Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists最新文献_第7页

The unique role of transdermal buprenorphine in the global chronic pain epidemic 经皮丁丙诺啡在全球慢性疼痛流行中的独特作用

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-06-01 DOI: 10.1016/j.aat.2015.06.001

Joseph V. Pergolizzi Jr. , Willem Scholten , Kevin J. Smith , James Leighton-Scott , Jenna C. Willis , Jack E. Henningfield

{"title":"The unique role of transdermal buprenorphine in the global chronic pain epidemic","authors":"Joseph V. Pergolizzi Jr. , Willem Scholten , Kevin J. Smith , James Leighton-Scott , Jenna C. Willis , Jack E. Henningfield","doi":"10.1016/j.aat.2015.06.001","DOIUrl":"10.1016/j.aat.2015.06.001","url":null,"abstract":"<div><p>Pain is a global epidemic, exacerbated by barriers to access of opioid analgesics. Regulations about opioids attempt to protect public health from the risks of harmful use of opioids, diversion, and dependence. Transdermal buprenorphine is an effective opioid analgesic agent with unique properties that may make it particularly well suited for more widespread use. It is a versatile analgesic product with demonstrated safety and effectiveness in cancer and noncancer pain populations. Its pharmacological properties make it a first-line opioid analgesic for geriatric patients and patients with renal dysfunction; no dosing adjustments need to be made. The 7-day transdermal delivery system is convenient for patients and promotes compliance. A low dose of buprenorphine can provide effective and well-tolerated pain relief. Although buprenorphine has been associated with certain opioid-related adverse effects, such as dizziness and nausea, it is associated with a lower rate of constipation than many other opioid analgesics. The potential for nonmedical use of buprenorphine is relatively low compared with other opioid agents. Buprenorphine has a relatively low <em>likeability</em> for nonmedical use and the transdermal matrix patch renders the substance particularly difficult to extract for illicit purposes.</p></div>","PeriodicalId":87042,"journal":{"name":"Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists","volume":"53 2","pages":"Pages 71-76"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.aat.2015.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33863833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

Concluding statement – neuropharmacological basis and clinical rationale for control of transdermal buprenorphine as a step II analgesic 结论:经皮丁丙诺啡作为二级镇痛药控制的神经药理学基础和临床依据

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-06-01 DOI: 10.1016/j.aat.2015.05.002

Jack E. Henningfield , Wei-Zen Sun

引用次数: 4

Current controlled drug regulation in Taiwan 台湾目前的药物管制

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-06-01 DOI: 10.1016/j.aat.2015.05.003

Shiow-Ing Wu, Wen-Ing Tsay, Meng-Hsiu Wu

引用次数: 6

Undertreatment of caner pain 癌症疼痛治疗不足

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-06-01 DOI: 10.1016/j.aat.2015.05.005

Shiu-Yu C. Lee , Cheng-Hsu Wang

引用次数: 8

Update on administration of anesthetics and psychoactive drugs for pain management in China 中国麻醉药和精神药物用于疼痛管理的最新进展

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-06-01 DOI: 10.1016/j.aat.2015.05.007

Weiping Gu

引用次数: 5

Improving access to adequate pain management in Taiwan 改善台湾获得适当疼痛管理的机会

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-06-01 DOI: 10.1016/j.aat.2015.05.004

Willem Scholten

{"title":"Improving access to adequate pain management in Taiwan","authors":"Willem Scholten","doi":"10.1016/j.aat.2015.05.004","DOIUrl":"10.1016/j.aat.2015.05.004","url":null,"abstract":"<div><p>There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence.</p><p>Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia.</p><p>Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment.</p></div>","PeriodicalId":87042,"journal":{"name":"Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists","volume":"53 2","pages":"Pages 62-65"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.aat.2015.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33383820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study 硬膜外分娩镇痛后剖宫产术中脊髓和硬膜外麻醉的比较:一项回顾性队列研究

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-03-01 DOI: 10.1016/j.aat.2015.01.003

Chia-Hsiang Huang , Yi-Jer Hsieh , Ko-Hsin Wei , Wei-Zen Sun , Shao-Lun Tsao

{"title":"A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study","authors":"Chia-Hsiang Huang , Yi-Jer Hsieh , Ko-Hsin Wei , Wei-Zen Sun , Shao-Lun Tsao","doi":"10.1016/j.aat.2015.01.003","DOIUrl":"10.1016/j.aat.2015.01.003","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aimed to investigate different types of regional anesthesia for cesarean section (CS) following epidural labor analgesia that could lead to various perioperative and postoperative outcomes.</p></div><div><h3>Methods</h3><p>We retrospectively included those parturients who received epidural labor analgesia but needed subsequent CS under regional anesthesia in our institution from January 2008 to June 2012.</p></div><div><h3>Results</h3><p>In all, 2341 of 6609 parturients underwent painless labor, and 334 of them converted to CS. Spinal anesthesia (SA) was used with 163 parturients, and epidural anesthesia (EA) with 96; the two groups were then compared. No high-level block or total SA was noted. The primary outcome revealed that the time from anesthesia to surgical incision and the total anesthesia time were shorter, hypotension episodes were more frequent, the rate of perioperative ephedrine administration was higher, and the rate of midazolam was lower in the SA group. With regard to secondary outcomes, the Apgar scores of the neonates recorded at 1 minute and 5 minutes and maternal satisfaction were similar. The neuraxial morphine dose was converted to parenteral morphine equivalent dose (MED), which revealed that the parturients in the spinal morphine group had lower dosages and visual analog scale (VAS) pain scores on postoperative Day 1.</p></div><div><h3>Conclusion</h3><p>For parturients with labor epidural analgesia needing CS, the use of SA led to shorter anesthetic time and lower postoperative pain scores, with lower morphine doses compared with EA. However, the high failure rate with both neuraxial techniques needs to be addressed.</p></div>","PeriodicalId":87042,"journal":{"name":"Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists","volume":"53 1","pages":"Pages 7-11"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.aat.2015.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33099653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 32

Tiny tweaks, big changes: An alternative strategy to empower ethical culture of human research in anesthesia (A Taiwan Acta Anesthesiologica Taiwanica–Ethics Review Task Force Report) 微小的调整，大的改变:赋予麻醉人体研究伦理文化的另一种策略(台湾麻醉学学报台湾伦理审查工作组报告)

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-03-01 DOI: 10.1016/j.aat.2015.03.001

Hsiang-Ning Luk , John F. Ennever , Yuan-Ji Day , Chih-Shung Wong , Wei-Zen Sun

{"title":"Tiny tweaks, big changes: An alternative strategy to empower ethical culture of human research in anesthesia (A Taiwan Acta Anesthesiologica Taiwanica–Ethics Review Task Force Report)","authors":"Hsiang-Ning Luk , John F. Ennever , Yuan-Ji Day , Chih-Shung Wong , Wei-Zen Sun","doi":"10.1016/j.aat.2015.03.001","DOIUrl":"10.1016/j.aat.2015.03.001","url":null,"abstract":"<div><p>For this guidance article, the Ethics Review Task Force (ERTF) of the Journal reviewed and discussed the ethics issues related to publication of human research in the field of anesthesia. ERTF first introduced international ethics principles and minimal requirements of reporting of ethics practices, followed by discussing the universal problems of publication ethics. ERTF then compared the accountability and methodology of several medical journals in assuring authors' ethics compliance. Using the Taiwan Institutional Review Board system as an example, ERTF expressed the importance of institutional review board registration and accreditation to assure human participant protection. ERTF presented four major human research misconducts in the field of anesthesia in recent years. ERTF finally proposed a flow-chart to guide journal peer reviewers and editors in ethics review during the editorial process in publishing. Examples of template languages applied in the <em>Ethics statement</em> section in the manuscript are expected to strengthen the ethics compliance of the authors and to set an ethical culture for all the stakeholders involved in human research.</p></div>","PeriodicalId":87042,"journal":{"name":"Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists","volume":"53 1","pages":"Pages 29-40"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.aat.2015.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33088003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Coagulation abnormalities in sepsis 脓毒症的凝血异常

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-03-01 DOI: 10.1016/j.aat.2014.11.002

Cheng-Ming Tsao , Shung-Tai Ho , Chin-Chen Wu

{"title":"Coagulation abnormalities in sepsis","authors":"Cheng-Ming Tsao , Shung-Tai Ho , Chin-Chen Wu","doi":"10.1016/j.aat.2014.11.002","DOIUrl":"10.1016/j.aat.2014.11.002","url":null,"abstract":"<div><p>Although the pathophysiology of sepsis has been elucidated with the passage of time, sepsis may be regarded as an uncontrolled inflammatory and procoagulant response to infection. The hemostatic changes in sepsis range from subclinical activation of blood coagulation to acute disseminated intravascular coagulation (DIC). DIC is characterized by widespread microvascular thrombosis, which contributes to multiple organ dysfunction/failure, and subsequent consumption of platelets and coagulation factors, eventually causing bleeding manifestations. The diagnosis of DIC can be made using routinely available laboratory tests, scoring algorithms, and thromboelastography. In this cascade of events, the inhibition of coagulation activation and platelet function is conjectured as a useful tool for attenuating inflammatory response and improving outcomes in sepsis. A number of clinical trials of anticoagulants were performed, but none of them have been recognized as a standard therapy because recombinant activated protein C was withdrawn from the market owing to its insufficient efficacy in a randomized controlled trial. However, these subgroup analyses of activated protein C, antithrombin, and thrombomodulin trials show that overt coagulation activation is strongly associated with the best therapeutic effect of the inhibitor. In addition, antiplatelet drugs, including acetylsalicylic acid, P2Y12 inhibitors, and glycoprotein IIb/IIIa antagonists, may reduce organ failure and mortality in the experimental model of sepsis without a concomitant increased bleeding risk, which should be supported by solid clinical data. For a state-of-the-art treatment of sepsis, the efficacy of anticoagulant and antiplatelet agents needs to be proved in further large-scale prospective, interventional, randomized validation trials.</p></div>","PeriodicalId":87042,"journal":{"name":"Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists","volume":"53 1","pages":"Pages 16-22"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.aat.2014.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32937889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 39

A rare case of pneumocephalus and pneumorrhachis after epidural anesthesia 硬膜外麻醉后出现气脑及气腹的罕见病例

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists Pub Date : 2015-03-01 DOI: 10.1016/j.aat.2015.01.002

Xhang-Xian Hsieh , Sun-Wung Hsieh , Chueng-He Lu , Zhi-Fu Wu , Da-Tong Ju , Billy Huh , Jia-Chang Wang , Chan-Yang Kuo

引用次数: 12