- |||||||||| Opioid-sparing Anesthetic Technique For Radical Resection Of Extensive Pelvic Tumor (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_2936;
17-year-old female with desmoid fibromatosis of left pelvis involving obturator nerve and external iliac vein and artery (s/p multiple resections, sorafenib)...Maintenance with ketamine, lidocaine, propofol, and dexmedetomidine infusions...Nicardipine for controlled hypotension. Post-procedure, IV methadone and PNB catheter ropivacaine infusion with excellent pain control (0-1/10, received morphine 3 mg once, catheter removed on post-op day 4).
- |||||||||| hydromorphone hydrochloride / Generic mfg.
Intraoperative Hydromorphone Decreases Post-operative Pain: An Instrumental Variable Analysis (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_2694;
This study suggests that the intraoperative administration of intermediate-duration opioids may not cause the same effects as short acting opioids with respect to post-operative pain. Instrumental variables can be an invaluable tool in estimating causal effects using observation data where unmeasured confounding is present.
- |||||||||| Sphenopalatine Ganglion Block: A Novel Therapy For Post-maxillectomy Facial Pain (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_2527;
Serial fluoroscopically guided SPGBs were performed using 2% lidocaine and 5 mg dexamethasone...Pain improvement was maintained at 1-year follow-up. We postulate that pain relief is due to blockade of maxillary derived sensory fibers, petrosal nerve and stellate ganglion derived sympathetic fibers that contribute to the pterygopalatine ganglion.
- |||||||||| morphine sulphate / Generic mfg.
High Spinal Anesthesia In Double Valve Replacement For Carcinoid Syndrome: High Risk Vs. High Reward (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_2333;
Intrathecal medications consisted of high-dose bupivacaine (45-52.5mg) and morphine (400-500mcg)...Spinal anesthesia is historically believed to be contraindicated in patients with symptomatic carcinoid syndrome due to the potential adverse hemodynamic effect. However, with the use of intra-operative octreotide, spinal anesthesia can be performed safely in this population.
- |||||||||| morphine sulphate / Generic mfg.
The Use Of Spinal Cord Stimulators For Abdominal Pain: A Narrative Review (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_2183;
Although the etiologies of abdominal pain in the patients reviewed varied, along with the location and type of pain experienced, the vast majority of patients experienced a benefit from SCS placement. This was supported by decreased pain scores, decreased MME requirements, relief of gastrointestinal symptoms, and improvement in quality of life.
- |||||||||| morphine sulphate / Generic mfg.
Withholding neuraxial morphine (Room 206-207) - Aug 15, 2022 - Abstract #ASA2022ASA_2003;
Current smoking status appears to decrease the likelihood of a favorable response to SCS. There is no abstract associated with this presentation.
- |||||||||| morphine sulphate / Generic mfg.
Identifying Racial Inequities In Pain Management In Opioid NaïVe Surgical Patients (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_1997;
Using standard conversion ratios, we calculated daily oral morphine equivalents on the discharge prescription...In addition, we found that in 19% of our study population race was unknown. This highlights the limitations of EMR data, which often fails to capture key health equity metrics, such as patient race, which are critical in identifying health disparities.
- |||||||||| morphine sulphate / Generic mfg.
Association Between Chronic Opioid Utilization And In-hospital Mortality From Sepsis: Analysis Of United States Administrative Claims Data From 2009 To 2015 (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_1980;
Outpatient opioid prescriptions were summarized by morphine milligram equivalents (MMEs)...Conclusions : In this analysis of large-scale administrative claims data from a population of working age adults, chronic opioid utilization greater than 20 average daily MMEs prior to hospitalization with sepsis was independently associated with increased odds of in-hospital mortality after adjustment for relevant covariates. These findings extend our knowledge both about risk factors for mortality from sepsis and the potentially deleterious impacts of chronic opioid therapy.
- |||||||||| morphine sulphate / Generic mfg.
Utilization Of Regional Anesthesia In A Critical Polytrauma Patient (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_1972;
Utilizing multiple ultra-sound guided peripheral nerve blocks, a polytrauma patient requiring high doses of narcotic with limited effect was able to decrease the required morphine dose equivalent in half. Targeted therapy with peripheral nerve blocks not only decreased the amount of narcotic required to manage the pain, but also aided in the patient’s tenuous respiratory status in the perioperative setting.
- |||||||||| morphine sulphate / Generic mfg.
The Effect Of Obesity On Opioid Consumption Following Quadratus Lumborum Block After Cesarean Delivery: A Retrospective Review (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_1588;
In addition to baseline demographics, outcome variables studied were opioid request rate, time to first rescue opioid analgesia, and opioid consumption measured as morphine milligram equivalents (MME)...Conclusion Our results suggest that obesity does not result in significantly increased opioid consumption following QLB for women who have undergone cesarean delivery. Quadratus lumborum blocks should be encouraged in obese patients and future clinical trials studying QLB should include patients with greater BMI.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Nociception-guided Intraoperative Analgesia For Improved Postoperative Recovery: A Randomized Trial (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_1444;
However, NOL guidance did not improve average pain scores or the fraction of patients with pain scores ≤4 during initial recovery. Our results contrast with previous similar trials conducted in Europe and Israel, both of which reported improved postoperative analgesia in NOL-guided patients.
- |||||||||| morphine sulphate / Generic mfg.
Pupillary Unrest Is A Measure Of Central Opioid Effect, Not Pain (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_697;
Oral morphine equivalents in the four hours preceding the block ranged from 0 to 139 mg...We conclude that PUAL is a more sensitive measure of opioid effect and not a measure of pain in this population. These findings suggests that the value of infrared pupillometry in pain management lies primarily in identifying central opioid effects that are associated with an increased risk for serious adverse events such as respiratory depression (4).
- |||||||||| Outcomes Of Non-opioid Analgesia In Adult Cardiac Surgical Patients: A Network Meta-analysis (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_443;
Other analgesics, including magnesium, clonidine, ketamine, dexamethasone, acetaminophen, pregabalin, and gabapentin also led to improvements in patient-important outcomes. Conversely, methylprednisolone and ketorolac were associated with an increased risk of MI and increased opioid consumption, respectively, though this should be interpreted with caution due to limited direct evidence.
- |||||||||| morphine sulphate / Generic mfg., gemcitabine / Generic mfg.
Intra-operative Magnesium Sulfate Is Associated With Decreased Anticholinergic Use After Urologic Procedures Of The Bladder (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_421;
This study aims to evaluate the effect of intra-operative Mag infusion on use of AC and BO in the PACU, post-operative pain control, and morphine milligram equivalent (MME) administration...Multivariate analysis adjusting for use of intravesical gemcitabine in the PACU, bladder tumor resection size, amount of fluid in catheter balloon, and use of AC pre-operatively still showed significant difference in use of AC/BO in the PACU between the two groups...No adverse events were associated with intra-operative use of Magnesium sulfate. Conclusion : Magnesium sulfate can help to reduce the usage of anticholinergic medications and B&O suppositories in the PACU after endoscopic procedures to resect bladder tumors.
- |||||||||| morphine sulphate / Generic mfg.
Pecs 2 Block Offers No Analgesic Benefit Over Surgical Infiltration For Open Bicep Tenodesis (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_393;
For the first 24 hours after surgery, the treatment group used 32.8 ± 26 mg morphine mg equivalents (MME) vs. 29.9 ± 21; p= 0.63...While Reynold et al. showed a benefit compared to a sham block, surgical infiltration seems simpler and yields comparable analgesia.Conclusion(s): While the preoperative higher pain scores in the Pecs could be a confounder, the theoretical advantage of the Pecs 2 block over surgical infiltration for open biceps tenodesis was not supported by this study, with similar opioid consumption and NRS scores in the Pecs 2 group.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Erector Spinae Nerve Block Vs. Local Anesthetic On Perioperative Opioid Use & Pain In Reduction Mammoplasty Patients (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_386;
All narcotic use in the perioperative period was recorded and standardized to morphine milligram equivalent (MME) units to account for use of varying opioids. Patients in the ESP group received significantly less intraoperative narcotics compared to the LLAB group (33.45 MME vs. 89.77 MME, p-value < 0.001), despite a non-significant difference in preoperative opioids administered (27.75 MME vs. 31.50 MME, p-value = 0.164).
- |||||||||| morphine sulphate / Generic mfg.
Thoracic Epidural vs. Continuous Paravertebral Block for Analgesia after VATS: a Meta-analysis (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_385;
24 and 48-hour opioid use was lower in TEA (mean difference (MD) 6.34 milligram morphine equivalents (MME), 95% CI 2.36-10.33, and 1.25 MME, 95% CI 0.63-1.87)...The anesthetic chosen for an individual may depend on patient factors, provider preference/experience, potential complications, and side effect profile. Further studies are needed to investigate the risks of complications and other outcomes such as chronic pain and length of hospital stay, however current data indicates that TEA can be considered the gold standard for managing acute postoperative pain after VATS.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., ketamine / Generic mfg.
Administration Of Intravenous Adjuvants During Cesarean Delivery: Retrospective Cohort Study (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_323;
Ultimately the goal is to improve patients’ experience by identifying predictors for PDCD, offering guidance for management of PDCD, and ensuring that women with a traumatic birth experience receive the appropriate follow-up. 1.Pain 2020;161(9):1976-822.Anaesth Crit Care Pain Med 2021;40:1009343.Int J Obstet Anesth 2016;28:70-54.Anaesthesia 2018;73:223-305.Anaesth Crit Care Pain Med 2021;40:1009386.Proc (Bayl Univ Med Cent) 2020;33:536-40
- |||||||||| Chirocaine (levobupivacaine) / Purdue, AbbVie
Cardiopulmonary Resucitation In A Pregnant With Guillain Barre Syndrome And Covid19: Case Report (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_306;
At the end, bilateral quadratus lumborum block (QL1) guided by US was indicated, with 0.25 levobupivacaine + 1% lidocaine, both with vasoconstrictor 20mL on each side...CPR reestablished the flow even before the arrival of the defibrillator, verified by pulse oximetry and capnography, leading to a quick outcome, which favored extubation in OR, and block for analgesic supplementation favored recovery. ICU discharge on the 1st postoperative day (PD), and hospital discharge on the 4PD with his newborn.
- |||||||||| Eladur (bupivacaine) / Amneal
Anesthetic Management Of Parturients With Achondroplasia During Labor And Delivery (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_302;
While there is very limited information about the use of regional anesthesia in patients with achondroplasia, routine use of general anesthesia is not free of risks such as difficult airway management, and potentially denies the parturient the opportunity to witness the birth of their child. Neuraxial anesthesia was effective and safe in our series of achondroplastic parturients and should be considered.
- |||||||||| Chirocaine (levobupivacaine) / Purdue, AbbVie
Cardiopulmonary Resuscitation In A Pregnant With Guillain Barre Syndrome And COVID19: Case Report (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_298;
At the end, bilateral quadratus lumborum block (QL1) guided by US was indicated, with 0.25 levobupivacaine + 1% lidocaine, both with vasoconstrictor 20mL on each side...CPR reestablished the flow even before the arrival of the defibrillator, verified by pulse oximetry and capnography, leading to a quick outcome, which favored extubation in OR, and block for analgesic supplementation favored recovery. ICU discharge on the 1st postoperative day (PD), and hospital discharge on the 4PD with his newborn.
- |||||||||| morphine sulphate / Generic mfg.
Single Center Retrospective Study Into Spinal Cord Stimulator Efficacy (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_158;
The average daily oral morphine equivalent pre-implant was found to be 35.66...This study demonstrates areas for further studying, such as: inclusion criteria, presence of selection bias, optimal documentation, and prospective focus on opioid use, pain score and functional score related to the spinal cord stimulator. Theses studies will provide better insight of which criteria are most important to patient selection and what factors may be most important for persistent pain relief after implantation.
- |||||||||| morphine sulphate / Generic mfg., dexmedetomidine / Generic mfg.
Dexmedetomidine Alleviates Chronic Morphine Tolerance In Neuropathic Rats Via Nf-κB Signaling (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_153;
Meanwhile, the expression of proteins and inflammatory factors related to NPP in the spinal cord (SC) would be tested by WB, ELISA and qRT-PCR, etc. The primary result of the current study reveals that DEX postpones the formation of morphine tolerance and enhance the analgesic effect of morphine. The mechanism may be related to inhibiting the activation of TLR4/NF-κB signaling pathway in the spinal cord and down-regulating the expressions of inflammatory factors.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Single Chest Drain Practice Reduces Discharge Opioid Prescriptions in Thoracic Surgery. (Pubmed Central) - Aug 14, 2022
These results demonstrate once again the complexity and multimodal mechanisms underlying the clinical experience and impact of chronic pain. Single chest drain practice in lobectomies and segmentectomies was associated with less opioid prescription requirement without any increase in complications.
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