Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Review Meta Analysis
Knowledge on Palliative Care and Associated Factors among Nurses in Ethiopia: A Systematic Review and Meta-Analysis.
Palliative care is a multidisciplinary team-based care for patients facing life-threatening illness and their families which addresses their physical, psychological, social, and spiritual needs to improve the quality of care. There is a strategy for an increase in palliative care services by integrating with the healthcare system. Therefore, this systematic review and meta-analysis was aimed to assess the overall pooled prevalence of nurses' knowledge towards palliative care in Ethiopia. ⋯ More than half of nurses had poor knowledge of palliative care. Educational status of nurses and palliative care training were significantly associated factors with the nurses' level of knowledge about palliative care. Therefore, palliative care training and improving nurses' careers through continuous professional development should be focused on regularly to improve nurses' knowledge about palliative care.
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The optimal dose and concentration of analgesic efficacy of ropivacaine (RPV) and bupivacaine (BPV) for postoperative pain relief in paediatric abdominal surgery patients is still unclear. Therefore, this meta-analysis compared the efficacy of these analgesics, their administered modes (ultrasound-guided RSB versus LAI) for postoperative pain relief, and side effects. ⋯ Both RPV and BPV were significantly effective in reducing postoperative pain score. It appears that RSB could be a preferred choice to deliver analgesia, due to reduced opiate dose requirement and improved clinical safety without significant postoperative adverse events.
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Randomized Controlled Trial
A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial.
Femoral nerve blocks (FNBs) are used as safe and useful procedures to control severe postoperative pain from total knee arthroplasty (TKA). Various adjuvants have been used to prolong the duration of the local anesthetic blockade. This study evaluated whether a low dose of naloxone administered with local anesthetics prolongs the duration of FNB. ⋯ The total dose of supplementary opioids consumed at 24 h postoperatively was significantly lower in group N (312.4 ± 141.7 μg) than that in group C (456.5 ± 279.5 μg) (P=0.007). Lower VAS scores were recorded in group N than that in group C at rest and during knee activity (rest, 12 h, P=0.001, 18 h, P=0.043; activity, 12 h, P=0.001). The addition of a low dose of naloxone to ropivacaine for FNB significantly delayed the first request for rescue analgesia and decreased the opioid consumption within 24 h, without significant complications.
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To provide a comprehensive review on the global scientific research status of comorbid pain and inflammation from 1981 to 2019 and capture its subsequent development trends. Data Sources. The primary database chosen to collect publications on comorbid pain and inflammation research from 1981 to 2019 was the Web of Science (WOS). Core of the search strategy was the key word "pain" and the key word "inflammation" in the medical subject headings' major field. Study Selection. All articles retrieved were included in the bibliometric analysis. Data Extraction. We used CiteSpace to analyze publication outputs, subject categories, distribution by country/institution/journal, and other types of information. Then, knowledge base, hot issues, and future development directions were explained. Data Synthesis. A total of 2887 papers met the inclusion criteria in our research. Linear regression analysis results showed that the publications of studies of comorbid pain and inflammation significantly increased (P < 0.001) and have grown about 192 times in 40 years. The countries with the most outputs were the USA (886 publications), China (375 publications), and England (236 publications). Besides, Harvard University was the most prolific institution with 730 publications and 6646 citations. In accordance with the subject categories of WOS, neurosciences (31.832%), pharmacology/pharmacy (18.427%), and clinical neurology (15.206%) were the main research areas of these 2887 papers. ⋯ The current study reveals that research on comorbid pain and inflammation has gradually become more extensive worldwide since 1981, and neuropathic pain was the most popular study type. Most of our research output in this field came from countries in Europe and North America, although some Asian countries showed promising performance.
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Acute postoperative pain delays recovery and increases morbidity and mortality. Opioid therapy is effective but is accompanied by adverse reactions. Patient-controlled analgesia (PCA) enables self-administration of analgesics. Oral-PCA is a safe and beneficial alternative to intravenous (IV) PCA. We have developed a novel Oral-PCA device, which enables self-administration of solid pills to the patient's mouth. This is a retrospective study comparing the effectiveness and usability of this novel Oral-PCA with those of IV-PCA. ⋯ Oral-PCA by using PCoA® Acute provides pain control and usability which is noninferior to the IV-PCA, as well as superior to pain reduction in rest and movement. These results, along with the noninvasiveness, medication flexibility, and reduced cost, suggest the potential of Oral-PCA, by using PCoA Acute, to replace IV-PCA for postoperative analgesia.