Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.07.001

F. Heid , T. Piepho , S. Stengel , A. Hofmann , J. Jage

{"title":"Premature termination of epidural analgesia—A prospective analysis to improve quality","authors":"F. Heid , T. Piepho , S. Stengel , A. Hofmann , J. Jage","doi":"10.1016/j.acpain.2009.07.001","DOIUrl":"10.1016/j.acpain.2009.07.001","url":null,"abstract":"<div><h3>Background and objective</h3><p>Epidural analgesia (EA) is a gold-standard in post-operative pain control. Therefore, modern treatment concepts targeting early patient recovery regularly implement EA. Due to its increasing impact, EA should meet high quality standards in respect to application and maintenance. Though, daily practice often reveals EA-related problems, our investigation aimed to improve EA quality by assessing incidence and reasons of undeliberate, premature termination of post-operative EA.</p></div><div><h3>Methods</h3><p>In the first step all patients with post-operative EA were retrospectively studied covering a 6-month period (group 1). We analysed incidences and reasons of undeliberate termination of EA. Thereafter we modified our treatment protocols (preferential thoracic EA, continuous peripheral blocks, low concentrated local anaesthetic solutions, standardized co-medication). This was followed by a prospective analysis of all EA patients for another 6 months (group 2).</p></div><div><h3>Results</h3><p>777 patients were included (group 1 <em>n</em>  =377). Undeliberate termination of post-operative EA was documented in 24.3% of group 1 patients (group 2: 14.1%; <em>p</em>  <!-->0.05). In all patients, pain was the leading reason of premature termination (group 1: 52%; group 2: 68%), followed by motor block (group 1: 21%; group 2: 7.5%) and catheter dislocation (group 1: 10%; group 2: 16.7%).</p></div><div><h3>Discussion</h3><p>Modified treatment protocols reduced the rate of premature termination of EA from 24% to 14%. Particularly, we noted less motor impairment but still this rate is disappointing. The increasing rate of catheter dislocations underlines that a continuous analysis of all treatment aspects must be compulsatory.</p></div>","PeriodicalId":100023,"journal":{"name":"Acute Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.acpain.2009.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75691261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuing use of droperidol in patient-controlled analgesia with morphine 哌啶醇在吗啡自控镇痛中的持续应用

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.09.002

C.M. Ball, P. Claydon

引用次数: 0

Nebulized fentanyl versus intravenous morphine in children with suspected limb fractures in the emergency department: A randomized controlled trial 急诊疑似肢体骨折患儿雾化芬太尼与静脉注射吗啡:一项随机对照试验

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.10.027

J.S. Furyk, W.J. Grabowski, L.H. Black

引用次数: 0

Predictive factors of postoperative pain after day-case surgery 日间手术后疼痛的预测因素

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.10.009

H.F. Gramke, J.M. de Rijke, M. van Kleef, A.G. Kessels, M.L. Peters, M. Sommer, M.A. Marcus

引用次数: 0

A multicenter, open-label, exploratory dose-ranging trial of intranasal hydromorphone for managing acute pain from traumatic injury 一项多中心、开放标签、探索性剂量范围试验:鼻内氢吗啡酮治疗外伤性急性疼痛

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/J.ACPAIN.2009.10.019

D. Wermeling, T. Clinch, A. C. Rudy, D. Dreitlein, S. Suner, P. Lacouture

引用次数: 2

New and emerging analgesics and analgesic technologies for acute pain management 新的和新兴的镇痛药和镇痛技术的急性疼痛管理

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.10.013

J.W. Heitz, T.A. Witkowski, E.R. Viscusi

引用次数: 0

Phantom limb like pain and sensations in an intact lower extremity 幻肢就像完整下肢的疼痛和感觉

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.07.004

Suparna Saha , Eldor L. Brish , Krishna Boddu

引用次数: 1

Gabapentin decreases morphine consumption and improves functional recovery following total knee arthroplasty 加巴喷丁减少吗啡的消耗，改善全膝关节置换术后的功能恢复

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.10.008

H. Clarke, S. Pereira, D. Kennedy, I. Gilron, J. Katz, J. Gollish, J. Kay

引用次数: 0

Comparison of fentanyl and butorphanol for postoperative pain relief with intravenous patient controlled analgesia 芬太尼与布托啡诺术后镇痛与静脉自控镇痛的比较

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/j.acpain.2009.09.001

Bhoomika Thakore, Jacqueline D’Mello, Shalini Saksena, Manju Butani

{"title":"Comparison of fentanyl and butorphanol for postoperative pain relief with intravenous patient controlled analgesia","authors":"Bhoomika Thakore, Jacqueline D’Mello, Shalini Saksena, Manju Butani","doi":"10.1016/j.acpain.2009.09.001","DOIUrl":"10.1016/j.acpain.2009.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Opioids are very effective as postoperative analgesics, influencing emotional aspects of pain as well as reducing the actual pain threshold. Fentanyl, a phenylpiperidine derivative and potent opioid agonist, has already been studied for postoperative analgesia. Butorphanol, a synthetic morphinan derivative – agonist–antagonist, has few studies to substantiate its use. The present study was undertaken to compare the effects of the two drugs on postoperative pain relief in terms of efficacy and safety.</p></div><div><h3>Methods</h3><p>A prospective, randomized controlled study of 100 patients [ASA I and II] undergoing total abdominal hysterectomies was conducted. Group F of 50 patients received fentanyl [0.4μg/kg/h] and group B received butorphanol [4μg/kg/h] as postoperative pain treatment via intravenous patient controlled analgesia [i.v. PCA]. Parameters monitored were pain score [VAS], pulse, blood pressure, respiratory rate, sedation score and side effects. The infusion rate, number of boluses, PCA demands and requirement of rescue analgesia were noted.</p></div><div><h3>Results</h3><p>Butorphanol had a better maintenance phase than fentanyl. The VAS scores were found to be reduced in the butorphanol group when compared with fentanyl group, significantly at 8h [F: 1.16±1.037; B: 0.78±0.582; <em>p</em>-value: 0.026]. The incidences of complications were comparable in both the groups.</p></div><div><h3>Conclusion</h3><p>Both the drugs are equally effective and safe as postoperative analgesics with i.v. PCA. The dose of 4μg/kg/h of butorphanol appeared effective but the dosage of fentanyl used, 0.4μg/kg/h, was not as effective as evidenced by the increased number of boluses taken by patients and needs to be increased.</p></div>","PeriodicalId":100023,"journal":{"name":"Acute Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.acpain.2009.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87329121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Effects of cognitive pain coping strategies and locus of control on perception of cold pressor pain in healthy individuals: Experimental study 认知疼痛应对策略和控制点对健康个体冷压力痛知觉影响的实验研究

Acute Pain Pub Date : 2009-12-01 DOI: 10.1016/J.ACPAIN.2009.10.003

N. Jokić-begić, D. Ivanec, Dragana Markanović

引用次数: 11

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