scholarly journals Evaluation of the Adding Paracetamol to Dexmedetomidine in Pain Management After Adult Cardiac Surgery

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Fatemehshima Hadipourzadeh ◽  
SeyedMehdi Mousavi ◽  
Avaz Heydarpur ◽  
Ali Sadeghi ◽  
Rasool Ferasat-Kish
Keyword(s):  
Cardiac Surgery ◽  
Pain Management ◽  
Side Effects ◽  
Continuous Infusion ◽  
Infusion Pump ◽  
Postoperative Pain Control ◽  
Drug Study ◽  
Before And After ◽  
Dexmedetomidine Infusion ◽  
Adult Cardiac Surgery

Background: Postoperative pain control after cardiac surgery is usually based on Opioids. These drugs are associated with side effects, and the use of drugs with fewer side effects is important for analgesia. Dexmedetomidine and paracetamol have fewer side effects than opioids. Objectives: The aim of the study was to evaluate the adding paracetamol to dexmedetomidine continuous infusion pump for pain management after adult cardiac surgery. Methods: In this study, 100 patients were divided into two groups. One group received a continuous infusion of dexmedetomidine and paracetamol (DP), and the other received dexmedetomidine (D). These two groups were evaluated for MAP, HR, and the need for prescribing opioids before and after extubation. Also, duration of intubation and pain before extubation and 36 hours after every 4 hours. Results: Patients in the DP group had lower mean MAP and HR during intubation period than the D group and needed fewer opioids and doses of opioids in addition to drug study infusion pre- (P = 0.001) and post-extubation (P = 0.001 and P = 0.022, respectively). The DP group patients were extubated earlier (P = 0.001). After extubation, the DP group had less pain than the D group. Conclusions: This study showed that adding paracetamol to the dexmedetomidine infusion pump can provide better analgesia.

scholarly journals Adherence to All Steps of a Pain Management Protocol in Intensive Care Patients after Cardiac Surgery Is Hard to Achieve

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
L. van Gulik ◽  
S. J. G. M. Ahlers ◽  
P. Bruins ◽  
D. Tibboel ◽  
C. A. J. Knibbe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Pain Management ◽  
Side Effects ◽  
Good Adherence ◽  
Intensive Care Patients ◽  
Morphine Infusion ◽  
Pain Scores ◽  
Management Protocol

Purpose.To investigate adherence to our pain protocol considering analgesics administration, number and timing of pain assessments, and adjustment of analgesics upon unacceptably high (NRS ≥ 4) and low (NRS ≤ 1) pain scores.Material and Methods.The pain protocol for patients in the intensive care unit (ICU) after cardiac surgery consisted of automated prescriptions for paracetamol and morphine, automated reminders for pain assessments, a flowchart to guide interventions upon high and low pain scores, and reassessments after unacceptable pain.Results.Paracetamol and morphine were prescribed in all 124 patients. Morphine infusion was stopped earlier than protocolized in 40 patients (32%). During the median stay of 47 hours [IQR 26 to 74 hours], 702/706 (99%) scheduled pain assessments and 218 extra pain scores were recorded. Unacceptably high pain scores accounted for 96/920 (10%) and low pain scores for 546/920 (59%) of all assessments. Upon unacceptable pain additional morphine was administered in 65% (62/96) and reassessment took place in 15% (14/96). Morphine was not tapered in 273 of 303 (90%) eligible cases of low pain scores.Conclusions.Adherence to automated prescribed analgesics and pain assessments was good. Adherence to nonscheduled, flowchart-guided interventions was poor. Improving adherence may refine pain management and reduce side effects.

scholarly journals Drug-Related Side Effects of Long-term Intrathecal Morphine Therapy

2007 ◽  
Vol 2;10 (3;2) ◽  
pp. 357-365
Author(s):  
Xiulu Ruan
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Opioid Receptors ◽  
Intrathecal Morphine ◽  
Infusion Pump ◽  
Pump Therapy ◽  
Morphine Administration ◽  
Opioid Administration ◽  
Morphine Therapy

Background: The introduction of intrathecal opioid administration for intractable chronic non-malignant pain and cancer pain is considered as one of the most important breakthroughs in pain management. Morphine, the only opioid approved by FDA for intrathecal administration, has been increasingly utilized for this purpose. For over 3 decades, there have been numerous reports on the non-nociceptive side effects associated with ever increasing long-term intrathecal morphine usage. Objectives: To review the literature on side effects due to long-term intrathecal morphine therapy with discussions of alternate treatment options. Design: English-language publications were identified through MEDLINE search and the bibliographies of identified articles were reviewed. Results: Most side effects of intrathecal morphine therapy are dose dependent and mediated by opioid receptors. Common ones include nausea, vomiting, pruritus, urinary retention, constipation, sexual dysfunction, and edema. Less common ones include respiratory depression, and hyperalgesia. Catheter tip inflammatory mass formation is a less common complication that may not be mediated by opioid receptors. Conclusion: The utilization of intrathecal morphine administration for cancer and intractable non-malignant chronic pain represents an important leap forward in pain management. Yet, a wide variety of non-nociceptive side effects may also occur in susceptible patients. The side effects due to intrathecal morphine administration are mostly mediated by opioid receptors. Treatment usually involves the utilization of opioid receptor antagonist, such as naloxone. Patients considering intrathecal opioid pump therapy should be informed and advised about the possible side effects associated with longterm intrathecal morphine administration prior to placement of a permanent morphine infusion pump. Key words: side effects, intrathecal morphine, opioid receptors

The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery

2016 ◽  
Vol 16 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Ann Kristin Bjørnnes ◽  
Monica Parry ◽  
Irene Lie ◽  
Morten Wang Fagerland ◽  
Judy Watt-Watson ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Control ◽  
Postoperative Pain Control ◽  
The Impact

Local Treatment of Recent Arterial Thromboembolic Occlusions with Brinase

1975 ◽  
Vol 34 (02) ◽  
pp. 498-503 ◽  
Author(s):  
D Nyman ◽  
M. A da Silva ◽  
L. K Widmer ◽  
F Duckert
Keyword(s):  
Side Effects ◽  
Local Treatment ◽  
Before And After ◽  
Local Side

SummaryBrinase was administered intra-arterially in 16 patients with thrombotic or embolic arterial occlusions. Angiography could be performed before and after treatment in 13 patients. Thrombolysis was obtained in 3 of 9 patients with thrombotic and in 3 of 4 patients with embolic occlusions. In 3 patients severe local side effects occurred.

Adult Cardiac Surgery During Covid-19 Pandemic

2020 ◽  
Vol 2 (4) ◽  
pp. 276-287
Author(s):  
Gerardo AK Laksono ◽  
◽  
Andreas MS Hutama ◽  
Paul L Tahalele ◽  
◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Adult Cardiac Surgery
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