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Preemptive Analgesia (preemptive + analgesia)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The Effect of Preemptive Analgesia in Postoperative Pain Relief,A Prospective Double-Blind Randomized Study

PAIN MEDICINE, Issue 1 2009
Seetharaman Hariharan MD
ABSTRACT Objective., To analyze the effect of infiltration of local anesthetics on postoperative pain relief. Design., Prospective randomized double-blind trial. Setting., University Teaching Hospital in Barbados, West Indies. Patients., Patients undergoing total abdominal hysterectomy. Interventions., Patients were randomly allocated into one of four groups according to the wound infiltration: 1) preoperative and postoperative 0.9% saline; 2) preoperative saline and postoperative local anesthetic mixture (10 mL 2% lidocaine added to 10 mL 0.5% bupivacaine); 3) preoperative local anesthetic mixture and postoperative saline; and 4) preoperative and postoperative local anesthetic mixture. Both patients and investigators were blinded to the group allocation. All patients received pre-incision tenoxicam and morphine, standardized anesthesia, and postoperative morphine by patient-controlled analgesia. Outcome measures., The amount of morphine used and the intensity of pain as measured by visual analog pain scale were recorded at 1, 2, 3, 4, 8, 12, 24, and 48 hours postoperatively. Results., Eighty patients were studied with 20 in each group. Total dose of morphine used by patients who received preoperative and postoperative local anesthetic infiltration was lesser compared to other groups, although there was no statistically significant difference. Similarly, there was no difference in the intensity of pain between any groups. Conclusions., Local anesthetic infiltration before and/or after abdominal hysterectomy does not reduce the intensity of postoperative pain and analgesic requirements. [source]

The Surgical Stress Response, Preemptive Analgesia, and Procedural Sedation in the Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 10 2008
James R. Miner MD
First page of article [source]

A Novel Interdisciplinary Analgesic Program Reduces Pain and Improves Function in Older Adults After Orthopedic Surgery

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2009
R. Sean Morrison MD
OBJECTIVES: To examine the effect of a multicomponent intervention on pain and function after orthopedic surgery. DESIGN: Controlled prospective propensity score,matched clinical trial. SETTING: New York City acute rehabilitation hospital. PARTICIPANTS: Two hundred forty-nine patients admitted to rehabilitation after hip fracture repair (n=51) or hip (n=64) or knee (n=134) arthroplasty. INTERVENTION: Pain assessment at rest and with physical therapy (PT) by staff using numeric rating scales (1 to 5). Physician protocols for standing analgesia and preemptive analgesia before PT were implemented on the intervention unit. Control unit patients received usual care. MEASUREMENTS: Pain, analgesic prescribing, gait speed, transfer time, and percentage of PT sessions completed during admission. Pain and difficulty walking at 6, 12, 18, and 24 weeks after discharge. RESULTS: In multivariable analyses intervention patients were significantly more likely than controls to report no or mild pain at rest (66% vs 49%, P=.004) and with PT (52% vs 38%, P=.02) on average for the first 7 days of rehabilitation, had faster 8-foot-walk times on Days 4 (9.3 seconds vs 13.2 seconds, P=.02) and 7 (6.9 vs 9.2 seconds, P=.02), received more analgesia (23.6 vs 15.6 mg of morphine sulfate equivalents per day, P<.001), were more likely to receive standing orders for analgesia (98% vs 48%, P<.001), and had significantly shorter lengths of stay (10.1 vs 11.3 days, P=.005). At 6 months, intervention patients were less likely than controls to report moderate to severe pain with walking (4% vs 15%, P=.02) and that pain did not interfere with walking (7% vs 18%, P=.004) and were less likely to be taking analgesics (35% vs 51%, P=.03). CONCLUSION: The intervention improved postoperative pain, reduced chronic pain, and improved function. [source]

Effects of ketamine on formalin-induced activity in the spinal dorsal horn of spinal cord-transected cats: differences in response to intravenous ketamine administered before and after formalin

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2000
H. Nagasaka
Background: Although formalin has been widely used as an algesic substance in rodent studies, the unique biphasic effect seen in rats is not present in humans. Humans, like cats, have a monophasic behavioral response to formalin injection. Electrophysiologically, spinal dorsal horn neurons in cats also have what could be considered a monophasic response after the initial burst of activity following formalin injection. Although several studies of the effects of ketamine on formalin responses have been carried out in rodents, we are unaware of similar studies in cats. We hypothesize that such species differences may explain observed differences in preemptive analgesic effects. Therefore, we examined the effects of ketamine on activity of spinal wide dynamic range (WDR) neurons evoked by formalin injection in cats. Methods: We investigated in cats the effect of ketamine on the activity of WDR neurons in the spinal dorsal horn that was evoked by formalin. In addition, we studied the effects of pre- and post-administration of ketamine on the maintained phase of the formalin response. Each dose was a subanesthetic, anesthetic or high anesthetic dose (3.0 mg · kg,1, 10 mg · kg,1, and 30 mg · kg,1). Results: Intravenously administered ketamine produced a dose-dependent depression of evoked activity that was significantly greater when the drug was administered before formalin. Conclusions: In spite of the species differences in responses to formalin, there still appears to be a clear preemptive effect of ketamine in the cat. Species differences may not explain apparent differences between human and animal preemptive analgesia. [source]

Tenoxicam controls pain without altering orthodontic movement of maxillary canines

ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 1 2009
GM Arantes
Structured Abstract Authors,,, Arantes GM, Arantes VMN, Ashmawi HA, Posso IP Objectives,,, To study the efficacy of tenoxicam for pain control, its potential for preemptive analgesia, and its influence on the orthodontic movement of upper canine teeth. Design,,, This was a randomized controlled double-blind cross-over study. The patients were divided into three groups. Two groups received tenoxicam in daily doses of 20 mg orally for 3 days. Group A received the first dose of the drug before orthodontic activation and group B, just afterwards. Group C (control) received a placebo for 3 days. All groups had access to 750 mg of paracetamol up to four times a day. Three orthodontic activations were performed at 30-day intervals. Each patient belonged to two different groups. Pain intensity was assessed using a descriptive Pain Scale and a Visual Analog Scale. Setting and Sample Population,,, Private clinic; 36 patients undergoing bilateral canine tooth retraction. Results,,, The statistical analysis did not show any difference in movement between the active groups and the control at any time. There was no statistical difference between the groups that received tenoxicam. Pain intensity in these groups was lower than in the placebo group. The difference in pain intensity between the active groups and the control was greatest at the assessment made 12 h after activation and it tended to zero, 72 h after activation. Conclusions,,, Tenoxicam did not influence orthodontic movement of the upper canines. It was effective for pain control and did not present any preemptive analgesic effect. [source]