controlled Clinical Trial. 53-58 10.1097/AJP.0000000000000521 Total thyroidectomy is recommended as a line of management (...) of thyroid cancer in many cases. Our aim was to compare postoperative analgesic effect of local ketamine 1 mg/kg instilled in the wound to that of intramuscular (IM) ketamine and placebo after total thyroidectomy. A total of 90 patients aged 18 to 60 years, American Society of Anesthesiologists (ASA) class I to II, with a body weight of 50 to 90 kg, scheduled for total thyroidectomy were enrolled after ethics committee approval in this prospective, randomized, double-blind, controlled study and divided

EvidenceUpdates2018

50. Parent/Nurse-Controlled Analgesia Compared with Intravenous PRN Opioids for Postsurgical Pain Management in Children with Developmental Delay: A Randomized Controlled Trial

Parent/Nurse-Controlled Analgesia Compared with Intravenous PRN Opioids for Postsurgical Pain Management in Children with Developmental Delay: A Randomized Controlled Trial 29099960 2017 11 03 1526-4637 2017 Nov 01 Pain medicine (Malden, Mass.) Pain Med Parent/Nurse-Controlled Analgesia Compared with Intravenous PRN Opioids for Postsurgical Pain Management in Children with Developmental Delay: A Randomized Controlled Trial. 10.1093/pm/pnx257 The aim of this study was to conduct a randomized (...) , controlled comparison of outcomes associated with parent/nurse-controlled analgesia (PNCA), with and without a basal (background) opioid infusion, with intravenous (IV) opioids intermittently administered by a nurse on an "as needed" basis (IV PRN) for postoperative pain management in children with developmental delay (DD). Participants included children with DD expected to require IV opioids for at least 24 postoperative hours. Patients were randomized to one of three groups: PNCA with a basal infusion

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

51. Postoperative Analgesia Using Peripheral Anesthetic Block of the Foot and Ankle

Postoperative Analgesia Using Peripheral Anesthetic Block of the Foot and Ankle 29160101 2017 11 21 1944-7876 2017 Nov 01 Foot & ankle international Foot Ankle Int Postoperative Analgesia Using Peripheral Anesthetic Block of the Foot and Ankle. 1071100717739670 10.1177/1071100717739670 Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been (...) expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries. Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form. The study was approved by the local ethics

EvidenceUpdates2018

52. Patient-controlled Intravenous Analgesia With Combination of Dexmedetomidine and Sufentanil on Patients After Abdominal Operation: A Prospective, Randomized, Controlled, Blinded, Multicenter Clinical Study

Patient-controlled Intravenous Analgesia With Combination of Dexmedetomidine and Sufentanil on Patients After Abdominal Operation: A Prospective, Randomized, Controlled, Blinded, Multicenter Clinical Study 28654556 2018 01 04 1536-5409 34 2 2018 Feb The Clinical journal of pain Clin J Pain Patient-controlled Intravenous Analgesia With Combination of Dexmedetomidine and Sufentanil on Patients After Abdominal Operation: A Prospective, Randomized, Controlled, Blinded, Multicenter Clinical Study (...) . 155-161 10.1097/AJP.0000000000000527 To investigate the effect of combination of dexmedetomidine and sufentanil on patient-controlled intravenous analgesia (PCIA) in patients after abdominal operation and to assess the safety and validity of this treatment. This is a prospective, randomized controlled, blinded, multicenter clinical study. A total of 210 patients from 9 clinical research centers underwent selective abdominal operation with general anesthesia were enrolled in the study, including

EvidenceUpdates2018

53. Perioperative adjuvant corticosteroids for postoperative analgesia in knee arthroplasty

Perioperative adjuvant corticosteroids for postoperative analgesia in knee arthroplasty 29065753 2017 10 25 1745-3682 2017 Oct 25 Acta orthopaedica Acta Orthop Perioperative adjuvant corticosteroids for postoperative analgesia in knee arthroplasty. 1-6 10.1080/17453674.2017.1391409 Background and purpose - Immediate postoperative pain management offered in knee arthroplasty is suboptimal in up to one-third of patients resulting in high opiate consumption and delayed discharge. In this meta (...) -analysis we investigate the analgesic effect and safety of perioperative adjuvant corticosteroids in knee arthroplasty. Methods - Databases Medline, Embase, and Central were searched for randomized studies comparing the analgesic effect of adjuvant perioperative corticosteroids in knee arthroplasty. Our primary outcome was pain score at 24 hours postoperatively. Secondary outcomes included pain at 12, 48, and 72 hours, opiate consumption, postoperative nausea and vomiting, infection, and discharge time

EvidenceUpdates2017 Full Text: Link to full Text with Trip Pro

54. Epidural Analgesia During the Second Stage of Labor: A Randomized Controlled Trial

Epidural Analgesia During the Second Stage of Labor: A Randomized Controlled Trial 29016499 2017 11 02 2017 11 02 1873-233X 130 5 2017 Nov Obstetrics and gynecology Obstet Gynecol Epidural Analgesia During the Second Stage of Labor: A Randomized Controlled Trial. 1097-1103 10.1097/AOG.0000000000002306 To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. We (...) conducted a double-blind, randomized, placebo-controlled trial involving nulliparous women with term cephalic singleton pregnancies who requested epidural analgesia. All women received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0.4 micrograms/mL sufentanil with patient-controlled epidural analgesia. At the onset of the second stage of labor, women were randomized to receive a blinded infusion of the same solution or placebo saline infusion. The primary outcome

EvidenceUpdates2017

55. Epidural Labor Analgesia-Fentanyl Dose and Breastfeeding Success: A Randomized Clinical Trial

Epidural Labor Analgesia-Fentanyl Dose and Breastfeeding Success: A Randomized Clinical Trial 28926440 2017 09 19 2017 10 03 2017 10 03 1528-1175 127 4 2017 Oct Anesthesiology Anesthesiology Epidural Labor Analgesia-Fentanyl Dose and Breastfeeding Success: A Randomized Clinical Trial. 614-624 10.1097/ALN.0000000000001793 Breastfeeding is an important public health concern. High cumulative doses of epidural fentanyl administered for labor analgesia have been reported to be associated with early (...) termination of breastfeeding. We tested the hypothesis that breastfeeding success is adversely influenced by the cumulative epidural fentanyl dose administered for labor analgesia. The study was a randomized, double-blind, controlled trial of parous women at greater than 38 weeks gestation who planned to breastfeed, had successfully breastfed a prior infant, and who received neuraxial labor analgesia. Participants were randomized to receive one of three epidural maintenance solutions for labor analgesia

EvidenceUpdates2017

56. Considerations for pediatric burn sedation and analgesia

Considerations for pediatric burn sedation and analgesia 29051890 2018 11 13 2321-3868 5 2017 Burns & trauma Burns Trauma Considerations for pediatric burn sedation and analgesia. 28 10.1186/s41038-017-0094-8 Burn patients experience anxiety and pain in the course of their injury, treatment, and recovery. Hence, treatment of anxiety and pain is paramount after burn injury. Children, in particular, pose challenges in anxiety and pain management due to their unique physiologic, psychologic (...) , and anatomic status. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. The purpose of this review is to describe the challenges associated with management of anxiety, pain, and sedation in burned children and to describe the different options for treatment of anxiety and pain in burned

Burns & trauma2017 Full Text: Link to full Text with Trip Pro

57. Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded, Randomized Controlled Trial

Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded, Randomized Controlled Trial 28816893 2017 08 17 2017 09 08 2017 09 08 1535-1386 99 16 2017 Aug 16 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded (...) by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104). The primary outcome of this study was cumulative narcotic consumption on postoperative days 0 through 3. Narcotic consumption data were collected retrospectively from in-hospital records while patients were in the hospital. Following discharge, narcotic consumption data were gathered from patient surveys, as were secondary outcomes measures. We did not identify greater narcotic use in the ON-Q

EvidenceUpdates2017

58. Local Infiltration Analgesia With Liposomal Bupivacaine Improves Pain Scores and Reduces Opioid Use After Total Knee Arthroplasty: Results of a Randomized Controlled Trial

Local Infiltration Analgesia With Liposomal Bupivacaine Improves Pain Scores and Reduces Opioid Use After Total Knee Arthroplasty: Results of a Randomized Controlled Trial 28802777 2017 08 13 2017 08 27 1532-8406 2017 Jul 25 The Journal of arthroplasty J Arthroplasty Local Infiltration Analgesia With Liposomal Bupivacaine Improves Pain Scores and Reduces Opioid Use After Total Knee Arthroplasty: Results of a Randomized Controlled Trial. S0883-5403(17)30640-X 10.1016/j.arth.2017.07.024 Local (...) infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed

EvidenceUpdates2017 Full Text: Link to full Text with Trip Pro

59. Flurbiprofen Axetil Provides Effective Analgesia Without Changing the Pregnancy Rate in Ultrasound-Guided Transvaginal Oocyte Retrieval: A Double-Blind Randomized Controlled Trial

Flurbiprofen Axetil Provides Effective Analgesia Without Changing the Pregnancy Rate in Ultrasound-Guided Transvaginal Oocyte Retrieval: A Double-Blind Randomized Controlled Trial 28430684 2017 04 21 2017 10 04 2017 10 04 1526-7598 125 4 2017 Oct Anesthesia and analgesia Anesth. Analg. Flurbiprofen Axetil Provides Effective Analgesia Without Changing the Pregnancy Rate in Ultrasound-Guided Transvaginal Oocyte Retrieval: A Double-Blind Randomized Controlled Trial. 1269-1274 10.1213/ANE (...) .0000000000002025 In this prospective double-blind randomized study, we evaluated the analgesic effect and potential effect on pregnancy rate of the nonsteroidal anti-inflammatory drug flurbiprofen axetil in patients undergoing ultrasound-guided transvaginal oocyte retrieval under propofol-remifentanil anesthesia. A total of 200 patients scheduled to undergo ultrasound-guided transvaginal oocyte retrieval were randomly allocated to receive 1.5 mg/kg of flurbiprofen axetil (FA group) or placebo (control group

EvidenceUpdates2017

60. Effects of preemptive analgesia with flurbiprofen ester on lymphocytes and natural killer cells in patients undergoing esophagectomy: A randomized controlled pilot study

Effects of preemptive analgesia with flurbiprofen ester on lymphocytes and natural killer cells in patients undergoing esophagectomy: A randomized controlled pilot study 28892265 2018 03 20 2018 11 13 1759-7714 8 6 2017 11 Thoracic cancer Thorac Cancer Effects of preemptive analgesia with flurbiprofen ester on lymphocytes and natural killer cells in patients undergoing esophagectomy: A randomized controlled pilot study. 649-654 10.1111/1759-7714.12502 Tumors may induce systemic immune (...) dysfunction, which can be aggravated by surgery and anesthesia/analgesia. Data on the effect of flurbiprofen preemptive analgesia on immune dysfunction is limited. The aim of this study was to investigate the effect of flurbiprofen preemptive analgesia on lymphocytes and natural killer (NK) cells in patients undergoing thoracotomy and thoracoscopy radical esophagectomy, and to explore the analgesic methods suitable for tumor patients. This was a randomized controlled pilot study of 89 patients

Thoracic cancer2017 Full Text: Link to full Text with Trip Pro