检索结果-南通市图书馆

Nonopioid perioperative analgesia in head and neck cancer surgery:A systematic review

World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 107-117页

作者： Beatrice C.Go Cammille C.Go Kevin Chorath Alvaro Moreira Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Perelman School of Medicine University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics Division of NeonatologyUniversity of Texas Health-San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:Management of postoperative pain after head and neck cancer surgery is a complex issue,requiring a careful balance of analgesic properties and side effects.The objective of this review is to discuss the efficacy and safety of multimodal analgesia(MMA)for these patients.Methods:Pubmed,Cochrane,Embase,Scopus,and clinicaltrials.gov were systematically searched for all comparative studies of patients receiving MMA(nonsteroidal anti-inflammatory drugs(NSAIDs),acetaminophen,anticonvulsants,local anesthetics,and corticosteroids)for head and neck cancer surgeries.The primary outcome was additional postoperative opioid usage,and secondary outcomes included subjective pain scores,complications,adverse effects,and 30-day outcomes.Results:A total of five studies representing 592 patients(MMA,n=275;non-MMA,n=317)met inclusion criteria.The most commonly used agents were gabapentin,NSAIDs,and acetaminophen(n=221),NSAIDs(n=221),followed by corticosteroids(n=35),dextromethorphan(n=40),and local nerve block(n=19).Four studies described a significant decrease in overall postoperative narcotic usage with two studies reporting a significant decrease in hospital time.Subjective pain scores widely varied with two studies reporting reduced pain at postoperative day 3.There were no differences in surgical outcomes,medical complications,adverse effects,or 30-day mortality and readmission rates.Conclusion:MMA is an increasingly popular strategy that may reduce dependence on opioids for the treatment of postoperative pain.A variety of regimens and protocols are available for providers to utilize in the appropriate head and neck cancer patient.

关键词： analgesia head and neck neoplasm NSAID opioids pain management

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Overprescription of opioid analgesia is common following ambulatory Otolaryngology—Head and Neck surgery procedures: A multicenter study

引用

World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 145-151页

作者： Amr F.Hamour Frederick Laliberte Jordan Levy Jason Xu Edward Park Vincent Lin John de Almeida Julie Strychowsky Antoine Eskander Eric Monteiro Department of Otolaryngology-Head and Neck Surgery University of TorontoTorontoOntarioCanada Department of Otolaryngology-Head and Neck Surgery London Health Sciences CentreLondonOntarioCanada Department of Otolaryngology-Head and Neck Surgery Mount Sinai HospitalTorontoOntarioCanada

Background: The rise in the use of prescription opioids for postoperative analgesia within surgery has mirrored an increased trend of opioid-related morbidity within Canada and the United States. This study prospectively studied daily pain levels and medication requirements postoperatively in patients undergoing elective Otolaryngology—Head and Neck surgery procedures.Methods: Patients were asked to prospectively document their pain level and medication use daily for 7 days postoperatively. A final survey was used to quantify unused medication left at home and clarify each patient's disposal plan. We included patients undergoing elective outpatient or short stay surgeries from three tertiary care centers in Toronto, Ontario from September 2016 to September 2017. Previous opioids users or patients suffering from chronic pain were excluded.Results: A final cohort of 56 eligible adult patients were included in the study. The most common procedures were thyroidectomy (n = 19), endoscopic sinus surgery (n= 10), tympanoplasty/ossiculoplasty (n= 7), and cochlear implant (n = 5). Most patients received a prescription for acetaminophen/codeine (n = 29, 51.8%) or acetaminophen/oxycodone (n = 22, 39.3%) and used on average 29% of their initial prescription. Patients most commonly opted to keep their unused narcotics at home (n = 23, 41%). A total of 710 tablets of narcotics were overprescribed in our study population, 351 of which were kept in patients'' home for future use.Conclusion: There is a clear tendency to overestimate postoperative pain resulting in significant overprescription of opioids among Otolaryngologists.

关键词： analgesia health policy opioid quality improvement quality of life

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Efficacy of patient-controlled hydromorphone analgesia in those undergoing uterine fibroid artery embolization via the right radial artery

引用

Journal of Interventional Medicine 2023年第1期6卷 20-23页

作者： Yanli Wang Yi Zhao Miao Xu Yanling Wang Songmei Li Yi Fang Xinwei Han Kai Zhang Department of Interventional Radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou450052China Department of Interventional Radiology The Third Affiliated Hospital of Zhengzhou UniversityZhengzhou450052China

Objective: To evaluate the efficacy and safety of patient-controlled analgesia(PCA) with hydromorphone as perioperative analgesia during uterine artery embolization(UAE) via the right radial artery.Patients and methods: A total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone(10 mg) was dispensed into a 100 ml PCA pump with normal saline. Pump administration was initiated 15 min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 h after the procedure. Side effects were also observed.Results: Thirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were observed.Conclusion: Patients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.

关键词： Uterine leiomyoma Uterine artery embolization(UAE) Radial artery analgesia Hydromorphone

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

电针对全膝关节置换术后辅助镇痛的临床疗效观察

引用

World Journal of Acupuncture-Moxibustion 2022年第2期32卷 131-136页

作者：石威侯燕严伟谭勇海余昕李磊邹德宝王杰王志洲姜红江安徽中医药大学研究生院合肥230000 山东省文登整骨医院关节三科威海264400

Objective:To observe the clinical effect of electroacupuncture(EA)for alleviating pain after total knee arthroplasty(TKA)in the patients with the end-stage knee osteoarthritis and its mechanism.Methods:A total of 80 subjects with unilateral TKA were divided into a celecox group(40 cases)and an EA combination group,using random number table in clinical trial.In the celecox group,after operation,celecox tablets were taken orally for analgesia.In the EA combination group,on the base of oral administration of celecox tablets,on the day of operation,EA was exerted on the affected limb,with disperse-dense wave,2 Hz/100 Hz in frequency,3 mA in current intensity,once daily,30 min each time,consecutively for 3 days.On the day after operation,Wàiqiū(外丘GB36),Jīnmén(金门BL63),Nèimádiǎn(内麻点EX-LE29)and ZúsānIǐ(足三里ST36)were selected in EA.24 h after removing the drainage tube,Liángqiū(梁丘ST34),Xuèhǎi(血海SP10),Dìjī(地机SP8)and Yánglíngquán(阳陵泉GB34)were used.Separately,the operation time,blood loss,the pain VAS score before operation,the pain VAS scores after 24,48 and 72 h of treatment and Self-rating scale of sleep(SRSS)score,as well as the stress factors,i.e.IL-6,IL-10 and TNF-αin serum were recorded and determined in the subjects of two groups.Results:Before treatment,the operation time and blood loss were not different between two groups(both P>0.05).24,48 and 72 h after operation,the visual analogue scale(VAS)scores in the celecox group were all higher than those in the EA combination group(all P<0.05).After treatment,SRSS score in the EA combination group was lower than that in the celecox group(P<0.05).The expressions of IL-6 and TNF-αwere reduced gradually in the two groups(all P<0.05)and the values in the EA combination group were lower than the celecox group(P<0.05).IL-10 was increased gradually(P<0.05)and the value in the EA combination group was higher than the celecox group(P<0.05).Conclusion:Electroacupuncture effectively alleviates pain induced by TKA and the curative effect is definite.This therapy contributes to accel

关键词： Total knee arthroplasty Postoperative pain Electroacupuncture analgesia Effect mechanism

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Initiation of Acupoint Molecular Mechanisms for Manual Acupuncture analgesia—Nuclear FactorκB Signaling Pathway

引用

Chinese Journal of Integrative Medicine 2021年第12期27卷 933-939页

作者： ZHANG Kuo ZHAO Xue YANG Tao ZHANG Yan-fang YAN Ya-wen XU Zhi-fang GONG Yi-nan LIU Yang-yang GUO Yong-ming GUO Yi Academy of Medical Engineering and Translational Medicine Tianjin UniversityTianjin(300072)China Research Center of Experimental Acupuncture Science Tianjin University of Traditional Chinese MedicineTianjin(301617)China Affiliated Hospital of Municipal Institute of Traditional Chinese Medicine of Changzhi City Shanxi Province(046000)China Sanhuai Road Community Health Service Center Tanggu StreetBinhai New AreaTianjin(300451)China School of Traditional Chinese Medicine Tianjin University of Traditional Chinese MedicineTianjin(301617)China

Objective To identify the prominent molecular signaling in acupoints and explore their roles in initiating the analgesia effect of manual acupuncture(MA).Method A three-step study was conducted,the experiment 1 was a genome-wide analysis of the tissue at acupoint Zusanli(ST 36),including 12 Wistar rats which were divided into control,control+MA1,and control+MA7 groups.In the experiment 2,the paw withdrawal latency(PWL),immunohistochemistry and Western blot analysis of phospho-nuclear factor kappa B(NFκB)p65(p-p65),phospho-NFκB p50(p-p50)at ST 36 were performed on rats of saline,saline+MA,and complete Freund’s adjuvant(CFA)+MA groups(n=6).In experiment 3,24 rats were divided into saline+DMSO,CFA+DMSO,CFA+DMSO+MA,and CFA+BAY 11–7082+MA groups,the PWL and immunofluorescence assay of NFκB p65 at ST 36 was conducted.Result(1)The gene:inhibitor of NFκB(Nfkbia),interleukin-1β(Il1b),interleukin-6(Il6),chemokine c-x-c motif ligand 1(Cxcl1),monocyte chemoattractant protein-1(MCP-1/Ccl2)expressions in the control+MA7 group were significantly increased(Panalgesia.

关键词： manual acupuncture acupoint analgesia nuclear factor kappa B

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Optimum interval time of programmed intermittent epidural bolus of ropivacaine 0.08%with sufentanyl 0.3 mg/mL for labor analgesia:a biased-coin up-and-down sequential allocation trial

引用

Chinese Medical Journal 2020年第5期133卷 517-522页

作者： Shuang-Qiong Zhou Jing Wang Wei-Jia Du Yu-Jie Song Zhen-Dong Xu Zhi-Qiang Liu Department of Anesthesia Shanghai First Maternity and Infant HospitalTongji University School of MedicineShanghai 201204China Department of Anesthesia Fujian Provincial Maternity and Children’s HospitalAffiliated Hospital of Fujian Medical UniversityFuzhouFujian 350001China

Background:The programmed intermittent epidural bolus(PIEB)technique is widely used in labor analgesia,but the parameter settings of PIEB have not yet been standardized.We designed a study to identify the optimal interval duration for PIEB using 10 mL of ropivacaine 0.08%and sufentanyl 0.3 mg/mL,a regimen commonly used to control labor pain in China,to provide effective analgesia in 90%of women during the first stage of labor without breakthrough pain.Methods:We conducted a double-blind sequential allocation trial to obtain the effective interval 90%(EI90%)during the first stage of labor between April 2019 and May 2019.This study included the American Society of Anesthesiologists physical status II–III nulliparous parturients at term,who requested epidural analgesia.The bolus volume was fixed at 10 mL of ropivacaine 0.08%with sufentanyl 0.3 mg/mL.Participants were divided into four groups(groups 60,50,40,and 30)according to the PIEB intervals(60,50,40,and 30 min,respectively).The interval duration of the first parturient was set at 60 min and that of subsequent parturients varied according to a biased-coin design.The truncated Dixon and Mood method and the isotonic regression analysis method were used to estimate the EI90%and its 95%confidence intervals(CIs).Results:Forty-four women were enrolled in this study.The estimated optimal interval was 44.1 min(95%CI 41.7–46.5 min)and 39.5 min(95%CI 32.5–50.0 min),using the truncated Dixon and Mood method and isotonic regression analysis,respectively.The maximum sensory block level above T6 was in nearly 20%of parturients in group 30;however,5.3%,0%,and 0%of the parturients presented with sensory block level above T6 in groups 40,50,and 60,respectively.There were no cases of hypotension and only one parturient complained of motor block.Conclusion:With a fixed 10 mL dose of ropivacaine 0.08%with sufentanyl 0.3 mg/mL,the optimal PIEB interval is about 42 min.Further studies are warranted to define the efficacy of this regimen throughout all stages of labor.

关键词： Anaesthetic techniques First stage labor Labor analgesia Ropivacaine

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

A comparative study of three concentrations of intravenous nalbuphine combined with hydromorphone for post-cesarean delivery analgesia

引用

Chinese Medical Journal 2020年第5期133卷 523-529页

作者： Chun-Yun Huang Shu-Xi Li Mei-Juan Yang Li-Li Xu Xin-Zhong Chen Department of Anesthesia Women’s HospitalZhejiang University School of MedicineHangzhouZhejiang 310006China

Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to explore an ideal concentration of nalbuphine for post-CS intravenous analgesia by evaluating the analgesic effects and side-effects of three different concentrations of nalbuphine combined with hydromorphone for post-CS intravenous analgesia in healthy parturients.Methods:One-hundred-and-fourteen parturients undergoing elective CS were randomly allocated to one of three groups(38 subjects per group)according to an Excel-generated random number sheet to receive hydromorphone 0.05 mg/mL+nalbuphine 0.5 mg/mL(group LN),hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL(group MN),and hydromorphone 0.05 mg/mL+nalbuphine 0.9 mg/mL(group HN)using patient-controlled analgesia(PCA)pump.Visual analog scale(VAS)for pain,PCA bolus demands,cumulative PCA dose,satisfaction score,Ramsay score,and side-effects such as urinary retention were recorded.Results:The number of PCA bolus demands and cumulative PCA dose during the first 48 h after CS were significantly higher in group LN(21±16 bolus,129±25 mL)than those in group MN(15±10 bolus,120±16 mL)(both P0.05).VAS scores were significantly lower in group HN than those in group MN and group LN for uterine cramping pain at rest and after breast-feeding within 12 h after CS(all P0.05).Ramsay sedation scale score in groupHNwas significantly higher than that in group MN at 8 and 12 h after CS(all P<0.01)and group LN at 4,8,12,24 h after CS(all P<0.05).Conclusions:Hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL f

关键词： Hydromorphone Nalbuphine Cesarean section Post-operative analgesia Patient-controlled intravenous analgesia

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Concerned topics of epidural labor analgesia:labor elongation and maternal pyrexia:a systematic review

引用

Chinese Medical Journal 2020年第5期133卷 597-605页

作者： Cai-Juan Li Fan Xia Shi-Qin Xu Xiao-Feng Shen Department of Anesthesiology Women’s Hospital of Nanjing Medical UniversityNanjing Maternity and Child Health Care HospitalNanjingJiangsu 210004China

Objective:Labor is a complex process and labor pain presents challenges for analgesia.Epidural analgesia(EA)has a well-known analgesic effect and is commonly used during labor.This review summarized frequently encountered and controversial problems surrounding EA during labor,including the labor process and maternal intrapartum fever,to build knowledge in this area.Data sources:We searched for relevant articles published up to 2019 in PubMed using a range of search terms(eg,“labor pain,”“epidural,”“analgesia,”“labor process,”“maternal pyrexia,”“intrapartum fever”).Study selection:The search returned 835 articles,including randomized control trials,retrospective cohort studies,observational studies,and reviews.The articles were screened by title,abstract,and then full-text,with a sample independently screened by two authors.Thirty-eight articles were included in our final analysis;20 articles concerned the labor process and 18 reported on maternal pyrexia during EA.Results:Four classic prospective studies including 14,326 participants compared early and delayed initiation of EA by the incidence of cesarean delivery.Early initiation following an analgesia request was preferred.However,it was controversial whether continuous use of EA in the second stage of labor induced adverse maternal and neonatal outcomes due to changes in analgesic and epidural infusion regimens.There was a high incidence of maternal pyrexia in women receiving EA and women with placental inflammation or histologic chorioamnionitis compared with those receiving systemic opioids.Conclusions:Early EA(cervical dilation≥1 cm)does not increase the risk for cesarean section.Continuous epidural application of low doses of analgesics and programmed intermittent epidural bolus do not prolong second-stage labor duration or impact maternal and neonatal outcomes.The association between EA and maternal pyrexia remains controversial,but pyrexia is more common with EA than without.A non-infectious inflammatory process is an accepted mechanism of epidural-relat

关键词： Epidural analgesia Labor process Maternal pyrexia Intrapartum fever Mechanism

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Expert consensus on management of analgesia and sedation for patients with severe coronavirus disease 2019

引用

Chinese Medical Journal 2020年第18期133卷 2186-2188页

作者： Xiang-Hong Yang Bo Hu You Shang Jiao Liu Ming Zhong Xiu-Lling Shang Zhi-Xiong Wu Zhui Yu Ren-Hua Sun Hong-Liang Wang Ming-Yan Zhao Mei Meng Qiang-Hong Xu Xia Zheng De-Chang Chen Department of Critical Care Medicine Zhejiang Provincial People’s Hospital(People’s Hospital of Hangzhou Medical College)HangzhouZhejiang 310014China Department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhanHubei 430071China Department of Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Critical Care Medicine Ruijin HospitalShanghai Jiaotong UniversitySchool of MedicineShanghai 200025China Department of Critical Care Medicine Zhongshan Hospital Fudan UniversityShanghai 200032China Department of Critical Care Medicine Fujian Provincial HospitalFujian Provincial Center for Critical Care MedicineFuzhouFujian 350001China Department of Critical Care Medicine Huadong HospitalShanghai 200040China Department of Critical Care Medicine Renmin HospitalWuhan UniversityWuhanHubei 430060China Department of Critical Care Medicine the Second Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiang 150001China Department of Critical Care Medicine The First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiang 150001China Department of Critical Care Medicine Zhejiang HospitalHangzhouZhejiang 310013China Department of Critical Care Medicine the First Affiliated Hospital of Zhejiang UniversityHangzhouZhejiang 310000China

The coronavirus disease 2019(COVID-19)has been declared a global pandemic and is a major public health issue worldwide.COVID-19 is a systemic disease damaging multiple organs,including the lung as the main target organ.

关键词： organs lung analgesia

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Sedation and analgesia in children with cerebral palsy:a narrative review

引用

World Journal of Pediatrics 2019年第5期15卷 432-440页

作者： Ingrid Rabach Francesca Peri Marta Minute Emanuela Aru Marianna Lucafò Alberto Di Mascio Giorgio Cozzi Egidio Barbi Institute for Maternal and Child Health IRCCS'Burlo Garofolo'Via dell'Istria 65/134100 TriesteItaly University of Trieste TriesteItaly Department of Medicine Surgery and Health SciencesUniversity of TriesteTriesteItaly

Background Patients with cognitive impairment due to cerebral palsy experience pain more often than healthy peers and frequently require diagnostic and therapeutic painful procedures.analgesia and procedural sedation outside the operating room are often required,but they may not adequately be provided because of the inability to accurately recognize and classify the state of pain and for the perceived higher risk of complications.Data sources We reviewed the available literature to highlight the specific risk factors and area of criticism,that should be further improved.We searched the Cochrane Library,Medline,Pubmed from 1987 to September 2018 using key words such as'cerebral palsy and children and pain'or'sedation and cerebral palsy and children'.Results While different pain scales are useful in recognizing pain expressions,anxiety scales are not available.Moreover,studies on non-pharmacological techniques do not always have comparable results.Several risk factors,from anatomic abnormalities to liver and kidney functioning,should be kept in mind before proceeding with sedation.Conclusions Large trials are needed to assess the impact of non-pharmacological techniques and to evaluate which pain control strategy(pharmacological and non-pharmacological)should be used in different settings.

关键词： analgesia Cerebral palsy Intellectual disability Pain Procedural sedation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：