The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
J. B. Dahl - One of the best experts on this subject based on the ideXlab platform.
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Adductor canal blockade for moderate to Severe Pain after arthroscopic knee surgery: a randomized controlled trial.
Acta Anaesthesiologica Scandinavica, 2014Co-Authors: M Espelund, Ulrik Grevstad, Pia Jæger, P Hölmich, L Kjeldsen, Ole Mathiesen, J. B. DahlAbstract:Background The analgesic effect of the adductor canal block (ACB) after knee surgery has been evaluated in a number of trials. We hypothesized that the ACB would provide substantial Pain relief to patients responding with moderate to Severe Pain after arthroscopic knee surgery. Methods Fifty subjects with moderate to Severe Pain after arthroscopic knee surgery were enrolled in this placebo-controlled, blinded trial. All subjects received two ACBs; an initial ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 25) (R group) or saline (n = 25) (C group) and after 45 min a second ACB with the opposite study medication, according to randomization. Primary outcome was Pain during 45 degrees active flexion of the knee at 45 min after the first block, assessed on a 0–100 mm visual analogue scale. Secondary outcome measures were: Pain at rest and during flexion of the knee, worst Pain experienced during a 5-m walk, patient's evaluation of muscle strength during walk, and amount of sufentanil administered during the 90-min study period. Results Regarding primary outcome, mean Pain score difference between groups was 34 (95% CI: 25 to 44) mm, P
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effect of adductor canal block on Pain in patients with Severe Pain after total knee arthroplasty a randomized study with individual patient analysis
BJA: British Journal of Anaesthesia, 2014Co-Authors: Ulrik Grevstad, Ole Mathiesen, T Lind, J. B. DahlAbstract:Background Total knee arthroplasty (TKA) is associated with varying degrees of Pain. A considerable proportion (25–40%) of patients experience Severe Pain, despite a comprehensive multimodal analgesic regimen. We hypothesized that adductor canal block (ACB) would reduce Pain in this patient category compared with placebo. Methods Fifty patients with Severe Pain, defined as having a visual analogue scale (VAS) Pain score of >60 during active flexion of the knee on the first or the second postoperative day after TKA, were included in this randomized, double-blind, placebo-controlled trial. All the patients had received a comprehensive multimodal analgesic regimen. Group A received an ACB with ropivacaine 0.75%, 30 ml at time 0 and isotonic saline after 45 min. Group B received an ACB with isotonic saline at time 0 and ropivacaine 0.75%, 30 ml after 45 min. Results A 32-mm difference in VAS Pain score, during active flexion of the knee (primary endpoint), was observed in favour of Group A, 95% confidence interval (CI): 23–42, P Conclusions ACB reduced VAS with 32 mm, during active flexion of the knee, in patients with Severe Pain after TKA, but a large proportion (78%) still had at least moderate, movement-related Pain. Clinical trial registration www.clinicaltrials.gov , NCT01549704.
Mayckel Da Silva Barreto - One of the best experts on this subject based on the ideXlab platform.
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Clinical approaches and satisfaction with analgesia of trauma victims with Severe Pain* Condutas clínicas e satisfação diante da analgesia em vítimas de trauma com dor intensa
2020Co-Authors: Andrea Regina Martin, Jamyle Rubio Soares, Débora Comin Baronceli, Sonia Silva Marcon, Mayckel Da Silva BarretoAbstract:BACKGROUND AND OBJECTIVES: The profile of victims assisted by emergency units with Severe Pain and the satisfaction with analgesia should guide therapeutic approaches and care in such services. This study aimed at observing socio-demographic characteristics associated to Severe Pain in trauma victims and at evaluating whether there have been differences in clinical approaches and satisfaction with analgesia for those with moderate or Severe Pain. METHODS: This is a descriptive cross-sectional study carried out with 83 patients with acute, moderate or Severe Pain after physical trauma. Data were collected in October 2013 by means of a structured tool with questions about socio-demographic profile and Pain evaluation after initial medical assistance. RESULTS: It was observed that 53.02% of respondents have classified Pain at admission as Severe, which was associated to age between 18 and 49 years and education less than eight years. Individuals with Severe Pain had higher chances of simultaneously receiving non-pharmacological measures and intravenous drugs, have reported improvement only 30 minutes after their administration and were not happy with analgesia. CONCLUSION: Most patients were young, with education less than eight years and have reported Severe Pain. Dissatisfaction with analgesia was more frequent among Severe Pain patients. Health professionals should be alert for age and education characteristics when evaluating Pain in trauma victims and should carefully evaluate clinical approaches to be used.
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Clinical approaches and satisfaction with analgesia of trauma victims with Severe Pain
Revista Dor, 2015Co-Authors: Andrea Regina Martin, Jamyle Rubio Soares, Débora Comin Baronceli, Sonia Silva Marcon, Mayckel Da Silva BarretoAbstract:BACKGROUND AND OBJECTIVES: The profile of victims assisted by emergency units with Severe Pain and the satisfaction with analgesia should guide therapeutic approaches and care in such services. This study aimed at observing socio-demographic characteristics associated to Severe Pain in trauma victims and at evaluating whether there have been differences in clinical approaches and satisfaction with analgesia for those with moderate or Severe Pain. METHODS: This is a descriptive cross-sectional study carried out with 83 patients with acute, moderate or Severe Pain after physical trauma. Data were collected in October 2013 by means of a structured tool with questions about socio-demographic profile and Pain evaluation after initial medical assistance. RESULTS: It was observed that 53.02% of respondents have classified Pain at admission as Severe, which was associated to age between 18 and 49 years and education less than eight years. Individuals with Severe Pain had higher chances of simultaneously receiving non-pharmacological measures and intravenous drugs, have reported improvement only 30 minutes after their administration and were not happy with analgesia. CONCLUSION: Most patients were young, with education less than eight years and have reported Severe Pain. Dissatisfaction with analgesia was more frequent among Severe Pain patients. Health professionals should be alert for age and education characteristics when evaluating Pain in trauma victims and should carefully evaluate clinical approaches to be used.
Ulrik Grevstad - One of the best experts on this subject based on the ideXlab platform.
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Adductor canal blockade for moderate to Severe Pain after arthroscopic knee surgery: a randomized controlled trial.
Acta Anaesthesiologica Scandinavica, 2014Co-Authors: M Espelund, Ulrik Grevstad, Pia Jæger, P Hölmich, L Kjeldsen, Ole Mathiesen, J. B. DahlAbstract:Background The analgesic effect of the adductor canal block (ACB) after knee surgery has been evaluated in a number of trials. We hypothesized that the ACB would provide substantial Pain relief to patients responding with moderate to Severe Pain after arthroscopic knee surgery. Methods Fifty subjects with moderate to Severe Pain after arthroscopic knee surgery were enrolled in this placebo-controlled, blinded trial. All subjects received two ACBs; an initial ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 25) (R group) or saline (n = 25) (C group) and after 45 min a second ACB with the opposite study medication, according to randomization. Primary outcome was Pain during 45 degrees active flexion of the knee at 45 min after the first block, assessed on a 0–100 mm visual analogue scale. Secondary outcome measures were: Pain at rest and during flexion of the knee, worst Pain experienced during a 5-m walk, patient's evaluation of muscle strength during walk, and amount of sufentanil administered during the 90-min study period. Results Regarding primary outcome, mean Pain score difference between groups was 34 (95% CI: 25 to 44) mm, P
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effect of adductor canal block on Pain in patients with Severe Pain after total knee arthroplasty a randomized study with individual patient analysis
BJA: British Journal of Anaesthesia, 2014Co-Authors: Ulrik Grevstad, Ole Mathiesen, T Lind, J. B. DahlAbstract:Background Total knee arthroplasty (TKA) is associated with varying degrees of Pain. A considerable proportion (25–40%) of patients experience Severe Pain, despite a comprehensive multimodal analgesic regimen. We hypothesized that adductor canal block (ACB) would reduce Pain in this patient category compared with placebo. Methods Fifty patients with Severe Pain, defined as having a visual analogue scale (VAS) Pain score of >60 during active flexion of the knee on the first or the second postoperative day after TKA, were included in this randomized, double-blind, placebo-controlled trial. All the patients had received a comprehensive multimodal analgesic regimen. Group A received an ACB with ropivacaine 0.75%, 30 ml at time 0 and isotonic saline after 45 min. Group B received an ACB with isotonic saline at time 0 and ropivacaine 0.75%, 30 ml after 45 min. Results A 32-mm difference in VAS Pain score, during active flexion of the knee (primary endpoint), was observed in favour of Group A, 95% confidence interval (CI): 23–42, P Conclusions ACB reduced VAS with 32 mm, during active flexion of the knee, in patients with Severe Pain after TKA, but a large proportion (78%) still had at least moderate, movement-related Pain. Clinical trial registration www.clinicaltrials.gov , NCT01549704.
Richard L Nahin - One of the best experts on this subject based on the ideXlab platform.
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Severe Pain in veterans the effect of age and sex and comparisons with the general population
The Journal of Pain, 2017Co-Authors: Richard L NahinAbstract:Abstract This study provides national prevalence estimates of US military veterans with Severe Pain, and compares veterans with nonveterans of similar age and sex. Data used are from the 2010 to 2014 National Health Interview Survey on 67,696 adults who completed the Adult Functioning and Disability Supplement. Participants with Severe Pain were identified using a validated Pain severity coding system imbedded in the National Health Interview Survey Adult Functioning and Disability Supplement. It was estimated that 65.5% of US military veterans reported Pain in the previous 3 months, with 9.1% classified as having Severe Pain. Compared with veterans, fewer nonveterans reported any Pain (56.4%) or Severe Pain (6.4%). Whereas veterans aged 18 to 39 years had significantly higher prevalence rates for Severe Pain (7.8%) than did similar-aged nonveterans (3.2%), veterans age 70 years or older were less likely to report Severe Pain (7.1%) than nonveterans (9.6%). Male veterans (9.0%) were more likely to report Severe Pain than male nonveterans (4.7%); however, no statistically significant difference was seen between the 2 female groups. The prevalence of Severe Pain was significantly higher in veterans with back Pain (21.6%), jaw Pain (37.5%), Severe headaches or migraine (26.4%), and neck Pain (27.7%) than in nonveterans with these conditions (respectively: 16.7%, 22.9%, 15.9%, and 21.4%). Although veterans (43.6%) were more likely than nonveterans (31.5%) to have joint Pain, no difference was seen in the prevalence of Severe Pain associated with this condition. Perspective Prevalence of Severe Pain, defined as that which occurs “most days” or “every day” and bothers the individual “a lot,” is strikingly more common in veterans than in members of the general population, particularly in veterans who served during recent conflicts. Additional assistance may be necessary to help veterans cope with their Pain.
Rob Riemsma - One of the best experts on this subject based on the ideXlab platform.
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Review Systematic review of tapentadol in chronic Severe Pain
2020Co-Authors: Rob Riemsma, Carol A Forbes, Julie Harker, Gill Worthy, Kate MissoAbstract:Aim: A systematic review of chronic Pain treatment with strong opioids (step 3 WHO Pain ladder) and a comparison to a new drug recently approved for the treatment of Severe chronic Pain in Europe, tapentadol (Palexia, Nucynta*), were performed. Methods: Thirteen electronic databases were searched as well as a number of other sources from 1980 up to November 2010 for relevant randomized controlled clinical trials in chronic moderate and Severe Pain investigating at least one step 3 opioid. Chronic Pain could be nociceptive or neuropathic, malignant or nonmalignant, all systemic administrations were considered as well as trials of different lengths. Two separate analyses were performed, one only for trials which reported (at least as sub-groups) the outcome in patients with Severe Pain, the other including both moderate and Severe Pain conditions. With the exception of the direct comparison between tapentadol, oxycodone and placebo, indirect comparisons were performed based on a network analysis. Trials with an enriched or an enriched withdrawal design were excluded. Primary (Pain intensity) and a number of secondary endpoints were evaluated, including Pain relief (30% and 50%), patient global impression of change, quality of life, quality of sleep, discontinuations, as well as serious adverse events and selected adverse events. Results: Only 10 trials were eligible for analysis of patients with Severe Pain (eight investigating tapentadol and two trials comparing buprenorphine patch vs placebo). For moderate and Severe Pain, 42 relevant trials were identified and indirect comparisons with transdermal buprenorphine, transdermal fentanyl, hydromorphone, morphine, and oxymorphone were performed. This report focuses on the network analysis. Tapentadol showed statistically favourable results over oxycodone for Pain intensity, 30% and 50% Pain relief, patient global impression of change (PGIC), and quality of life. Furthermore, some of the most important adverse events of chronic opioid treatment were significantly less frequent with tapentadol as compared to oxycodone, i.e. constipation, nausea, and vomiting; discontinuations due to these adverse events were found significantly reduced with tapentadol. Similar results were obtained for the network analysis, i.e. tapentadol was superior for the primary outcome (Pain intensity) to hydromorphone and morphine, whereas fentanyl and oxymorphone showed trends in favour of these treatments. Significantly less frequent gastrointestinal adverse events of tapentadol were observed in comparison with fentanyl, hydromorphone, morphine, and oxymorphone, apparently leading to significantly reduced treatment discontinuations (for any reason).
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systematic review of tapentadol in chronic Severe Pain
Current Medical Research and Opinion, 2011Co-Authors: Rob Riemsma, Carol A Forbes, Julie Harker, Gill Worthy, Kate Misso, Michael Schafer, Jos Kleijnen, Steffen SturzebecherAbstract:AbstractAim:A systematic review of chronic Pain treatment with strong opioids (step 3 WHO Pain ladder) and a comparison to a new drug recently approved for the treatment of Severe chronic Pain in Europe, tapentadol (Palexia, Nucynta *Co-manufactured. Palexia is a registered trade name of Grunenthal, Aachen Germany. Nucynta is a registered trade name of Johnson and Johnson, New Brunswick, NJ, USA.), were performed.Methods:Thirteen electronic databases were searched as well as a number of other sources from 1980 up to November 2010 for relevant randomized controlled clinical trials in chronic moderate and Severe Pain investigating at least one step 3 opioid. Chronic Pain could be nociceptive or neuropathic, malignant or non-malignant, all systemic administrations were considered as well as trials of different lengths. Two separate analyses were performed, one only for trials which reported (at least as sub-groups) the outcome in patients with Severe Pain, the other including both moderate and Severe Pain co...
