Pain Management for General Surgery

2018 ◽  
Author(s):  
Katherine Stammen ◽  
Harish Siddaiah ◽  
Cody Brechtel ◽  
Elyse M. Cornett ◽  
Charles J. Fox ◽  
...  
Keyword(s):  
Pain Management ◽  
Best Practice ◽  
Synergistic Effects ◽  
Treatment Modalities ◽  
Negative Consequences ◽  
Pain Pathways ◽  
Peripheral Nerve Blockade ◽  
Short And Long Term ◽  
Long Acting

Pain is multidimensional and subjective, which makes it difficult to treat. Newer treatment modalities have been under development with a better understanding of pain pathways in recent years. These treatments take advantage of the multifactorial components of pain, including agents such as ketamine, capsaicin, gabapentin, pregabalin, long-acting opioids, peripheral nerve blockade, and patient-controlled analgesia. Numerous studies have revealed not only efficacy but additive and/or synergistic effects when multiple agents are utilized for pain management. Overall, adequate perioperative pain control is important both in an acute setting and in preventing the development of a chronic pain condition, which causes significant short- and long-term negative consequences. Best practice strategies are being utilized based on clinical studies to reduce pain and improve patient needs after surgery.

Pain Management for General Pediatric Surgery

2018 ◽  
Author(s):  
Jodi-Ann Oliver ◽  
Lori-Ann Oliver ◽  
Michael Casimir ◽  
Caroline Walker
Keyword(s):  
Pain Management ◽  
Pediatric Population ◽  
Perioperative Period ◽  
Postoperative Pain Management ◽  
Nerve Blocks ◽  
Perioperative Pain ◽  
Pain Pathways ◽  
Inflammatory Drugs ◽  
Long Acting

As the misconception that children and infants do not experience pain in the same way as adults has been vastly discredited, the management of perioperative pain in the pediatric population has become a rapidly developing field. Inadequate treatment of perioperative pain in this population can lead to serious long-term or permanent sequela for not only the patients but also their families. Postoperative pain management in children is best accomplished using a multimodal approach in which different classes of drugs such as opioids (short or long acting), non-opioid adjuncts (nonsteroidal anti-inflammatory drugs, acetaminophen), and antineuroleptics (gabapentin) are used alone or in combination with regional anesthesia techniques (peripheral nerve blocks, caudals, epidurals, or spinals). When placed prior to surgical incision, the use of peripheral and central blocks is beneficial not only in decreasing the total opioid consumption in the perioperative period but also in preventing activation of pain pathways that are ultimately responsible for the development of chronic pain.

The Neurobiology of Pain

2019 ◽  
pp. 387-414
Author(s):  
Maria Fitzgerald ◽  
Michael W. Salter
Keyword(s):  
Early Life ◽  
Pain Perception ◽  
Long Term Effects ◽  
Male And Female ◽  
Functional Changes ◽  
Pain Pathways ◽  
Developmental Age ◽  
Short And Long Term ◽  
Age And Sex

The influence of development and sex on pain perception has long been recognized but only recently has it become clear that this is due to specific differences in underlying pain neurobiology. This chapter summarizes the evidence for mechanistic differences in male and female pain biology and for functional changes in pain pathways through infancy, adolescence, and adulthood. It describes how both developmental age and sex determine peripheral nociception, spinal and brainstem processing, brain networks, and neuroimmune pathways in pain. Finally, the chapter discusses emerging evidence for interactions between sex and development and the importance of sex in the short- and long-term effects of early life pain.

scholarly journals Combined secondary compounds naturally found in nectars enhance honeybee cognition and survival

2021 ◽  
Vol 224 (6) ◽  
Author(s):  
Ignacio L. Marchi ◽  
Florencia Palottini ◽  
Walter M. Farina
Keyword(s):  
Cognitive Ability ◽  
Sucrose Solution ◽  
Synergistic Effects ◽  
Secondary Compounds ◽  
Learning Performance ◽  
Memory Retention ◽  
Olfactory Conditioning ◽  
Significant Survival ◽  
Short And Long Term

ABSTRACT The alkaloid caffeine and the amino acid arginine are present as secondary compounds in nectars of some flower species visited by pollinators. Each of these compounds affects honeybee appetitive behaviours by improving foraging activity and learning. While caffeine potentiates responses of mushroom body neurons involved in honeybee learning processes, arginine acts as precursor of nitric oxide, enhancing the protein synthesis involved in memory formation. Despite existing evidence on how these compounds affect honeybee cognitive ability individually, their combined effect on this is still unknown. We evaluated acquisition and memory retention in a classical olfactory conditioning procedure, in which the reward (sucrose solution) contained traces of caffeine, arginine or a mixture of the two. The results indicate that the presence of the single compounds and their most concentrated mixture increases bees' learning performance. However, memory retention, measured in the short and long term, increases significantly only in those treatments offering combinations of the two compounds in the reward. Additionally, the most concentrated mixture triggers a significant survival rate in the conditioned bees. Thus, some nectar compounds, when combined, show synergistic effects on cognitive ability and survival in an insect.

Anoxic Brain Injury

2018 ◽  
pp. 58-67
Author(s):  
Jonathan Elmer ◽  
Jon C. Rittenberger
Keyword(s):  
Cardiac Arrest ◽  
Best Practice ◽  
Coronary Revascularization ◽  
Temperature Management ◽  
Long Term Outcomes ◽  
Initial Management ◽  
Short And Long Term ◽  
Patterns Of Injury ◽  
Active Temperature

Cardiac arrest is common and deadly. Fortunately, with advances in care, short- and long-term outcomes of those resuscitated after cardiac arrest are steadily improving. Initial management focuses on general critical care support of multisystem organ dysfunction and diagnostic workup to identify the etiology of cardiac arrest. Thereafter, provision of a comprehensive bundle of care including active temperature management, coronary revascularization, delayed multimodal neurological prognostication, and best practice neurocritical care can result in a substantial proportion of patients experiencing favorable recovery despite patterns of injury once thought to be incompatible with survival.

Opioid Analgesics for Sedation and Analgesia During Mechanical Ventilation

2015 ◽  
Vol 34 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Brandy Zeller ◽  
Jeanne Giebe
Keyword(s):  
Pain Management ◽  
Adverse Reactions ◽  
Management Strategies ◽  
Opioid Analgesics ◽  
Chronic Complications ◽  
Mechanically Ventilated ◽  
Routine Administration ◽  
Sedation And Analgesia ◽  
Short And Long Term

AbstractNeonates are exposed to repetitive pain and stress during their stay in a NICU, which can lead to chronic complications related to their neurodevelopment and neurobehavior. Approximately 20 percent of all neonates in a NICU are intubated, mechanically ventilated, and require suctioning, which can cause both acute and chronic pain. Pain management in the neonate can be challenging. Nurses and other caregivers need to be well trained to assess pain in the neonate to effectively identify and provide appropriate pain management strategies. There is a lack of evidence to support routine administration of opiates in the neonate. As with any medication, the possibility of short- and long-term adverse reactions must be considered. Nonpharmacologic therapy should be used as much as possible.

The Role of Long Acting Antipsychotics in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S15-S15
Author(s):  
E. Vieta
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Term Treatment ◽  
Patient Profile ◽  
Long Term Treatment ◽  
Short And Long Term ◽  
Competing Interest ◽  
Long Acting

Antipsychotics are widely used for the short and long-term treatment of bipolar disorder. Depot and long-acting injectable formulations (LAIs) can be particularly useful for certain subgroups of patients. This lecture will discuss the available data from randomized controlled trials of LAIs in bipolar disorder. A recently published meta-analysis and individual studies assessing depot medications, as well as modern LAIs such as risperidone, paliperidone and aripiprazole, will be reviewed, looking carefully into the prevention of either pole of illness and tolerability. Potential indications and patient profile, based on data and clinical experience, will be discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals PENGUNGKAPAN ANTI KORUPSI DAN KINERJA KEUANGAN PERUSAHAAN: STUDI KASUS PERUSAHAAN TERDAFTAR DI INDEKS SRI KEHATI

2017 ◽  
Vol 15 (2) ◽  
pp. 28
Author(s):  
Nina Karina Karim ◽  
A Animah ◽  
Elin Erlina Sasanti
Keyword(s):  
Financial Performance ◽  
Negative Consequences ◽  
Whistle Blowing ◽  
The Public ◽  
Short And Long Term ◽  
Market Distortion ◽  
Corporate Social ◽  
Corporate Customers ◽  
Disclosure Practice

Corruption within the corporation has become an important issue in the academic and public debate. The negative consequences caused by companies that engage in corruption are enormous, such as market distortion and incentives, resource allocation inefficiencies, as well as the increased of poverty and social inequality. Companies have the opportunity through a corporate responsibility (CSR) to prevent the problem of corruption. As important as labor, human and environmental rights, corruption mitigation is an important aspect in promoting CSR. CSR can be profitable in sales revenue and market share by improving the perception of ethical corporate customers. However, with the involvement of corruption, it can reduce the confidence of investors and the public against the company which may result in reduced financial performance. The purpose of this study is to determine empirically the correlation of anti-corruption disclosure reported by the companies listed in the Sri Kehati Index and FTSEGoods Bursa Malaysia Index on their financial performance, both the short and long term. The results showed that only the whistle blowing policies were fully disclosed by all companies in the sample of this study. The results also show that the disclosure of anti-corruption has significant influence on the company's profitability only in the long term for companies registered in Sri Kehati Indonesia index. As for the sample of companies registered in Malaysia FTSEGoods Index, the results showed that the disclosure of anti-corruption affect the company's financial performance both in the short term and in the long term. This implies that investors were responding to the anti corruption issues disclosed by the companies and companies should keep the disclosure practice in the future. Keywords: anti-corruption, corporate social responsibility, disclosure, financial performance.

scholarly journals Risk Factors For Gestational Diabetes – An Update

2015 ◽  
Vol 22 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Carmen Dobjanschi ◽  
Rucsandra Dănciulescu Miulescu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Treatment Modalities ◽  
Substantial Impact ◽  
Short And Long Term

AbstractWomen with gestational diabetes mellitus (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). GDM has a substantial impact on maternal and foetal short and long-term health. Risk factors for GDM may be genetic or nongenetic and have been analysed in numerous studies. Researches in recent years allowed the identification of other risk factors for GDM except for those already known. Knowledge and identification of all risk factors for GDM allows the elaboration of a prevention strategy of T2DM, it may influence the screening, diagnosis, and, subsequently, treatment modalities for this disease.

scholarly journals Singing, sharing, soothing – biopsychosocial rationales for parental infant-directed singing in neonatal pain management

2018 ◽  
Vol 1 ◽  
pp. 205920431878084 ◽  
Author(s):  
Alexandra Ullsten ◽  
Mats Eriksson ◽  
Maria Klässbo ◽  
Ulrik Volgsten
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Neonatal Intensive Care ◽  
Parental Participation ◽  
Music Therapist ◽  
Neonatal Pain ◽  
Short And Long Term ◽  
Early Parent ◽  
Pain Care

Infant-directed singing is a medium for parents and infants to communicate in a mutual relationship. Parental infant-directed singing is a multisensory, biopsychosocial communication that applies to ill and vulnerable hospitalised infants. The primary musical features of infant-directed singing are ideal for emotional coordination and sharing between parent and infant without the risk of over-stimulation. In this article, we suggest that parental infant-directed singing is regarded as a nonpharmacological emotion regulation intervention, which may modify the painful experience for both the infant and the parent before, during and after painful procedures in the neonatal intensive care context. Parents have the biopsychosocial resources to alleviate their infant’s pain through infant-directed singing, if they are empowered to do so and coached in this process. A music therapist specialised in neonatal music therapy methods can mentor parents in how to use entrained and attuned live lullaby singing in connection to painful procedures. Pain and the vast amount of painful procedures early in infancy, combined with early parent–infant separation and lack of parental participation in the care of the infant during neonatal intensive care, place arduous strain on the new family’s attachment process and on the infant’s and parents’ mental health, both from a short and long-term perspective. Therefore, we argue with biopsychosocial rationales, that live parental infant-directed singing should be promoted in neonatal pain care worldwide. Consequently, parents should be welcomed round the clock and invited as prescribed pain management for their infant.

scholarly journals Why are long-acting injectable antipsychotics still underused?

2015 ◽  
Vol 21 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Peter Bosanac ◽  
David Jonathan Castle
Keyword(s):  
Best Practice ◽  
Treatment Guidelines ◽  
Term Treatment ◽  
Key Factors ◽  
Long Term Treatment ◽  
Service Barriers ◽  
Long Acting ◽  
Evidence Based Care

Summary‘Depot antipsychotics' (‘long-acting injectable antipsychotic medications' or LAIs) are underused in the treatment of schizophrenia (including first episodes) and, possibly, of schizophrenia with comorbid substance use disorders. Patients' and clinicians' beliefs and attitudes, and service barriers, affect best practice and evidence-based care in LAI prescription. Poor medication adherence is a key reason for LAI prescription, but patients receiving LAIs may still relapse or experience significant side-effects. Patients' and clinicians' attitudes towards antipsychotic medication, as well as the quality of their recovery-focused relationship, are key factors in adherence. Clinicians should avoid a dichotomous ‘oralv. LAI’ choice: LAIs may have a place at various stages in the continuum of care and they should be one of the options discussed with any patient requiring long-term treatment, even early in the illness course. Many clinicians need better education about LAIs and greater familiarity with schizophrenia treatment guidelines.

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