Side Effects Of Propofol

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

In addition, Ozyilmaz K etal 2012(15) assessed wound infiltration with saline, levobupivacaine, tramadol or tramadol plus levobupivacaine in lumbar disc surgeries. They observed that the time to first analgesia was earliest in saline group, followed by levobupivacaine group then tramadol group. None of the patients in tramadol plus levobupivacaine group required postoperative analgesic supplementation, and the visual analog scale scores were <3 at all measurement times and this may be attributed to high levobupivacaine dose (100 mg) which is double of our study.

2A). Baclofen in all three doses increased the pain threshold in randall sellitto test and significant differences observed in mechanical hyperalgesia comparing to pre injection values (df:42,5 ; F=6.93; P<0.05) (Fig. 2B). The effect of different doses of baclofen on pain threshold in acetone test was differed and intrathecal injection of lowest dose (0.01 μg) significantly decreased the cold allodynia (df:42,5 ; F=5.84; P<0.001) but intrathecal injection of 1 and 0.1 μg of baclofen did not show any significant effect (fig. 2C). Also the effect of different doses of baclofen on mechanical allodynia was not similar and injection of 0.01 μg did not change the pain threshold compared to pre injection values. Intrathecal injection of 0.01 and 0.1 μg of baclofen decreased the mechanical allodynia (P<0.01 and P<0.05 respectively).

Adequate and effective management of perineal pain begins with a comprehensive assessment (Marcus et al, 2009; Breivikl et al, 2008; Dalton et al, 1999). However, Andrews et al, (2008) UK-based study concluded that there is no pain scale to date that has been developed to appropriately and accurately assess the perineal pain that women experience during the postnatal period. This begins to offer explanation as why up to 92% of new mothers endure perineal pain in the early postpartum period (Macarthur and Macarthur, 2004).To further support these findings Way (2012) discovered that women expect perineal pain following vaginal birth but under estimate the severity of the pain. Women will experience high levels of pain before requesting analgesia as they attempt to normalise the pain as a consequence of vaginal delivery (Swain and Dahlen, 2013). Macarthur and Macarthur (2004) conclude that the current management of perineal pain is inadequate as the use of analgesia is not standardised.

Pain intensity 14 days post haemorrhoidectomy was similar in sucralfate and lidocaine groups (P>0.05) and both were significantly lower than placebo (P<0.05). Later on, visits showed no significant difference regarding pain intensity between all groups.

In all, when compared to other GABAa agonist such as thiopental, methohexital, and etomidate, propofol has shown to decrease the occurrence of major side effects involved with general anesthesia in use today. This, along with its perfusion proficiency and high positive outcome rate are why propofol is in continued use, even after over 30 years of medical advancement, and bad press due to recreational propofol abuse, leading to the deaths of those without the proper training needed to administer such a

Propofol was originally available in 1986 and has been used as an anesthesia, for “short sedation in endoscopies and cardioversions, and for long-term sedations in intensive care units and also used for rapid opiate detoxification”(Bonnet, 2012). Propofol is used, unapproved by the FDA, as pain reliever for severe chronic headaches and as a sleep aid for insomnia.

More possible drugs treatments that are used include Gabapentin and Pregabalin. These two are thought to be effective in variety of neuropathic pain problems. They act by binding to voltage gated calcium channels. However, the side effects of this drug are somnolence and dizziness, which can be minimized by using gradual dose titration. Intravenous Lidocaine also has been reported that it brings good results in neuropathic pain. Mexiletine, an oral analogue of intravenous Lidocaine has been shown in a small study that is results in pain relief in phantom limb

Local anaesthetics are naturally vasodilators; that makes their action shorter and less profound. Adrenaline with its vasoconstrictive role increases the depth and the duration hence makes the action of local anaesthetic more profound. 1,2,3,4,9 This action is governed by many factors like the type of the anaesthetic used, the concentration of the epinephrine and site of injection. For example, one study shows that the use of the 1% Lidocaine with 1: 100 000 epinephrine has better anesthetic effect in maxilla if compared with 4% Articaine without epinephrine. The same review reports a study that shows 1% Lidocaine without epinephrine doesn’t have an effect when used for infiltration in the maxilla.1 In the mandible, one study shows that epinephrine in a concentration of 1:100 000 significantly affects the duration and onset of action of 4% Articaine. The author argues that other aspects such as intra and post-operative pain and injection pain remain unaffected. Hence it is suggested that when this property is not needed, such as in simple extractions of lower teeth, IANB with plain 4% Articaine can work well. 11Another beneficial effect of epinephrine is related to producing hemostasis that helps with the visibility of the working area and hence increases the efficiency and accuracy of certain procedures.9 It is evident that this effect is primarily governed by the concentration of the epinephrine and the

This study was carried out comparing the efficacy of analgesia, occurrence of side effects from the drugs employed and patient compliance during the drug usage with diclofenac sodium trans dermal patch 100 mg, oral supplementation of diclofenac sodium 50 mg given as twice daily medication and intra muscular administration of 75 mg diclofenac sodium once

The duration of sensory block in L (114.30 ± 38.416), LF (234.27 ± 49.087 ), and motor block in L (151.67 ± 50.84), LF (192 ± 41.33) out lasted the duration of surgery .Time to analgesia was 157.67 ± 37.66 (L), versus 241.3 ± 65.04 (LF).In fentanyl group, there was significant prolongation of sensory block , motor block and the total analgesia time (P < 0.05). Pruritus was experienced by 8.6% patients in fentanyl group.No significant hemodynamic changes were noted.

Background: Postoperative pain in pediatrics causes psychological and physiological problems, so preemptive analgesia is important, even in newborns. Caudal block is a useful adjuvant with general anesthesia and for postoperative analgesia for infraumbilical operations. Levobupivacaine is less cardiotoxic, less neurotoxic and equally potent local anesthetic compared to its racemate.

Hysterectomy assisted by laparoscopic techniques has been used for 25 years and recently also by a robot-assisted procedure. The robot-assisted procedure has been shown to have certain advantages over conventional laparoscopic hysterectomy, as it is associated with shorter length of stay (LOS) and fewer conversions to laparotomy 1. Both conventional laparoscopic hysterectomy and the robot-assisted procedure have many advantages over open surgery, as it significantly reduces the need for blood transfusion as well as pain and the amount of analgesia used 2. However, well-performed studies with multimodal pain-management are needed in order to reduce the amount of opioids used and thereby reducing the well-known side-effects, such as postoperative nausea and vomiting (PONV) 3.

Background: Transversus Abdominis –Plane (TAP) block used for management of surgical abdominal pain by injecting local anesthestics into plane between the internal oblique and transversus abdominis muscles. Injecting opioids close to the nerve trunks or nerve endings to improve efficacy of post-operative analgesia. We aimed to explore the effect of adding morphine to bupivacaine in ultrasound guided TAP-block in patients undergoing lower abdominal cancer surgery.

Pethidine is a synthetic opioid and was historically used as a sedative. It intervenes in the transmission of pain signals to the central nervous system and induces a state of euphoria and sleepiness/sedation. However, pethidine is used in New Zealand for pain relief despite the fact that it does not relief pain (Goodsone & Martis, 2014, p.23). In Watts’ article, it was found in a double-blind randomised controlled trial that 23.8% of 84 labouring women who used intravenous pethidine had their pain being relieved compared to 7% of them who had placebo. There is a significant difference between these two groups (p < 0.05) but there was no significant difference between the median or mean visual analogue pain scores in the pethidine and placebo groups. Pethidine significantly increased the sedation scores, dizziness, nausea and vomiting (2004).