Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Dec 2010
Randomized Controlled Trial Comparative StudyPropofol versus propofol/ketamine for brief painful procedures in the emergency department: clinical and bispectral index scale comparison.
The ideal procedural sedation drug for emergency department (ED) use would be easily titrated, rapid in onset, brief in duration, and provide sedation and analgesia without respiratory or hemodynamic compromise. Although many agents have been tried, no single drug fits this profile. The authors evaluated the comparative effectiveness and safety of propofol versus propofol/ketamine combination for procedural sedation using bispectral index monitoring for measuring depth of sedation. ⋯ No patient in either group experienced respiratory depression or required any intervention. The combination of propofol and ketamine provides an attractive combination for procedural sedation in the emergency department. Compared to propofol alone, "ketofol" results in less hypotension, better sedation, and enhanced patient comfort and safety.
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J Pain Palliat Care Pharmacother · Dec 2010
The medical consumption of opioids in Colombia, 1997-2007.
The World Health Organization classifies opioid analgesics as essential medicines in the treatment of severe pain and recommends their increased availability. The combination of availability, training of professionals, and a legal framework granting access to these medicines has led to a sharp increase in the consumption of morphine and other opioids in developed countries. However, in Colombia, consumption of opioid analgesics appears to fail to meet patient needs. ⋯ The unreliable availability of opioid analgesics may be responsible for their limited consumption. Chronic underuse and a trend toward increased consumption have been confirmed. Monitoring of consumption to promote rational use is recommended.