Articles: analgesia.
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Review Meta Analysis
Oral analgesic for musculoskeletal injuries in children: A systematic review and network meta-analysis.
Pain in pediatric musculoskeletal (MSK) injuries can lead to increased anxiety, fear, and avoidance of medical care, making analgesic management critical. Therefore, we evaluated analgesic efficacy and adverse effects to select the optimal analgesic agent in pediatric patients with MSK injuries. ⋯ Our NMA found ibuprofen to be the most effective and least adverse analgesic in pediatric patients with MSK injuries.
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Paediatric anaesthesia · Jan 2024
Randomized Controlled TrialUltrasound-guided selective supraclavicular nerve block for postoperative pain control in children receiving Hickman catheter or chemoport insertion: A randomized controlled trial.
Optimal pain management after insertion of a central venous catheter in children remains unclear. ⋯ Ultrasound-guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.
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Anesthesia and analgesia · Jan 2024
Patient Satisfaction With, and Outcomes of, Ultrasound-Guided Regional Anesthesia at a Referral Hospital in Tanzania: A Cross-Sectional Study.
Regional anesthesia techniques are increasingly used in high-income countries (HICs) for both surgical anesthesia and postoperative analgesia. However, regional anesthesia has not been utilized to the same degree in low- to middle-income countries (LMICs) due to a lack of resources and trained personnel. This study evaluates patient satisfaction with, and outcomes of, ultrasound-guided regional anesthesia for extremity surgery at Kilimanjaro Christian Medical Center (KCMC) in the Northeastern zone of Tanzania. ⋯ Our study found that ultrasound-guided regional anesthesia in a resource-constrained setting was effective for extremity surgery and resulted in high patient satisfaction. No complications occurred. The use of ultrasound-guided regional anesthesia shows promise for the safe and effective care of patients undergoing extremity surgery in LMICs.
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Minerva anestesiologica · Jan 2024
Epidural vs. systemic analgesia in the Intensive Care Unit: retrospective study of patient outcomes.
Patients admitted to the Intensive Care Unit (ICU) often experience acute pain. Causes include major surgery, multisystem trauma, and pancreatitis. Most ICU patients who require pain management are treated with systemic analgesia, usually intravenous opioids. This study compared the rate of pain and delirium scores, as well as mortality and morbidity between ICU patients treated with systemic vs. epidural analgesia. ⋯ Epidural analgesia reduced the number of delirium events and was associated with a shorter ICU stay, fewer ventilation days and a lower mortality rate. Further research is needed to confirm these findings.
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Intranasal (IN) medications offer a safe non-invasive way to rapidly deliver drugs in situations where intravenous (IV) access and intramuscular (IM) administration is challenging or not feasible. In the prehospital setting, this can be an essential alternative in time critical situations including trauma management, seizures, and agitated patients. However, there is a paucity of evidence summarizing its efficacy in this environment. This systematic review aims to assess the current evidence supporting the use of IN medicine (midazolam, ketamine, fentanyl, morphine, glucagon, and naloxone) in the prehospital setting alone. ⋯ Prehospital IN medication administration has wide-ranging potential, particularly for administering analgesia. There are likely to be certain populations, for example, pediatrics, that will benefit the most, although conclusions are limited by the quality of evidence currently available. We encourage additional research in this area, particularly with robust prospective double-blind RCTs.