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[PMID]:26754752
[Au] Autor:Wiesmann T; Piechowiak K; Duderstadt S; Haupt D; Schmitt J; Eschbach D; Feldmann C; Wulf H; Zoremba M; Steinfeldt T
[Ad] Endereço:Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Philipps University, Marburg, Baldingerstrasse, 35033, Marburg, Germany. wiesmann@med.uni-marburg.de.
[Ti] Título:Continuous adductor canal block versus continuous femoral nerve block after total knee arthroplasty for mobilisation capability and pain treatment: a randomised and blinded clinical trial.
[So] Source:Arch Orthop Trauma Surg;136(3):397-406, 2016 Mar.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Continuous femoral nerve blocks for total knee arthroplasty can cause motor weakness of the quadriceps muscle and thus prevent early mobilisation. Perioperative falls may result as an iatrogenic complication. In this randomised and blinded trial, we tested the hypothesis that a continuous adductor canal block is superior to continuous femoral nerve block regarding mobilisation ('timed up-and-go' test and other tests) after total knee arthroplasty under general anaesthesia. METHODS: In our study, we included patients scheduled for unilateral knee arthroplasty under general anaesthesia into a blinded and randomised trial. Patients were allocated to a continuous adductor canal block (CACB) or a continuous femoral nerve block (CFNB) for three postoperative days (POD 1-3); with a bolus of 15 ml ropivacaine 0.375%, followed by continuous infusion of ropivacaine 0.2% and patient-controlled bolus administration. Both groups received an additional continuous sciatic nerve block as well as a multimodal systemic analgesic treatment. The primary outcome parameter was mobilisation capability, assessed by 'timed up-and-go' (TUG) test. Analgesic quality, need for opioid rescue and local anaesthetic consumption were also assessed. RESULTS: Forty-two patients were included and analysed (21 patients per group). No significant difference was noted in respect to mobilisation at POD 3 (TUG [s]: CACB 45, CFNB 51). It is worth saying that pain scores (numeric rating scale, NRS) were similar in both groups at POD 3 {rest [median (interquartile range)]: CACB 0 (0-3), CFNB 1 (0-3); stress: CACB 4 (2-5), CFNB 3 (2-4)}. CONCLUSIONS: Concerning the mobilisation capability, we did not actually observe a superior effect of CACB compared with CFNB technique in our patients following total knee arthroplasty. Moreover, no difference was observed concerning analgesia quality.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Anestésicos Locais/administração & dosagem
Artroplastia do Joelho/métodos
Deambulação Precoce
Nervo Femoral
Bloqueio Nervoso/métodos
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Acidentes por Quedas/prevenção & controle
Idoso
Analgesia/métodos
Analgésicos/administração & dosagem
Analgésicos Opioides/uso terapêutico
Anestesia por Condução/métodos
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Meia-Idade
Debilidade Muscular/induzido quimicamente
Manejo da Dor
Dor Pós-Operatória/tratamento farmacológico
Modalidades de Fisioterapia
Pirinitramida/uso terapêutico
Período Pós-Operatório
Músculo Quadríceps
Nervo Isquiático
Coxa da Perna
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Amides); 0 (Analgesics); 0 (Analgesics, Opioid); 0 (Anesthetics, Local); 4RP92LYZ2F (Pirinitramide); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160113
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-015-2403-7


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[PMID]:26681082
[Au] Autor:Bartosová O; Polanecký O; Perlík F; Adámek S; Slanar O
[Ad] Endereço:Institute of Pharmacology, First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Prague, Czech Republic. olga.matouskova@lf1.cuni.cz.
[Ti] Título:OPRM1 and ABCB1 polymorphisms and their effect on postoperative pain relief with piritramide.
[So] Source:Physiol Res;64 Suppl 4:S521-7, 2015.
[Is] ISSN:1802-9973
[Cp] País de publicação:Czech Republic
[La] Idioma:eng
[Ab] Resumo:Genetic factors may contribute to the differential response to opioids. The aim of this study was to evaluate the association between polymorphisms of µ1-opioid receptor gene OPRM1 (rs1799971), and P-glycoprotein transporter gene ABCB1 (rs1045642, rs2032582), and piritramide efficacy under postoperative patient-controlled analgesia (PCA). In 51 patients, OPRM1 variant was associated with decreased efficacy in early postoperative period evidenced by sum of pain intensity difference in the 0-6 h postoperative period (SPID(0-6)), (F=3.27, p=0.029). Mean (SD) SPID(0-6) was observed in the 118AA genotype 22.9 (6.1) mm, which was significantly higher from the 118GG genotype 10.0 (4.4) mm, p=0.006. The lowest cumulative dose was recorded in 118AA genotype 19.1 (9.8) mg, which was significantly less than in the 118GG genotype group 36.6 (6.1) mg, p=0.017. Opioid-induced adverse effects were observed in 11, 30, and 100 % of patients in 118AA, 118AG, and 118GG genotype groups, respectively (p<0.05). Piritramide efficacy and safety was not significantly affected by ABCB1 (rs1045642, rs2032582) polymorphisms. Variant OPRM1 118G allele is associated with decreased acute postoperative pain relief after piritramide. Decreased efficacy leads to higher drug consumption under PCA settings, which however, does not fully compensate insufficient pain relief, but increases incidence of adverse effects.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Dor Pós-Operatória/tratamento farmacológico
Dor Pós-Operatória/genética
Pirinitramida/uso terapêutico
Receptores Opioides mu/genética
[Mh] Termos MeSH secundário: Subfamília B de Transportador de Cassetes de Ligação de ATP/genética
Adulto
Idoso
Analgésicos Opioides/farmacologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Medição da Dor/efeitos dos fármacos
Medição da Dor/métodos
Dor Pós-Operatória/diagnóstico
Pirinitramida/farmacologia
Polimorfismo Genético/genética
Estudos Prospectivos
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (ABCB1 protein, human); 0 (ATP Binding Cassette Transporter, Sub-Family B); 0 (Analgesics, Opioid); 0 (OPRM1 protein, human); 0 (Receptors, Opioid, mu); 4RP92LYZ2F (Pirinitramide)
[Em] Mês de entrada:1609
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151219
[St] Status:MEDLINE


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[PMID]:25413485
[Au] Autor:Klein A; Karrer S; Horner C; Werner A; Heinlin J; Zeman F; Koller M; Landthaler M; Szeimies RM; Gruber M; Graf B; Hansen E; Kerscher C
[Ad] Endereço:Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.
[Ti] Título:Comparing cold-air analgesia, systemically administered analgesia and scalp nerve blocks for pain management during photodynamic therapy for actinic keratosis of the scalp presenting as field cancerization: a randomized controlled trial.
[So] Source:Br J Dermatol;173(1):192-200, 2015 Jul.
[Is] ISSN:1365-2133
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Photodynamic therapy (PDT) using methyl aminolaevulinate (MAL) is an effective treatment for extensive actinic keratosis (AK). However, pain is a major side-effect of this therapy. OBJECTIVES: To investigate whether scalp nerve blocks (group 1) provide adequate pain relief during MAL-PDT of the scalp and forehead in 32 men with baldness. METHODS: The patients received intravenous (IV) analgesia [piritramide 7.5 mg IV, plus oral metamizole (40 drops 30 min prior to PDT)] in combination with cold-air analgesia (group 2; IV analgesia) and cold-air analgesia alone (group 3). Maximum pain was evaluated by means of a visual analogue scale (VAS) during and up to 300 min after PDT. Pain during PDT was further analysed according to a pain perception scale. Furthermore, we measured haemodynamics and investigated stress hormone levels in blood samples at different time points. RESULTS: Maximum pain during PDT (primary end point) was significantly reduced in the treatment group receiving scalp nerve blocks (VAS 2.1 ± 1.3) compared with the treatment groups receiving IV analgesia (VAS 7.3 ± 1.1) and cold-air analgesia (VAS 8.4 ± 2.0; P < 0.05). No significant difference was found between groups 2 and 3 with regard to pain relief (P = 0.32). The increase in systolic blood pressure during the first 3 min of PDT was significantly lower for group 1 than for groups 2 and 3 (P < 0.001). No correlation between stress hormone levels and pain were found. CONCLUSIONS: Scalp nerve blocks provide an effective method for pain management during PDT for patients with extensive AK.
[Mh] Termos MeSH primário: Analgesia/métodos
Dermatoses Faciais/tratamento farmacológico
Ceratose Actínica/tratamento farmacológico
Dor/prevenção & controle
Fotoquimioterapia/efeitos adversos
Dermatoses do Couro Cabeludo/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Oral
Idoso
Ácido Aminolevulínico/administração & dosagem
Ácido Aminolevulínico/análogos & derivados
Analgésicos Opioides/administração & dosagem
Análise de Variância
Anti-Inflamatórios não Esteroides/administração & dosagem
Temperatura Baixa
Dipirona/administração & dosagem
Dermatoses Faciais/fisiopatologia
Testa
Hemodinâmica/fisiologia
Seres Humanos
Injeções Intravenosas
Ceratose Actínica/fisiopatologia
Masculino
Meia-Idade
Bloqueio Nervoso/métodos
Nervo Oftálmico
Medição da Dor
Satisfação do Paciente
Fotoquimioterapia/métodos
Fármacos Fotossensibilizantes/administração & dosagem
Pirinitramida/administração & dosagem
Qualidade de Vida
Couro Cabeludo/inervação
Dermatoses do Couro Cabeludo/fisiopatologia
Nervo Troclear
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Photosensitizing Agents); 4RP92LYZ2F (Pirinitramide); 585NM85KYM (methyl 5-aminolevulinate); 6429L0L52Y (Dipyrone); 88755TAZ87 (Aminolevulinic Acid)
[Em] Mês de entrada:1604
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141122
[St] Status:MEDLINE
[do] DOI:10.1111/bjd.13547


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[PMID]:25179415
[Au] Autor:Sebastian H
[Ad] Endereço:Klinik für Anästhesiologie und Intensivmedizin, Elblandklinikum Meißen, Elblandkliniken Stiftung & Co KG, Nassauweg 7, 01662, Meißen, Deutschland, holger.sebastian@elblandkliniken.de.
[Ti] Título:[Piritramide versus oxycodone for patient-controlled intravenous analgesia. Opioid-induced side effects].
[Ti] Título:Patientenkontrollierte i.v.-Analgesie mit Piritramid vs. Oxycodon. Opiatinduzierte Nebenwirkungen..
[So] Source:Schmerz;28(6):614-21, 2014 Dec.
[Is] ISSN:1432-2129
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:BACKGROUND: The aim of the study was to compare the opioid piritramide (7.5 mg/ml) which is commonly used in Germany (equipotential 5 mg morphine) to oxycodone (10 mg/ml) when given for patient-controlled intravenous analgesia (PCIA) in surgical disciplines, such as general surgery, orthopedic surgery, trauma surgery and gynecological surgery. Typical side effects of the respective opioids and safety of the procedures were compared. Oxycodone is available both as parenteral and oral formulations. MATERIALS AND METHODS: Data from the acute pain service during patient-controlled analgesia were evaluated. Quantitative data regarding opioid consumption and typical opioid side effects as well as qualitative results of patient satisfaction were recorded and evaluated for the respective specialist disciplines. RESULTS: Between 1 April 2005 and 31 August 2007 (35 months) 2,231 patients were treated with piritramide PCIA (PPCIA) and between 1 September 2007 and 31 December 2012 (64 months) 4,714 patients were treated with oxycodone PCIA (OPCIA). Patient satisfaction: overall, patients in both groups rated PCIA as very good or good with a higher percentage (98.9 %) in the oxycodone group than in the piritramide group (96.7 %) and 0.3 % of patients were only moderately satisfied or dissatisfied with the therapy. Typical side effects of opioids: the rate of side effects in the oxycodone group (6.7 %) was approximately 50 % lower compared with the piritramide treatment group (12.7 %). Nausea: with approximately 4 % in the piritramide group across all 4 specialties the incidence of nausea was markedly higher in the piritramide group than in the oxycodone group; however, this difference was statistically significant only for general and orthopedic surgery. Vomiting: vomiting was reported in about 6 % (mean) for PPCIA and significantly less frequently in 2 % (mean) for OPCIA. Fatigue and somnolence: these two side effects typically seen with opioid PCIA occurred only very rarely in a total of 1 % of all patients. In the PPCIA group the incidence was 1 % as directly compared to the significantly lower incidence of 0.6 % in the OPCIA group. CONCLUSION: The direct comparison of piritramide and oxycodone showed advantages for oxycodone in terms of typical opioid side effects. The effectiveness of analgesia was comparable in both groups.
[Mh] Termos MeSH primário: Analgesia Controlada pelo Paciente
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/efeitos adversos
Oxicodona/administração & dosagem
Oxicodona/efeitos adversos
Dor Pós-Operatória/tratamento farmacológico
Pirinitramida/administração & dosagem
Pirinitramida/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Relação Dose-Resposta a Droga
Esquema de Medicação
Feminino
Seres Humanos
Infusões Intravenosas
Masculino
Meia-Idade
Dor Pós-Operatória/diagnóstico
Satisfação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 4RP92LYZ2F (Pirinitramide); CD35PMG570 (Oxycodone)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140903
[St] Status:MEDLINE
[do] DOI:10.1007/s00482-014-1478-3


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[PMID]:25163233
[Au] Autor:Servicl-Kuchler D; Maldini B; Borgeat A; Bilic N; Kosak R; Mavcic B; Novak-Jankovic V
[Ti] Título:The influence of postoperative epidural analgesia on postoperative pain and stress response after major spine surgery--a randomized controlled double blind study.
[So] Source:Acta Clin Croat;53(2):176-83, 2014 Jun.
[Is] ISSN:0353-9466
[Cp] País de publicação:Croatia
[La] Idioma:eng
[Ab] Resumo:Major spinal surgery is associated with severe postoperative pain and stress response, bowel dysfunction, and a potential for chronic pain development. Epidural analgesia has been shown to be advantageous compared to intravenous analgesia alone. The aim of the study was to investigate whether postoperative addition of epidural levobupivacaine to intravenous opioid analgesia offers advantage over intravenous opioid analgesia alone. Eighty-one patients scheduled for spinal fusion were enrolled in the study and randomized into two groups. Postoperatively, group A received 0.125% epidural levobupivacaine and group B received saline. Both groups also received intravenous piritramide as a rescue analgesic. Pain intensity, rescue analgesic consumption, blood glucose, cholesterol and cortisol levels, postoperative blood loss, paresthesia, time to first postoperative defecation, and length of hospital stay were recorded. Sixty-eight patients completed the study. The visual analog scale score (mean 2 vs. 4, p = 0.01), consumption ofpiritramide (25 mg vs. 51.5 mg, p = 0.01) and metamizole (1400 vs. 1875 mg, p < 0.01), incidence of nausea (6% vs. 28% p = 0.02) and blood loss (450 mL vs. 650 mL, p < 0.05) were significantly lower in group A. Bowel recovery and first postoperative defecation also occurred earlier in group A (6% vs. 45%, p < 0.01). Blood cortisol, glucose and cholesterol levels and the incidence of paresthesia did not differ between the groups. In conclusion, after spinal fusion, postoperative epidural administration of levobupivacaine provides better analgesia and fewer side effects with no impact on stress response.
[Mh] Termos MeSH primário: Analgesia Epidural
Anestésicos Locais/administração & dosagem
Bupivacaína/análogos & derivados
Dor Pós-Operatória/prevenção & controle
Fusão Vertebral/efeitos adversos
Estresse Fisiológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Analgésicos Opioides/administração & dosagem
Bupivacaína/administração & dosagem
Defecação
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Meia-Idade
Dor Pós-Operatória/etiologia
Pirinitramida/administração & dosagem
Hemorragia Pós-Operatória/etiologia
Hemorragia Pós-Operatória/prevenção & controle
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 4RP92LYZ2F (Pirinitramide); A5H73K9U3W (levobupivacaine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1409
[Cu] Atualização por classe:140828
[Lr] Data última revisão:
140828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140829
[St] Status:MEDLINE


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[PMID]:25123092
[Au] Autor:Probst S; Cech C; Haentschel D; Scholz M; Ender J
[Ti] Título:A specialized post anaesthetic care unit improves fast-track management in cardiac surgery: a prospective randomized trial.
[So] Source:Crit Care;18(4):468, 2014 Aug 15.
[Is] ISSN:1466-609X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Fast-track treatment in cardiac surgery has become the global standard of care. We compared the efficacy and safety of a specialised post-anaesthetic care unit (PACU) to a conventional intensive care unit (ICU) in achieving defined fast-track end-points in adult patients after elective cardiac surgery. METHODS: In a prospective, single blinded, randomized study, 200 adult patients undergoing elective cardiac surgery (coronary artery bypass graft (CABG), valve surgery or combined CABG and valve surgery), were selected to receive their postoperative treatment either in the ICU (n = 100), or in the PACU (n = 100). Patients who, at the time of surgery, were in cardiogenic shock, required renal dialysis, or had an additive EuroSCORE of more than 10 were excluded from the study. The primary end points were: time to extubation (ET), and length of stay in the PACU or ICU (PACU/ICU LOS respectively). Secondary end points analysed were the incidences of: surgical re-exploration, development of haemothorax, new onset cardiac arrhythmia, low cardiac output syndrome, need for cardio-pulmonary resuscitation, stroke, acute renal failure, and death. RESULTS: Median time to extubation was 90 [50; 140] min in the PACU vs. 478 [305; 643] min in the ICU group (P < 0.001). Median length of stay in PACU was 3.3 [2.7; 4.0] hours vs. 17.9 [10.3; 24.9] hours in the ICU (P < 0.001). Of the adverse events examined, only the incidence of new onset cardiac arrhythmia (25 in PACU vs. 41 in ICU, P = 0.02) was statistically different between groups. CONCLUSIONS: Treatment in a specialised PACU rather than an ICU, after elective cardiac surgery leads to earlier extubation and quicker discharge to a step down unit, without compromising patient safety. TRIAL REGISTRATION: ISRCTN71768341. Registered 11 March 2014.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos
Pressão Positiva Contínua nas Vias Aéreas/métodos
Intubação Intratraqueal
Tempo de Internação/estatística & dados numéricos
Cuidados Pós-Operatórios/métodos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Analgésicos Opioides/administração & dosagem
Pressão Positiva Contínua nas Vias Aéreas/estatística & dados numéricos
Controle de Custos/métodos
Procedimentos Cirúrgicos Eletivos
Seres Humanos
Unidades de Terapia Intensiva/economia
Unidades de Terapia Intensiva/estatística & dados numéricos
Tempo de Internação/economia
Avaliação de Resultados (Cuidados de Saúde)/economia
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Segurança do Paciente
Piperidinas/administração & dosagem
Pirinitramida/administração & dosagem
Cuidados Pós-Operatórios/economia
Cuidados Pós-Operatórios/normas
Estudos Prospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Piperidines); 4RP92LYZ2F (Pirinitramide); P10582JYYK (remifentanil)
[Em] Mês de entrada:1509
[Cu] Atualização por classe:140904
[Lr] Data última revisão:
140904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140816
[St] Status:MEDLINE
[do] DOI:10.1186/s13054-014-0468-2


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[PMID]:24988826
[Au] Autor:Vandebroek A; Vertommen M; Huyghe M; Van Houwe P
[Ti] Título:Ultrasound guided femoral nerve block and lateral femoral cutaneous nerve block for postoperative pain control after primary hip arthroplasty: a retrospective study.
[So] Source:Acta Anaesthesiol Belg;65(1):39-44, 2014.
[Is] ISSN:0001-5164
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this study was to evaluate the use of an ultrasound guided femoral nerve (FN) block together with an ultrasound guided lateral femoral cutaneous nerve (LFCN) block in addition to a patient controlled intravenous analgesia (PCIA) pump with piritramide as a strategy for postoperative pain-management after primary hip arthroplasty. METHODS: In a retrospective study, data recorded from 32 patients undergoing primary hip arthroplasty in 2008, before peripheral blocks were used, were compared with data from 38 patients undergoing primary hip arthroplasty in 2011, when an ultrasound guided single shot FN and LFCN block was used. As primary endpoint the total piritramide consumption after 48 hours was analyzed. A score on a visual analog pain scale at rest and during movement was included as a secondary outcome. RESULTS: Patients receiving the peripheral nerve blocks used significantly less piritramide in comparison to the patients who received no peripheral nerve blocks (p < 0.01). Moreover, pain scores at rest and during movement were significantly lower in the group with the peripheral nerve block (p-values respectively < 0.01 and < 0.05). CONCLUSIONS: This retrospective study indicates that a FN block in combination with a LFCN block as supplementary postoperative analgesia after primary hip arthroplasty, can reduce the piritramide consumption. Furthermore, patients receiving the peripheral nerve block report lower pain scores at rest and during movement compared with the patients who did not receive a peripheral block. However, as this is a retrospective study, conclusions have to be drawn cautiously.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Nervo Femoral/efeitos dos fármacos
Bloqueio Nervoso/métodos
Dor Pós-Operatória/tratamento farmacológico
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Analgesia Controlada pelo Paciente/métodos
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/uso terapêutico
Anestésicos Locais/administração & dosagem
Anestésicos Locais/uso terapêutico
Artroplastia de Quadril/métodos
Bupivacaína/administração & dosagem
Bupivacaína/análogos & derivados
Bupivacaína/uso terapêutico
Quimioterapia Combinada/métodos
Feminino
Seres Humanos
Masculino
Meia-Idade
Manejo da Dor/métodos
Medição da Dor/métodos
Pirinitramida/administração & dosagem
Pirinitramida/uso terapêutico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 4RP92LYZ2F (Pirinitramide); A5H73K9U3W (levobupivacaine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1407
[Cu] Atualização por classe:140703
[Lr] Data última revisão:
140703
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140704
[St] Status:MEDLINE


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[PMID]:24813061
[Au] Autor:Gözen AS; Tokas T; Akin Y; Atis G; Hruza M; Rassweiler J
[Ad] Endereço:1 Department of Urology, SLK-Kliniken, University of Heidelberg , Heilbronn, Germany .
[Ti] Título:Pain after hernia repair with simultaneous extraperitoneal laparoscopic radical prostatectomy.
[So] Source:J Endourol;28(9):1143-8, 2014 Sep.
[Is] ISSN:1557-900X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare postoperative pain levels and postoperative morbidity between patients who underwent extraperitoneal laparoscopic radical prostatectomy (EPLRP) concomitant hernia repair and patients who underwent only EPLRP, by matched-pair analyses. METHODS: From December 2003 to December 2012, 54 patients who underwent EPLRP with simultaneous hernia repair were categorized as group 1. Their postoperative pain levels were quantitatively compared with those of 54 patients who underwent only EPLRP (group 2), in matched-pair analyses, including age, body mass index, and American Society of Anesthesiologists scoring. Preoperative tumor characteristics, operative and postoperative data were recorded. Pain levels were evaluated by using the visual analog scale (VAS) scoring, every day, during the first postoperative week. Statistical analyses were performed. RESULTS: Mean follow-up was 21 months. Mean age was 65±0.5 years. Preoperative, perioperative, and postoperative data were similar in the two groups. Group 1 needed a mean of 9.17 mg and group 2 needed a mean of 8.06 mg morphine derivative analgesic (piritramide) postoperatively. Total mean VAS scores were 5.65 and 4.98, in group 1 and group 2, respectively (P=0.06). Moreover, there was no significant difference between groups for complications. CONCLUSION: Simultaneous hernia repair does not affect pain levels after EPLRP. The procedure also does not result in prolongation of operative time and does not increase complication rates.
[Mh] Termos MeSH primário: Hérnia Inguinal/cirurgia
Laparoscopia/métodos
Medição da Dor/métodos
Dor Pós-Operatória/diagnóstico
Prostatectomia/métodos
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Analgésicos
Analgésicos Opioides/administração & dosagem
Índice de Massa Corporal
Herniorrafia/efeitos adversos
Herniorrafia/métodos
Seres Humanos
Laparoscopia/efeitos adversos
Masculino
Análise por Pareamento
Meia-Idade
Duração da Cirurgia
Dor Pós-Operatória/tratamento farmacológico
Dor Pós-Operatória/etiologia
Pirinitramida/administração & dosagem
Prostatectomia/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics); 0 (Analgesics, Opioid); 4RP92LYZ2F (Pirinitramide)
[Em] Mês de entrada:1502
[Cu] Atualização por classe:161018
[Lr] Data última revisão:
161018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140513
[St] Status:MEDLINE
[do] DOI:10.1089/end.2014.0223


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[PMID]:24492959
[Au] Autor:Ullah H; Samad K; Khan FA
[Ad] Endereço:Department of Anaesthesiology, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, Pakistan, 74800.
[Ti] Título:Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery.
[So] Source:Cochrane Database Syst Rev;(2):CD007080, 2014 Feb 04.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: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 Register of Controlled Trials (CENTRAL) (2012, Issue 12), MEDLINE (1950 to December 2012), EMBASE (1980 to December 2012), Web of Science (1954 to December 2012), CINAHL (1982 to December 2012) and bibliographies of published studies. SELECTION CRITERIA: We included randomized controlled trials assessing the effectiveness of continuous ISBPB compared with different forms of parenteral opioid analgesia in relieving pain in adult participants undergoing elective major shoulder surgery. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted outcome data. MAIN RESULTS: We included two randomized controlled trials (147 participants). A total of 17 participants were excluded from one trial because of complications related to continuous ISBPB (16) or parenteral opioid analgesia (one). Thus we have information on 130 participants (66 in the continuous ISBPB group and 64 in the parenteral opioid group). The studies were clinically heterogeneous. No meta-analysis was undertaken. However, results of the two included studies showed better pain relief with continuous ISBPB following major shoulder surgery and a lower incidence of complications when interscalene block is performed under ultrasound guidance rather than without it. AUTHORS' CONCLUSIONS: Because of the small number of studies (two) relevant to the subject and the high risk of bias of the selected studies, no reasonable conclusion can be drawn.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Anestesia Local/métodos
Plexo Braquial
Bloqueio Nervoso/métodos
Dor Pós-Operatória/terapia
Ombro/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Pirinitramida/administração & dosagem
Ensaios Clínicos Controlados Aleatórios como Assunto
Sufentanil/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 4RP92LYZ2F (Pirinitramide); AFE2YW0IIZ (Sufentanil)
[Em] Mês de entrada:1410
[Cu] Atualização por classe:160602
[Lr] Data última revisão:
160602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140205
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD007080.pub2


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[PMID]:24289500
[Au] Autor:Kern KU; Nowack W; Poole C
[Ad] Endereço:Centre of Pain Medicine and Palliative Care, Wiesbaden, Germany.
[Ti] Título:Treatment of neuropathic pain with the capsaicin 8% patch: is pretreatment with lidocaine necessary?
[So] Source:Pain Pract;14(2):E42-50, 2014 Feb.
[Is] ISSN:1533-2500
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The capsaicin 8% patch can effectively treat neuropathic pain, but application can cause discomfort or a burning sensation. Until March 2013, it was recommended that patients be pretreated with a topical anesthetic, for example lidocaine, before capsaicin patch application. However, speculation existed over the need for pretreatment and its effectiveness in alleviating treatment-associated discomfort. This article compares tolerability to and efficacy of the capsaicin patch in pretreated and non-pretreated patients. All patients received a single capsaicin patch application. Pretreated patients received a lidocaine plaster before and intravenous lidocaine and metamizole infusions during capsaicin patch application. Pain levels, assessed using a Numeric Rating Scale (NRS), were used to determine tolerability and efficacy. All patients (pretreated n = 32; non-pretreated n = 26) completed 100% of the intended capsaicin patch application duration. At the time of capsaicin patch removal, 69% of pretreated and 88% of non-pretreated patients reported an NRS score increase, which returned to baseline by 6 hours post-treatment. There was no significant difference in mean NRS score between patient groups at any time during or after capsaicin patch treatment. Response was similar between patient groups; capsaicin patch treatment provided rapid and significant pain reductions that were sustained over 12 weeks. The same proportion of pretreated and non-pretreated patients reported willingness to receive retreatment with the capsaicin patch. This analysis shows that the capsaicin 8% patch is generally tolerable, and the small discomfort associated with patch application is short-lived. Lidocaine pretreatment does not have a significant effect on tolerability, efficacy, or patient willingness to receive retreatment.
[Mh] Termos MeSH primário: Analgésicos/administração & dosagem
Anestésicos Locais/administração & dosagem
Capsaicina/administração & dosagem
Lidocaína/administração & dosagem
Neuralgia/tratamento farmacológico
[Mh] Termos MeSH secundário: Analgésicos/efeitos adversos
Analgésicos/uso terapêutico
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/uso terapêutico
Anestésicos Locais/uso terapêutico
Anti-Inflamatórios não Esteroides/administração & dosagem
Anti-Inflamatórios não Esteroides/uso terapêutico
Capsaicina/efeitos adversos
Capsaicina/uso terapêutico
Dipirona/administração & dosagem
Dipirona/uso terapêutico
Feminino
Seres Humanos
Lidocaína/uso terapêutico
Masculino
Meia-Idade
Medição da Dor
Pirinitramida/administração & dosagem
Pirinitramida/uso terapêutico
Fatores de Tempo
Adesivo Transdérmico
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Analgesics); 0 (Analgesics, Opioid); 0 (Anesthetics, Local); 0 (Anti-Inflammatory Agents, Non-Steroidal); 4RP92LYZ2F (Pirinitramide); 6429L0L52Y (Dipyrone); 98PI200987 (Lidocaine); S07O44R1ZM (Capsaicin)
[Em] Mês de entrada:1409
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:131203
[St] Status:MEDLINE
[do] DOI:10.1111/papr.12143



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