Articles: opioid-analgesics.
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Randomized Controlled Trial
Remifentanil for Procedural Sedation and Analgesia in Central Venous Catheter Insertion: A Randomized, Controlled Trial.
Central venous catheter (CVC) insertion is a common practice for anesthetists, but this invasive procedure generates anxiety and pain in patients that are often underestimated. We compared target-controlled infusion of remifentanil and local lidocaine infiltration with placebo and local lidocaine infiltration to decrease pain scores during CVC placement. ⋯ Target-controlled infusion of remifentanil is an effective drug to reduce pain during CVC insertion in association with lidocaine-based local anesthesia, in conscious patients.
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Randomized Controlled Trial
Intravenous Patient-controlled Analgesia Versus Thoracic Epidural Analgesia After Open Liver Surgery: A Prospective, Randomized, Controlled, Noninferiority Trial.
We conducted a randomized, controlled, noninferiority trial to investigate if intravenous, multimodal, patient-controlled analgesia (IV-PCA) could be noninferior to multimodal thoracic epidural analgesia (TEA) in patients undergoing open liver surgery. ⋯ IV-PCA was noninferior to TEA for the treatment of postoperative pain in patients undergoing open liver resection.
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Randomized Controlled Trial
Intravenous vs Oral Acetaminophen for Analgesia After Cesarean Delivery: A Randomized Trial.
Examination of postoperative analgesia with intravenous and oral acetaminophen. ⋯ Intravenous acetaminophen did not reduce 24-hour opioid consumption or other outcomes compared with oral acetaminophen. Intravenous acetaminophen did decrease opioid consumption and pain scores compared with no acetaminophen.
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Randomized Controlled Trial
Adverse childhood experiences predict autonomic indices of emotion dysregulation and negative emotional cue-elicited craving among female opioid-treated chronic pain patients.
Through autonomic and affective mechanisms, adverse childhood experiences (ACEs) may disrupt the capacity to regulate negative emotions, increasing craving and exacerbating risk for opioid use disorder (OUD) among individuals with chronic pain who are receiving long-term opioid analgesic pharmacotherapy. This study examined associations between ACEs, heart rate variability (HRV) during emotion regulation, and negative emotional cue-elicited craving among a sample of female opioid-treated chronic pain patients at risk for OUD. ⋯ Both ACEs and duration of opioid use significantly predicted blunted HRV during negative emotion regulation and increased negative emotional cue-elicited craving. Analysis of study findings from a multiple-levels-of-analysis approach suggest that exposure to childhood abuse occasions later emotion dysregulation and appetitive responding toward opioids in negative affective contexts among adult women with chronic pain, and thus this vulnerable clinical population should be assessed for OUD risk when initiating a course of extended, high-dose opioids for pain management.
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J Bone Joint Surg Am · Jul 2019
Randomized Controlled TrialRegional or General Anesthesia in the Surgical Treatment of Distal Radial Fractures: A Randomized Clinical Trial.
Most patients undergoing surgery for the treatment of a distal radial fracture are treated in a day-surgery setting and are given either general anesthesia (GA) or regional anesthesia (RA). The main purpose of this study was to investigate the impact of the anesthesia method on patients' postoperative opioid consumption during the first 3 days following surgery. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.