scholarly journals Pethidine’s Half-life Alterations following Orthopedic Surgery: Is Available Literature Always Compatible with the Data Obtained at the Bedside?

2020 ◽  
Author(s):  
Shima Afshar ◽  
Farshad Hashemian ◽  
Sasan Anari ◽  
Mahnaz Qomi ◽  
Mohammadreza Rouini
Keyword(s):  
Pain Management ◽  
Orthopedic Surgery ◽  
Half Life ◽  
Pain Perception ◽  
Smoking Status ◽  
Pain Scale ◽  
Related Factors ◽  
Blood Samples ◽  
Physical Status Classification ◽  
Inferior Limb

Background:  It is suggested that surgery results in changes in kinetic profile of some medication. The aim of this study was to investigate possible alterations in pethidine’s half-life in postoperative pain management following orthopedic surgery of the inferior limb. Methods: Twelve patients, who were classified as class I patients according to the American society of anesthesiologists physical status classification, were enrolled. Following the surgery of the lower limb, 25 mg of pethidine was injected intravenously. After that, 5, 30, 60 and 180 minutes following the injection, blood samples were taken and concentration of pethidine in blood samples was measured by High Performance Liquid Chromatography method. Moreover, patients’ pain levels were assessed on visual analogue scales. Results: The average half-life of pethidine was measured to be 29.68 minutes. Thirty minutes after the injection, significant relationship between plasma levels of pethidine and pain scale was reported (p= 0.041, r= 0.595). Moreover, men were found to perceive more pain than women. Pain scale was considerably different between smokers and non-smokers (p= 0.006), although blood concentration of pethidine was not significantly different between these two groups (p=0.09). Conclusions: The average half-life of pethidine was shorter compared to the established half-life in literature. Orthopedic surgery most probably results in alterations in pharmacokinetic profile of pethidine. Moreover, gender and smoking status of the patients influence pain perception. Thus, pharmacokinetic alterations due to inferior limb orthopedic surgery, gender-related factors and smoking status of the patients should be considered in pain management in clinical settings. J Pharm Care 2019; 7(4): 82-86.

scholarly journals Perception of Pain, Attitude and Satisfaction of Pain Management among Postoperative Patients

2021 ◽  
Author(s):  
Uma Venkatesan ◽  
Sruthi Kamal ◽  
Jasmine Viswanathan
Keyword(s):  
Pain Management ◽  
General Surgery ◽  
Pain Perception ◽  
Pearson Correlation ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Pain Scale ◽  
Postoperative Recovery ◽  
Cross Sectional ◽  
Urological Surgery

Introduction: Pain is considered as a fifth vital sign. Pain management and patients satisfaction with the treatment decreases early postoperative recovery. Aim: The study aim was to assess the satisfaction of pain management among postoperative patients. Materials and Methods: A cross-sectional study was used to conduct a study among 180 postoperative patients’ undergone surgeries (General surgery patients, ortho-paedic surgery and urological surgery patients) at selected hospitals, Puducherry. The purpose of the study was to associate the pain level with satisfaction. The patients were selected based on purposive sampling technique. After obtaining consent, the researcher used numerical pain scale to assess the pain perception of the patient, closed ended questionnaire to assess attitude level and modified short assessment questionnaire for patient satisfaction towards pain management. The study was analysed using Statistical Package for the Social Science (SPSS) software version 20.0. The descriptive statistics was used to assess the level of pain and attitude and inferential statistics like Pearson correlation coefficient were carried out to find the correlation between pain and satisfaction. Results: Severe pain was felt by nearly all (70%) among general surgery patients, 60% in orthopaedic surgery patients and 50% had moderate pain in urological surgery patients respectively. Regarding attitude, majority (78%, 88% and 83%) of the patients had positive attitude towards pain management in General surgery, Orthopaedic and Urology surgery patients. Most (74%) of them were satisfied with their pain management in general surgery patients, whereas in orthopaedic and urological patients, nearly all 90%, 96% of the clients were very satisfied towards pain management. Conclusion: The study concluded, optimal satisfaction toward pain management will increase quality of early postoperative recovery.

Effect of General Anesthesia and Orthopedic Surgery on Serum Tryptase

2010 ◽  
Vol 112 (5) ◽  
pp. 1184-1189 ◽  
Author(s):  
Lene H. Garvey ◽  
Birgitte Bech ◽  
Holger Mosbech ◽  
Mogens Krøigaard ◽  
Bo Belhage ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Orthopedic Surgery ◽  
Corticosteroid Treatment ◽  
Reference Interval ◽  
Intravenous Fluid ◽  
High Dose ◽  
Serum Tryptase ◽  
Intraindividual Variation ◽  
Blood Samples ◽  
Physical Status Classification

Background Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to investigate the effect of anesthesia and surgery on serum tryptase in the absence of anaphylaxis. Methods The study included 120 patients (median age, 54 yr; range, 19-94 yr) undergoing elective orthopedic surgery in general anesthesia. Exclusion criteria were allergic reactions during this or previous anesthesia, hematologic disease, or high-dose corticosteroid treatment. Blood samples for tryptase analysis (ImmunoCAP; Phadia, Uppsala, Sweden) were drawn shortly before anesthesia and after anesthesia and surgery. Results Median duration of anesthesia was 105 min (range, 44-263 min). Median interval between blood samples was 139 min (range, 39-370 min). Mean tryptase before surgery was 5.01 microg/l, with a mean decrease of 0.55 microg/l (P < 0.0001; 95% CI, 0.3-0.8) postoperatively. All patients received intravenous fluid (median value 750 ml; range, 200-2000 ml) perioperatively. There was no significant effect of gender, age, American Society of Anesthesiologist's physical status classification, or self-reported allergy on serum tryptase. Conclusions Serum tryptase shows small intraindividual variation in the absence of anaphylaxis. A small decrease was observed postoperatively, likely due to dilution by intravenous fluid. On suspected anaphylaxis during anesthesia, tryptase values, even within the normal reference interval, should, when possible, be compared with the patient's own basal level taken more than 24 h after the reaction.

Movement Matters; How Physical Activity Impacts Endodontic Therapy

2021 ◽  
Vol 15 (8) ◽  
pp. 2073-2075
Author(s):  
Muhammad Shairaz Sadiq ◽  
Usman Sana ◽  
Arham Nawaz Chohan ◽  
Fareed Ahmad ◽  
Junaid Dayar ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pain Management ◽  
Pain Perception ◽  
Dental Treatment ◽  
Positive Impact ◽  
Statistical Significance ◽  
Pain Scale ◽  
Numeric Pain Scale ◽  
Operative Assessment ◽  
Keywords Exercise

Objective: To understand impact of physical activity on pain perception in patients presenting with acute pulpitis for endodontic therapy. Study Design: It was quantitative correlational by design. Place and duration of study: Department of Operative Dentistry, Dental Section, Islam Dental College, Sialkot. Materials & Methods: 500 patients from the Dental Section of Islam Dental College Sialkot were included in this study. The correlation of movement/walk and pain during endodontic treatment was determined. Numeric pain scale was used to document pain. Activity was measured by the number of minutes of walk of the patient. Results: There is a significant association between physical activity/exercise and pain. Statistical significance between pain and exercise was -.158. Conclusion: Pre-operative assessment of physical activity may be a predictor of pain perceived by patients. Therefore, it is important to educate and consider patient’s physical activity to manage pain during the dental treatment. Life style modification may seems insignificant but has proven positive impact in pain management. Keywords: Exercise, local anaesthesia (LA), endodontic therapy, pain.

Striae Gravidarum, Vitamin C and Other Related Factors

2011 ◽  
Vol 81 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Rahime Bedir Findik ◽  
Nurcihan Karakurt Hascelik ◽  
Kadir Okhan Akin ◽  
Ayse Nurcan Unluer ◽  
Jale Karakaya
Keyword(s):  
Family History ◽  
Vitamin C ◽  
Pregnant Women ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Blood Levels ◽  
Significant Relation ◽  
Related Factors ◽  
Thigh Circumference ◽  
Striae Gravidarum

Background: Striae gravidarum, a clinical condition commonly seen in pregnant women, produces serious cosmetic problems and may lead to psychological problems. Aim: The present study investigated whether there was any relation between the presence of striae in primigravid pregnant women and blood vitamin C levels, and factors thought to contribute to the formation of striae such as family history, weight gained during pregnancy, smoking status, abdominal and thigh circumference, and age. Methods: Overall, 69 primigravid women attending routine antenatal follow-up and, using prophylactic iron and vitamin preparations, underwent investigation. All were pregnant 36 or more weeks. Scoring was based on striae examination and whether striae were present. The relation between the presence of striae, vitamin C blood levels, and other factors was investigated. Results and Conclusions: Multiple logistic regression analysis showed a significant relation between the presence of striae and blood vitamin C levels (p = 0.046) and between the presence of striae and family history (p = 0.023). No significant relation was found between the presence of striae and age, weight gained during pregnancy, abdominal and thigh circumference, or smoking status. It was concluded that further, more comprehensive studies on the issue are required.

scholarly journals Indonesian adolescents’ perspectives on smoking habits: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fithria Fithria ◽  
Muhammad Adlim ◽  
Syarifah Rauzatul Jannah ◽  
Teuku Tahlil
Keyword(s):  
Qualitative Study ◽  
Junior High School ◽  
Smoking Status ◽  
Smoking Habit ◽  
Peer Pressure ◽  
Prevention Programs ◽  
Smoking Prevention ◽  
Smoking Habits ◽  
Related Factors ◽  
Effective Prevention

Abstract Background The prevalence of smoking among adolescents is high in Indonesia. Therefore, this qualitative research aimed to explore the perspectives of Muslim adolescents on smoking habits as a reference for developing effective prevention programs. Methods Three focus group discussions involving 24 junior high school male students (mean age = 13.75 years) were the main source of data for this phenomenological qualitative study. The discussion guide was developed by the researchers based on the reviewed literature and validated by experts. The research findings were analyzed using an inductive content analysis with systematic steps based on the stages of qualitative data analysis. Results Adolescent perspectives on smoking were grouped into two themes: perception of smoking and smoking-related factors. The perception of smoking encompassed three sub-themes: smoking as a social habit, contradictive feelings, and the Islamic perspective. The smoking-related factors included peer pressure, the parents’ smoking status, masculinity and curiosity. The results indicated that adolescents consider smoking as a social habit but with contradictory feelings. The smoking habit was also stimulated by peer pressure, imitating parents who smoke, feeling masculine and curiosity. Conclusion We suggest that health professionals who are interested in developing smoking prevention programs in Indonesia should consider the adolescent perspective on smoking so that the prevention program will be more effective and appropriate for adolescents.

scholarly journals Equine Discomfort Ethogram

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 580
Author(s):  
Catherine Torcivia ◽  
Sue McDonnell
Keyword(s):  
Pain Management ◽  
Line Drawing ◽  
Clinical Work ◽  
Pain Scale ◽  
University Of Pennsylvania ◽  
Systematic Evaluation ◽  
Clear Understanding ◽  
Physical Discomfort ◽  
Professional Health ◽  
The University

In recent years, there has been a growing interest in and need for a comprehensive ethogram of discomfort behavior of horses, particularly for use in recognizing physical discomfort in domestically managed horses. A clear understanding of the physical discomfort behavior of horses among caretakers, trainers, and professional health care personnel is important to animal welfare and caretaker safety. This is particularly relevant to pain management for hospitalized equine patients. Various pain scale rubrics have been published, typically incorporating only a few classically cited pain behaviors that, in many cases, are specific to a particular body system, anatomic location, or disease condition. A consistent challenge in using these rubrics in practice, and especially in research, is difficulty interpreting behaviors listed in various rubrics. The objective of this equine discomfort ethogram is to describe a relatively comprehensive catalog of behaviors associated with discomfort of various degrees and sources, with the goal of improving understanding and clarity of communication regarding equine discomfort and pain. An inventory of discomfort-related behaviors observed in horses has been compiled over 35 years of equine behavior research and clinical consulting to medical and surgical services at the University of Pennsylvania School of Veterinary Medicine’s equine hospital. This research and clinical work included systematic evaluation of thousands of hours of video-recordings, including many hundreds of normal, healthy horses, as well as hospitalized patients with various complaints and/or known medical, neurologic, or orthopedic conditions. Each of 73 ethogram entries is named, defined, and accompanied by a line drawing illustration. Links to online video recorded examples are provided, illustrating each behavior in one or more hospitalized equine patients. This ethogram, unambiguously describing equine discomfort behaviors, should advance welfare of horses by improving recognition of physical discomfort, whether for pain management of hospitalized horses or in routine husbandry.

scholarly journals Feasibility of Extrapolating Randomly Taken Plasma Samples to Trough Levels for Therapeutic Drug Monitoring Purposes of Small Molecule Kinase Inhibitors

2021 ◽  
Vol 14 (2) ◽  
pp. 119
Author(s):  
Ruben A. G. van Eerden ◽  
Esther Oomen-de Hoop ◽  
Aad Noordam ◽  
Ron H. J. Mathijssen ◽  
Stijn L. W. Koolen
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Small Molecule ◽  
Trough Concentration ◽  
Drug Monitoring ◽  
Half Life ◽  
Kinase Inhibitors ◽  
Therapeutic Drug ◽  
Blood Samples ◽  
Elimination Half ◽  
Trough Levels

Small molecule kinase inhibitors (SMKIs) are widely used in oncology. Therapeutic drug monitoring (TDM) for SMKIs could reduce underexposure or overexposure. However, logistical issues such as timing of blood withdrawals hamper its implementation into clinical practice. Extrapolating a random concentration to a trough concentration using the elimination half-life could be a simple and easy way to overcome this problem. In our study plasma concentrations observed during 24 h blood sampling were used for extrapolation to trough levels. The objective was to demonstrate that extrapolation of randomly taken blood samples will lead to equivalent estimated trough samples compared to measured Cmin values. In total 2241 blood samples were analyzed. The estimated Ctrough levels of afatinib and sunitinib fulfilled the equivalence criteria if the samples were drawn after Tmax. The calculated Ctrough levels of erlotinib, imatinib and sorafenib met the equivalence criteria if they were taken, respectively, 12 h, 3 h and 10 h after drug intake. For regorafenib extrapolation was not feasible. In conclusion, extrapolation of randomly taken drug concentrations to a trough concentration using the mean elimination half-life is feasible for multiple SMKIs. Therefore, this simple method could positively contribute to the implementation of TDM in oncology.

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