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

161. Ropivacaine continuous wound infusion versus epidural morphine for postoperative analgesia after cesarean delivery: a randomized controlled trial

Ropivacaine continuous wound infusion versus epidural morphine for postoperative analgesia after cesarean delivery: a randomized controlled trial 22025490 2011 12 20 2012 07 16 2015 11 19 1526-7598 114 1 2012 Jan Anesthesia and analgesia Anesth. Analg. Ropivacaine continuous wound infusion versus epidural morphine for postoperative analgesia after cesarean delivery: a randomized controlled trial. 179-85 10.1213/ANE.0b013e3182368e87 The infusion of local anesthetic in the surgical wound (...) is helpful in the multimodal management of postoperative pain. We hypothesized that local anesthetic wound infusion after cesarean delivery would provide better pain control than epidural morphine analgesia. Healthy, term women scheduled for elective cesarean delivery were included in this assessor-blinded, randomized study. Patients were randomly assigned to receive analgesia through a multiorifice wound catheter placed below the fascia and connected to a 5 mL/h ropivacaine 2 mg/mL infusion

EvidenceUpdates2012

162. Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient-Controlled Analgesia-Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient-Controlled Analgesia-Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial 22297625 2012 04 17 2012 08 23 2013 11 21 1432-2323 36 4 2012 Apr World journal of surgery World J Surg Comparison of dexamethasone with ondansetron or haloperidol for prevention of patient-controlled analgesia-related postoperative nausea and vomiting: a randomized clinical trial. 775-81 10.1007/s00268-012-1446-y (...) Patient-controlled analgesia (PCA) with parenteral opioids is associated with a high incidence of postoperative nausea and vomiting (PONV). The aim of the present study was to compare the efficacy of dexamethasone plus haloperidol with dexamethasone plus ondansetron for the prevention of PCA-related PONV. Patients who received dexamethasone alone were used as controls. A total of 135 female patients (n = 45 in each of three groups) were eligible to participate in this randomized trial. A total of 135

EvidenceUpdates2012

163. Bupivacaine / fentanyl (Bufyl infusion) - epidural analgesia to relieve pain during labour and to control post operative pain

Bupivacaine / fentanyl (Bufyl infusion) - epidural analgesia to relieve pain during labour and to control post operative pain Published 12 March 2012 Product Update: bupivacaine HCL 1.0mg/mL and 1.25mg/mL plus fentanyl (as citrate) 2 microgram/mL solution for infusion (Bufyl®) (No: 761/12) Goldshield Pharmaceuticals Ltd 13 January 2012 (Issued 10 February 2012) The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug (...) and Therapeutic Committees (ADTCs) on its use in NHS Scotland. The advice is summarised as follows: ADVICE: following an abbreviated submission bupivacaine HCL 1.0mg/mL and 1.25mg/mL plus fentanyl (as citrate) 2 microgram/mL solution for infusion (Bufyl®) is accepted for use in NHS Scotland. Indication under review: epidural analgesia to relieve pain during labour and to control post operative pain. For patients in whom the combination of bupivacaine and fentanyl is an appropriate choice of therapy, Bufyl

Scottish Medicines Consortium2012

164. Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates

Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates 21471025 2011 12 15 2012 02 07 2013 11 21 1468-2052 97 1 2012 Jan Archives of disease in childhood. Fetal and neonatal edition Arch. Dis. Child. Fetal Neonatal Ed. Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates. F24-9 10.1136/adc.2010.203851 To assess, in newborn infants submitted to surgical procedures, the efficacy of two opioids-fentanyl and tramadol-regarding time to extubate, time (...) to achieve 100 ml/kg of enteral feeding and pain in the first 72 h after surgery. Controlled, blind, randomised clinical trial. Neonatal intensive care unit. 160 newborn infants up to 28 days of life requiring major or minor surgeries. Patients were randomised to receive analgesia with fentanyl (1-2 μg/kg/h intravenously) or tramadol (0.1-0.2 mg/kg/h intravenously) in the first 72 h of the postoperative period, stratified by surgical size and by patient's gender. Pain assessed by validated neonatal

EvidenceUpdates2012

165. Systematic review and meta-analysis: No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in (term) labour

Systematic review and meta-analysis: No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in (term) labour No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in (term) labour | Evidence-Based Medicine 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 No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in (term) labour Article Text Therapeutics Systematic review and meta-analysis No increased risk

Evidence-Based Medicine (Requires free registration)2012

166. Ropivacaine for ultrasound-guided interscalene block: 5 mL provides similar analgesia but less phrenic nerve paralysis than 10 mL

Ropivacaine for ultrasound-guided interscalene block: 5 mL provides similar analgesia but less phrenic nerve paralysis than 10 mL 21858614 2011 10 17 2012 02 09 2012 11 15 1496-8975 58 11 2011 Nov Canadian journal of anaesthesia = Journal canadien d'anesthesie Can J Anaesth Ropivacaine for ultrasound-guided interscalene block: 5 mL provides similar analgesia but less phrenic nerve paralysis than 10 mL. 1001-6 10.1007/s12630-011-9568-5 Interscalene brachial plexus block (interscalene block (...) ) complications usually depend on the dose administered. The objective of this study was to determine whether ultrasound-guided interscalene block with a 5-mL dose of 0.75% ropivacaine would have sufficient analgesic efficacy after shoulder arthroscopic surgery when compared with a 10-mL dose. Patients undergoing arthroscopic rotator cuff repair surgery (n = 60) were assigned randomly to one of two groups receiving 5 mL (Group 5) or 10 mL (Group 10) of 0.75% ropivacaine. Ultrasound-guided interscalene block

EvidenceUpdates2012

167. Intraarticular vs. extraarticular ropivacaine infusion following high-dose local infiltration analgesia after total knee arthroplasty

Intraarticular vs. extraarticular ropivacaine infusion following high-dose local infiltration analgesia after total knee arthroplasty 22026413 2011 11 25 2012 01 23 2016 12 15 1745-3682 82 6 2011 Dec Acta orthopaedica Acta Orthop Intraarticular vs. extraarticular ropivacaine infusion following high-dose local infiltration analgesia after total knee arthroplasty: a randomized double-blind study. 692-8 10.3109/17453674.2011.625535 Ropivacaine infusion following high-volume local infiltration (...) analgesia has been shown to be effective after total knee arthroplasty, but the optimum site of administration of ropivacaine has not been evaluated. We compared the effects of intraarticular and extraarticular adminstration of the local anesthetic for postoperative supplementation of high-volume local infiltration analgesia. In this double-blind study, 36 rheumatic patients aged 51-78 years with physical status ASA 2-3 who were scheduled for total knee arthroplasty were randomized into 2 groups. All

EvidenceUpdates2012 Full Text: Link to full Text with Trip Pro

168. The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial

The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial 21680059 2011 09 29 2011 11 29 2016 11 25 1097-6760 58 4 2011 Oct Annals of emergency medicine Ann Emerg Med The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial. 360-364.e3 10.1016/j.annemergmed.2011.05.018 We determine whether high-flow oxygen reduces the incidence

EvidenceUpdates2011

169. Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory: an integrative review

Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory: an integrative review 21601855 2011 07 25 2011 11 18 2012 11 15 1873-491X 48 8 2011 Aug International journal of nursing studies Int J Nurs Stud Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory: an integrative review. 1012-23 10.1016/j.ijnurstu.2011.04.013 To identify and appraise the literature concerning nurse-administered procedural sedation and analgesia in (...) to monitor ventilation because deeply sedated patients are more likely to experience complications related to sedation. These initiatives will go some way to ensuring patients receiving nurse-administered procedural sedation and analgesia for a procedure in the cardiac catheter laboratory are cared for using consistent, safe and evidence-based practices. Copyright © 2011 Elsevier Ltd. All rights reserved. Conway Aaron A School of Nursing and Midwifery (QLD), Australian Catholic University & Cardiac

EvidenceUpdates2011

170. Obstetric outcomes and maternal satisfaction in nulliparous women using patient-controlled epidural analgesia

Obstetric outcomes and maternal satisfaction in nulliparous women using patient-controlled epidural analgesia 22071061 2011 11 10 2012 02 02 2013 11 21 1097-6868 205 3 2011 Sep American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Obstetric outcomes and maternal satisfaction in nulliparous women using patient-controlled epidural analgesia. 271.e1-6 10.1016/j.ajog.2011.06.041 The purpose of this study was to compare obstetric outcomes and maternal satisfaction in nulliparous (...) women in spontaneous labor who used patient-controlled epidural analgesia (PCEA) vs continuous epidural infusion (CEI). We conducted a double-masked trial of 270 nulliparous women who were assigned randomly to 3 groups (with a concentration 0.1% bupivacaine and 2 μg/mL fentanyl): group I, CEI-only (10 mL/h); group II, CEI + PCEA (CEI 10 mL/h plus PCEA 10 mL, at 20 minutes); group III, PCEA-only (10 mL, at 20 minutes). A PCEA bolus button was given to each subject. The primary outcome was the dosage

EvidenceUpdates2011

171. Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single-centre, non-blinded, non-inferiority study

Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single-centre, non-blinded, non-inferiority study Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single-centre, non-blinded, non-inferiority study Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single (...) provide equivalent postoperative analgesia and a similar safety profile to intravenous patient-controlled analgesia with morphine for patients undergoing elective primary total hip replacement under spinal anaesthesia. An analysis of the economic impact of the two strategies was a secondary aim. Oral analgesia with oxycodone was an excellent alternative to morphine, with both logistic and cost advantages. The clinical trial was well designed and reported, but the economic analysis was weak. Type

NHS Economic Evaluation Database.2011

172. The efficacy of a novel approach to transversus abdominis plane block for postoperative analgesia after colorectal surgery

The efficacy of a novel approach to transversus abdominis plane block for postoperative analgesia after colorectal surgery 21467560 2011 05 26 2011 08 09 2013 11 21 1526-7598 112 6 2011 Jun Anesthesia and analgesia Anesth. Analg. The efficacy of a novel approach to transversus abdominis plane block for postoperative analgesia after colorectal surgery. 1504-8 10.1213/ANE.0b013e3182159bf8 The analgesic efficacy of transversus abdominis plane (TAP) block has been established for patients (...) undergoing abdominal surgery. We evaluated the efficacy of a novel approach to TAP block for postoperative analgesia after colorectal surgery. Forty adult ASA physical status I to III patients undergoing colorectal surgery were recruited to this double-blind randomized controlled trial. A standard general anesthetic technique was used. TAP block was performed at the end of surgery by piercing the transversus abdominis muscle from inside the abdominal wall at the midaxillary line at the level

EvidenceUpdates2011

173. Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial

Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial 21368651 2011 05 02 2011 07 18 2012 01 23 1528-1175 114 5 2011 May Anesthesiology Anesthesiology Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial. 1144-54 10.1097/ALN.0b013e31820fc7d2 Severe preamputation pain is associated with phantom limb pain (PLP (...) ) development in limb amputees. We investigated whether optimized perioperative analgesia reduces PLP at 6-month follow-up. A total of 65 patients underwent lower-limb amputation and were assigned to five analgesic regimens: (1) Epi/Epi/Epi patients received perioperative epidural analgesia and epidural anesthesia; (2) PCA/Epi/Epi patients received preoperative intravenous patient-controlled analgesia (PCA), postoperative epidural analgesia, and epidural anesthesia; (3) PCA/Epi/PCA patients received

EvidenceUpdates2011

174. No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty.

No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty. 21619503 2011 05 30 2011 07 22 2016 12 15 1745-3682 82 3 2011 Jun Acta orthopaedica Acta Orthop No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty. 315-20 10.3109/17453674.2011.570671 Postoperative analgesia after primary total (...) hip arthroplasty (THA) using opioids is associated with troublesome side effects such as nausea and dizziness, and epidural analgesic means delayed mobilization. Thus, local infiltration analgesia (LIA) during surgery prolonged with local infusion analgesia (LINFA) into the soft tissue in the hip region through a catheter in the first postoperative days has gained major interest in THA fast-track settings within a short period of time. LIA at the time of surgery is a validated treatment. We

EvidenceUpdates2011 Full Text: Link to full Text with Trip Pro

175. 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

176. 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

177. 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

178. 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

179. 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

180. 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