scholarly journals Usability and effectiveness of inhaled methoxyflurane for prehospital analgesia - a prospective, observational study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Helmut Trimmel ◽  
Alexander Egger ◽  
Reinhard Doppler ◽  
Mathias Pimiskern ◽  
Wolfgang G. Voelckel
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Observational Study ◽  
User Satisfaction ◽  
Severe Pain ◽  
Trauma Patients ◽  
Minor Trauma ◽  
User Friendliness ◽  
Technical Problems ◽  
Vital Parameters

Abstract Background Pain relief in the prehospital setting is often insufficient, as the administration of potent intravenous analgesic drugs is mostly reserved to physicians. In Australia, inhaled methoxyflurane has been in routine use by paramedics for decades, but experience in Central European countries is lacking. Thus, we aimed to assess whether user friendliness and effectiveness of inhaled methoxyflurane as sole analgesic match the specific capabilities of local ground and air-based EMS systems in Austria. Methods Observational study in adult trauma patients (e.g. dislocations, fracture or low back pain following minor trauma) with moderate to severe pain (numeric rating scale [NRS] ≥4). Included patients received a Penthrop® inhaler containing 3 mL of methoxyflurane (maximum use 30 min). When pain relief was considered insufficient (NRS reduction < 3 after 10 min), intravenous analgesics were administered by an emergency physician. The primary endpoint was effectiveness of methoxyflurane as sole analgesic for transport of patients. Secondary endpoints were user friendliness (EMS personell), time to pain relief, vital parameters, side effects, and satisfaction of patients. Results Median numeric pain rating was 8.0 (7.0–8.0) in 109 patients. Sufficient analgesia (reduction of NRS ≥3) was achieved by inhaled methoxyflurane alone in 67 patients (61%). The analgesic effect was progressively better with increasing age. Side effects were frequent (n = 58, 53%) but mild. User satisfaction was scored as very good when pain relief was sufficient, but fair in patients without benefit. Technical problems were observed in 16 cases (14.7%), mainly related to filling of the inhaler. In every fifth use, the fruity smell of methoxyflurane was experienced as unpleasant. No negative effects on vital signs were observed. Conclusion In prehospital use, inhaled methoxyflurane as sole analgesic is effective for transport of trauma patients (62%) with moderate to severe pain. Older patients benefit especially from inhaled methoxyflurane. Side effects are mild and vital parameters unaffected. Thus, inhaled methoxyflurane could be a valuable device for non-physician EMS personnel rescue services also in the central Europe region.

Changes in management of patients with diseases of musculoskeletal system and joints

2021 ◽  
pp. 36-40
Author(s):  
A. L. Vertkin ◽  
A. N. Barinov ◽  
G. Yu. Knorring
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Cooperative Action ◽  
Pain Syndromes ◽  
Adequate Pain Relief ◽  
Inflammatory Drugs ◽  
Group B ◽  
Group B Vitamins

Pain syndrome accompanies the vast majority of diseases; therefore, the issues of adequate pain relief remain topical not only for urgent conditions, but also for everyday medical practice. Modern and changed in recent years approaches to the appointment of anesthetic therapy should take into account not only the pathogenetic mechanisms of the development of pain syndrome in a particular patient, but also the need to use drug combinations. This allows for the potentiation of the analgesic effect, reduction of effective dosages of individual drugs and minimization of side effects. In case of severe pain syndrome in the presence of signs of impaired nociception, neuropathic and muscle-fascial pain syndromes, the use of non-steroidal anti-inflammatory drugs in conjunction with group B vitamins is justified. The article considers the pathogenetic details of such a combination therapy, reveals the mechanisms of the cooperative action of the proposed combination of drugs.

A Clinical Comparison of Orally Administered Aspirin, Dextropropoxyphene and Pentazocine in the Treatment of Post-Operative Pain

1974 ◽  
Vol 2 (2) ◽  
pp. 149-152 ◽  
Author(s):  
B Kay
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Severe Pain ◽  
The Other ◽  
Onset Of Action ◽  
Double Blind ◽  
Duration Of Action ◽  
Analgesic Drugs ◽  
Patient Study ◽  
Post Operative Pain

A double-blind between-patient study involving 225 adult patients was carried out to compare the efficacy of oral aspirin ( 650 mg), dextropropoxyphene (65 mg) and pentazocine ( 50 mg) in post-operative pain. All the patients were initially in moderate or severe pain and all three drugs produced some degree of pain relief. The onset of action of pentazocine was significantly more rapid than that of aspirin or dextropropoxyphene. The analgesia provided by dextropropoxyphene was significantly inferior to that achieved with aspirin or pentazocine and the duration of action, assessed by patient demand for further analgesic drugs, was also significantly shorter than that of the other two drugs. The incidence and severity of side-effects was greatest in the dextropropoxyphene group and it is concluded from these results that pentazocine should be the oral analgesic of choice in the treatment of post-operative pain.

Evaluation of Intravenous Tramadol for Use in the Prehospital Situation by Ambulance Paramedics

1997 ◽  
Vol 12 (2) ◽  
pp. 87-91 ◽  
Author(s):  
Michael E. Ward ◽  
John Radburn ◽  
Steve Morant
Keyword(s):  
Logistic Regression ◽  
Side Effects ◽  
Pain Relief ◽  
Open Study ◽  
Severe Pain ◽  
Statistical Tests ◽  
Opioid Analgesic ◽  
Regression Analyses ◽  
Pain Scores ◽  
Control Study

AbstractIntroduction:An evaluation of the opioid analgesic tramadol (Zydol, Searle United Kingdom) was carried-out by ambulance paramedics to assess its efficacy in providing pain relief in the prehospital situation.Methods:Type of subjects—Patients suffering severe pain from any cause uncontrolled by other simple methods.Number of subjects—101 patients received tramadol and 41 patients served as a control. Study design—Random, open study.Statistical tests—Pain score at scene and on arrival at hospital were compared using Fisher's exact tests (2 sides). Logistic regression analyses also were applied to other factors.Results:Pain scores improved for 93.1% of the tramadol treated patients and for 44.0% of the controls. A total of 30.7% of patients treated with tramadol complained of nausea after treatment compared with 17.1% before treatment and with 12.2% of the control patients.Conclusion:Pain was significantly decreased by the administration of tramadol. It was safe with only minimal side effects, the major one being nausea. Suggestions are made for areas of further study.

Pentazocine Suppositories versus Pethidine Injections in 500 Patients with Post-Operative Pain

1979 ◽  
Vol 7 (6) ◽  
pp. 592-600 ◽  
Author(s):  
E N Copsidas ◽  
J N Ward-McQuaid
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Visual Analogue Scale ◽  
Severe Pain ◽  
Analogue Scale ◽  
Moderate Pain ◽  
Gynaecological Surgery ◽  
Good Relationship ◽  
Post Operative Pain ◽  
Good Pain Relief

Pentazocine (Fortral) suppositories (50 mg) were compared with pethidine (100 mg) by injection in 500 patients after general and gynaecological surgery. Pain was assessed by patients using a pain thermometer, (a modification of a visual analogue scale), and by observers using an adjectival scale. There was a good relationship between these methods. Good pain relief was obtained with both drugs and there was little difference between the treatments in moderate pain. Pethidine was faster and more effective, particularly in severe pain. There were fewer side-effects with pentazocine suppositories. They are a useful alternative to injections, especially in moderate pain.

scholarly journals Comparison of Efficacy and Safety of Patient Taking Pregabalin and Desvenlafaxine in Neuropathic Pain

2020 ◽  
Vol 5 (8) ◽  
pp. 231-235
Author(s):  
Neenu Rachel Santhosh ◽  
Ajay K Raj ◽  
Rahmathullah SN ◽  
Dr.Abdu Rahman ◽  
Sereena A
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Pain Relief ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Prolonged Pain

To compare safety and efficacy of pregabalin and desvenlafaxine respectively for treating Neuropathic Pain. 04 patients were entered into a prospective observational study of pregabalin and desvenlafaxine in neuropathic pain for 6 months. Patients were randomly arranged into 2 groups, 52 patients received pregabalin and other group of 52 patients received desvenlafaxine. The initialassessement were made during the first visit and two subsequent reviews were done in 2 months interval, up to 6 months. Visual analogue pain scores, incidence of side effects were measured. The pain scores(mean±S.D.) were 5.37±1.14 and 6.7±1.39 respectively for desvenlafaxine and pregabalin.The low pain score of desvenlafaxine was associated with prolonged pain relief. There were pronounced differences in incidence of side effect between the two drugs: pregabalin, 36.5% compared to desvenlafaxine, 7%. The study findings revealed that desvenlafaxine is more safe and efficacious than pregabalin. Thus this study recommends the use of desvenlafaxine for neuropathic pain over pregabalin

Butorphanol: A Double-Blind Comparison with Pentazocine in Post-Operative Patients with Moderate to Severe Pain

1976 ◽  
Vol 4 (4) ◽  
pp. 255-264 ◽  
Author(s):  
M S Gilbert ◽  
R S Forman ◽  
D S Moylan ◽  
F S Caruso
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Randomized Trial ◽  
Side Effect ◽  
Severe Pain ◽  
Weight Basis ◽  
Common Side Effect ◽  
Double Blind ◽  
Maximum Pain ◽  
Blind Comparison

A double-blind, randomized trial was conducted with 124 post-operative patients to compare the analgesic activity and possible side-effects of a new synthetic analgesic—butorphanol tartrate (1, 2, and 4 mg)—and pentazocine lactate (30 and 60 mg), administered intramuscularly. Butorphanol was determined to be 16 times more potent than pentazocine, on a weight basis. Both medications provided maximum pain relief within one hour after administration, and had comparable durations of action. Drowsiness was the most common side-effect, and it appeared to be dose-related in all test groups.

Pain assessment and management in critically ill postoperative and trauma patients: a multisite study

1999 ◽  
Vol 8 (2) ◽  
pp. 105-117 ◽  
Author(s):  
KC Carroll ◽  
PJ Atkins ◽  
GR Herold ◽  
CA Mlcek ◽  
M Shively ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Management ◽  
Pain Relief ◽  
Pain Intensity ◽  
Critically Ill ◽  
Severe Pain ◽  
Management Practices ◽  
Management Plan ◽  
Trauma Patients

BACKGROUND: Pain in critically ill patients is undertreated. OBJECTIVES: To examine patients' perceptions of pain and acute pain management practices in a large metropolitan area to provide direction for improvements in pain relief. METHODS: In a descriptive, correlational study, data were collected from 213 patients in 13 hospitals. Interviews with patients, chart reviews, and interviews with nurse leaders were used to examine institutional and individual approaches to pain management. RESULTS: Twenty-eight percent of patients did not recall an explanation of a pain management plan, and 64% were often in moderate to severe pain while in the intensive care unit. High pain intensity correlated with wait for an analgesic (P &lt; .001), expectations of less pain (P &lt; .001), and longer stay in the intensive care unit (P &lt; .001). Low satisfaction correlated with expectations of less pain (P &lt; .001), often being in moderate to severe pain (P &lt; .001), and long wait for an analgesic (P &lt; .001). In the first 24 hours postoperatively, only 54% of patients had a numerical pain rating documented; 91% had a pain description. The amount of opioid given on postoperative day 1 was influenced by pain intensity (P &lt; .001), the patient's age (P = .03), type of surgery (P = .002), and route of analgesic (P &lt; .001). Only 33% of patients had nonpharmacological pain interventions documented. CONCLUSIONS: Despite moderate to severe pain, patients are generally satisfied with their pain relief. Measuring patients' satisfaction alone is not a reliable outcome for determining the effectiveness of pain management. Realistic expectations of patients about their pain may enhance coping, increase satisfaction, and decrease pain intensity after surgery.

scholarly journals Dexmedetomidine as a part of multimodal analgesia in postoperative period in trauma patients

2018 ◽  
Vol 9 (3) ◽  
pp. 50-53
Author(s):  
N. V. Kutsevolova ◽  
Yu. E. Makhno ◽  
A. E. Kuklenko ◽  
E. V. Vasiliauskiene ◽  
I. V. Andronova ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Period ◽  
Severe Pain ◽  
Pain Treatment ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Trauma Patients ◽  
Endoprosthetic Replacement ◽  
Postoperative Pain Treatment

Despite the large arsenal of analgetics acting through different pharmacological mechanisms and the development of various anesthesia methods, the problem of postoperative pain treatment still remains urgent. Providing a complete pain relief after a surgery remains a desired, but not always a reachable goal. According to the literature, 30 to 75% of patients undergoing surgery suffer from the severe pain syndrome in the postoperative period. This article presents the experience with the use of a prolonged intravenous infusion of Dexmedetomidine as a part of multimodal analgesia in patients who underwent endoprosthetic replacement of large joints.

RESEARCH EPIDURAL ANALGESIA TO PAIN RELIEF ON LABOR PROGRESS

2012 ◽  
pp. 31-41
Author(s):  
Quang Thuy Phung ◽  
Ngoc Thanh Cao ◽  
Quang Vinh Truong
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Pain Relief ◽  
Epidural Anesthesia ◽  
Good Condition ◽  
Cervical Dilation ◽  
Normal Birth ◽  
Normal Limits ◽  
Constant Pain ◽  
Background Pain

Background: Pain during labor as pain in the fracture is not treated, chronic pain, so pain is very essential issues to be studied. Epidural anesthesia (NMC) has many advantages over spinal anesthesia in constant pain. Study objectives: 1. Assessing the effects analgesia by epidural anesthesia during labor. 2. Assessing progress and final results of labor for pregnant women and fetuses. Materials and Methods: The study described 37 pregnant from 38 to less than 42 weeks had a positive phase of labor to pain relief by continuous epidural anesthesia method, with cervical dilation between 3 cm and 4 cm. Results: Women feel very satisfied (67.5%) on methods of natural pain relief during labor. Most women deliver normally (73%). Evolution of the cervix takes place smoothly. Duration of labor within the normal birth. Breast sucking good condition accounted for 86.5% rate, the reflecting normal 94.6%. Conclusions: This is the effective method of pain relief during labor birth. Duration of labor in normal limits. Side effects occur less and can be well controlled. Keywords: epidural anesthesia; relief pain on labor.

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