Prevention of injury-induced functional alterations in the CNS by pre-emptive analgesia is a fascinating working hypothesis based on substantial scientific evidence. Studies investigating the treatment of pain via drug delivery across the nasal mucosa show an equivalent or superior pain control to intravenous, intramuscular or subcutaneous delivery methods. Several endoscopic ENT procedures have been recently developed with the aim of minimizing surgical invasiveness; they are associated with mild to moderate post-operative Previous studies used fentanyl by aerosol for postoperative analgesia and They concluded that inhaled fentanyl is an effective, safe and convenient method of analgesia which merits further investigation into such areas as mode of action and method of administration6. Similarly, we also found good analgesic effect of fentanyl by instillation via intranasal route in doses of 2mcg/kg without any significant adverse effect. J M Malinovsky et al (1996)7did a study in which during halothane anaesthesia, 32 children, aged 2-9 year, weight 10-30 kg were allocated randomly to receive ketamine 3 mg kg-1 nasally (group IN3) or ketamine 9 mg kg-1 nasally (group IN9); ketamine 9 mg kg-1 rectally (group IR9); or ketamine 3 mg kg-1 …show more content…
huge V et al 11randomized sixteen patients with neuropathic pain of various origins into two treatment groups: (S)-ketamine 0.2mg/kg (group 1); (S)-ketamine 0.4mg/kg (group 2). They concluded that Intranasal administration of low dose (S)-ketamine rapidly induces adequate plasma concentrations of (S)-ketamine and subsequently of its metabolite (S)-norketamine. The time course of analgesia correlated with plasma concentrations. In our study with intranasal ketamine (1.5mg/kg) we observed (mean±S.D) VAS score (2.32±0.47) in postoperative period, which was inferior to fentanyl group but definitely better when compared to control
Prior to intubation for a surgical procedure, the anesthesiologist administered a single dose of the neuromuscular blocking agent, succinylcholine, to a 23-year-old female to provide muscular relaxation during surgery and to facilitate the insertion of the endotracheal tube. Following this, the inhalation anesthetic was administered and the surgical procedure completed.
1Fentanyl is a powerful synthetic opiate analgesic, which has a primary function in managing malignant and non-malignant contractible pain, similar to morphine however it is more potent. This is because fentanyl has an octanol-water partition of 9550 compared to morphine, which has 6. This effectively demonstrates that fentanyl is highly lipid soluble, crossing the blood brain barrier more rapidly. Hence it has a quicker reaction time but at a shorter duration compared to morphine. It is commonly used to treat patients with severe pain or patients experiencing pain after a surgery. Fentanyl can also be used to treat patients with chronic pain that are physically tolerant to opiates. Patients who are not physically tolerant to opiates should avoid the use of fentanyl as this can cause undesirable side effects, which can in some cases be toxic. Fentanyl is registered as a class II prescription drug, meaning that it has a greater potential for being abused, which could have negative implications on a patient’s health as it can result in psychological or physical dependence.1
It has been shown that intrathecal administriton of GABA receptor antagonists cause hyperalgesia and allodynia. Constitutive, the increase in the endogenous GABA activity in the spinal cord alleviate pain resulting from noxious and innoxious mechanical and thermal stimuli. Different GABA receptors have different roles in alleviating thermal and mechanical pain in different animal pain models. There is no study to date that has examined the involvement of GABA A and GABA B in sensory dimension of neuropathic pain resulting from compression of spinal cord. The current study tests the hypothesis that GABA A or GABA B receptors contributes to the allodynia and hyperalgesia observed after spinal cord injury. The results showed that the effect of GABA A and GABA B receptors on mechanical hyperalgesia is similar but these receptors have different effects on thermal hyperalgesia. While using baclofen as GABA B receptor agonist does not affect the thermal pain, thermal hyperalgesia resulting from spinal cord injury was greatly alleviated by different doses of GABA A agonist, muscimol. Both Baclofen and muscimol are able to reduce the mechanical and cold allodynia has been seen after spinal cord injury but the effect of baclofen is dose dependent with no effect in higher doses used in this study. While almost all doses of muscimol were used in this study reduce the amount of cold and mechanical allodynia. The other result obtained in this study is the short term effect of GABA agonist. The anitinociceptive effect of Baclofen and muscimol appear to be maxium at 15 min after injection and gradually diminished by time and their analgesic effect disappeared 3 hours after injection.
In October of 1982, Tylenol, the leading pain-killer in the United States at the time faced a crisis. Seven people in Chicago were reported dead after taking Tylenol. 12-year-old Mary Kellerdman of Elk Grove Village, Illinois, Adam Janus of Arlington Heights, Illinois, his brother Stanley Janus, and his wife Theresa Janus, Mary Reiner of Winfield, Paula Price, and Mary McFarland of Elmhurst Illinois was the last victim of the cyanide-laced Tylenol capsules. This happened bﴱᄃecause there was Extra-Strength Tylenol capsules that had been distributed and tampered with. The capsules contained 65 milligrams of cyanide. The amount necessary to kill a human is five to seven micrograms, which means that the person used 10,000 times more poison that what was needed.. The tampering had occurred when the products reached the shelves. The connection between the deaths and the Tylenol was discovered within days by two off-duty firemen who were listing to their police radios. Phillip Cappitelli and Richard Keyworth were the men to make the connection and tell there superiors.
It is not uncommon for a patient to experience pain and anxiety before or after a major procedure or breathing treatment. Imagining the myriad of complications that might occur during an operation can send one into multiple panic attacks. Coping with the loss of mobility and independence joined by the pain that accompanies recovery are only a few examples of the complex and traumatic experiences awaiting pre/post-operation patients. Fortunately, a medication was synthesized by Armin Walser and Rodney I. Fryer in 1975 to aid patients by easing anxiety and promoting sleepiness before an operation. An added benefit was that the events experienced during the operation were also forgotten while the medication was still in effect.
Lindley, P., Pestano, C. R., & Gargiulo, K. (2009). Comparison of postoperative pain management using two patient-controlled analgesia methods: Nursing perspective. Journal of Advanced Nursing, 65(7), 1370-1380. doi: 10.1111/j.1365-2648.2009.04991.x
Have you ever wondered why when you stub your toe on the chair in the living room, it helps tremendously to yell out an expletive or two and vigorously rub the area? I may not be able to discuss the basis for such language in this paper, but we will explore the analgesic response to rubbing that toe, in addition to the mechanism of pain and alternative treatments such as acupuncture and transcutaneous electrical nerve stimulation.
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Acetaminophen serves one basic purpose, to relieve pain. It is the main ingredient in pain killers that relieve headaches. It also substitutes anesthesia in circumcision surgery because anesthesia often cannot be used on infants. Dr. Michael Weitzman and 2 other doctors performed an experiment on an infant to test the effectiveness of the drug. The results were not identical, but there were increases in heart rate respiratory rate and crying. But the drug did more good as a pain reliever after the surgery than before the surgery.
Volles, D. F. (2011, April 11). University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures. Retrieved May 12, 2011, from University of Virgina Health System: University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures
Potent pain medication contains the aspects of utilizing medications such as morphine or demerol, how the medications are dispensed, and t...
Although the comorbidities and type of surgery dictate certain decisions in managing patient care, anesthesiologists maintain various modalities for the perioperative period. These consist of anything from local to regional anesthesia, including neuraxial techniques and peripheral nerve blocks, as well as monitored anesthesia care with sedation to general anesthesia. Overlapping of different anesthetic types and combinations of regional analgesics to supplement general anesthesia occur frequently.
This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.
The nurse should educate the patient of the importance of pain control and how controlling pain is essential to a patient’s wellbeing and recovery. It needs to be a balance of what the patient says and what the nurse observes and interprets while always respecting the wishes of the patient. Nurses have a variety of assessment tools available to assess pain in their patients. One dimensional pain scales such as visual analog scale, verbal descriptor scale, numeric pain intensity scale and the combined thermometer scale all measure the intensity of the pain (Jensen, 2011). Other pain scales such as McGill pain questionnaire, brief pain inventory, and brief pain impact questionnaire take into account aspects beyond intensity (Jensen 2011). There are additional pain assessments specialized for children, older adults, patients who are unable to respond, and patients with opioid tolerance (Jensen, 2011). The nurse should be familiar with these methods of pain assessment and know the appropriate use of each. Incorrect medication and treatment choices due to inaccurate or poor pain assessment cause patient suffering (Jensen,