Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2016
Smoking history, nicotine dependence and opioid use in patients with chronic non-malignant pain.
Previous studies have demonstrated a positive association between smoking and addiction to opioids in patients with chronic non-malignant pain. This could be explained by a susceptibility in some patients to develop addiction. Another explanation could be that nicotine influences both pain and the opioid system. The objective of the study was to investigate whether smoking, former smoking ± nicotine use and nicotine dependence in patients with chronic non-malignant pain were associated with opioid use and addiction to opioids. ⋯ The study supports previous evidence that smoking is associated with chronic pain. Our data suggest that information about use of nicotine substitution in chronic non-malignant patients are relevant both in a clinical setting, but also in future studies of the association between smoking habits, pain and opioid use.
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Acta Anaesthesiol Scand · Aug 2016
ReviewScandinavian SSAI clinical practice guideline on pre-hospital airway management.
The Scandinavian society of anaesthesiology and intensive care medicine task force on pre-hospital airway management was asked to formulate recommendations following standards for trustworthy clinical practice guidelines. ⋯ This guideline for pre-hospital airway management includes a combination of techniques applied in a stepwise fashion appropriate to patient clinical status and provider training.
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Acta Anaesthesiol Scand · Aug 2016
Comment ReviewAdverse event assessment and reporting in trials of newer treatments for post-operative pain.
Assessment and reporting of adverse events (AEs) in studies of perioperative interventions is critical given the potential for unintended and preventable iatrogenic morbidity and mortality. This focused review evaluated the quality of AE assessment and reporting in acute post-operative pain treatment trials. Since older analgesics (e.g., opioids, NSAIDs) already have a well-characterized safety profile, we concentrated on trials of pregabalin and gabapentin as a representative sample of studies where the perioperative safety profile was relatively unknown. ⋯ Considerable widespread improvements are needed in AE reporting for post-operative pain treatment trials. In addition to heightened awareness among clinical investigators, mandatory journal editorial policies may further facilitate improvements in safety assessment and reporting.
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The prevalence of persistent post-sternotomy pain (PPSP) varies largely and has been mainly studied using questionnaires. We decided to perform a systematic qualitative and quantitative sensory examination study on a power-calculated sample of patients who had undergone sternotomy for cardiac surgery. Pain was diagnosed as PPSP if the patient complained of sternal pain that had developed after surgery together with corresponding sensory disturbances. ⋯ PPSP is a clinical diagnosis easily achieved using simple diagnostic tools and a medical history. Severity and extent of sensory abnormalities were found to be greater in the PPSP group.
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Acta Anaesthesiol Scand · Aug 2016
CommentShock treatment in a cohort of Scandinavian intensive care units in 2014.
Shock is common in intensive care units, and treatment includes fluids, vasopressor and/or inotropic drugs, guided by hemodynamic monitoring. The aim of this study was to identify current practice for treatment of shock in Scandinavian intensive care units. ⋯ In this survey, Ringer's solution and noradrenaline were the most common first-line treatments in shock. The use of starches and dopamine were rare. Almost all patients were monitored with invasive arterial blood pressure, but comprehensive hemodynamic monitoring was used only in a minority of patients.