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Truchot J, Mezaïb K, Ricard-Hibon A, Vicaut E, Claessens YE, Soulat L, Milon JY, Serrie A, Plaisance P. Assessment of procedural pain in French emergency departments: a multi-site, non-interventional, transverse study in patients with minor trauma injury. Hosp Pract (1995) 2019; 47:143-148. [PMID: 31343374 DOI: 10.1080/21548331.2019.1646074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To determine the mean number of procedural painful episodes per patient, and to retrieve information regarding diagnosis, therapeutic procedures and analgesic management, in patients visiting Emergency Departments (EDs) for minor trauma. Methods: This observational, non-interventional, multicenter study in adult patients was performed in 35 French EDs. All patients entering the EDs for minor trauma on a specified day between noon and 10 pm were registered; consenting patients were included in the study. Pain intensity was assessed using a verbal Numerical Rating Scale from 0 (no pain) to 10 (worst possible pain). An episode was described as painful if the difference in pain intensity between pain just before the procedure and maximal pain during the procedure was ≥2. Two independent nurses recorded data on 1 day in each center. Results: Overall, 909 patients were registered, 422 were included in the study, and complete data for 409 patients (1899 procedures) were available for analysis. The mean number of painful episodes per patient was 1.0 ± 1.3. Fifty-one percent of patients reported at least one painful procedure episode. Twenty-one percent of procedures were considered painful. Clinical examination was the procedure most often reported as painful. No preventive or curative analgesic treatment was reported in 95.1% of procedures. Conclusions: There is a need for improvement in routine pain assessment and, therefore, procedural pain management for ED patients. Specific protocols should be developed for procedural pain management, and teams should be trained especially for procedures usually not considered painful.
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Affiliation(s)
- Jennifer Truchot
- Department of Emergency Medicine, Lariboisière University Hospital, AP-HP, Paris Diderot University , Paris , France
| | - Karima Mezaïb
- Department of Pain Medicine, Institut Gustave Roussy , Villejuif , France
| | | | - Eric Vicaut
- Clinical Research Unit, Fernand Widal University Hospital , Paris , France
| | | | - Louis Soulat
- Department of Emergency Medicine, Rennes University Hospital , Rennes , France
| | | | - Alain Serrie
- Department of Pain and Palliative Medicine, Lariboisière University Hospital , Paris , France
| | - Patrick Plaisance
- Department of Emergency Medicine, Lariboisière University Hospital, AP-HP, Paris Diderot University , Paris , France
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Poursalehan S, Nesioonpour S, Akhondzadeh R, Mokmeli S. The Effect of Low-Level Laser on Postoperative Pain After Elective Cesarean Section. Anesth Pain Med 2018; 8:e84195. [PMID: 30719420 PMCID: PMC6347730 DOI: 10.5812/aapm.84195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/20/2018] [Accepted: 10/30/2018] [Indexed: 11/16/2022] Open
Abstract
Background Postoperative pain is one of the major concerns about a cesarean in pregnant women that can lead to serious complications and delayed recovery for patients. Objectives The objective is to investigate the effect of low power laser on acute pain after elective cesarean. Methods In this randomized, double-blind clinical trial, 80 candidates for an elective cesarean were divided randomly into two groups, control and laser. The type of surgery was the same for both groups, which contained the spinal anesthesia technique. At the end of surgery, the surgical incision in patients who were treated with laser, (GaAlAs: 804 nm and GaAlInp: 650 nm) was irradiated by laser. The control group also received laser off by the same method. Patients were monitored for 24 hours to assess the severity of postoperative pain by VAS, the first request for analgesic and the total consumption of analgesic. Results The results demonstrated significant reduction of pain in the laser group 1, 4, 8, 12, 16, 24 hours after surgery, compared with the control group (P value < 0.05). Additionally, the average of total received analgesic in the group laser was less than the controls (P value = 0.006). The first request for analgesic in the laser received group was significantly longer than the controls (P value = 0.005). Conclusions Low power laser therapy is a good method to reduce postoperative pain due to the fact that it is a safe and non-invasive method which is also accepted by patients.
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Affiliation(s)
- Sara Poursalehan
- Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Corresponding Author: Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Tel: +98-9166716704, E-mail:
| | - Sholeh Nesioonpour
- Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Akhondzadeh
- Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Soheila Mokmeli
- Canadian Optic and Laser Center, COL Center, Victoria, Canada
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Rahimzadeh P, Faiz SHR, Hoseini M, Mousavie SH, Imani F, Negah AR. Comparison of intraperitoneal bupivacaine, acetazolamide, and placebo on pain relief after laparoscopic cholecystectomy surgery: A clinical trial. Med J Islam Repub Iran 2018; 32:112. [PMID: 30815407 PMCID: PMC6387819 DOI: 10.14196/mjiri.32.112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Indexed: 01/04/2023] Open
Abstract
Background: Given the importance of patients' pain after laparoscopic surgeries, this study was conducted to compare the effectiveness of intraperitoneal bupivacaine, acetazolamide, and placebo on pain relief after laparoscopic cholecystectomy surgery. Methods: Patients admitted to Rasool Akram hospital with physical status I or II, based on the American Society of Anesthesiologists (ASA) system, who were candidates for laparoscopic cholecystectomy surgery due to gallstones, were included in this study. Patients were divided into 3 groups (each group containing 20 patients) using block randomization with foursome blocks. Group 1 received bupivacaine, group 2 acetazolamide, and group 3 intravenous saline as placebo. After surgery, pain score was assessed by visual analogue scale, and shoulder pain and analgesic doses were also measured. The mentioned parameters were assessed at 1, 4, 8, 12, and 24 hours after surgery. Results: In this study, 60 patients were included in 3 groups. The mean pain recorded (VAS) at 1, 4, and 8 hours after surgery was not significantly different between acetazolamide and bupivacaine groups, but their score was significantly lower than the placebo group (p<0.05). However, the score recorded at 12 and 24 hours after surgery was not significantly different between the 3 groups (p>0.05). Mean of pain reliever (acetaminophen) injected to the patients when needed was not significantly different among the 3 intervention groups (p<0.05). The highest prevalence of shoulder pain (70%) belonged to the placebo group and the lowest (25%) to acetazolamide (p<0.05). Mean heart rate, systolic blood pressure, diastolic blood pressure, and the respiratory rate were not significantly different among intervention groups in 1, 4, 8, 12, and 24 hours after surgery (p>0.05). Conclusion: According to the results, acetazolamide and bupivacaine injection reduced pain in early hours after laparoscopy. However, pain intensity was not different between intervention groups and the control group after 12 hours, so re-prescription seems to be appropriate at this time. Acetazolamide injection significantly reduces shoulder pains after surgery.
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Affiliation(s)
- Poupak Rahimzadeh
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mostafa Hoseini
- Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Farnad Imani
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Negah
- Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Abstract
Pain has been identified as one of the most significant factors in patients' experience of cancer and its treatment. Pain experienced during cancer treatment procedures such as radiotherapy can be unpleasant and distressing for the patient, as well as for their family and carers. Nurses have an important role in assessing and managing any pain associated with such procedures. This article explores the procedural pain that may be experienced by patients in general, and by those with cancer specifically, and details the pharmacological and non-pharmacological strategies that nurses can use to manage this challenging complication.
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Affiliation(s)
- Eamon McMonagle
- Pain Service, Imperial College Healthcare NHS Trust, London, England
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5
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Lilius TO, Jokinen V, Neuvonen MS, Niemi M, Kalso EA, Rauhala PV. Ketamine coadministration attenuates morphine tolerance and leads to increased brain concentrations of both drugs in the rat. Br J Pharmacol 2016; 172:2799-813. [PMID: 25297798 PMCID: PMC4439876 DOI: 10.1111/bph.12974] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 09/05/2014] [Accepted: 10/03/2014] [Indexed: 12/25/2022] Open
Abstract
Background and Purpose The effects of ketamine in attenuating morphine tolerance have been suggested to result from a pharmacodynamic interaction. We studied whether ketamine might increase brain morphine concentrations in acute coadministration, in morphine tolerance and morphine withdrawal. Experimental Approach Morphine minipumps (6 mg·day–1) induced tolerance during 5 days in Sprague–Dawley rats, after which s.c. ketamine (10 mg·kg–1) was administered. Tail flick, hot plate and rotarod tests were used for behavioural testing. Serum levels and whole tissue brain and liver concentrations of morphine, morphine-3-glucuronide, ketamine and norketamine were measured using HPLC-tandem mass spectrometry. Key Results In morphine-naïve rats, ketamine caused no antinociception whereas in morphine-tolerant rats there was significant antinociception (57% maximum possible effect in the tail flick test 90 min after administration) lasting up to 150 min. In the brain of morphine-tolerant ketamine-treated rats, the morphine, ketamine and norketamine concentrations were 2.1-, 1.4- and 3.4-fold, respectively, compared with the rats treated with morphine or ketamine only. In the liver of morphine-tolerant ketamine-treated rats, ketamine concentration was sixfold compared with morphine-naïve rats. After a 2 day morphine withdrawal period, smaller but parallel concentration changes were observed. In acute coadministration, ketamine increased the brain morphine concentration by 20%, but no increase in ketamine concentrations or increased antinociception was observed. Conclusions and Implications The ability of ketamine to induce antinociception in rats made tolerant to morphine may also be due to increased brain concentrations of morphine, ketamine and norketamine. The relevance of these findings needs to be assessed in humans.
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Affiliation(s)
- T O Lilius
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland
| | - V Jokinen
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland
| | - M S Neuvonen
- Haartman Institute, Department of Clinical Pharmacology, University of Helsinki, Finland
| | - M Niemi
- Haartman Institute, Department of Clinical Pharmacology, University of Helsinki, Finland.,HUSLAB, Helsinki University Central Hospital, Finland
| | - E A Kalso
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.,Department of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Pain Clinic, Helsinki University Central Hospital, Finland
| | - P V Rauhala
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland
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Martinez V, Derivaux B, Beloeil H. Ketamine for pain management in France, an observational survey. Anaesth Crit Care Pain Med 2015; 34:357-61. [PMID: 26541218 DOI: 10.1016/j.accpm.2015.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/07/2015] [Accepted: 04/27/2015] [Indexed: 10/22/2022]
Abstract
CONTEXT Before updating the French guidelines on postoperative pain treatment in 2015, the Pain Committee of the French Society of Anaesthesiology and Intensive Care (SFAR) conducted a survey on the medical use of ketamine in France. METHODS An online questionnaire was nationally distributed to members of SFAR, the French Pain Society (SFETD) and the French Society of Emergency Medicine (SFMU). The questionnaire included questions on demographic data, the type of patients for whom ketamine was prescribed, the doses used, the side effects and safety measures associated with the administration of ketamine. RESULTS A total of 1388 questionnaires were analysed. Ninety-two percent of the responders declared that they used ketamine. Ketamine was widely used as anti-hyperalgesic medication but the modalities of administration and the doses varied greatly and were not in accordance with the guidelines. Despite the lack of evidence and guidelines, ketamine has also been used to treat acute and chronic pain. Doses, duration and localization of the patients during administration have varied greatly. Psychedelic effects and hallucinations are the most feared side effects. In terms of monitoring during ketamine infusion, 15% of physicians declared that no monitoring was necessary while 59%, 55%, 59% and 77% monitored heart rate, SpO2, blood pressure and level of consciousness, respectively. CONCLUSION Anaesthesiologists have integrated the benefit of ketamine in preventing hyperalgesia but there is no consensus on doses and duration. For other indications (acute and chronic pain treatment), toxicity and the absence of significant benefit call for guidelines from scientific societies.
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Affiliation(s)
- Valeria Martinez
- Service d'anesthésie-réanimation chirurgicale, hôpital Raymond-Poincaré, AP-HP, université Versailles - Saint-Quentin, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - Benoit Derivaux
- Inserm UMR 991, service d'anesthésie-réanimation, CHU de Rennes, université Rennes 1, 35033 Rennes, France
| | - Helene Beloeil
- Inserm UMR 991, service d'anesthésie-réanimation, CHU de Rennes, université Rennes 1, 35033 Rennes, France.
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Affiliation(s)
- Rachel Quibell
- Newcastle upon Tyne Hospitals Foundation Trust, Newcastle, United Kingdom
| | - Marie Fallon
- University of Edinburgh, Edinburgh, United Kingdom
| | - Mary Mihalyo
- Mylan School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania, USA
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Mohtadi A, Nesioonpour S, Salari A, Akhondzadeh R, Masood Rad B, Aslani SMM. The effect of single-dose administration of dexamethasone on postoperative pain in patients undergoing laparoscopic cholecystectomy. Anesth Pain Med 2014; 4:e17872. [PMID: 25237639 PMCID: PMC4165022 DOI: 10.5812/aapm.17872] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/26/2014] [Accepted: 06/11/2014] [Indexed: 12/24/2022] Open
Abstract
Background: Postoperative pain is considered as a reason of patient’s delay in discharge and disability aggravation. Therefore, multimodal approaches have been suggested in order to mitigate pain and decrease postoperative side effects. Objectives: The aim of this study was to evaluate analgesic effect of a single dose injection of dexamethasone on reducing postoperative pain in laparoscopic cholecystectomy. Patients and Methods: In this double-blind, prospective study, 122 patients aged 18-60 years old, whom were selected for laparoscopic cholecystectomy, were classified into two case and control groups, and 61 patients were included in each group. The case (D) group underwent general anesthesia and a single- dose intravenous injection of dexamethasone. The Control (C) group received general anesthesia and intravenous injection of normal saline. Total dose of consumed meperidine and pain intensity during first 24 hours were evaluated in both groups. Results: No significant difference existed between two groups regarding age, sex, weight and operation time. Pain intensity in group D was significantly less than group C (P < 0.01) after two, six and 12 hoursof surgery. No significant difference existed in pain intensity between two groups at the beginning of and 24 hours after the surgery (P > 0.05). Meperidine consumption in group D was significantly less than group C (P < 0.05). Conclusions: Findings of present study showed that single dose of intravenous dexamethasone, led to less pain intensity and amounts of meperidine consumption, in comparison with placebo.
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Affiliation(s)
- Ahmadreza Mohtadi
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sholeh Nesioonpour
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Corresponding author: Sholeh Nesioonpour, Azadegan Ave., Imam Khomeini Hospital, Ahvaz, Iran Tel: +98-6112220168, Fax: +98-6112220168, E-mail:
| | - Amir Salari
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Akhondzadeh
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Babak Masood Rad
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Mehdi Aslani
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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9
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Behaeen K, Soltanzadeh M, Nesioonpour S, Ebadi A, Olapour A, Aslani SMM. Analgesic effect of low dose subcutaneous ketamine administration before and after cesarean section. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e15506. [PMID: 24829783 PMCID: PMC4005445 DOI: 10.5812/ircmj.15506] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 12/18/2013] [Accepted: 01/28/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pain is considered as an importantissue after cesarean section. Multimodal approach to post cesarean pain management may not only enhance analgesia but also reduce side effects after the surgery. OBJECTIVES This study was aimed to evaluate the clinical efficacy of subcutaneous injection of low dose ketamine at the incision site to reduce cesarean section pain. PATIENTS AND METHODS Sixty patients, aged between 18 and 25 years old, scheduled for elective cesarean section, were enrolled to this double-blind randomized controlled trial study. Patients were divided into three groups of 20 patients each group one (k-pre) received 0.5 mg/kg ketamine before skin incision and normal saline after skin closure, group two (k-post) received normal saline before skin incision and 0.5 mg/kg ketamine after skin closure and group three (C) received normal saline before skin incision and after skin closure; subcutaneously at the incision site. The first analgesic request, the amount of analgesic and the pain intensity were evaluated for 24 hours. RESULTS The first time analgesic requested was longer and the amount of analgesic used during the first 24 hours was significantly lower in groups K-pre and K-post compared with group C (P < 0.05). Pain intensity was significantly lower at 2, 4, 6 and 12 hours in groups K-pre and K-post compared with group C (P < 0.05). Nevertheless, pain intensity was not significantly different at 18 and 24 hours in group C (P > 0.05). The first requested time, total used amount of analgesicand pain intensity were not meaningfully different in K-pre and K-post groups (P > 0.05). CONCLUSIONS Patients who were given ketamine before or after cesarean section subcutaneously at incision site had lower pain intensity and less analgesic consumption than patients who were given placebo.
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Affiliation(s)
- Kaveh Behaeen
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Mansour Soltanzadeh
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Sholeh Nesioonpour
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ahmad Ebadi
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Alireza Olapour
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Seyed Mohammad Mehdi Aslani
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding Author: Seyed Mohammad Mehdi Aslani, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6112220168, Fax: +98-6112220168, E-mail:
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Gardner SE, Blodgett NP, Hillis SL, Borhart E, Malloy L, Abbott L, Pezzella P, Jensen M, Sommer T, Sluka KA, Rakel BA. HI-TENS reduces moderate-to-severe pain associated with most wound care procedures: a pilot study. Biol Res Nurs 2013; 16:310-9. [PMID: 23956353 DOI: 10.1177/1099800413498639] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study systematically examined pain associated with wound care procedures (WCPs) and evaluated the effectiveness of high-intensity transcutaneous electrical nerve stimulation (HI-TENS) for reducing this pain in a two-phase design. Phase 1 (N = 57) examined patient, wound, and procedural factors, as well as analgesic intake, associated with WCPs. Pain during the WCPs was rated on a 0-10 numerical scale. Subjects reported a mean pain of 6.0 (standard deviation 3.04) during Phase 1, with 43 (75.4%) subjects experiencing moderate or severe pain (i.e., ≥4). Subjects who received opioid and/or nonopioid analgesia 1 hr before or during the WCPs (36.8%) reported significantly higher pain levels than those who had not received analgesia (p = .013). In Phase 2, 23 subjects with ≥4 pain during Phase 1 had HI-TENS applied to the area surrounding the wound during the WCPs. HI-TENS significantly reduced WCP pain by a mean of 2.0 (±2.31; effect size = 0.67; p = .001). This effect was significant for subjects with severe Phase 1 pain (i.e., ≥8; effect size = 1.00; p = .007) but not for subjects with moderate Phase 1 pain (i.e., 4-7; effect size = 0.40; p = .053). These findings demonstrate that pain during WCPs is a significant problem, that nurses appropriately administer analgesics but these are not sufficient, and that using HI-TENS may further reduce pain, particularly in patients experiencing severe WCP pain.
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Affiliation(s)
- Sue E Gardner
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | | | - Stephen L Hillis
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Ellen Borhart
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Lynna Malloy
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Linda Abbott
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Pat Pezzella
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Marge Jensen
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Teresa Sommer
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Barbara A Rakel
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
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11
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Emerging applications of low-dose ketamine for pain management in the ED. Am J Emerg Med 2013; 31:416-9. [DOI: 10.1016/j.ajem.2012.08.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 08/19/2012] [Accepted: 08/22/2012] [Indexed: 11/19/2022] Open
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12
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McPherson ML, Kim M, Walker KA. 50 Practical Medication Tips at End of Life. ACTA ACUST UNITED AC 2012; 10:222-9. [DOI: 10.1016/j.suponc.2012.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/01/2012] [Accepted: 08/02/2012] [Indexed: 10/27/2022]
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13
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Current World Literature. Curr Opin Support Palliat Care 2012; 6:289-98. [DOI: 10.1097/spc.0b013e328353e091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Non-opioid IV adjuvants in the perioperative period: Pharmacological and clinical aspects of ketamine and gabapentinoids. Pharmacol Res 2012; 65:411-29. [DOI: 10.1016/j.phrs.2012.01.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/04/2012] [Accepted: 01/04/2012] [Indexed: 11/18/2022]
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15
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Honarmand A, Safavi M, Karaky H. Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy. J Pain Res 2011; 5:1-6. [PMID: 22328829 PMCID: PMC3273401 DOI: 10.2147/jpr.s26476] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Ketamine, an N-methyl-D-aspartate receptor antagonist, can suppress hyperalgesia and allodynia. The purpose of the present study was to evaluate the clinical efficacy of preincisional intravenous or subcutaneous infiltration of ketamine for postoperative pain relief after appendectomy. METHODS Ninety patients, aged 18-60 years, scheduled for appendectomy was enrolled in this study. Patients were divided into three groups of 30 each and received subcutaneous infiltration of ketamine 0.5 mg/kg (KS), intravenous ketamine 0.5 mg/kg (KI), or subcutaneous infiltration of normal saline 3 mL (C) before surgery. Visual analog scale (VAS) values and analgesic consumption were evaluated for 24 hours after surgery. RESULTS VAS scores were significantly lower at the time of arrival in the recovery room, and at 10, 20, and 30 minutes thereafter in group KI and group KS compared with group C (P < 0.05). VAS scores were not significantly different between group KI and group KS at these intervals. Postoperative VAS scores were significantly lower at 6, 12, 18, and 24 hours in group KI compared with group C (P < 0.05). In group KS, the postoperative VAS score was significantly lower at 6 hours (P < 0.05). VAS scores were significantly lower at 12, 18, and 24 hours after surgery in group KI compared with group KS (P < 0.05). CONCLUSION A 0.5 mg/kg dose of ketamine given at approximately 15 minutes before surgery by the intravenous route provided analgesia for 24 hours after surgery in patients undergoing appendectomy.
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Affiliation(s)
- Azim Honarmand
- Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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