Articles: acute-pain.
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Current models incompletely risk-stratify patients with acute chest pain. In this study, N-terminal pro-B-type natriuretic peptide and cystatin C were incorporated into a contemporary chest pain triage algorithm in a clinically stratified population to improve acute coronary syndrome discrimination. Adult patients with chest pain presenting without myocardial infarction (n = 382) were prospectively enrolled from 2008 to 2009. ⋯ No major adverse cardiac events occurred at 6 months in the low-risk subgroup that underwent stress testing. In conclusion, N-terminal pro-B-type natriuretic peptide and cystatin C levels predict the results of stress tests in low-risk patients with chest pain but should not be substituted for stress testing in intermediate-risk patients. There is potential for their use in the early discharge of low-risk patients after clinical risk stratification.
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Carbohydrate polymers · Feb 2013
Polysaccharide glucomannan isolated from Heterodermia obscurata attenuates acute and chronic pain in mice.
Glucomannan (GM) is a polysaccharide obtained from Heterodermia obscurata lichens. The present study was conducted to elucidate the antinociceptive effect of GM in behavioural models of acute and chronic pain in mice. ⋯ Systemic treatment with GM inhibited the nociception induced by intraplantar injection of glutamate and by intrathecal injection of N-methyl-d-aspartic acid (NMDA), (±)-1-aminocyclopentane-trans-1,3-dicarboxylic acid (trans-ACPD), tumour necrosis factor α (TNF-α) and IL-1β. Taken together, our data demonstrate that GM has significant antinociceptive effect in acute and chronic pain, suggesting a potential interest in the development of new clinically relevant drugs for the management of pain.
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Randomized Controlled Trial Multicenter Study
Nitrous oxide for early analgesia in the emergency setting: a randomized, double-blind multicenter prehospital trial.
Although 50% nitrous oxide (N(2) O) and oxygen is a widely used treatment, its efficacy had never been evaluated in the prehospital setting. The objective of this study was to demonstrate the efficacy of premixed N(2) O and oxygen in patients with out-of-hospital moderate traumatic acute pain. ⋯ This study demonstrates the efficacy of N(2) O for the treatment of pain from acute trauma in adults in the prehospital setting.
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Mayo Clinic proceedings · Feb 2013
ReviewTopical analgesics in the management of acute and chronic pain.
Oral analgesics are commonly prescribed for the treatment of acute and chronic pain, but these agents often produce adverse systemic effects, which sometimes are severe. Topical analgesics offer the potential to provide the same analgesic relief provided by oral analgesics but with minimal adverse systemic effects. This article describes the results of a systematic review of the efficacy of topical analgesics in the management of acute and chronic pain conditions. ⋯ Strong evidence was identified for the use of topical diclofenac and topical ibuprofen in the treatment of acute soft tissue injuries or chronic joint-related conditions, such as osteoarthritis. Evidence also supports the use of topical lidocaine in the treatment of postherpetic neuralgia and diabetic neuropathy. Currently, limited evidence is available to support the use of other topical analgesics in acute and chronic pain.
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Multicenter Study Comparative Study
[Quality management in regional anesthesia using the example of a Regional Anesthesia Surveillance System (RASS)].
Regional anesthesia and regional analgesia techniques with or without a continuous catheter are frequently utilized in all areas of modern anesthesiology. There are individual and economic benefits but also risks involved with those techniques. ⋯ Therefore, it is important to create national and international databases with large case numbers utilizing standardized definitions of complications in order to allow realistic risk assessment and early discovery of potential dangers and preventive actions. This article shows the integration of standardized codes from the Regional Anesthesia Surveillance System with a software tool to allow high-quality data acquisition and the building of a foundation for national and international data collection and analysis as well as for feedback of institutional data for individual process optimization as part of a quality management system.