Patterns of anesthesia(AS) and analgesia(AG) practice in gynecological brachytherapy in India.

Analgesia and Anesthesia Practice Patterns for Gynecologic Brachytherapy Procedures and Potential Impact on Women's Procedural Experience: A National Survey

IntroductionAcupuncture analgesia (AA) is widely used in clinical practice. The autonomic nervous system (ANS) may be an important pathway for acupuncture signal transduction. However, real-time changes in autonomic function during AA and the effect of “needle sensation” remain unclear.MethodsWe established a human pain model in healthy adults and randomly assigned 128 participants to the model, sham acupuncture, and acupuncture groups in a 1:1:2 ratio. Heart rate variability (HRV), including total power (TP), low-frequency power (LF), high-frequency power (HF), ratio of LF to HF (LF/HF), standard deviation of the normal-normal intervals (SDNN), and root mean square of successive interval differences (RMSSD), were used to assess autonomic function. The visual analog scale (VAS) and efficiency were used to assess the analgesic effect of acupuncture. The Massachusetts General Hospital acupuncture sensation scale (MASS) was used to indicate the intensity of the needle sensation. Anxiety levels were also measured. Finally, the correlation of MASS with HRV, VAS, and anxiety levels was analyzed.ResultsVAS decreased after 10 min of needling and 5 min after needle withdrawal in the acupuncture group compared with those in the model group (p = 0.038, p = 0.020). The efficacy rates were 82.0, 50.0, and 61.3% in the acupuncture, model, and sham groups, respectively. These represent significant differences between the acupuncture group and the model and sham acupuncture groups (p < 0.001 in each case). No differences were observed between the model and sham acupuncture groups. HF, TP, SDNN, and RMSSD were all increased in the acupuncture group compared with those in the model group (p = 0.045, p = 0.041, p = 0.002, p = 0.006, respectively). No differences were observed in the sham acupuncture group compared to the model group (p = 0.632, p = 0.542, p = 0.093, p = 0.222, respectively). The LF and LF/HF did not differ among all three groups. A positive correlation was observed between MASS and RMSSD2, LF2, RMSSD4, TP4, VAS5, and anxiety levels.ConclusionAA was associated with enhanced vagal activity. The intensity of needle sensation was positively correlated with vagal and sympathetic nerve activities. Acupuncture is an effective means of regulating autonomic function, and needle sensation may be an important modulator.

Introduction. The objective of this prospective study was to investigate the relationship between age and total morphine consumption during knee ligament reconstruction using three analgesic techniques. Assumption. Young age is a predictive factor of overconsumption of morphine independently of the intensity of pain. Materials. 165 patients were Included who underwent primary reconstruction of the anterior cruciate ligament of the knee. All patients were operated on under spinal anesthesia. The first systemic analgesia (SA) group will receive systemically balanced analgesia postoperatively and for a minimum of five days based on Paracetamol, Diclofenac and a PCA with morphine. The second femoral analgesia (FA) group will benefit, in addition to the systemic analgesia already described, from a femoral perinervous catheter in the crural position. 20 ml of bupivacaine at 0.125% concentration is injected; maintenance is implemented immediately with a continuous flow of 8 ml/h for 36 hours. The third intra-articular analgesia (AIA) group will receive, in addition to the same systemic analgesia, an infusion through an epidural-type catheter of 20 ml of 0.125% bupivacaine then maintenance with 8 ml/h of the same local anesthetic by electric syringe pusher for 36 hours. The cumulative consumption of morphine and the estimation of pain at rest were evaluated using a numerical scale (EN) from 1 to 10. Results. Data were collected from H0 to H36. The overall consumption was 15.13 ± 12.35 mg. The difference in consumption was not significant depending on sex and ASA but it is based on the average age. A negative correlation between age and morphine consumption exists with a Pearson's R at -0.19 p 0.016. Discussion. this study raises the suspicion that age is a factor in morphine consumption that must be taken into consideration when managing postoperative pain, but also when interpreting research results in this context.

Objective: to find perioperative analgesic effectiveness of low dose Ketamine in radical nephrectomy operations and comparing its anodyne potency with Nalbuphine Hcl (Nalbin). Study Design: Quasi-experimental study. Place and Duration of Study: Armed forces institute of urology from Sep 2016 to June 2019. Methodology: The 60 randomly selected surgical patients for radical nephrectomy were divided into two groups in a random manner. The Anaesthetic technique used in both groups (K and N) was standard along with 10 mg injection Nalbin given to both groups at induction. Group-K (n=30) patients had IV Ketamine bolus 0.3 mg /kg followed by 0.1 mg/kg/h infusion at induction till completion of surgery. Group-N (n=30) received a similar volume of saline in bolus as well as an infusion. The pain score (VAS) at different intervals and total Nalbin consumed in 12 hours were recorded for each group. Patient satisfaction and complications were recorded during this period. Results: The effective intraoperative analgesia was achieved with an infusion of low dose Ketamine which continued till completion of surgery as seen in group K which has reduced Nalbin requirement 8.8± 3.5 mg (Group N 25±5 mg). There was a statistically significant reduction in overall pain scores and Nalbin demand (P≤0.05) in the Ketamine group (p≤0.00, 0.036, 0.286, 0.257, 0.253 respectively). Patient satisfaction was better in the Ketamine group but few patients in this group had delayed recovery. Conclusion: Intraoperative low-dose Ketamine infusion provides good postoperative analgesia while reducing the need for opioid analgesics, which must be con

Стаття присвячена одному з актуальних питань при інвазивних втручаннях — післяопераційному знеболюванню. Наведено дані щодо ефективності планового застосування декскетопрофену (препарат Кейвер) як засобу, що може нівелювати періоди неадекватної аналгезії у травматологічних хворих, які перенесли ендопротезування кульшового суглоба. Доведено, що застосування декскетопрофену в схемі премедикації та у складі мультимодальної аналгезії в післяопераційному періоді у травматологічних хворих дозволяє досягти більш якісного знеболювання порівняно з аналгезією «за потребою» опіатами чи іншими нестероїдними протизапальними засобами, а також вагомо знизити потреби в наркотичних анальгетиках в післяопераційному періоді (зі 100 до 29,6 %).

Дослідження проведені у 62 дітей віком 14,2 ± 4,2 року, прооперованих з приводу пухлин черевної порожнини — 24 (38,7 %) дитини, пухлин заочеревинного простору — 38 (41,3 %) дітей. Комплексне вивчення реакцій больової поведінки, фізіологічних показників і лабораторних стресових тестів показало, що використання схеми комбінованої регіональної анестезії бупівакаїном 0,375% та безперервною внутрішньовенною інфузією фентанілу в дозі 10 мкг/кг/год для післяопераційного знеболювання призводить до ефективної аналгезії після травматичних онкологічних оперативних втручань. Мультимодальна аналгезія — регіональна анестезія та безперервна внутрішньовенна інфузія опіоїдних анальгетиків покращує показники центральної та мезентеріальної гемодинаміки і, можливо, знижує ризик розвитку ускладнень у післяопераційному періоді та призводить до зменшення проявів гіпералгезії, а використання парацетамолу як додаткового знеболювання призводить до адекватного знеболювання та не впливає на розвиток гіпералгезії на відміну від наркотичних анальгетиків.

IntroductionChronic lower back pain (CLBP) is a frequent cause of medical consultations worldwide, and it results in decreased quality of life and disability. Current treatments for CLBP are often not...

Цель исследования — изучение эффективности и безопасности различных вариантов мультимодальной аналгезии при хирургическом лечении колоректального рака. Материалы и методы. В исследование включено 90 пациентов, оперированных по поводу рака прямой кишки. Проведен анализ изменений гемодинамики, уровня маркера стресса — сахара в крови и интенсивности боли по визуально-аналоговой шкале в трех группах пациентов в зависимости от метода периоперационного обезболивания. Результаты. В результате исследования установлено, что использование различных вариантов мультимодальной аналгезии с применением эпидуральной аналгезии (ЭА) с ингаляционной и внутривенной анестезией эффективнее защищает пациента от хирургического стресса при колоректальном раке в сравнении с тотальной внутривенной анестезией, сохраняет гемодинамическую стабильность, уменьшает дозу фентанила и мышечных релаксантов. Выводы. Использование ЭА смесью местного анестетика с фентанилом и ЭА местным анестетиком с контролируемой пациентом аналгезией фентанилом в сочетании с парентеральным нестероидным противовоспалительным препаратом и парацетамолом как компонентов мультимодальной аналгезии безопасно для применения в послеоперационном периоде после колоректальных операций, эффективнее контролирует острую послеоперационную боль, поддерживает стабильным уровень сахара в крови в сравнении с послеоперационным обезболиванием омнопоном.

Целью данного исследования было сравнение анальгетических эффектов налбуфина гидрохлорида и фентанила как основных компонентов в схеме интраоперационной мультимодальной анальгезии у пациентов с морбидным ожирением во время лапароскопических бариатрических вмешательств. Материалы и методы. В исследовании приняли участие 18 пациентов с морбидным ожирением, разделенные на две равнозначные группы (n = 9). В первой группе пациенты в качестве основного анальгетического компонента во время анестезии получали фентанил, во второй группе — налбуфина гидрохлорид. Уровень послеоперационной боли оценивался по визуально-аналоговой шкале (ВАШ) в течение первых послеоперационных суток. Результаты. Уровень послеоперационной боли по ВАШ в первые послеоперационные сутки статистически не отличался между пациентами обеих групп. Выводы. В соответствии с полученными данными налбуфина гидрохлорид является эффективной альтернативой фентанилу в качестве основного анальгетического компонента в схеме мультимодальной интраоперационной анальгезии у пациентов с морбидным ожирением при лапароскопических бариатрических вмешательствах.

Back pain is the most common symptom of vertebral osteomyelitis and can be difficult to manage. Pain may persist despite appropriate antibiotic medications and may be refractory to common analgesic treatments. We present a case of a 53-year-old man with acute onset severe low back pain. Clinical evaluation and diagnostic workup were consistent with L1 osteomyelitis. The patient continued to report pain following treatment with intravenous antibiotics and typical analgesic therapy. Opioids were discontinued and low-dose celecoxib was initiated with appreciable improvement in pain and activity tolerance. Celecoxib may be a good option and alternative to opioids in the pain management of this population. J Med Cases. 2021;12(7):291-294 doi: https://doi.org/10.14740/jmc3699

Catheter-related bladder discomfort (CRBD) is a clinical syndrome frequently observed in patients undergoing urinary catheterization. The main risk factors are male sex, catheter diameter and type of surgery. There is a wide variety of medications available for the treatment and prevention of this syndrome. The best known are antimuscarinics, which already used for the treatment of overactive bladder. These drugs have the disadvantage of producing adverse effects such as facial flushing and dry mouth. Other drugs, such as antiepileptics and analgesics, have been used for the treatment of this pathology. The last one that could be effective in the management of discomfort related to urinary catheterization is magnesium sulfate. In addition to being useful in treating various pathologies, it can be effective in reducing the incidence and severity of CRBD.

Burned patients suffer significant physical aggression generating intense pain that requires specific and multidisciplinary training for proper treatment. Despite the advances in the study of analgesic treatments, burned patients still remain under-treated in a high percentage. It is necessary to know the different therapeutic options that we have, as well as the pathophysiology of pain in burned patients to be able to properly treat them.

The steady growth in population has led to an enhanced water demand and immense pressure on water resources Pharmaceutical residues (PRs) are unused or non-assimilated medicines found in water supplies that originate from the human and animal consumption of antibiotics, antipyretics, analgesics etc These have been detected recently in sewage effluents, surface water, ground water and even in drinking water Due to their toxicity and potential hazard to the environment, humans and aquatic life, PRs are now categorized as the emerging contaminants (ECs) India figures in the top five manufacturers of medicines in the world and every third pill consumed in the world is produced in India Present day conventional wastewater treatment methods are ineffective and don’t eliminate them completely The use of nanotechnology via advanced oxidation processes (AOP) is one of the most effective methods for the removal of these PRs Present study is aimed at reviewing the presence of various PRs in water supplies and also to describe the process of AOP to overcome their threat This study is also very important in view of World Health Organization report confirming more than 30 million cases of COVID-19 worldwide This will lead to an alleviated use of antibiotics, antipyretics etc and their subsequent occurrence in water bodies Need of the hour is to devise a proper treatment strategy and a decision thereof by the policymakers to overcome the possible threat to the environment and health of humans and aquatic life © 2021 Techno-Press, Ltd

Objetivo: Relatar as principais atividades biológicas de Agave sisalana, descrevendo detalhes de sua classificação botânica, aspectos da composição química e bioativa, além de destacar seu uso como antimicrobiano. Metodologia: Trata-se de uma revisão da literatura de caráter descritiva com abordagem qualitativa, elaborada por meio da análise de materiais indexados nas plataformas: SciELO, PubMed e o portal de periódicos da CAPES, publicados entre os anos de 2002 a 2021, redigidos nos idiomas: português, inglês e espanhol. Após aplicação dos critérios de inclusão e exclusão, bem como leitura dos materiais, 38 conteúdos foram selecionados para a composição do presente estudo. Resultados e discussão: A atividade bioativa de Agave sisalana, está vinculada aos componentes do seu metabolismo secundário, onde podem ser mensurados: derivados alcaloides, cumarinas, taninos e saponínicos. No que se refere as saponinas do sisal, estas são apontadas como detentoras de ação antifúngica e antibacteriana, principalmente contra microrganismos patogênicos. Além das atribuições mencionadas, os estudos vêm mostrando seus efeitos como: inseticida, larvicida, ovicida, antiparasitário, antioxidante, imunomodulador, analgésico, anti-inflamatório, sob a atividade comportamental e neuroquímica, bem como na quimioprevenção e controle do câncer. Conclusão: Variadas são as aplicações da Agave sisalana, seja ao âmbito industrial, artesanal terapêutico ou na agropecuária. Sua atividade antimicrobiana é cientificamente comprovada, seja na inferência de fungos ou bactérias, fazendo desta uma importante alternativa, frente a incidência de microrganismos resistentes.

Pain is an unpleasant experience which can produce changes in all the systems of the body. Pain in children is not different from that in adults and can lead to similar detrimental effects on the body. The anticipation and effective treatment of pain in pediatric patients is thus, an essential component of care. A careful assessment of pediatric pain using age-specific pain scoring systems allows for exact quantification of pain. The use of various analgesics should be done early and in adequate doses for them to be effective. The use of multimodal approach with weaker analgesics along with regional blocks is an effective modality to control pain and prevent severe adverse effects associated with higher doses of potent analgesics. The advancement in the pharmacology of analgesics allows for their more widespread use with minimal side-effects. The use of patient or nurse controlled analgesia and continuous regional nerve blocks with the use of indwelling catheters can augment the pediatric pain management. Keywords: Pediatrics; Postoperative pain management; Neuraxial Citation: Kulshrestha A, Bajwa SJS. Management of acute postoperative pain in pediatric patients. Anaesth Pain & Intensive Care 2014;18(1):101-107

Introduction: Comparison of the analgesic effect of Intramuscular Pethidine and Intramuscular Morphine on an Orthopedic Population. Settings and Design: 1) Single Blinded Randomized Controlled study: Patients were divided into Morphine group or Pethidine group 2) Patient Satisfaction survey was administered to patients at the end of stay. Material and Methods: 1) Visual Analogue Scores (VAS) were taken at eight hourly intervals for three consecutive days or until the day of discharge. Incidence of opioid related complications was noted 2) A patient satisfaction survey was administered at the end of stay. Statistical Analysis: Average VAS during movement on day one during the 8am to 4pm period was calculated for both the morphine group and pethidine group. The percentage decrease in VAS was calculated for morphine vs. pethidine group on movement on Day 1. Pearson’s correlation was used to assess the relationship between opioid, side effects and overall patient satisfaction. T-test was used to evaluate the relationship between morphine, pethidine and twenty-four-hour pain relief.A one-way ANOVA test was used to evaluate the statistical significance between the morphine and the pethidine group and patient satisfaction. Results: The morphine group as compared with the pethidine group experienced an 18.5% decrease in Visual Analogue Score for pain on movement on day 1 (8 am-4 pm period). The morphine group was associated more drowsiness and prolonged time to first bowel action compared to the pethidine group. Only 1.4% (1) of patients experienced desaturation during the study which occurred in the morphine group. Overall, opioids were associated with minimal side effects and were generally safe to use. Patients who underwent regional anaesthesia used more morphine equivalents compared to those undergoing general anaesthesia. The morphine group was associated with overall increased patient satisfaction when compared to the Pethidine group. Conclusion: The study demonstrated a notable 18.5% decrease in VAS on movement with the morphine group as compared to pethidine group. Statistical significance was placed at 15%. Opioids were found to have a limited adverse side effect profile, with drowsiness and time to first bowel action being the most predominant. Only one patient representing 1.4% of the population had an episode of desaturation (Sp02 < 90%). Due to the minimal side effect profile opioids should be considered safe to use.

Objectives: Yukmijihwang-won (Liuweidihuang-wan in Chinese) is a frequently used medicinal herbal formula. It is used as Yin tonic in Korea and China to recover patients from Yin deficiency. However, the scientific evidence on this drug has not revealed the beneficial effect or mechanism of its effects on the neurological disorder. We designed this study to examine the antidepressive and analgesic effects of Yukmijihwang-won (YJ-01) and the minor modification of YJ-01, YJ-06 on the reserpine-induced pain-depression dyad mice model. Methods: Reserpine (1 mg/kg) was administered subcutaneously once a day for three consecutive days to induce pain and depression-like behavior. The oral administration of YJ-01 and YJ-06 (100, 200, or 300 mg/kg) was performed once daily from three days after the reserpine injection. Results: Repeated administration of the YJs significantly reduced the immobility time in a forced swimming test and increased the moved distance and number of crossings in the open field test. In the von-Frey filament test, the oral administration of YJs remarkably suppressed the increase in paw withdrawal frequency. Conclusions: The results of this study suggest that YJ-01 and 06 may be good candidates to treat the pain-depression dyad.

Clinical practice guidelines are clear about which medications are recommended or acceptable for patients with diabetic peripheral neuropathy; notably,

Opioid analgesic expenditure decreases after cannabis legalised