NSAIDs and Tonsillectomy: Efficacy for Pain Relief
|
|
- Edmund Bradford
- 5 years ago
- Views:
Transcription
1 NSAIDs and Tonsillectomy: Efficacy for Pain Relief Natasha Cohen, Sarah Lapner, Jayant Ramakrishna, Lehana Thabane, Doron Sommer, Gideon Koren McMaster OTL HNS Resident Research Day October 25 th 2013
2 CanMEDS Medical Expert: Management of post-tonsillectomy pain Role of NSAIDs for treatment of this pain Scholar: Overview of current literature Best evidence currently available addressing the analgesic efficacy of NSAIDs for post-tonsillectomy pain (1a)
3 NSAIDs Non-Steroidal Anti-Inflammatory Drugs BACKGROUND
4 Anti-platelet Pain Inhibition of surgically induced miosis and prevention of postoperative macular edema with nepafenac Clin Ophthalmol. 2009;3:
5 Tonsillectomy Tonsillectomy most commonly performed surgery in NA Complications Pain: Can be intractable Can result in dehydration, re-admission Other: Fever Hemorrhage: 0.2-2%
6 NSAIDs Seldom used in OTL HNS Increase in bleeding risk Studies in other surgical fields (eg: orthopedics, neurosurgery, general surgery) have established the safety and efficacy of NSAID s post-op
7 No statistically significant difference in bleeding for NSAIDS
8 Analgesic dilemma Codeine Over the last decade Severe respiratory depression and death Feb 2013 FDA issued a black box warning against codeine post-operatively AAO-HNS & CSO HNS endorsed NSAIDs and Acetaminophen Efficacy of NSAIDs has been shown in RCT s but no SR s exist on this topic
9 Available limited evidence suggests that prophylactic NSAIDs are at least as effective as prophylactic administration of opioids
10 P: Patients of all ages undergoing tonsillectomy I: NSAIDs C: Other analgesic regimens O: Pain control T: Post-operative period (T=0 à 3 weeks)
11 Methods Systematic Review Medline, EMBASE systematic search through OVID Cochrane trial registry Grey literature searched using Web of Science Search conducted September 25 th independent reviewers
12 Outcomes Primary Analgesic efficacy All measures accepted Secondary: Vomiting Bleeding (clinically significant) Readmission to hospital
13 Inclusions RCT s only NSAIDs vs other English and French Report on pain (primary or secondary outcome)
14 Statistical Analysis RevMan version 5.2 (Cochrane Collaboration 2012) Pain: Standardized mean difference Vomiting: Odds ratio
15 ANSWER RESULTS
16 Search results
17 Search results Number of patients: 4782 Average number of subjects per study: 83.9 SD 52.3 min 25, max 340 Pediatric: 38 studies Adult: 19 studies 1 not specified Publication date: 1964 to 2013
18 Mean total dose rescue at 24h Morphine Tramadol Acetaminophen Lidocaine Acetaminophen Diclofenac PR Lornoxicam IV Flurbiprophen IV Diclofenac PR Rofecoxib PO Sensitivity analysis: pediatric vs. adult studies did not affect results
19 Pain Scores at 24h Oropivalone bacitracin Acetaminophen Papaveretum Rofecoxib po Flurbiprophen IV Ketorolac IV Rofecoxib po
20 Vomiting at 24h
21 Vomiting at <6h
22 Long Term Pain Study NSAID Comparator Follow up duration Results Angot 1987 Niflumic Acid po Oropivalone gel caps 8 days NSAID>comparator POD 1 and 2, NS POD 3,4 &7 Bean Lejewski 2007 Rofecoxib po Acetaminophen and hydrocodone po 3 day diary NSAID < comparator for active pain Courtney 2001 Diclofenac po Tramadol po 14 days Not statistically significantly better Harley 1998 Ibuprofen po Acetaminophen and codeine po POD 1, 3, 14 Comparator > NSAID POD 1 & 3, NS POD 5 Ozkiris 2013 Ibuprofen po Metamizole and Acetaminophen po 7 days Pain not reported Parker 1986 Ibuprofen po Placebo 6 days Long term results only graphical Roy 1968 Oxyphenbutazone po Placebo 8 days NSAID> placebo (stats not done) Stewart 2002 Piroxicam po Dexamethasone po 8 days NSAID< comparator (statistically significant)
23 Discussion NSAIDs =/> in pain control posttonsillectomy Varied measurement tools Homogeneity achieved with sensitivity analyses based on pre-existing hypotheses Placebo group?
24 Discussion Limitations: little long term data available beyond 24h, and could not be meta-analyzed Heterogeneous methods (analgesics) and reporting of pain (timing, scale) Small N for pain comparisons Advantage for vomiting Well recognized in previous studies Compared to both opioids, nonopioids and placebo
25 Conclusions NSAIDs are adequate options for post-operative pain control Little evidence available for long term pain outcome posttonsillectomy Randomized controlled trial needed to address the adequacy of pain control
26 What s next RCT Issues: Pediatric population Exclusion criteria? Which NSAID? Rescue and comparator Morphine? Pain measurement tool? Short vs. long term Follow up Minimize attrition Validity of recordings Timing, frequency vs.
POSTOPERATIVE PAIN MANAGEMENT IN PEDIATRICS
POSTOPERATIVE PAIN MANAGEMENT IN PEDIATRICS PRESENTED BY: JENIFER LICHTENFELS, M.D. PHARMACISTS OBJECTIVES Identify risk factors for narcotic induced respiratory depression in children with OSA State the
More informationNonsteroidal anti-inflammatory drugs and perioperative bleeding in paediatric tonsillectomy (Review)
Nonsteroidal anti-inflammatory drugs and perioperative bleeding in paediatric tonsillectomy (Review) Lewis SR, Nicholson A, Cardwell ME, Siviter G, Smith AF This is a reprint of a Cochrane review, prepared
More informationSystematic review on the role of paracetamol and non steroid anti-inflammatory drugs for cancer pain (EPCRC opioid guidelines project)
Systematic review on the role of paracetamol and non steroid anti-inflammatory drugs for cancer pain (EPCRC opioid guidelines project) Maria Nabal MDPhD Silvia Librada MD Mª Jose Redondo MD www.arnau.scs.es
More informationBalanced Analgesia With NSAIDS and Coxibs. Raymond S. Sinatra MD, Ph.D
Balanced Analgesia With NSAIDS and Coxibs Raymond S. Sinatra MD, Ph.D Prostaglandins and Pain The primary noxious mediator released from damaged tissue is prostaglandin (PG) PG is responsible for nociceptor
More informationScreening - inclusion criteria
A Date of data collection: B Time of data collection: C Ward where data is collected: 2 0 1 Y M M D D H H M M D Research assistant Code: Patient code (local): Room number: Screening - inclusion criteria
More informationScreening - inclusion criteria
PAIN OUT Community research EU ROP EAN COMMISSION A Date of data collection: B Time of data collection: C Ward where data is collected: 2 0 1 Y M M D D H H M M D Research assistant Code: Room number: Screening
More informationPAIN PODCAST SHOW NOTES:
PAIN PODCAST SHOW NOTES: Dallas Holladay, DO Ultrasound Fellow Cook County Hospital Rush University Medical Center Jonathan D. Alterie, DO PGY-2, Emergency Medicine Midwestern University An overview of
More informationI. Mechanisms of action the role of prostaglandins a. Mediators of inflammation b. and much more
NSAID steroid update Leo Semes, OD, FAAO I. Mechanisms of action the role of prostaglandins a. Mediators of inflammation b. and much more II. Topical NSAIDS ophthalmic application III. Oral NSAIDs a. Precautions
More informationNerve Blocks & Long Acting Analgesia for Plastic Surgeons. Karol A Gutowski, MD, FACS
Nerve Blocks & Long Acting Analgesia for Plastic Surgeons Karol A Gutowski, MD, FACS Disclosures None related to this topic Why is Non-Opioid Analgesia Important Opioid epidemic Less opioid use Less PONV
More informationShow Me the Evidence: Epidurals, PVBs, TAP Blocks Christopher L. Wu, MD Professor of Anesthesiology The Johns Hopkins Hospital
Show Me the Evidence: Epidurals, PVBs, TAP Blocks Christopher L. Wu, MD Professor of Anesthesiology The Johns Hopkins Hospital Overview Review overall (ERAS and non-eras) data for EA, PVB, TAP Examine
More informationNonsteroidal Anti-Inflammatory Drugs for Postoperative Pain A Focus on Children
REVIEW ARTICLE Pediatr Drugs 2003; 5 (2): 103-123 1174-5878/03/0002-0103/$30.00/0 Adis International Limited. All rights reserved. Nonsteroidal Anti-Inflammatory Drugs for Postoperative Pain A Focus on
More informationEffective pain management begins with OFIRMEV (acetaminophen) injection FIRST Proven efficacy with rapid reduction in pain 1
Effective pain management begins with OFIRMEV (acetaminophen) injection FIRST Proven efficacy with rapid reduction in pain 1 Fast onset of pain relief with 7% reduction in visual analog scale (VAS) scores
More informationPaediatric Quality-Based Procedures Tonsillectomy with and without Adenoidectomy
Paediatric Quality-Based Procedures Tonsillectomy with and without Adenoidectomy Webinar #1 (Feb 19 th, 2014) and Webinar #2 (Mar 27 th, 2014) Questions & Answers Q 1 Is the webinar presentation being
More informationPostoperative Analgesia for Children After Tonsillectomy
Postoperative Analgesia for Children After Tonsillectomy A/Prof George Chalkiadis Pain Medicine Physician, Anaesthetist Head, Children s Pain Management Service, RCH Clinical Associate Professor, University
More informationPhysician Orders PEDIATRIC: LEB NEURO SURG Surgical Spine Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Neuro Surg Spine Postop Phase, When to Initiate: LEB Neuro Surgical Spine Post Op Phase Admission/Transfer/Discharge
More informationMonth/Year of Review: January 2012 Date of Last Review: February 2007
Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-945-5220 Fax 503-947-1119 Month/Year of Review: January 2012 Date of Last Review:
More informationAnalgesic Subcommittee of PTAC Meeting held 1 March 2016
Analgesic Subcommittee of PTAC Meeting held 1 March 2016 (minutes for web publishing) The Analgesic Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology and
More informationCryotherapy is currently being used in some health centres following TKA as part of a
McGill University Health Centre: Nursing Research and MUHC Libraries What evidence exists that describes whether the use of cryotherapy (cold therapy) is effective for improving adult patient outcomes
More informationTOTAL knee arthroplasty (TKA) is a common surgery to
PAIN MEDICINE Anesthesiology 2010; 113:1144 62 Copyright 2010, the American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins Femoral Nerve Block Improves Analgesia Outcomes after Total
More informationDISCLOSURES. Learning goals 19/09/2013 PEDIATRIC ACUTE PAIN MANAGEMENT. No financial investment in the material or medications presented
PEDIATRIC ACUTE PAIN MANAGEMENT Dr. Samina Ali, MDCM, FRCPC(PEM) Associate Professor Departments of Pediatrics & Emergency Medicine University of Alberta September 2013 DISCLOSURES No financial investment
More informationPharmacogenetics of Codeine. Lily Mulugeta, Pharm.D Office of Clinical Pharmacology Pediatric Group FDA
Pharmacogenetics of Codeine Lily Mulugeta, Pharm.D Office of Clinical Pharmacology Pediatric Group FDA 1 Codeine Overview Naturally occurring opium alkaloid Demethylated to morphine for analgesic effect
More informationSpecific Care Question : Question Originator: Plain Language Summary from The Office of Evidence Based Practice: Conditional Recommendation
Ketorolac for Refractory Migraine in the ED Specific Care Question : In the pediatric patient diagnosed with refractory migraine is ketorolac an effective treatment? Question Originator: Migraine Therapy
More informationPerioperative Ketorolac Increases Post-Tonsillectomy Hemorrhage in Adults But Not Children
The Laryngoscope VC 2014 The American Laryngological, Rhinological and Otological Society, Inc. Perioperative Ketorolac Increases Post-Tonsillectomy Hemorrhage in Adults But Not Children Dylan K. Chan,
More informationThis document has not been circulated to either the industry or Consultants within the Suffolk system.
New Medicine Report Document Status COX II Inhibitors In Acute Analgesia For Suffolk Drug & Therapeutics Committee Date of Last Revision 15 th February 2002 Reviewer s Comments There seems to be a growing
More informationWORRIED ABOUT PAIN AFTER ORAL SURGERY?
WORRIED ABOUT PAIN AFTER ORAL SURGERY? OPIOIDS ARE NOT THE ONLY WAY TO MANAGE PAIN Ask your doctor about opioid-free EXPAREL EXPAREL is indicated for single-dose infiltration in adults to produce postsurgical
More informationWhat is stronger oxycodone 5 mg or tramadol 50 mg
P ford residence southampton, ny What is stronger oxycodone 5 mg or tramadol 50 mg Hey guys im still a newbie so feel free to move this.. My pet has a prescription for Tramadol and Oxycodone as he has
More informationThe analgesic efficacy of cyclooxygenase-2 selective inhibitors in paediatric adenotonsillectomy: a systematic review
Systematic Review Page 1 of 10 The analgesic efficacy of cyclooxygenase-2 selective inhibitors in paediatric adenotonsillectomy: a systematic review Patrick Stokes 1, Mark Guirguis 1,2, Dean Page 1,2 1
More informationeappendix A. Opioids and Nonsteroidal Anti-Inflammatory Drugs
eappendix A. Opioids and Nonsteroidal Anti-Inflammatory Drugs Nonsteroidal Anti-Inflammatory Drugs Nonselective nonsteroidal anti-inflammatory drugs Diclofenac, etodolac, flurbiprofen, ketorolac, ibuprofen,
More informationCodeine and Paracetamol in Paediatric use, an Update 5 th October 2013
Codeine and Paracetamol in Paediatric use, an Update 5 th October 2013 This guidance should be read in parallel to the detailed guidelines on pain management in children (APA guidelines) 2 nd edition.
More informationOral Pain Medications in Your Practice Scot Morris, OD, FAAO
Oral Pain Medications in Your Practice Scot Morris, OD, FAAO COURSE DESCRIPTION This course addresses common oral pharmaceuticals used as analgesics as well as their effect on the ocular system and overall
More informationPain therapeutics. Acetaminophen/NSAIDs Acute pain Osteoarthritis Migraine Acute Gout Neuropathic pain
Pain therapeutics Acetaminophen/NSAIDs Acute pain Osteoarthritis Migraine Acute Gout Neuropathic pain James McCormack, Pharm.D. Professor Faculty of Pharmaceutical Sciences, UBC Common types of pain killers
More informationIs tramadol stronger than tylenol codeine 3
Search Search Is tramadol stronger than tylenol codeine 3 Strongest between Tramadol 50mg and codeine. the dose was less potent than co-dydramol, but the wobbly,. 3 years ago. still get confused. 5-1-2015
More informationCOMPOUNDING PHARMACY SOLUTIONS PRESCRIPTION COMPOUNDING FOR PAIN MANAGEMENT
JUNE 2012 COMPOUNDING PHARMACY SOLUTIONS PRESCRIPTION COMPOUNDING WWW.CPSRXS. COM We customize individual prescriptions for the specific needs of our patients. INSIDE THIS ISSUE: Acute Pain 2 Neuropathic
More informationdisease or in clients who consume alcohol on a regular basis. bilirubin
NON-OPIOID Acetaminophen(Tylenol) Therapeutic class: Analgesic, antipyretic Aspirin (ASA, Acetylsalicylic Acid) Analgesic, NSAID, antipyretic Non-Opioid Analgesics COMMON USES WHAT I NEED TO KNOW AS A
More informationAnaesthetic pharmacology for children. Noel Roberts Monash Children s Hospital
Anaesthetic pharmacology for children Noel Roberts Monash Children s Hospital Aims To briefly summarize the evidence concerning neurotoxicity and its implications for pediatric anaesthetic practice To
More informationDrug Class Review on Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Drug Class Review on Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs) Final Report Update 3 Evidence Tables November 2006 Original Report Date: May 2002 Update 1 Report
More informationDose: Metoclopramide -0.1 mg/kg (max 10 mg) IV, over 15 minutes
Metoclopramide for Refractory Migraine in the ED Specific Care Question : In the pediatric patient diagnosed with refractory migraine, is metoclopramide an effective treatment? Question Originator: Migraine
More informationFDA hormone replacement therapy Web site 6
TABLE OF CONTENTS Caring for pain at UIMCC 1-5 FDA hormone replacement therapy Web site 6 P&T Committee Formulary Action - September 2003 6 Caring for pain at UIMCC The International Association for the
More informationThe Effect of Fever Control on Mortality in ICU Patients: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Protocol The Effect of Fever Control on Mortality in ICU Patients: A Systematic Review and Meta-Analysis of Randomised Controlled Trials Protocol No. 1 Registration: This systematic review and meta-analysis
More informationLiterature Scan: Topical Analgesics
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationDrug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis
Pain Physician 2013; 16:E685-E704 ISSN 2150-1149 Systematic Review Drug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis Joanne WY Chung, PhD 1, Yingchun
More informationOAA Survey 156: Current prescribing practices for post-operative analgesia following emergency and elective LSCS
OAA Survey 56: Current prescribing practices for post-operative analgesia following emergency and elective LSCS Janis M Ferns, Jennifer Lambert, Dharshini Radhakrishnan 2. Specialty Trainee, Barts and
More informationOxymorphone (Opana ) is indicated for the relief of moderate-to-severe acute pain where the use of an opioid is appropriate.
Page 1 of 7 Policies Repository Policy Title Policy Number Schedule II Prior Authorization FS.CLIN.16 Application of Pharmacy Policy is determined by benefits and contracts. Benefits may vary based on
More informationThe Participant will be able to: All Better!: Pediatric Adenotonsillectomy Pain Management
All Better!: Pediatric Adenotonsillectomy Pain Management Deborah Scalford, RN, MSN The Children s Hospital of Philadelphia Objectives The Participant will be able to: Identify reasons why pain is unrelieved.
More informationThe prophylactic effect of rectal diclofenac versus intravenous pethidine on postoperative pain after tonsillectomy in children
Saleh and Hassan Ain-Shams Journal of Anesthesiology (2019) 11:1 https://doi.org/10.1186/s42077-018-0017-3 Ain-Shams Journal of Anesthesiology ORIGINAL ARTICLE Open Access The prophylactic effect of rectal
More informationDexamethasone and haemorrhage risk in paediatric tonsillectomy: a systematic review and meta-analysis
British Journal of Anaesthesia 3 (): 3 4 (4) doi:.93/bja/aeu5 Dexamethasone and haemorrhage risk in paediatric tonsillectomy: a systematic review and meta-analysis J. R. Bellis *, M. Pirmohamed 4, A. J.
More informationDoes the use of NSAIDs amongst patients with long-bone fractures increase the risk of non-union: A structured review protocol for a systematic review.
1. TITLE OF PROJECT Does the use of NSAIDs amongst patients with long-bone fractures increase the risk of non-union: A structured review protocol for a systematic review. 2. TEAM and LEAD Alder Hey Orthopaedic
More informationSubstitute for tramadol for dogs
There are a number of pain relief medications made specifically for dogs, as well as holistic treatments.. Narcotics: Veterinarians will sometimes use narcotics ( opioids), such as morphine, codeine, hydrocodone,
More information! Somatic! Visceral! Neuropathic! Psychogenic. ! Analgesic! Relief without sedation! Works on peripheral pain receptors
PAIN, PAIN, GO AWAY. TYPES OF PAIN! Somatic! Visceral! Neuropathic! Psychogenic Jill Autry, OD, RPh Eye Center of Texas, Houston drjillautry@tropicalce.com ANALGESIA! Mild! Aspirin! Paracetamol! Moderate!
More informationThe Efficacy of Gabapentin/Pregabalin in Improving Pain After Tonsillectomy: A Meta-Analysis
The Laryngoscope VC 2015 The American Laryngological, Rhinological and Otological Society, Inc. The Efficacy of Gabapentin/Pregabalin in Improving Pain After Tonsillectomy: A Meta-Analysis Se Hwan Hwang,
More informationOpioids silent killers?
Opioids silent killers? Jason Boland Senior clinical lecturer and honorary consultant in palliative medicine Hull York Medical School and North East Lincolnshire, UK Does it depend on the situation? Opioids
More informationCONCERNED ABOUT TAKING OPIOIDS AFTER SURGERY?
CONCERNED ABOUT TAKING OPIOIDS AFTER SURGERY? ASK YOUR DOCTOR ABOUT EXPAREL FOR LONG-LASTING, NON-OPIOID PAIN RELIEF. VISIT EXPAREL.com/patient FOR MORE INFORMATION. YOU HAVE A SAY IN HOW YOUR PAIN IS
More informationLearning Objectives. Perioperative goals. Acute Pain in the Chronic Pain Patient for Ambulatory Surgery 9/8/16
Acute Pain in the Chronic Pain Patient for Ambulatory Surgery Danielle Ludwin, MD Associate Professor of Anesthesiology Division of Regional and Orthopedic Anesthesia Columbia University Medical Center
More informationSupplementary Online Content
Supplementary Online Content Chang AK, Bijur PE, Esses D, Barnaby DP, Baer J. Effect of a single dose of oral opioid and nonopioid analgesics on acute extremity pain in the emergency department: a randomized
More informationPrescription Opioids: The Real Story 4/30/15
Prescription Opioids: The Real Story 4/30/15 Don Teater MD Medical Advisor National Safety Council Masters student at the UNC Gillings School of Global Public Health Don Teater MD Disclaimer: The information
More informationComparative Efficacy and Safety of Long-Acting Oral Opioids for Chronic Non-Cancer Pain: A Systematic Review
1026 Journal of Pain and Symptom Management Vol. 26 No. 5 November 2003 Review Article Comparative Efficacy and Safety of Long-Acting Oral Opioids for Chronic Non-Cancer Pain: A Systematic Review Roger
More informationInpatient Management of Trauma Related Pain
Inpatient Management of Trauma Related Pain STOMP Summit September 9, 2016 Ann O Rourke, MD, MPH University of Wisconsin Department of Surgery 1 Our patient Small SDH Intubated Hemopneumothorax with multiple
More informationHow to manage severe postoperative pain? Pr Patricia Lavand homme Anesthesiology Dpt & Acute Pain Service Brussels, Belgium
How to manage severe postoperative pain? Pr Patricia Lavand homme Anesthesiology Dpt & Acute Pain Service Brussels, Belgium No conflict of interest to declare. Does severe acute postoperative pain still
More informationPAIN MANAGEMENT IN HIP SURGERY. Khoa D. Nguyen, MD, PhD Dept. of Rheumatology, Cho Ray Hosital
PAIN MANAGEMENT IN HIP SURGERY Khoa D. Nguyen, MD, PhD Dept. of Rheumatology, Cho Ray Hosital MUSCULOSKELETAL PAIN IS COMMON Hip replacement increasing POSTOPERATIVE PAIN: INTRODUCTION Very common Causes
More informationPain Management in Older Adults. Mary Shelkey, PhD, ARNP
Pain Management in Older Adults Mary Shelkey, PhD, ARNP Cause of Death/ Demographic and Social Trends Early 1900s Current Medicine's Focus Comfort Cure Cause of Death Infectious Diseases/ Communicable
More informationFrequently Asked Questions
Page 1 Frequently Asked Questions Codeine and all multiple-ingredient products containing codeine are restricted on the AHS Provincial Drug Formulary to patients 18 years of age and older. 1. What does
More informationSystematic review: The effectiveness and safety of diclofenac for the. pain management after cesarean
Systematic review: The effectiveness and safety of diclofenac for the pain management after cesarean ABSTRACT This is the protocol of systematic review and there is no abstract. The objective is to evaluate
More informationSingle dose oral analgesics for acute postoperative pain in adults (Review)
Single dose oral analgesics for acute postoperative pain in adults (Review) Moore RA, Derry S, McQuay HJ, Wiffen PJ This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration
More informationPaediatric Tonsillectomy Clinical Guidelines. With or without adenoidectomy
Paediatric Tonsillectomy Clinical Guidelines With or without adenoidectomy Table of Contents Pre-procedure recommendations... 3 Risk assessment for post-operative bleeding... 3 Diagnosis for Obstructive
More informationAnalgesics: Management of Pain In the Elderly Handout Package
Analgesics: Management of Pain In the Elderly Handout Package Analgesics: Management of Pain in the Elderly Each patient or resident and their pain problem is unique. A complete assessment should be performed
More informationCelecoxib Powder, Diclofenac Powder, Flurbiprofen Powder, Ibuprofen Powder, Ketoprofen Powder, Meloxicam Powder, Tramadol Powder
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.02.26 Subject: Anti-Inflammatory Pain Powders Page: 1 of 5 Last Review Date: December 3, 2015 Anti-Inflammatory
More informationMedicine. Chao Han (MD) a, Xiao-dan Li (MD) b, Hong-qiang Jiang (MD) a, Jian-xiong Ma (PhD) a, Xin-long Ma (MD) a, Systematic Review and Meta-Analysis
Systematic Review and Meta-Analysis Medicine The use of gabapentin in the management of postoperative pain after total knee arthroplasty A PRISMA-compliant meta-analysis of randomized controlled trials
More informationR Sim, D Cheong, KS Wong, B Lee, QY Liew Tan Tock Seng Hospital Singapore
Prospective randomized, double-blind, placebo-controlled study of pre- and postoperative administration of a COX-2- specific inhibitor as opioid-sparing analgesia in major colorectal resections R Sim,
More informationA Statewide Evaluation of Opioid Prescribing Patterns with an Emphasis on Drug Diversion and Substance Abuse
A Statewide Evaluation of Opioid Prescribing Patterns with an Emphasis on Drug Diversion and Substance Abuse INVESTIGATIVE TEAM: STEERING COMMITTEE FOR THE TUFTS HEALTH CARE INSTITUTE ON OPIOID RISK MANAGEMENT
More informationAssociate Professor Supranee Niruthisard Department of Anesthesiology Faculty of Medicine Chulalongkorn University January 21, 2008
Associate Professor Supranee Niruthisard Department of Anesthesiology Faculty of Medicine Chulalongkorn University January 21, 2008 PAIN MECHANISMS Somatic Nociceptive Visceral Inflammatory response sensitizes
More informationGUIDELINEs ON PAIN MANAGEMENT IN UROLOGY
GUIDELINEs ON PAIN MANAGEMENT IN UROLOGY (Text update March 2009) P. ader (chair), D. Echtle, V. Fonteyne, G. De Meerleer, E.G. Papaioannou, J.H. Vranken General principles of cancer pain management The
More informationCOMPOUNDING PHARMACY SOLUTIONS PRESCRIPTION COMPOUNDING FOR PAIN MANAGEMENT
JANUARY 2012 COMPOUNDING PHARMACY SOLUTIONS PRESCRIPTION COMPOUNDING WWW.CPSRXS. COM We customize individual prescriptions for the specific needs of our patients. INSIDE THIS ISSUE: Osteoarthritis Pain
More informationTACKLING THE OPIOID EPIDEMIC: THE DENTAL TEAM'S RESPONSIBILITY ACUTE PAIN MANAGEMENT
TACKLING THE OPIOID EPIDEMIC: THE DENTAL TEAM'S RESPONSIBILITY ACUTE PAIN MANAGEMENT John E. Lindroth, DDS Associate Professor University of Kentucky College of Dentistry FACULTY DISCLOSURE Neither my
More informationCymbalta anti inflammatory
Cymbalta anti inflammatory The Borg System is 100 % Cymbalta anti inflammatory 11/01/2017 Abcya math man games 11/02/2017 Lalaloopsy 11/03/2017 Free keno wheels Cymbalta and ibuprofen. View detailed information
More informationDigital RIC. Rhode Island College. Linda M. Green Rhode Island College
Rhode Island College Digital Commons @ RIC Master's Theses, Dissertations, Graduate Research and Major Papers Overview Master's Theses, Dissertations, Graduate Research and Major Papers 1-1-2013 The Relationship
More informationDrug Class Review Nonsteroidal Antiinflammatory Drugs (NSAIDs)
Drug Class Review Nonsteroidal Antiinflammatory Drugs (NSAIDs) Preliminary Scan Report #2 May 2014 Last Report: Update #4 (November 2010) Last Preliminary Scan: July 2013 The purpose of reports is to make
More informationPAIN MANAGEMENT IN UROLOGY
24 PAIN MANAGEMENT IN UROLOGY F. Francesca (chairman), P. Bader, D. Echtle, F. Giunta, J. Williams Eur Urol 2003; 44(4):383-389 Introduction Pain is defined as an unpleasant sensory and emotional experience
More informationENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP ADMIT PLAN - Phase: Begin Immediately/PACU
- Phase: Begin Immediately/PACU Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status:
More informationOral Oxycodone for Acute Postoperative Pain: A Review of Clinical Trials. Pain Physician Opioid Special Issue 2017; 20:SE33-SE52
Pain Physician 2017; 20:SE33-SE52 ISSN 2150-1149 Narrative Review Oral Oxycodone for Acute Postoperative Pain: A Review of Clinical Trials Chi Wai Cheung, MD 1, Stanley Sau Ching Wong, MBBS 1, Qiu Qiu,
More informationGuideline topic: Sore Throat Review
Guideline topic: Sore Throat Review General comments Search coverage Patient searches Medline, Embase, CINAHL, PsycInfo Guidelines (run on) The guideline search used the patient stem. Guidelines evaluated
More informationDaniel S. Sitar, BScPharm, PhD, FCP Professor Emeritus University of Manitoba Editor: Journal of Clinical Pharmacology
March 8, 2011 Daniel S. Sitar, BScPharm, PhD, FCP Email: sitar@cc.umanitoba.ca Professor Emeritus University of Manitoba Editor: Journal of Clinical Pharmacology DEFINITIONS Pain: The unpleasant sensory
More informationResults of a one-year, retrospective medication use evaluation. Joseph Ladd, PharmD PGY-1 Pharmacy Resident BHSF Homestead Hospital
Results of a one-year, retrospective medication use evaluation Joseph Ladd, PharmD PGY-1 Pharmacy Resident BHSF Homestead Hospital Briefly review ketamine s history, mechanism of action, and unique properties
More informationPediatric Pain Pharmacotherapy Update
Pediatric Pain Pharmacotherapy Update Peter N. Johnson, Pharm.D., BCPS Assistant Professor of Pharmacy Practice University of Oklahoma College of Pharmacy Adjunct Assistant Professor of Pediatrics University
More informationSupplementary material
Supplementary material Methods: Search strategy for MEDLINE Intervention "analgesics, opioid"[mesh Terms] OR codeine OR fentanyl OR hydrocodone OR hydromorphone OR levophanol OR meperidine OR morphine
More informationAppendix A: Pharmacologic approaches to pain management during MVA
Pain medication Though the medications shown below are commonly used for pain management during uterine evacuation, many other options exist. This table does not cover general anesthetic agents. Both anxiolytics
More informationDisclosure. Learning Objectives 1/17/2018. Pumping the Breaks in Pain Management: An Update on Cardiovascular Risk with NSAID Use
Disclosure Pumping the Breaks in Pain Management: An Update on Cardiovascular Risk with Liz Van Dril, PharmD, BCPS PGY2 Ambulatory Care Resident January 17 th, 2018 Dr. Liz Van Dril has no actual or potential
More informationPEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders
- Phase: Pediatric Spine Surgery General Orders PHYSICIAN S Diagnosis Weight Allergies Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert
More informationbleeding was the secondary outcome.
TABLE OF CONTENTS Use of PPIs in noncritically ill patients risk of gastrointestinal bleeding 1-2 Update on use of vitamin D 2011 guidelines from the Endocrine Society 2-3 Intravenous acetaminophen use
More informationNSAIDS for Managing Post-Operative Endodontic Pain in Patients who Present with Pre-Operative Pain: A Systematic Review and Meta-Analysis
Oregon Health & Science University OHSU Digital Commons Scholar Archive 6-2016 NSAIDS for Managing Post-Operative Endodontic Pain in Patients who Present with Pre-Operative Pain: A Systematic Review and
More informationCataract and Diabetic macular edema: What should I do?
Cataract and Diabetic macular edema: What should I do? Irini Chatziralli Ophthalmic Surgeon, University Scholar 2 nd Department of Ophthalmology, University of Athens (Director: Prof P. Theodossiadis)
More informationAppropriate Opioid Prescribing for Acute Pain after Surgery
Appropriate Opioid Prescribing for Acute Pain after Surgery Richard J. Barth Jr. Professor of Surgery Chief, Section of General Surgery Dartmouth Hitchcock Medical Center Clinical Trials Network Webinar
More informationInflammatory rheumatic diseases
Learning objectives Inflammatory rheumatic diseases Bruce Kidd Barts & The London, Queen Mary, University of London To understand: 1. prevalence and range of the rheumatological s 2. clinical features
More informationCARDIOVASCULAR RISK and NSAIDs
CARDIOVASCULAR RISK and NSAIDs Dr. Syed Ghulam Mogni Mowla Assistant Professor of Medicine Shaheed Suhrawardy Medical College, Dhaka INTRODUCTION NSAIDs are most commonly prescribed drugs Recent evidence
More information5/9/2013. Children who require chronic opioids for chronic pain are at significant risk of developing opioid addiction?
I have no financial relationships with a commercial entity producing heathcarerelated products and/or services relevant to the content I am presenting.. Angela C. Anderson, MD Children who require chronic
More informationGeriatric Grand Rounds
Geriatric Grand Rounds Tuesday, February 12, 2008 12:00 noon Dr. Bill Black Auditorium Glenrose Rehabilitation Hospital To receive the poster, and handouts via email, subscribe to our E-mailing list at
More informationEffective Health Care Program
Comparative Effectiveness Review Number 38 Effective Health Care Program Analgesics for Osteoarthritis: An Update of the 2006 Comparative Effectiveness Review Executive Summary Background Osteoarthritis
More informationERAS: Enhanced Recovery After Surgery. Christopher L. Wu, M.D. Professor of Anesthesiology The Johns Hopkins University; Baltimore, Maryland
ERAS: Enhanced Recovery After Surgery Christopher L. Wu, M.D. Professor of Anesthesiology The Johns Hopkins University; Baltimore, Maryland Overview History and basic principles of ERAS Review published
More informationDrug Class Review Nonsteroidal Antiinflammatory Drugs (NSAIDs)
Drug Class Review Nonsteroidal Antiinflammatory Drugs (NSAIDs) Final Update 4 Report November 2010 The purpose of the is to summarize key information contained in the Drug Effectiveness Review Project
More informationENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP PLAN - Phase: Begin Immediately/PACU
- Phase: Begin Immediately/PACU PHYSICIAN S Diagnosis Weight Allergies Laboratory Calcium Level STAT Outpatient/PACU, T;N PTH Intact STAT Outpatient/PACU, T;N 1 of 7 - Phase: When Patient Arrives to Room
More information