American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Am J Health Syst Pharm · Apr 2006
Patient-controlled analgesia: Finding a balance between cost and comfort.
Despite the growing movement in acute pain management, acute postoperative pain continues to be undermanaged. Although numerous clinical practice guidelines for pain management have been published throughout the last 12 years, inadequate pain relief remains a significant health care issue. Insufficient dosage of analgesics is a common problem, and therapy for those patients still with pain represents a considerable health care dilemma. ⋯ Current PCA techniques using i.v. or epidural administration have limitations. Development of new technology offering alternative routes for PCA administration is at the forefronts of PCA research.
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The pharmacology, bioavailability and pharmacokinetics, indications, clinical efficacy, adverse effects and toxicities, and dosage and administration of the inhaled anesthetics are reviewed. ⋯ The inhaled anesthetics have been shown to be both safe and effective in inducing and maintaining anesthesia. These agents differ in potency, adverse-effect profile, and cost. Newer anesthetic gases, such as sevoflurane and desflurane, appear to have more favorable physico-chemical properties. These factors, as well as patient characteristics and duration and type of procedure, must be considered when selecting an inhaled anesthetic.