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

101. Multimodal Analgesia in Total Knee Arthroplasty: A Randomized, Double-Blind, Controlled Trial on Additional Efficacy of Periarticular Anesthesia

Multimodal Analgesia in Total Knee Arthroplasty: A Randomized, Double-Blind, Controlled Trial on Additional Efficacy of Periarticular Anesthesia 26072302 2015 11 09 2016 06 27 2015 11 09 1532-8406 30 11 2015 Nov The Journal of arthroplasty J Arthroplasty Multimodal Analgesia in Total Knee Arthroplasty: A Randomized, Double-Blind, Controlled Trial on Additional Efficacy of Periarticular Anesthesia. 2038-42 10.1016/j.arth.2015.05.035 S0883-5403(15)00428-3 Pain management is a main determinant (...) of functional recovery after total knee arthroplasty (TKA). We performed a randomized, controlled, double blind study to evaluate additive efficacy of periarticular anesthesia in patients undergoing TKA in reducing post-operative pain, operated limb edema and improving post-operative mobility. Patients were randomly assigned to study or control group; all subjects received the same analgesic protocol; before wound closure, the study group received also a periarticular anesthesia (ropivacaine 1% 20 mL

EvidenceUpdates2015

102. Preemptive multimodal analgesia for postoperative pain management after lumbar fusion surgery: a randomized controlled trial.

Preemptive multimodal analgesia for postoperative pain management after lumbar fusion surgery: a randomized controlled trial. 26324284 2016 04 27 2017 05 07 1432-0932 25 5 2016 May European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Preemptive multimodal analgesia for postoperative pain management after lumbar fusion surgery: a randomized controlled trial (...) . 1614-1619 10.1007/s00586-015-4216-3 To assess the efficacy of a novel preemptive multimodal analgesic regimen for reducing postoperative pain and complications after primary lumbar fusion surgery. Preemptive multimodal analgesia is revealed to be an effective alternative to conventional morphine administration providing improved postoperative pain control with diminished side effects. However, an optimal regimen for spinal fusion surgery remains unknown. After Institutional Review Board approval

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2015

103. Epidural Analgesia During Childbirth: Safety and Guidelines

Epidural Analgesia During Childbirth: Safety and Guidelines Epidural Analgesia During Childbirth: Safety and Guidelines | CADTH.ca Find the information you need Epidural Analgesia During Childbirth: Safety and Guidelines Epidural Analgesia During Childbirth: Safety and Guidelines Published on: August 4, 2015 Project Number: RB0893-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the clinical evidence regarding the safety of epidural (...) analgesia for mothers and babies during and after childbirth? What are the evidence-based guidelines regarding the use of epidural analgesia during childbirth? Key Message One health technology assessment, three systematic reviews (two with meta-analysis), and one evidence-based guideline were identified regarding the safety and recommended use of epidural analgesia during childbirth. Tags analgesia, anesthesia, labor pain, natural childbirth, gynecology/obstetrics, Delivery, Epidural, Labor, Obstetric

Canadian Agency for Drugs and Technologies in Health - Rapid Review2015

104. Epidural Analgesia During Childbirth: Safety and Guidelines

Epidural Analgesia During Childbirth: Safety and Guidelines Epidural Analgesia During Childbirth: Safety and Guidelines | CADTH.ca Find the information you need Epidural Analgesia During Childbirth: Safety and Guidelines Epidural Analgesia During Childbirth: Safety and Guidelines Published on: August 4, 2015 Project Number: RB0893-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the clinical evidence regarding the safety of epidural (...) analgesia for mothers and babies during and after childbirth? What are the evidence-based guidelines regarding the use of epidural analgesia during childbirth? Key Message One health technology assessment, three systematic reviews (two with meta-analysis), and one evidence-based guideline were identified regarding the safety and recommended use of epidural analgesia during childbirth. Tags analgesia, anesthesia, labor pain, natural childbirth, gynecology/obstetrics, Delivery, Epidural, Labor, Obstetric

Canadian Agency for Drugs and Technologies in Health - Rapid Review2015

105. PAin SoluTions In the Emergency Setting (PASTIES)-patient controlled analgesia versus routine care in emergency department patients with non-traumatic abdominal pain: randomised trial.

PAin SoluTions In the Emergency Setting (PASTIES)-patient controlled analgesia versus routine care in emergency department patients with non-traumatic abdominal pain: randomised trial. OBJECTIVE: To determine whether patient controlled analgesia (PCA) is better than routine care in providing effective analgesia for patients presenting to emergency departments with moderate to severe non-traumatic abdominal pain. DESIGN: Pragmatic, multicentre, parallel group, randomised controlled trial SETTING (...) : Five English hospitals. PARTICIPANTS: 200 adults (66% (n=130) female), aged 18 to 75 years, who presented to the emergency department requiring intravenous opioid analgesia for the treatment of moderate to severe non-traumatic abdominal pain and were expected to be admitted to hospital for at least 12 hours. INTERVENTIONS: Patient controlled analgesia or nurse titrated analgesia (treatment as usual). MAIN OUTCOME MEASURES: The primary outcome was total pain experienced over the 12 hour study period

BMJ2015 Full Text: Link to full Text with Trip Pro

106. PAin SoluTions In the Emergency Setting (PASTIES)-patient controlled analgesia versus routine care in emergency department patients with pain from traumatic injuries: randomised trial.

PAin SoluTions In the Emergency Setting (PASTIES)-patient controlled analgesia versus routine care in emergency department patients with pain from traumatic injuries: randomised trial. OBJECTIVE: To determine whether patient controlled analgesia (PCA) is better than routine care in patients presenting to emergency departments with moderate to severe pain from traumatic injuries. DESIGN: Pragmatic, multicentre, parallel group, randomised controlled trial. SETTING: Five English hospitals (...) . PARTICIPANTS: 200 adults (71% (n = 142) male), aged 18 to 75 years, who presented to the emergency department requiring intravenous opioid analgesia for the treatment of moderate to severe pain from traumatic injuries and were expected to be admitted to hospital for at least 12 hours. INTERVENTIONS: PCA (n = 99) or nurse titrated analgesia (treatment as usual; n = 101). MAIN OUTCOME MEASURES: The primary outcome was total pain experienced over the 12 hour study period, derived by standardised area under

BMJ2015 Full Text: Link to full Text with Trip Pro

107. Pain control after simultaneous bilateral total knee arthroplasty: a randomized controlled trial comparing periarticular injection and epidural analgesia

Pain control after simultaneous bilateral total knee arthroplasty: a randomized controlled trial comparing periarticular injection and epidural analgesia 25740026 2015 03 05 2015 04 23 2016 05 12 1535-1386 97 5 2015 Mar 04 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am Pain control after simultaneous bilateral total knee arthroplasty: a randomized controlled trial comparing periarticular injection and epidural analgesia. 367-73 10.2106/JBJS.N.00373 Periarticular (...) injection is becoming more commonly utilized for pain relief following total knee arthroplasty. However, we are aware of no randomized controlled trial that has investigated the efficacy of periarticular injection for pain relief after simultaneous bilateral total knee arthroplasty. We performed a randomized controlled trial of patients scheduled for simultaneous bilateral total knee arthroplasty. Seventy-one patients with 142 involved knees were randomly assigned to receive periarticular injection

EvidenceUpdates2015

108. Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients

Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients 25772701 2015 04 08 2015 12 29 2015 04 08 1496-8975 62 5 2015 May Canadian journal of anaesthesia = Journal canadien d'anesthesie Can J Anaesth Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients. 476-84 10.1007/s12630-014-0310-y Gabapentin was investigated as a single-dose adjunct to morphine for postoperative (...) pain management. The primary objective was to determine if gabapentin given preoperatively and for two days postoperatively as part of multimodal analgesia would decrease postoperative morphine consumption in patients undergoing primary total hip arthroplasty (THA). The study group included 102 patients aged 19-90 years who were undergoing primary THA in a single joint with no contraindications to the study medications, no chronic pain syndrome, and no chronic opioid use. Intervention group

EvidenceUpdates2015

109. Buprenorphine added to bupivacaine prolongs femoral nerve block duration and improves analgesia in patients undergoing primary total knee arthroplasty-a randomised prospective double-blind study

Buprenorphine added to bupivacaine prolongs femoral nerve block duration and improves analgesia in patients undergoing primary total knee arthroplasty-a randomised prospective double-blind study 25512031 2015 02 09 2015 08 04 2015 02 09 1532-8406 30 2 2015 Feb The Journal of arthroplasty J Arthroplasty Buprenorphine added to bupivacaine prolongs femoral nerve block duration and improves analgesia in patients undergoing primary total knee arthroplasty-a randomised prospective double-blind study (...) . 320-4 10.1016/j.arth.2014.07.016 S0883-5403(14)00484-7 The aim of the study was to determine whether the addition the long-acting opioid buprenorphine as an adjuvant to the local anaesthetic agent would improve quality and prolong duration of femoral nerve blockade in post-operative analgesia following primary total knee arthroplasty. The study involved 48 patients. The femoral nerve was anaesthetised with a 0.25% solution of bupivacaine with adrenaline or with the addition of 0.3mg

EvidenceUpdates2015

110. Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial.

Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial. 25713015 2015 02 25 2015 06 01 2015 10 28 1756-1833 350 2015 Feb 23 BMJ (Clinical research ed.) BMJ Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial. h846 10.1136/bmj.h846 To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared (...) with epidural analgesia during labour. Multicentre randomised controlled equivalence trial. 15 hospitals in the Netherlands. Women with an intermediate to high obstetric risk with an intention to deliver vaginally. To exclude a clinically relevant difference in satisfaction with pain relief of more than 10%, we needed to include 1136 women. Because of missing values for satisfaction this number was increased to 1400 before any analysis. We used multiple imputation to correct for missing data. Before

BMJ2015 Full Text: Link to full Text with Trip Pro

111. Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial.

Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial. OBJECTIVE: To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. DESIGN: Multicentre randomised controlled equivalence trial. SETTING: 15 hospitals in the Netherlands. PARTICIPANTS: Women with an intermediate to high obstetric risk with an intention to deliver vaginally (...) . To exclude a clinically relevant difference in satisfaction with pain relief of more than 10%, we needed to include 1136 women. Because of missing values for satisfaction this number was increased to 1400 before any analysis. We used multiple imputation to correct for missing data. INTERVENTION: Before the onset of active labour consenting women were randomised to a pain relief strategy with patient controlled remifentanil or epidural analgesia if they requested pain relief during labour. MAIN OUTCOME

BMJ2015

112. Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty

Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty 25428755 2015 05 13 2015 08 20 2016 12 15 1745-3682 86 3 2015 Jun Acta orthopaedica Acta Orthop Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty: a randomized double-blind study of 200 patients. 373-7 10.3109/17453674.2014.991629 Local infiltration analgesia (LIA) is well established for effective postoperative pain relief in total knee arthroplasty (TKA). To prolong (...) the effect of LIA, infusion pumps with local intraarticular analgesia can be used. We evaluated the effect of such an infusion pump for the first 48 h postoperatively regarding pain, knee function, length of stay (LOS) in hospital, and complications. 200 patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at 2 mL/h. The patients were randomized either to ropivacaine (7.5 mg/mL) or to NaCl (9 mg/mL) in the pump. Visual analog scale (VAS) pain (0-100 mm

EvidenceUpdates2015 Full Text: Link to full Text with Trip Pro

113. Intra-Articular Analgesia After Knee Arthroscopy: A Rapid Review

Intra-Articular Analgesia After Knee Arthroscopy: A Rapid Review Intra-articular analgesia after knee arthroscopy: a rapid review Intra-articular analgesia after knee arthroscopy: a rapid review Health Quality Ontario Citation Health Quality Ontario. Intra-articular analgesia after knee arthroscopy: a rapid review. Toronto: Health Quality Ontario (HQO). Rapid Review. 2014 Authors' conclusions Based on results from 2 SRs that were limited in their ability to meta-analyse because (...) of their heterogeneous studies and outcome measures, the following conclusions were made in regards to IA analgesia for knee arthroscopy: There is very low quality evidence of an improvement in pain with IA-bupivacaine or IA-morphine in comparison to placebo. There is low to very low quality evidence of a reduction in the number of additional analgesics required with IA-bupivacaine or IA-morphine in comparison to placebo. No systematic reviews were identified that reported on the effectiveness of IA analgesia on

Health Technology Assessment (HTA) Database.2014

114. Single periarticular local infiltration analgesia reduces opiate consumption until 48 hours after total knee arthroplasty

Single periarticular local infiltration analgesia reduces opiate consumption until 48 hours after total knee arthroplasty 25238439 2014 11 21 2015 03 02 2017 02 20 1745-3682 85 6 2014 Dec Acta orthopaedica Acta Orthop Single periarticular local infiltration analgesia reduces opiate consumption until 48 hours after total knee arthroplasty. A randomized placebo-controlled trial involving 56 patients. 614-9 10.3109/17453674.2014.961399 Randomized trials evaluating efficacy of local infiltration (...) analgesia (LIA) have been published but many of these lack standardized analgesics. There is a paucity of reports on the effects of LIA on functional capability and quality of life. 56 patients undergoing unilateral total knee arthroplasty (TKA) were randomized into 2 groups in this placebo-controlled study with 12-month follow-up. In the LIA group, a mixture of levobupivacaine (150 mg), ketorolac (30 mg), and adrenaline (0.5 mg) was infiltrated periarticularly. In the placebo group, infiltration

EvidenceUpdates2014 Full Text: Link to full Text with Trip Pro

116. Efficacy of palonosetron versus ramosetron on preventing opioid-based analgesia-related nausea and vomiting after lumbar spinal surgery: a prospective, randomized, and double-blind trial

Efficacy of palonosetron versus ramosetron on preventing opioid-based analgesia-related nausea and vomiting after lumbar spinal surgery: a prospective, randomized, and double-blind trial 24480956 2014 04 17 2015 02 12 2014 04 17 1528-1159 39 9 2014 Apr 20 Spine Spine Efficacy of palonosetron versus ramosetron on preventing opioid-based analgesia-related nausea and vomiting after lumbar spinal surgery: a prospective, randomized, and double-blind trial. E543-9 10.1097/BRS.0000000000000236 (...) A prospective, randomized, and double-blind study. To compare the efficacy of ramosetron and palonosetron on preventing postoperative nausea and vomiting (PONV) associated with opioid-based intravenous patient-controlled analgesia (IV-PCAopioid) after lumbar spinal surgery. IV-PCAopioid, an effective method to control pain after lumbar spinal surgery, accompanies PONV. Ramosetron and palonosetron are novel 5-hydroxytryptamine 3 antagonists known to have longer action duration and higher receptor affinity

EvidenceUpdates2014

117. Tramadol/Acetaminophen Tablets Provide Rapid, Effective, and Dose-Dependent Analgesia Following Dental Surgery

Tramadol/Acetaminophen Tablets Provide Rapid, Effective, and Dose-Dependent Analgesia Following Dental Surgery UTCAT2725, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Tramadol/Acetaminophen Tablets Provide Rapid, Effective, and Dose-Dependent Analgesia Following Dental Surgery Clinical Question Following dental surgery, does Tramadol provide adequate analgesia when compared to hydrocodone/APAP or codeine/APAP (...) combination drug preparations? Clinical Bottom Line Tramadol/Acetaminophen 75/650mg tablets provide effective, rapid ( Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Jung/2004 128 healthy adults undergoing extraction of > or = 1 impacted 3rd molars Randomized Controlled Trial Key results Tr/APAP 75/650mg and Co/APAP/Ibuprofen 20/500/400mg mean total pain relief and the sum of pain intensity difference were

UTHSCSA Dental School CAT Library2014

118. Systematic review and meta-analysis of continuous local anaesthetic wound infiltration versus epidural analgesia for postoperative pain following abdominal surgery

Systematic review and meta-analysis of continuous local anaesthetic wound infiltration versus epidural analgesia for postoperative pain following abdominal surgery Systematic review and meta-analysis of continuous local anaesthetic wound infiltration versus epidural analgesia for postoperative pain following abdominal surgery Systematic review and meta-analysis of continuous local anaesthetic wound infiltration versus epidural analgesia for postoperative pain following abdominal surgery Ventham (...) NT, Hughes M, O'Neill S, Johns N, Brady RR, Wigmore SJ CRD summary The review concluded that use of local anaesthetic wound infiltration was associated with pain scores comparable to those obtained with epidural analgesia. The authors' conclusions appear broadly to be a fair reflection of the evidence, but the lack of use of their trial quality assessment results hinders the interpretation of the pooled estimates. Authors' objectives To compare epidural analgesia with continuous local anaesthetic

DARE.2014

119. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery.

Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. BACKGROUND: Postoperative pain may lead to adverse effects on the body, which might result in an increase in morbidity. Its management therefore poses a unique challenge for the clinician. Major shoulder surgery is associated with severe postoperative pain, and different modalities are available to manage such pain, including opioid and non-opioid analgesics (...) , local anaesthetics infiltrated into and around the shoulder joint and regional anaesthesia. All of these techniques, alone or in combination, have been used to treat the postoperative pain of major shoulder surgery but with varying success. OBJECTIVES: The objective of this review was to compare the analgesic efficacy of continuous interscalene brachial plexus block (ISBPB) with parenteral opioid analgesia for pain relief after major shoulder surgery. SEARCH METHODS: We searched the Cochrane Central

Cochrane2014