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Wrist-ankle acupuncture combined with pain nursing for the treatment of urinary calculi with acute pain

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World Journal of Clinical Cases 2023年第18期11卷 4287-4294页

作者： Li-Mei Wu Qian Liu Xiao-Hua Yin Li-Ping Yang Jun Yuan Xiao-Qi Zhang Yan-Li Wang Nursing Clinic Hebei Provincial Hospital of Traditional Chinese MedicineShijiazhuang 050000Hebei ProvinceChina Nursing Clinic Hebei Technology Innovation Center of TCM Spleen and Kidney DiseasesShijiazhuang 050000Hebei ProvinceChina Department of Nursing Hebei Provincial Hospital of Traditional Chinese MedicineShijiazhuang 050000Hebei ProvinceChina Department of Acupuncture and Moxibustion Orthopaedics Hebei Provincial Hospital of Traditional Chinese MedicineShijiazhuang 050000Hebei ProvinceChina Department of Acupuncture and Moxibustion Hebei Provincial Hospital of Traditional Chinese MedicineShijiazhuang 050000Hebei ProvinceChina Experimental Acupuncture and Moxibustion Teaching and Research Office Acupuncture and Moxibustion Tuina College of Hebei University of Traditional Chinese MedicineShijiazhuang 050200Hebei ProvinceChina Department of Respiratory Hebei Provincial Hospital of Traditional Chinese MedicineShijiazhuang 050000Hebei ProvinceChina

BACKGROUND Urological calculi often cause renal colic,which is characterized by paroxysmal or persistent severe pain in the upper abdomen or lumbar *** of methods to quickly relieve these pain symptoms has garnered clinical ***-ankle acupuncture is a type of floating acupuncture therapy administered at selected points in the carpal and ankle areas,and it has good pain-relieving *** used wrist-ankle acupuncture combined with pain nursing for pain intervention in patients with renal calculi to confirm its application and *** To study the effect of wrist-ankle acupuncture combined with pain nursing in the treatment of urinary calculi with acute *** Eighty-two patients with urinary calculi with acute pain as the first symptom followed at our hospital from November 2019 to June 2021 were enrolled in the study and classified into two groups according to the odd and even numbers of the visit sequences,each with 41 *** control group received a routine nursing intervention and intramuscular injection of nonsteroidal anti-inflammatory drugs,whereas the observation group received pain management nursing and wrist-ankle ***,the pain-relieving effect was compared between the two *** The score on the visual analog scale(VAS)at 24,48,and 72 h postintervention was decreased in both groups compared with the baseline data;moreover,the observation group scored significantly lower than the control group on the VAS at each time point after the intervention(P0.05).In turn,the pain recurrence rate at 72 h postintervention was lower in the observation group compared with the control group(P<0.05).Finally,the nursing satisfaction rate in the observation group was significantly higher than that observed in the control group(P<0.05).No serious adverse reactions occurred during the treatment and th

关键词： Urinary calculi Renal colic Wrist-ankle acupuncture pain nursing acute pain Therapeutic effect

Evaluation of the Use of Ketamine for acute pain in the Emergency Department at a Tertiary Academic Medical Center

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Pharmacology & Pharmacy 2016年第1期7卷 19-24页

作者： Nahal Beik Katelyn Sylvester Megan Rocchio Michael B. Stone Department of Pharmacy Brigham and Women’s Hospital Boston USA Department of Emergency Medicine Brigham and Women’s Hospital Boston USA

Introduction: At subdissociative doses of 0.1 - 0.5 mg/kg, ketamine provides effective analgesia when used alone or as an adjunct to opioid analgesics without causing cardiovascular or respiratory compromise. Ketamine is a beneficial analgesic agent in the emergency department (ED), particularly in patients with opioid-resistant pain or polytrauma patients who are hemodynamically unstable. Purpose: The purpose of this study was to evaluate current practice and describe clinical outcomes associated with the use of low-dose ketamine for acute pain in the ED. Methods: Adult patients receiving ketamine were retrospectively evaluated between March 1, 2012 and March 31, 2013. Patients were included if they were ordered for ketamine in the ED to treat acute pain. Outcomes included dose administered, cumulative doses, concurrent opioid administration, and any efficacy or adverse events documented after the administration of ketamine. Continuous variables are reported as mean (standard deviation [SD]) or median (interquartile range [IQR]). Results: A total of 46 patients were evaluated for inclusion. Of the 25 patients included, 38 doses of ketamine were documented. The mean age was 41 years old with 64% of the patients being female. The average initial ketamine dose was 0.12 ± 0.06 mg/kg and 8 (32%) patients received multiple doses of ketamine (1.5 ± 0.8 doses per patient). Ketamine was added to opioid therapy in 23 (92%) patients. pain scores decreased post administration of ketamine from 10 (9 - 10) to 5 (4 - 7). Adequate pain relief was documented in 11 (44%) patients (felt comfortable going home);partial pain relief was noted in 5 (20%) patients;3 (12%) patients reported no pain relief;3 (12%) patients were able to have a procedure done, and efficacy was not documented in 3 (12%) patients. Anxiety and agitation were documented in 2 (8%) patients. No adverse outcomes were documented in 84% of patients. Conclusion: Administration of low-dose ketamine for acute pain in the

关键词： Ketamine acute pain Emergency Department

The involvement of central cholinergic system in the analgesic effect of intracerebroventricularly injected CDPcholine in acute pain models of rats

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The involvement of central cholinergic system in the analges...

Effect of Ketamine Instillation on acute and Chronic Post Mastectomy pain, a Dose Finding Clinical Study

第十五届国际药理学大会

作者： HAMURTEKIN EMRE GURUN MINE SIBEL Uludag Univ Medical FacultyDept.of Pharmacology16059Bursa/TURKEY Uludag Univ Medical FacultyDept.of Pharmacology16059Bursa/TURKEY

＜正＞ In the present study,intracerebroventricularly injected CDP-choline （0.5, 1, 2 micromoles） induced dose and time dependent antinociceptive effects in thermal and mechanical paw withdrawal tests and acetic acid writhing tests in rats. E-quimolar dose of CDP- choline （imicromole） and choline （imicromole） caused similar antinociceptive effects while cytidine （Imicromole） produced small,transient but statically significant antinociceptive effect. Mecamylamine, MLA and HC - 3 pretreatments completely antagonized CDP - choline induced antinocicep-tion in acute thermal and mechanical tests while HC - 3. MLA. mecamylamine and atropine pretreatments partially blocked the antinociceptive effect of CDP -choline in the acetic acid writhing test. CDPcholine did not impair motor performance of rats evaluated by rota - rod test. These results indicate that centrally administered CDP - choline induced dose and time dependent antinociception in rats by activating mainly central cholinergic nicotinic receptors through the activation of presynaptic cholinergic mechanisms.

关键词： CDP-choline antinociception acute pain cholinergic

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Open Journal of Anesthesiology 2022年第4期12卷 146-159页

作者： Fatma El Sherif Hany Elmorabaa Khaled Mohamed Fares Sahar Abdel-Baky Mohamed Nourhan M. Elgalaly Khalid Rezk Moaaz Tohamy Department of Anesthesia ICU and Pain Management South Egypt Cancer Institute Assiut University Assiut Egypt Department of Anesthesia ICU and Pain Management Faculty of Medicine Assuit University Assiut Egypt

Background: Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. Objectives: To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2, or 3 mg/kg) for acute and chronic post mastectomy pain (PMP). Methods: Ninety female patients with cancer breast, aged (18 - 60 yrs), weighted (50 - 90 kg), scheduled for modified radical mastectomy, randomly allocated into 3 groups to receive ketamine instillation after surgical homeostasis before wound closure (1 of 3 doses;1, 2, or 3 mg/kg as A, B or C groups respectively) patients were followed up for 48 h for acute pain (total morphine consumption, the first request of analgesia and visual analog scale at rest and movement (VASR/M), chronic pain by Leeds assessment of neuropathic signs and symptoms (LANSS) for six-months, hemodynamics, and side effects. Results: Median total dose of morphine consumption was 8 mg (5 - 10) versus 6 mg (6 - 7) in A and B groups respectively in the first 48 h postoperatively. Lowest VASR/M was recorded in C then B and lastly A group (P = 0.037). No patients in the C group requested analgesia versus thirty (100%) and nine (30%) patients in the A and B groups respectively with the first request of analgesia was 12 h (5 - 36) in the A group versus 30 h (12 - 36) in the B group respectively (P Conclusion: Ketamine instillation effectively controlled acute post mastectomy pain (PMP) in a dose-dependent manner and reduced the incidence and severity of chronic pain in patients who undergoing a modified radical mastectomy.

关键词： acute pain Breast Cancer Chronic pain Ketamine Instillation Modified Radical Mastectomy

acute and Persistent Post-Craniotomy pain: A Prospective 6-Month Follow-Up Questionnaire Study

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Open Journal of Anesthesiology 2023年第6期13卷 119-133页

作者： Pasi Lahtinen Ville Koskela Pawel Florkiewicz Juha E. Jääskeläinen Timo Koponen Jari Halonen Tadeusz Musialowicz Department of Anesthesia and Intensive Care Medicine Kuopio University Hospital Kuopio Finland Department of Neurosurgery of Neuro Centre Unit Kuopio University Hospital Kuopio Finland Department of Anesthesia and Intensive Care Medicine North Karelia Central Hospital Joensuu Finland Heart Center Department Kuopio University Hospital Kuopio Finland

Introduction: The incidence of acute pain after craniotomy differs remarkably in previous studies, and the prevalence of persistent pain is not precisely known. We conducted 6-month follow-up surveys on the incidence and intensity of acute and persistent pain after elective craniotomy. Methods: We carried out a prospective cohort study via a series of structured questionnaires to record acute pain intensity preoperatively and postoperatively, and the incidence of persistent pain 3 and 6 months after a craniotomy in a tertiary care center. Patients scheduled for elective craniotomy were interviewed the day before surgery, postoperatively before discharge from the hospital, and 3 and 6 months after surgery. pain was assessed on a numeric rating scale (0 - 10) at rest and movement, as well as expectations of pain before surgery, efficacy of pain therapy, and satisfaction with pain treatment. The incidence of adverse events, sleep time and interruptions caused by pain, different pain types, and drugs used for pain treatment were also recorded. Results: A total of 152 patients were enrolled in the study and completed the preoperative questionnaire;123 (81%) completed postoperative questionnaire and 108 (72%) completed the 3- and 6-month follow-ups. The average pain score at the time of the postoperative questionnaire was moderate, 4 at rest and 5 upon movement. The percentage of patients experiencing mild pain at rest and upon movement was 52% and 49%, and moderate pain was 15% and 16%, respectively. Severe postoperative pain was detected in 5% and 8% of patients at rest and upon movement, respectively. Three months after surgery, 6% of patients reported mild pain at rest, 3% moderate pain at rest, and 1% severe pain at rest. Persistent mild and moderate pain at rest after 6 months was reported by 3% and 1% of patients, respectively. The most common adverse events were postoperative nausea and vomiting (11%) and abdominal discomfort (8%). During postoperative pain treatm

关键词： Craniotomy acute pain Persistent pain pain Treatment Adverse Events Neurosurgery

Rapid acupuncture for musculoskeletal pain in the emergency room of the Hospital Servidor Publico Estadual, Brazil: A quasi-experimental study

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Journal of Integrative Medicine 2020年第4期18卷 313-318页

作者： Luciana Aikawa Alexandre Massao Yoshizumi Mirian Matsura Shirassu Marcia Kiyomi Koike Programa de Pós-Graduação em Ciências da Saúde Instituto de Assistência Médica ao Servidor Público Estadual(IAMSPE)Vila ClementinoSão PauloSP 04029-000Brazil Associação Médica Brasileira de Acupuntura Vila MarianaSão PauloSP 04011-002Brazil

Objective:To compare differences in self-reported musculoskeletal pain before and after receiving rapid acupuncture for pain at an outpatient emergency ***:Exactly 102 patients presenting to the emergency room of the Hospital Servidor Publico Estadual in Sao Paulo,Brazil,participated in this before-and-after *** participants had musculoskeletal pain and were treated with the technique proposed by Marques *** emergency acupuncture involved inserting a needle at a point defined by traditional Chinese medicine and applying intense stimulation for 10 s;no more than two points were used on any individual *** was measured using a numerical visual scale before and immediately after the ***:Participants in this study were mostly women(78%),had a college degree(47%)and were below the age of 60(56%).The most common region of pain was the lower back(31%),and the most common type of pain was acute and exacerbated chronic *** meridians most commonly involved were the eight extra meridians(40%),and the points most often used for treatment were Houxi(SI3),Shenmai(BL62)and Zulinqi(GB41).Almost all participants reported a decrease in pain intensity,independent of sex,education level,pain site and pain type(acute/chronic;P<0.05).At the end of the session,only4%of the participants reported a desire for allopathic ***:This emergency acupuncture technique for analgesia appears to reduce musculoskeletal *** registration:Brazilian Registry of Clinical Trials(http://***/)with ***-8 dmfjf.

关键词： Acupuncture analgesia Emergency medical services acute pain Acupuncture therapy

Nuclear Factor I/A Controls A-fiber Nociceptor Development

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Neuroscience Bulletin 2020年第7期36卷 685-695页

作者： Lu Qi Guangjuan Yin Yongchao Zhang Yeqi Tao Xiaohua Wu Richard M.Gronostajski Mengsheng Qiu Yang Liu College of Life Sciences Zhejiang UniversityHangzhou 310058China Zhejiang Key Laboratory of Organ Development and Regeneration Institute of Life SciencesHangzhou Normal UniversityHangzhou 310036China Department of Biochemistry Program in GeneticsGenomics and BioinformaticsCenter of Excellence in Bioinformatics and Life SciencesState University of New York at BuffaloBuffaloNY 14203USA

Noxious mechanical information is transmitted through molecularly distinct nociceptors,with pinprickevoked sharp sensitivity via A-fiber nociceptors marked by developmental expression of the neuropeptide Y receptor 2(Npy2 r)and von Frey filament-evoked punctate pressure information via unmyelinated C fiber nociceptors marked by ***,the molecular programs controlling their development are only beginning to be *** we demonstrate that Npy2 r-expressing sensory neurons are in fact divided into two groups,based on transient or persistent Npy2 r ***2 r-transient neurons are myelinated,likely including A-fiber nociceptors,whereas Npy2 r-persistent ones belong to unmyelinated pruriceptors that co-express *** then showed that the transcription factors NFIA and Runx1 are necessary for the development of Npy2 r-transient A-fiber nociceptors and MrgprD^+C-fiber nociceptors,***,mice with conditional knockout of Nfia,but not Runx1 showed a marked attenuation of pinprick-evoked nocifensive *** studies therefore identify a transcription factor controlling the development of myelinated nociceptors.

关键词： Dorsal root ganglion acute pain Pinprick pain Npy2r Nppb Nociceptor A-fiber mechanonociceptor

Advances in the clinical application of oxycodone in the perioperative period

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World Journal of Clinical Cases 2022年第16期10卷 5156-5164页

作者： Hong-Yang Chen Zi-Ning Wang Wei-Yi Zhang Tao Zhu Department of Anesthesiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina The Research Units of West China(2018RU012)-Chinese Academy of Medical Sciences West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Anesthesiology West China School of Clinical MedicineSichuan UniversityChengdu 610041Sichuan ProvinceChina

To review the research progress of pure opioid receptor agonist *** research progress of oxycodone in terms of pharmacokinetics,pharmacodynamics,adverse reactions,clinical application,combined medication and new progress in clinical application was summarized by referring to the *** is a semi-synthetic thebaine derivative of opioid alkaloids,and is a pure opioidμandκreceptor *** main action sites are the central nervous system and visceral smooth *** to its advantages of low adverse reactions,good analgesic effects,and a wide range of safe doses,the drug has been widely used in the control of acute and chronic postoperative pain,as well as malignant and non-malignant *** the end of the 20^(th) century,researchers have begun to formulate antipyretic analgesics,opioid receptor agonists,opioid receptor antagonists,dopamine receptor antagonists and other drugs with oxycodone in different proportions to enhance the analgesic *** the same time,it can reduce the dosage of oxycodone and reduce its adverse reactions,so as to achieve the purpose of limiting opioid *** the continuous research on the efficacy and safety of oxycodone in the perioperative period at home and abroad,oxycodone has become the only dual-opioid potent analgesic that can be used in clinical work.

关键词： Oxycodone Anesthesia acute pain Clinical application Pharmacodynamics

Patterns of Ketorolac dosing by emergency physicians

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World Journal of Emergency Medicine 2017年第1期8卷 43-46页

作者： Emil Soleyman-Zomalan Sergey Motov Antonios Likourezos Victor Cohen Illya Pushkar Christian Fromm Department of Emergency Medicine Texas Health Arlington Memorial HospitalArlingtonTX76012USA Department of Emergency Medicine Maimonides Medical CenterBrooklynNY 11219USA Corporate Clinical Director of Pharmacy services New York City Health+HospitalsNYNY 10013USA

BACKGROUND: Ketorolac tromethamine is a non-steroidal anti-inflammatory drug(NSAIDs) that is widely used in the emergency department(ED) for the treatment of moderate-to-severe pain. Ketorolac, like other NSAIDs, exhibits an analgesic ceiling effect and previous research suggests that 10 mg is possibly the ceiling dose. Do the patterns of ketorolac dosing by emergency physicians follow its analgesic ceiling dose?METHODS: This was a single center retrospective, descriptive study to characterize patterns of ketorolac administration in ED patients. Data for all patients who received ketorolac during the ten year study period from January 1, 2003 to January 1, 2013 were collected from the electronic medical record of an urban community ED with an annual volume of 116 935 ***: There were 49 605 ketorolac administrations during the study period; 38 687(78%) were given intravenously, 9 916(20%) intramuscularly, and 1 002(2%) orally. Through the intravenous route, 5 288(13.7%) were 15 mg, 32 715(84.6%) were 30 mg, 15(0.03%) were 60 mg, and 669(1.7%) were other varying doses. Through the intramuscular route, 102(1.0%) were 15 mg, 4 916(49.6%) were 30 mg, 4 553(45.9%) were 60 mg, and 345(3.5%) were other varying doses. The most common diagnoses at discharge were renal colic(21%), low back pain(17%) and abdominal pain(11%).CONCLUSION: The data show that ketorolac was prescribed above its ceiling dose of 10 mg in 97% of patients who received intravenous doses and in 96% of patients receiving intramuscular doses.

关键词： Ketorolac NSAID Analgesic ceiling acute pain Prescription pattern