Articles: analgesia.
-
This study assessed the effect of expectation of analgesia on conditioned pain modulation (CPM) in healthy participants stratified into inhibitors and non-inhibitors. ⋯ Several studies have investigated whether cognitive modulation can alter the magnitude of the inhibitory response of conditioned pain modulation (CPM), yet some gaps remain. This study accounted for measurement error to accurately determine changes in CPM influenced by expectation of analgesia.
-
J Clin Monit Comput · Nov 2024
Characterization of the temporal profile of the antinociceptive effects of an intravenous bolus of ketamine using the analgesia nociception index in no-anesthetized adult patients.
An effect-site target-controlled infusion (TCI) would allow a more precise titration of intravenous analgesics effect. The analgesia nociception index (ANI) continuously monitors the analgesia/nociception balance during general anesthesia. This study aims to derive a PKPD model of ketamine antinociceptive effect using the Domino PK parameter set and the ANI response data in awake patients without other drugs affecting the ANI response. ⋯ Hysteresis was characterized, incorporating an estimated Keo of 0.238 (CI95% 0.20-0.28) min-1 to the described PK parameters set. The developed PKPD model, using Domino's PK parameters and the ANI response data, adequately characterized the temporal profile of ketamine's antinociceptive effect. The current estimated model parameters can be used to perform an effect-site TCI of ketamine for analgesic purposes.
-
The role of differential nerve block in the development of analgesia after erector spinae plane block has been questioned. While highly myelinated nerves are more sensitive to local anesthetics than unmyelinated ones in vitro, factors influencing drug diffusion, particularly pKa, are more relevant in the clinical setting. ⋯ The greater sensitivity of myelinated axons to local anesthetic action will only be apparent if the drug can reach their membranes in significant concentrations. In the very dynamic situation pertaining to a local anesthetic injection (no matter the site), diffusion factors mean that the concentration of the drug around the axons is likely to be very low and may result in an effect on unmyelinated fibers only.
-
Journal of anesthesia · Nov 2024
The effect of intravenous lidocaine infusion on subarachnoid anesthesia in patients undergoing total knee replacement: a randomised controlled trial.
Intravenous lidocaine is a non-opioid analgesic adjunct for perioperative pain relief. The aim of our study was to explore whether concurrent administration of intravenous lidocaine prolongs the duration of sensory block during total knee replacement (TKR) under spinal anaesthesia. ⋯ During unilateral TKR under spinal anaesthesia, concurrent use of intravenous lidocaine prolonged sensory block and reduced postoperative analgesic requirements.
-
Minerva anestesiologica · Nov 2024
Regional analgesia techniques following nephrectomy: a systematic review and network meta-analysis.
This network meta-analysis (NMA) was performed to assess the relative efficacy and safety of various regional analgesic techniques used in patients undergoing partial nephrectomy or nephrectomy. ⋯ This available evidence suggests that ESPB and TPVB are more likely to reduce pain scores within 24 hours and shorten the length of hospital stay. QLB-L and QLB-TM are more likely to reduce the cumulative opiates consumption within 24 hours. RLB and QLB-LSAL are more likely to decrease the incidence of PONV. The wound infiltration (WI), intraperitoneal instillation (IPI), and WI+IPI are less likely to be effective.