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

61. Randomized Clinical Trial of Epidural Compared with Conventional Analgesia after Minimally Invasive Colorectal Surgery

Randomized Clinical Trial of Epidural Compared with Conventional Analgesia after Minimally Invasive Colorectal Surgery 28782603 2017 08 07 2017 08 29 1879-1190 2017 Aug 03 Journal of the American College of Surgeons J. Am. Coll. Surg. Randomized Clinical Trial of Epidural Compared with Conventional Analgesia after Minimally Invasive Colorectal Surgery. S1072-7515(17)31702-7 10.1016/j.jamcollsurg.2017.07.1063 The effectiveness of thoracic epidural analgesia (EA) vs conventional IV analgesia (IA (...) ) after minimally invasive surgery is still unproven. We designed a randomized controlled trial comparing EA with IA after minimally invasive colorectal surgery. A total of 87 patients who underwent minimally invasive colorectal procedures at a single institution between 2011 and 2014 were enrolled. Eight patients were excluded and 38 were randomized to EA and 41 to IA. Pain was assessed with the Visual Analogue Scale and quality of life with the Overall Benefit of Analgesia Score daily until

EvidenceUpdates2017

62. A Randomized Controlled Trial of Postoperative Thoracic Epidural Analgesia Versus Intravenous Patient-controlled Analgesia After Major Hepatopancreatobiliary Surgery

A Randomized Controlled Trial of Postoperative Thoracic Epidural Analgesia Versus Intravenous Patient-controlled Analgesia After Major Hepatopancreatobiliary Surgery 28746153 2017 07 26 2017 09 13 2017 09 13 1528-1140 266 3 2017 Sep Annals of surgery Ann. Surg. A Randomized Controlled Trial of Postoperative Thoracic Epidural Analgesia Versus Intravenous Patient-controlled Analgesia After Major Hepatopancreatobiliary Surgery. 545-554 10.1097/SLA.0000000000002386 The primary objective (...) of this randomized trial was to compare thoracic epidural analgesia (TEA) to intravenous patient-controlled analgesia (IV-PCA) for pain control over the first 48 hours after hepatopancreatobiliary (HPB) surgery. Secondary endpoints were patient-reported outcomes, total narcotic utilization, and complications. Although adequate postoperative pain control is critical to patient and surgeon success, the optimal analgesia regimen in HPB surgery remains controversial. Using a 2.5:1 randomization strategy, 140

EvidenceUpdates2017

63. Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Randomized Blinded Study

Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Randomized Blinded Study 28763413 2017 08 01 2017 08 01 1535-1386 99 15 2017 Aug 02 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Randomized Blinded Study. 1274-1281 10.2106/JBJS.16.01266 Pain following total knee arthroplasty (TKA) is often severe (...) and can inhibit rehabilitation. Motor-sparing analgesic techniques such as periarticular infiltrations and adductor canal blocks have been popularized for knee analgesia since they preserve motor strength and permit early mobilization. Our primary objective was to compare the duration of analgesia from motor-sparing blocks with that of a standard periarticular infiltration. We used the time to first rescue analgesia as the end point. We randomized 82 patients scheduled for elective TKA to receive

EvidenceUpdates2017 Full Text: Link to full Text with Trip Pro

64. Continuous Ropivacaine Subfascial Wound Infusion Compared With Intrathecal Morphine for Postcesarean Analgesia: A Prospective, Randomized Controlled, Double-Blind Study

Continuous Ropivacaine Subfascial Wound Infusion Compared With Intrathecal Morphine for Postcesarean Analgesia: A Prospective, Randomized Controlled, Double-Blind Study 28368941 2017 04 03 2017 09 07 2017 09 07 1526-7598 125 3 2017 Sep Anesthesia and analgesia Anesth. Analg. Continuous Ropivacaine Subfascial Wound Infusion Compared With Intrathecal Morphine for Postcesarean Analgesia: A Prospective, Randomized Controlled, Double-Blind Study. 907-912 10.1213/ANE.0000000000001892 After cesarean (...) delivery, postoperative pain management allows early rehabilitation and helps prevent postpartum depression and chronic pain. Our present prospective, randomized controlled, double-blind study assessed the duration and effect of intrathecal analgesia and continuous ropivacaine wound infiltration versus a control group after cesarean delivery. The primary outcome was analgesia duration, defined as time to first morphine request. Secondary outcomes were cumulative postoperative morphine consumption

EvidenceUpdates2017

65. Intrathecal Morphine Improves Hemodynamic Parameters and Analgesia in Patients Undergoing Aortic Valve Replacement Surgery: A Prospective, Double-Blind, Randomized Trial

Intrathecal Morphine Improves Hemodynamic Parameters and Analgesia in Patients Undergoing Aortic Valve Replacement Surgery: A Prospective, Double-Blind, Randomized Trial 28727703 2017 07 20 2017 07 20 2150-1149 20 5 2017 Jul Pain physician Pain Physician Intrathecal Morphine Improves Hemodynamic Parameters and Analgesia in Patients Undergoing Aortic Valve Replacement Surgery: A Prospective, Double-Blind, Randomized Trial. 405-412 Intrathecal morphine (ITM) has been used in hopes of providing (...) good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. A randomized, double-blind trial. Academic medical center. Forty-four patients, who underwent aortic valve replacement, were randomly assigned to receive ITM, before the induction

EvidenceUpdates2017

66. Intravenous vs Oral Acetaminophen as an Adjunct to Multimodal Analgesia After Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Clinical Trial

Intravenous vs Oral Acetaminophen as an Adjunct to Multimodal Analgesia After Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Clinical Trial 28690041 2017 07 10 2017 09 22 1532-8406 32 10 2017 Oct The Journal of arthroplasty J Arthroplasty Intravenous vs Oral Acetaminophen as an Adjunct to Multimodal Analgesia After Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Clinical Trial. 3029-3033 S0883-5403(17)30444-8 10.1016/j.arth.2017.05.019 The efficacy (...) of intravenous (IV) acetaminophen compared with its oral formulation for postoperative analgesia is unknown. We hypothesized that the addition of acetaminophen to a multimodal analgesia regimen would provide improved pain management in patients after total knee arthroplasty (TKA) and that the effect of acetaminophen would be variable based on the route of delivery. The study was a single-center, randomized, double-blinded, placebo-controlled clinical trial on the efficacy of IV vs oral acetaminophen

EvidenceUpdates2017

67. Intraoperative "Analgesia Nociception Index"-Guided Fentanyl Administration During Sevoflurane Anesthesia in Lumbar Discectomy and Laminectomy: A Randomized Clinical Trial

Intraoperative "Analgesia Nociception Index"-Guided Fentanyl Administration During Sevoflurane Anesthesia in Lumbar Discectomy and Laminectomy: A Randomized Clinical Trial 28598927 2017 06 09 2017 08 08 2017 08 08 1526-7598 125 1 2017 Jul Anesthesia and analgesia Anesth. Analg. Intraoperative "Analgesia Nociception Index"-Guided Fentanyl Administration During Sevoflurane Anesthesia in Lumbar Discectomy and Laminectomy: A Randomized Clinical Trial. 81-90 10.1213/ANE.0000000000001984 (...) The "Analgesia Nociception Index" (ANI; MetroDoloris Medical Systems, Lille, France) is a proposed noninvasive guide to analgesia derived from an electrocardiogram trace. ANI is scaled from 0 to 100; with previous studies suggesting that values ≥50 can indicate adequate analgesia. This clinical trial was designed to investigate the effect of intraoperative ANI-guided fentanyl administration on postoperative pain, under anesthetic conditions optimized for ANI functioning. Fifty patients aged 18 to 75 years

EvidenceUpdates2017

68. Epidural Dexamethasone Influences Postoperative Analgesia after Major Abdominal Surgery

Epidural Dexamethasone Influences Postoperative Analgesia after Major Abdominal Surgery 28535549 2017 05 23 2017 07 13 2017 07 13 2150-1149 20 4 2017 May Pain physician Pain Physician Epidural Dexamethasone Influences Postoperative Analgesia after Major Abdominal Surgery. 261-269 Epidurally administered dexamethasone might reduce postoperative pain. However, the effect of epidural administration of dexamethasone on postoperative epidural analgesia in major abdominal surgery has been doubtful (...) with 8 mL of 0.375% ropivacaine as a loading dose. After the surgery, 0.2% ropivacaine - fentanyl 4 ?g/mL was epidurally administered for analgesia. The infusion was set to deliver 4 mL/hr of the PCEA solution, with a bolus of 2 mL per demand and 15 minutes lockout time. The infused volume of PCEA, intensity of postoperative pain using visual analogue scale (VAS) during rest and coughing, incidence of postoperative nausea and vomiting (PONV), usage of rescue analgesia and rescue antiemetic, and side

EvidenceUpdates2017

69. Continuous adductor canal block added to local infiltration analgesia (LIA) after total knee arthroplasty has no additional benefits on pain and ambulation on postoperative day 1 and 2 compared with LIA alone

Continuous adductor canal block added to local infiltration analgesia (LIA) after total knee arthroplasty has no additional benefits on pain and ambulation on postoperative day 1 and 2 compared with LIA alone 28627290 2017 06 19 2017 08 14 1745-3682 88 5 2017 Oct Acta orthopaedica Acta Orthop Continuous adductor canal block added to local infiltration analgesia (LIA) after total knee arthroplasty has no additional benefits on pain and ambulation on postoperative day 1 and 2 compared with LIA (...) - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial. The TKA was performed under spinal analgesia and every participant was given single-dose LIA intraoperatively. Patients were then randomized into 2 groups, treatment group receiving 0.2% ropivacaine and control group receiving normal saline. First a 20 mL bolus was given into the adductor canal and 4 hours later a continuous flow at 6 mL/h was initiated for 2 postoperative days through

EvidenceUpdates2017 Full Text: Link to full Text with Trip Pro

70. Comparative Effectiveness of Patient-Controlled Analgesia for Treating Acute Pain in the Emergency Department

Comparative Effectiveness of Patient-Controlled Analgesia for Treating Acute Pain in the Emergency Department 28601270 2017 06 11 2017 06 11 1097-6760 2017 Jun 07 Annals of emergency medicine Ann Emerg Med Comparative Effectiveness of Patient-Controlled Analgesia for Treating Acute Pain in the Emergency Department. S0196-0644(17)30360-8 10.1016/j.annemergmed.2017.03.064 We assess the effectiveness of patient-controlled analgesia in the emergency department (ED). We hypothesized that decline (...) in pain intensity from 30 to 120 minutes after initial intravenous opioid administration is greater in patients receiving morphine by patient-controlled analgesia compared with usual care and would differ by a clinically significant amount. This was a pragmatic randomized controlled trial of patient-controlled analgesia and usual care (opioid and dose at physician's discretion) in 4 EDs. Entry criteria included age 18 to 65 years and acute pain requiring intravenous opioids. The primary outcome

EvidenceUpdates2017

71. Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial

Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial 28525512 2017 05 19 2017 05 19 1526-7598 124 6 2017 Jun Anesthesia and analgesia Anesth. Analg. Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial. 1992-2000 10.1213/ANE.0000000000002095 Severe pain and high-dose (...) opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours

EvidenceUpdates2017

72. The improved quality of postoperative analgesia after intrathecal morphine does not result in improved recovery and quality of life in the first 6 months after orthopedic surgery: a randomized controlled pilot study

The improved quality of postoperative analgesia after intrathecal morphine does not result in improved recovery and quality of life in the first 6 months after orthopedic surgery: a randomized controlled pilot study 28533694 2017 05 23 2017 05 26 1178-7090 10 2017 Journal of pain research J Pain Res The improved quality of postoperative analgesia after intrathecal morphine does not result in improved recovery and quality of life in the first 6 months after orthopedic surgery: a randomized (...) controlled pilot study. 1059-1069 10.2147/JPR.S135142 In orthopedic surgery, it is well known that the use of intrathecal morphine (ITM) leads to an improved quality of postoperative analgesia. Little is known how this improved analgesia affects the long-term course after surgery. A randomized, double-blind trial. Academic medical center. Forty-nine patients undergoing total hip or knee replacement surgery in spinal anesthesia. Patients were randomly assigned to receive either 0.1 mg (n=16) or 0.2 mg (n

EvidenceUpdates2017 Full Text: Link to full Text with Trip Pro

73. Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia

Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia 28713495 2018 11 13 2008-5842 9 5 2017 May Electronic physician Electron Physician Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia. 4274-4280 10.19082/4274 Labor pain is one of the most severe forms of pain that women experience throughout their lifetime. Many pregnant women decide to have an epidural anesthesia to cope with labor pain. This study has focused on general awareness about (...) of Obstetrics & Gynecology, Jeddah, Saudi Arabia. eng Journal Article 2017 05 25 Iran Electron Physician 101645099 2008-5842 Epidural analgesia Labor pain Regional anesthesia Conflict of Interest: There is no conflict of interest to be declared. 2017 01 15 2017 04 02 2017 7 18 6 0 2017 7 18 6 0 2017 7 18 6 1 epublish 28713495 10.19082/4274 epj-09-4274 PMC5498688 J Pak Med Assoc. 2005 Feb;55(2):63-6 15813631 Hong Kong Med J. 2007 Jun;13(3):208-15 17548909 Int J Obstet Anesth. 2009 Jan;18(1):38-42 19046871 J

Electronic physician2017 Full Text: Link to full Text with Trip Pro

74. Clonidine for sedation and analgesia for neonates receiving mechanical ventilation.

Clonidine for sedation and analgesia for neonates receiving mechanical ventilation. BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal (...) , met the inclusion criteria for this review. Term newborn infants on mechanical ventilation with the need for continuous analgesia and sedation with fentanyl and midazolam were eligible for enrollment during the first 96 hours of ventilation. Study authors administered clonidine 1 μg/kg/h or placebo on day 4 after intubation.We found no differences between the two groups in all-cause death during hospitalization (risk ratio [RR] 0.69, 95% confidence interval [CI] 0.12 to 3.98). The quality

Cochrane2017

76. Capnography versus standard monitoring for emergency department procedural sedation and analgesia.

Capnography versus standard monitoring for emergency department procedural sedation and analgesia. BACKGROUND: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED

Cochrane2017

77. Ketamine Analgesia for Acute Pain in the Emergency Department

Ketamine Analgesia for Acute Pain in the Emergency Department Emergency Medicine > Journal Club > Archive > April 2016 Toggle navigation April 2016 Ketamine Analgesia for Acute Pain in the Emergency Department Vignette It's two o'clock in the afternoon during a typical weekend TCC shift, when you get a page that a triage patient is coming to room 4. You look at the chart and see that it's a 45-year-old man who was riding his horse and got bucked off, landing on his left arm in an awkward (...) , especially one that's less familiar to him. Curious about what the evidence actually shows, and wanting to be prepared to look smart in front of your pompous attending, you decide to search the literature and see what the evidence actually shows... PICO Question Population: Adult patients in the ED with acute pain Intervention: IV ketamine Comparison: Usual care with IV opiate analgesia Outcome: Pain control, adverse events (hypoxia, respiratory depression, dysphoria, etc.) patient satisfaction, ED

Washington University Emergency Medicine Journal Club2017

78. Obstetric Analgesia and Anesthesia

Obstetric Analgesia and Anesthesia Sign In (ACOG) Sign in to your ACOG account Email is required. Please enter valid Email. was not found in our system. Would you like to associated with your account? Forgot your email address? JSOG Member? © 2018 - American College of Obstetricians and Gynecologists

American College of Obstetricians and Gynecologists2017

79. Systematic review: Intravenous paracetamol or intravenous propacetamol can provide effective postoperative analgesia for some patients

Systematic review: Intravenous paracetamol or intravenous propacetamol can provide effective postoperative analgesia for some patients Intravenous paracetamol or intravenous propacetamol can provide effective postoperative analgesia for some patients | Evidence-Based Nursing This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. 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 using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Intravenous paracetamol or intravenous propacetamol can provide effective postoperative analgesia for some patients Article Text Nursing issues Systematic review Intravenous paracetamol or intravenous propacetamol can provide effective postoperative analgesia

Evidence-Based Nursing (Requires free registration)2017