Articles: opioid.
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Spinal anaesthesia is the primary anaesthetic technique for many types of surgeries. Adjuncts to the local anaesthetics (LA) used in spinal anaesthesia can exhibit undesirable side-effects like respiratory depression, urinary retention, pruritis, haemodynamic instability and nausea and vomiting, limiting their use. Magnesium when used in therapeutic doses avoids all of these side-effects. ⋯ N-methyl-D-aspartate (NMDA) receptor antagonist, magnesium when administered intrathecally along with local anaesthetics prolongs the duration of spinal analgesia without adverse effects.
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This study was designed to compare the effects of intranasal (IN) and intravenous (IV) administration of naloxone in patients who had overdosed on opioids. ⋯ Intranasal naloxone is as effective as IV naloxone in reversing both respiratory depression and depressive effects on the central nervous system caused by opioid overdose.
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Internal medicine journal · May 2014
Opioid conversion ratios used in palliative care: is there an Australian consensus?
Opioid switching or rotation is reported to be a common practice in palliative care. Published tables of opioid conversion ratios have been found to vary in their recommendations, potentially leading to significant differences in clinical practice. ⋯ Further discussion among Australian palliative care specialist organisations is recommended in order to produce uniform conversion guidelines to improve consistency and safety in the prescribing of opioids.
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Observational Study
Thermal quantitative sensory testing to predict postoperative pain outcomes following gynecologic surgery.
To evaluate the relationship of preoperative thermal quantitative sensory testing (QST) values with postoperative pain and opiate consumption in opiate-naïve patients following gynecologic surgery. ⋯ Reduced tolerance to both heat and cold thermal pain stimulus was associated with increased postoperative analgesic requirements. Combined responses to multiple pain modalities may be more useful than a single stimulus paradigm.
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To evaluate the degree of knowledge about pain management and opioids use by professionals working at three pediatric units. ⋯ Problems in the processes of pain identification, measurement, and treatment have been found. Results suggest that there is a need for both an investment in continuing education of professionals and the development of protocols to optimize the analgesic therapy, thus preventing increased child suffering.