Articles: analgesics.
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J Pain Palliat Care Pharmacother · Dec 2021
Randomized Controlled TrialImpact of Standardized Educational Intervention on Improvement in Analgesic Knowledge and Its Compliance among Patients of Advanced Cancer Patients Attending Palliative Clinic: Prospective Randomized Study.
Patient education is a low-cost intervention that can help in improving the knowledge and compliance regarding analgesics. This study aimed to assess the effectiveness of the standardized educational intervention on knowledge regarding analgesic, its compliance, and barriers to compliance among advanced cancer patients attending palliative care clinic. In this randomized control trial, 100 advanced cancer patients with pain were randomly allocated to two groups. ⋯ There was also a statistically significant decrease in barriers to compliance in the experimental group as compared to the control group. A significant correlation between the knowledge and compliance score at 4 weeks in the experimental group was found with a Karl Pearson correlation coefficient, r = 0.628 (p = 0.001). The standardized educational intervention was found to be effective in improving the analgesic knowledge and analgesic compliance among cancer patients with pain at 2 and 4 weeks follow up as compared to the usual care.
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Am. J. Respir. Crit. Care Med. · Dec 2021
Randomized Controlled Trial Comparative StudyA Phase II Cluster-Crossover Randomized Trial of Fentanyl vs. Morphine for Analgosedation in Mechanically Ventilated Patients.
Rationale: The continuous infusion of fentanyl or morphine is often prescribed to assist with analgesia and sedation (analgosedation) during mechanical ventilation. Objectives: To compare the effect of fentanyl versus morphine on patient-centered outcomes in ventilated patients. Methods: We conducted a cluster-randomized, cluster-crossover trial between July 2019 and August 2020 in two adult ICUs. ⋯ All other secondary outcomes were not statistically different by treatment group. Conclusions: Among adult patients requiring mechanical ventilation, compared with morphine, fentanyl infusion significantly increased the median number of ventilator-free days at Day 28. The choice of opioid infusion agent may affect clinical outcomes and requires further investigation.
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Anesthesia and analgesia · Dec 2021
Randomized Controlled Trial Comparative StudyComparison of Oral Loading Dose to Intravenous Acetaminophen in Children for Analgesia After Tonsillectomy and Adenoidectomy: A Randomized Clinical Trial.
Acetaminophen is a frequently used adjunct analgesic in pediatric patients undergoing tonsillectomy and adenoidectomy. We compared opioid administration following preoperative intravenous (IV) or oral acetaminophen in addition to a standard multimodal regimen to test the hypothesis that 1 loading dose approach would provide superior opioid sparing effects among pediatric surgical patients undergoing tonsillectomy and adenoidectomy. ⋯ Opioid-sparing effects did not differ following an oral or standard IV acetaminophen loading dose with no identified acetaminophen toxicity in pediatric patients undergoing tonsillectomy and adenoidectomy who received standardized multimodal postoperative analgesia. An oral loading dose may provide more consistent serum acetaminophen levels at lower cost compared to a standard IV dose.
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Randomized Controlled Trial
Hydroxyzine for lowering patient's anxiety during prehospital morphine analgesia: A prospective randomized double blind study.
Hydroxyzine is an antihistamine drug used for symptomatic relief of anxiety and tension. We hypothesized that managing the anxiety of patients with severe pain by adding hydroxyzine to a conventional intravenous morphine titration would relieve their pain more effectively. ⋯ Addition of hydroxyzine to morphine in the prehospital setting did not reduce pain or anxiety in patients with acute severe pain and therefore is not indicated based on our results.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Randomized Controlled TrialA Randomized Double-Blind Controlled Trial to Assess the Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Cardiac Surgery.
Cardiac surgical pain is of moderate-to-severe intensity. Ineffective pain control may lead to increased cardiopulmonary complications and poor surgical outcomes. This study aimed to assess the efficacy of ultrasound-guided erector spinae plane block in providing analgesia in adult cardiac surgeries. ⋯ Single-shot erector spinae plane block provides superior analgesia as compared with sham block. It decreased the first 24-hour postoperative analgesic consumption by 64.5% and risk of pain by five times in the authors' population. It also reduced the sedation and duration of mechanical ventilation in postcardiac surgery patients.