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Yehuda Shavit - One of the best experts on this subject based on the ideXlab platform.
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continuous physostigmine combined with morphine based patient controlled analgesia in the Postoperative Period
Acta Anaesthesiologica Scandinavica, 2005Co-Authors: Benzion Beilin, M. Weinstock, Hanna Bessler, L Papismedov, Yehuda ShavitAbstract:Background: Recently, new drugs and techniques for the treatment of Postoperative pain were introduced, with the goal of enhancing opiates' analgesia while minimizing their side-effects. Cholinergic agents play an antinociceptive role, but their clinical use is quite limited, due to side-effects. Physostigmine is a cholinesterase inhibitor, which crosses the blood–brain barrier and elevates brain acetylcholine level. Physostigmine can produce analgesia by itself, and enhance opiate analgesia; but these effects are of short duration following bolus administration. Methods: We compared pain intensity and morphine consumption in two Postoperative treatment groups: One group received continuous physostigmine infusion combined with morphine-based patient-controlled analgesia (PCA), and the other received PCA alone. Cholinergic anti-inflammatory pathways have recently been described. We therefore also compared changes in proinflammatory cytokine production in the two pain management groups. Results: Continuous infusion of physostigmine combined with morphine-based PCA in the Postoperative Period significantly reduced opiate consumption, and enhanced the analgesic response. Patients in the physostigmine group also exhibited reduced ex-vivo production of the proinflammatory cytokine, IL-1β. At the same time, physostigmine increased nausea and vomiting, mostly in the first 2 h of the Postoperative Period. Conclusions: Physostigmine combined with morphine in the Postoperative Period reduced morphine consumption, enhanced analgesia, and attenuated production of the proinflammatory cytokine, IL-1β. This latter finding may account for the decreased pain observed in this group; this cytokine is known to mediate basal pain sensitivity and induce hyperalgesia in inflammatory conditions. Taking into account the other potential beneficial effects of physostigmine, we suggest that a continuous infusion of physostigmine should be considered as a useful component in multimodal Postoperative analgesia.
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effects of preemptive analgesia on pain and cytokine production in the Postoperative Period
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BACKGROUND: The Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuated proinflammatory cytokine response in the Postoperative Period. In the present study, the authors examined whether preemptive analgesia continued with PCEA may further attenuate the proinflammatory cytokine response and reduce pain sensitivity in the Postoperative Period. They compared cytokine production in two groups of patients, one receiving PCEA, the other receiving preemptive epidural analgesia continued by PCEA. METHODS: Female patients hospitalized for transabdominal hysterectomy were randomly assigned to one of two pain management techniques: PCEA or preemptive epidural analgesia followed by PCEA (PA + PCEA). Postoperative pain was assessed using the visual analog scale. Blood samples were collected before, 24, 48, and 72 h following surgery. Production of the following cytokines was assessed in stimulated peripheral blood mononuclear cells: interleukin (IL)-1beta, tumor necrosis factor alpha, IL-6, IL-1ra, IL-10, and IL-2. RESULTS: Patients of the PA + PCEA group exhibited lower pain scores throughout the 72 h Postoperatively, compared with patients of the PCEA group. In patients of the PA + PCEA group in the Postoperative Period, production of IL-1beta, IL-6, IL-1ra, and IL-10 was significantly less elevated, while IL-2 production was significantly less suppressed. CONCLUSIONS: Proinflammatory cytokines are key mediators of illness symptoms, including hyperalgesia. The present results suggest that preemptive epidural analgesia is associated with reduced Postoperative pain and attenuated production of proinflammatory cytokines.
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Effects of preemptive analgesia on pain and cytokine production in the Postoperative Period.
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BackgroundThe Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuat
Benzion Beilin - One of the best experts on this subject based on the ideXlab platform.
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low dose ketamine affects immune responses in humans during the early Postoperative Period
BJA: British Journal of Anaesthesia, 2007Co-Authors: Benzion Beilin, Y Rusabrov, Yoram Shapira, Leonid Roytblat, Lev Greemberg, I Z Yardeni, Hanna BesslerAbstract:Background Anaesthesia and surgery are associated with impairment of the immune system expressed as an excessive proinflammatory immune response and suppression of cell-mediated immunity that may affect the course of the Postoperative Period. Addition of anaesthetic agents capable of attenuating the alterations in perioperative immune function may exert a favourable effect on patients' healing. We have assessed the effect of preoperative administration of a sub-anaesthetic dose of ketamine on the mitogen response and production of interleukin (IL)-1β, IL-2, IL-6, and tumour necrosis factor (TNF)-α by peripheral blood mononuclear cells (PBMCs), as well as natural killer cell cytotoxicity (NKCC) in patients undergoing abdominal surgery. Methods Seventeen patients admitted for elective abdominal surgery were given ketamine 0.15 mg kg −1 i.v. 5 min before induction of general anaesthesia. Nineteen patients received a similar volume of isotonic saline 5 min before induction of the anaesthesia. PBMCs were isolated from venous blood before and 4, 24, 48, and 72 h after operation for IL-1β, IL-2, IL-6, and TNF-α secretion, and NKCC assessment. Results Four hours after operation, the cells from patients in the ketamine group showed a significantly suppressed production of IL-6 ( P P Conclusions Addition of small doses of ketamine before induction of anaesthesia resulted in attenuation of secretion of the proinflammatory cytokines IL-6 and TNF-α, and in preservation of IL-2 production at its preoperative level. It is suggested that this anaesthetic may be of value in preventing immune function alterations in the early Postoperative Period.
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continuous physostigmine combined with morphine based patient controlled analgesia in the Postoperative Period
Acta Anaesthesiologica Scandinavica, 2005Co-Authors: Benzion Beilin, M. Weinstock, Hanna Bessler, L Papismedov, Yehuda ShavitAbstract:Background: Recently, new drugs and techniques for the treatment of Postoperative pain were introduced, with the goal of enhancing opiates' analgesia while minimizing their side-effects. Cholinergic agents play an antinociceptive role, but their clinical use is quite limited, due to side-effects. Physostigmine is a cholinesterase inhibitor, which crosses the blood–brain barrier and elevates brain acetylcholine level. Physostigmine can produce analgesia by itself, and enhance opiate analgesia; but these effects are of short duration following bolus administration. Methods: We compared pain intensity and morphine consumption in two Postoperative treatment groups: One group received continuous physostigmine infusion combined with morphine-based patient-controlled analgesia (PCA), and the other received PCA alone. Cholinergic anti-inflammatory pathways have recently been described. We therefore also compared changes in proinflammatory cytokine production in the two pain management groups. Results: Continuous infusion of physostigmine combined with morphine-based PCA in the Postoperative Period significantly reduced opiate consumption, and enhanced the analgesic response. Patients in the physostigmine group also exhibited reduced ex-vivo production of the proinflammatory cytokine, IL-1β. At the same time, physostigmine increased nausea and vomiting, mostly in the first 2 h of the Postoperative Period. Conclusions: Physostigmine combined with morphine in the Postoperative Period reduced morphine consumption, enhanced analgesia, and attenuated production of the proinflammatory cytokine, IL-1β. This latter finding may account for the decreased pain observed in this group; this cytokine is known to mediate basal pain sensitivity and induce hyperalgesia in inflammatory conditions. Taking into account the other potential beneficial effects of physostigmine, we suggest that a continuous infusion of physostigmine should be considered as a useful component in multimodal Postoperative analgesia.
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effects of preemptive analgesia on pain and cytokine production in the Postoperative Period
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BACKGROUND: The Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuated proinflammatory cytokine response in the Postoperative Period. In the present study, the authors examined whether preemptive analgesia continued with PCEA may further attenuate the proinflammatory cytokine response and reduce pain sensitivity in the Postoperative Period. They compared cytokine production in two groups of patients, one receiving PCEA, the other receiving preemptive epidural analgesia continued by PCEA. METHODS: Female patients hospitalized for transabdominal hysterectomy were randomly assigned to one of two pain management techniques: PCEA or preemptive epidural analgesia followed by PCEA (PA + PCEA). Postoperative pain was assessed using the visual analog scale. Blood samples were collected before, 24, 48, and 72 h following surgery. Production of the following cytokines was assessed in stimulated peripheral blood mononuclear cells: interleukin (IL)-1beta, tumor necrosis factor alpha, IL-6, IL-1ra, IL-10, and IL-2. RESULTS: Patients of the PA + PCEA group exhibited lower pain scores throughout the 72 h Postoperatively, compared with patients of the PCEA group. In patients of the PA + PCEA group in the Postoperative Period, production of IL-1beta, IL-6, IL-1ra, and IL-10 was significantly less elevated, while IL-2 production was significantly less suppressed. CONCLUSIONS: Proinflammatory cytokines are key mediators of illness symptoms, including hyperalgesia. The present results suggest that preemptive epidural analgesia is associated with reduced Postoperative pain and attenuated production of proinflammatory cytokines.
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Effects of preemptive analgesia on pain and cytokine production in the Postoperative Period.
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BackgroundThe Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuat
Hanna Bessler - One of the best experts on this subject based on the ideXlab platform.
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low dose ketamine affects immune responses in humans during the early Postoperative Period
BJA: British Journal of Anaesthesia, 2007Co-Authors: Benzion Beilin, Y Rusabrov, Yoram Shapira, Leonid Roytblat, Lev Greemberg, I Z Yardeni, Hanna BesslerAbstract:Background Anaesthesia and surgery are associated with impairment of the immune system expressed as an excessive proinflammatory immune response and suppression of cell-mediated immunity that may affect the course of the Postoperative Period. Addition of anaesthetic agents capable of attenuating the alterations in perioperative immune function may exert a favourable effect on patients' healing. We have assessed the effect of preoperative administration of a sub-anaesthetic dose of ketamine on the mitogen response and production of interleukin (IL)-1β, IL-2, IL-6, and tumour necrosis factor (TNF)-α by peripheral blood mononuclear cells (PBMCs), as well as natural killer cell cytotoxicity (NKCC) in patients undergoing abdominal surgery. Methods Seventeen patients admitted for elective abdominal surgery were given ketamine 0.15 mg kg −1 i.v. 5 min before induction of general anaesthesia. Nineteen patients received a similar volume of isotonic saline 5 min before induction of the anaesthesia. PBMCs were isolated from venous blood before and 4, 24, 48, and 72 h after operation for IL-1β, IL-2, IL-6, and TNF-α secretion, and NKCC assessment. Results Four hours after operation, the cells from patients in the ketamine group showed a significantly suppressed production of IL-6 ( P P Conclusions Addition of small doses of ketamine before induction of anaesthesia resulted in attenuation of secretion of the proinflammatory cytokines IL-6 and TNF-α, and in preservation of IL-2 production at its preoperative level. It is suggested that this anaesthetic may be of value in preventing immune function alterations in the early Postoperative Period.
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continuous physostigmine combined with morphine based patient controlled analgesia in the Postoperative Period
Acta Anaesthesiologica Scandinavica, 2005Co-Authors: Benzion Beilin, M. Weinstock, Hanna Bessler, L Papismedov, Yehuda ShavitAbstract:Background: Recently, new drugs and techniques for the treatment of Postoperative pain were introduced, with the goal of enhancing opiates' analgesia while minimizing their side-effects. Cholinergic agents play an antinociceptive role, but their clinical use is quite limited, due to side-effects. Physostigmine is a cholinesterase inhibitor, which crosses the blood–brain barrier and elevates brain acetylcholine level. Physostigmine can produce analgesia by itself, and enhance opiate analgesia; but these effects are of short duration following bolus administration. Methods: We compared pain intensity and morphine consumption in two Postoperative treatment groups: One group received continuous physostigmine infusion combined with morphine-based patient-controlled analgesia (PCA), and the other received PCA alone. Cholinergic anti-inflammatory pathways have recently been described. We therefore also compared changes in proinflammatory cytokine production in the two pain management groups. Results: Continuous infusion of physostigmine combined with morphine-based PCA in the Postoperative Period significantly reduced opiate consumption, and enhanced the analgesic response. Patients in the physostigmine group also exhibited reduced ex-vivo production of the proinflammatory cytokine, IL-1β. At the same time, physostigmine increased nausea and vomiting, mostly in the first 2 h of the Postoperative Period. Conclusions: Physostigmine combined with morphine in the Postoperative Period reduced morphine consumption, enhanced analgesia, and attenuated production of the proinflammatory cytokine, IL-1β. This latter finding may account for the decreased pain observed in this group; this cytokine is known to mediate basal pain sensitivity and induce hyperalgesia in inflammatory conditions. Taking into account the other potential beneficial effects of physostigmine, we suggest that a continuous infusion of physostigmine should be considered as a useful component in multimodal Postoperative analgesia.
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effects of preemptive analgesia on pain and cytokine production in the Postoperative Period
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BACKGROUND: The Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuated proinflammatory cytokine response in the Postoperative Period. In the present study, the authors examined whether preemptive analgesia continued with PCEA may further attenuate the proinflammatory cytokine response and reduce pain sensitivity in the Postoperative Period. They compared cytokine production in two groups of patients, one receiving PCEA, the other receiving preemptive epidural analgesia continued by PCEA. METHODS: Female patients hospitalized for transabdominal hysterectomy were randomly assigned to one of two pain management techniques: PCEA or preemptive epidural analgesia followed by PCEA (PA + PCEA). Postoperative pain was assessed using the visual analog scale. Blood samples were collected before, 24, 48, and 72 h following surgery. Production of the following cytokines was assessed in stimulated peripheral blood mononuclear cells: interleukin (IL)-1beta, tumor necrosis factor alpha, IL-6, IL-1ra, IL-10, and IL-2. RESULTS: Patients of the PA + PCEA group exhibited lower pain scores throughout the 72 h Postoperatively, compared with patients of the PCEA group. In patients of the PA + PCEA group in the Postoperative Period, production of IL-1beta, IL-6, IL-1ra, and IL-10 was significantly less elevated, while IL-2 production was significantly less suppressed. CONCLUSIONS: Proinflammatory cytokines are key mediators of illness symptoms, including hyperalgesia. The present results suggest that preemptive epidural analgesia is associated with reduced Postoperative pain and attenuated production of proinflammatory cytokines.
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Effects of preemptive analgesia on pain and cytokine production in the Postoperative Period.
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BackgroundThe Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuat
Sally Waichi Chan - One of the best experts on this subject based on the ideXlab platform.
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patients experiences of performing self care of stomas in the initial Postoperative Period
Cancer Nursing, 2015Co-Authors: Sally Waichi Chan, Honggu HeAbstract:Abstract With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management. The aim of this study was to investigate patients' experiences of performing self-care of stomas in the initial Postoperative Period. This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month Postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data. Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education. This study highlights the importance of health professionals' role in helping patients adjust preoperatively and Postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day Postoperative Period. Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.
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patients experiences of performing self care of stomas in the initial Postoperative Period
Cancer Nursing, 2015Co-Authors: Siew Hoon Lim, Sally Waichi ChanAbstract:Background With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management. Objective The aim of this study was to investigate patients' experiences of performing self-care of stomas in the initial Postoperative Period. Methods This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month Postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data. Results Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education. Conclusions This study highlights the importance of health professionals' role in helping patients adjust preoperatively and Postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day Postoperative Period. Implications for practice Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.
Eduard Mayburd - One of the best experts on this subject based on the ideXlab platform.
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effects of preemptive analgesia on pain and cytokine production in the Postoperative Period
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BACKGROUND: The Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuated proinflammatory cytokine response in the Postoperative Period. In the present study, the authors examined whether preemptive analgesia continued with PCEA may further attenuate the proinflammatory cytokine response and reduce pain sensitivity in the Postoperative Period. They compared cytokine production in two groups of patients, one receiving PCEA, the other receiving preemptive epidural analgesia continued by PCEA. METHODS: Female patients hospitalized for transabdominal hysterectomy were randomly assigned to one of two pain management techniques: PCEA or preemptive epidural analgesia followed by PCEA (PA + PCEA). Postoperative pain was assessed using the visual analog scale. Blood samples were collected before, 24, 48, and 72 h following surgery. Production of the following cytokines was assessed in stimulated peripheral blood mononuclear cells: interleukin (IL)-1beta, tumor necrosis factor alpha, IL-6, IL-1ra, IL-10, and IL-2. RESULTS: Patients of the PA + PCEA group exhibited lower pain scores throughout the 72 h Postoperatively, compared with patients of the PCEA group. In patients of the PA + PCEA group in the Postoperative Period, production of IL-1beta, IL-6, IL-1ra, and IL-10 was significantly less elevated, while IL-2 production was significantly less suppressed. CONCLUSIONS: Proinflammatory cytokines are key mediators of illness symptoms, including hyperalgesia. The present results suggest that preemptive epidural analgesia is associated with reduced Postoperative pain and attenuated production of proinflammatory cytokines.
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Effects of preemptive analgesia on pain and cytokine production in the Postoperative Period.
Anesthesiology, 2003Co-Authors: Benzion Beilin, Hanna Bessler, Eduard Mayburd, Genady Smirnov, Arie Dekel, Israel Z Yardeni, Yehuda ShavitAbstract:BackgroundThe Postoperative Period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuat
