Sickle cell disease (SCD) is an umbrella term that defines a group of inherited diseases (in-cluding sickle cell anaemia (SCA), HbSC and HbSβ-thalassaemia) characterized by mutations in the gene encoding the haemoglobin subunit β1. One of the most frequent and debilitant complications of the disease is the vaso-occlusive crisis (VOC), which is mediated by multicell adhesion between red blood cells (RBCs), white blood cells, platelets, and endo-thelial cells and causes intense pain in conse-quence of impaired oxygen supply, but also in-farction-reperfusion injury2,3. Continue reading
The objective of postoperative pain management after thoracotomy is the prevention of postoperative complications, the reduction of the length of hospital stay, the increase of the patient’s satisfaction and finally the resumption of the daily living’s normal activities.
Thoracic surgery affects postoperative respiratory function, along with a high risk of developing postoperative pulmonary complications. Pain is a subjective experience. Postoperative pain management in thoracic surgery patients should be individually applied, based on a well-organized health care system that emphasizes consistent nursing education regarding proper pain management techniques, with an effective communication between the patient and members of the existing multidisciplinary team, especially the nursing staff.
Continue readingThe study compares the efficacy of postoperative analgesia after the intravenous administration of opioids (nalbuphine, tramadol or morphine) in combination with ketamine in patients undergoing radical prostatectomy.Eighty eight patients scheduled for radical prostatectomy were randomly assigned in three groups. In Group A (n=31) Morphine was administered {bolus dose (BD) 0.05mg/Kg and continuous infusion (CI) at a dose [mg/24h =18-(agex0.15)]}, in Group B (n=28) Nalbuphine (BD 0.2mg/kg and CI at a rate 0.05mg/kg/h) and in Group C (n=29) Tramadol (BD 1.5mg/Kg and CI at a rate 0.15mg/Kg/h).
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The aim of this study was to examine and compare the efficacy and safety of combining strong opioids (transdermal fentanyl) with weak opioids (codeine or tramadol) for the management of severe cancer pain. Forty six patients (25 male / 21 female) aged 42-80 years were studied. According to an eleven-grade numeric rating scale (NRS; 0 = no pain, 10 = severe pain), they all had severe steady pain intensity greater than 5 (NRS >5) despite treatment with weak opioids and adjuvant drugs, as proposed by the 2nd step of the World Health Organization (WHO) analgesic ladder, at the maximum tolerated doses.
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Neurolytic celiac plexus block (NCPB) is a useful technique for pain control in patients with intra-abdominal tumors or pain secondary to chronic pancreatitis that does not respond to other therapeutic modalities (not interventional). The anterior approach for NCPB has been considered a relatively safe approach, with a low rate of complications and little risk of neurologic injury secondary to the spread of a neurolytic agent. This is the first national case report of successful NCPB using the anterior approach under CT guidance.
Continue readingAlthough the experience of nociceptive pain ultimately depends on interpretation by the cerebral cortex, it occurs primarily as a result of a noxious stimulus (one which when prolonged produces damage resulting in the humoral and cellular responses of inflammation) activating myelinated A-δ and unmyelinated C noci-ceptors.
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