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Effect of a multimodal analgesia strategy on remifentanil daily consumption in mechanically ventilated adult ICU patients: study protocol for a randomised, placebo-controlled, double-blind, parallel-group clinical trial.
BMJ Open
January 2025
Division of Anesthesia Critical care, Emergency and Pain Medicine, University Hospital Centre Nimes, Nimes, Occitanie, France.
Introduction: Intensive care unit (ICU) patients under mechanical ventilation experience mild-to-severe pain. International guidelines emphasise the importance and benefits of multimodal analgesia to minimise opioid consumption and its side effects. However, no recommendation about drugs or protocol has been formulated.
View Article and Find Full Text PDFMultimodal analgesia with parasternal plane block protocol within an enhanced recovery after cardiac surgery program decreases opioid use.
JTCVS Open
December 2024
Department of Cardiac Surgery, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France.
Objective: This study investigated the efficacy of a multimodal analgesia (MMA) with an opioid-sparing strategy, incorporating a parasternal plane block (PPB) within a systematic standardized Enhanced Recovery After Surgery (ERAS) program for patients undergoing elective cardiac surgery.
Methods: From 2015 to 2021, 3153 patients underwent elective coronary artery bypass grafting and/or valve procedures. Patients were dichotomized by the presence or absence of an ERAS program including a perioperative MMA with an opioid-sparing approach and PPB protocols.
Transitioning to Opioid-free Anesthesia for Pediatric Supracondylar Fracture Repairs: A Patient Safety Report.
Pediatr Qual Saf
January 2025
From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Wash.
Introduction: Supracondylar fractures are among the most common injuries in the pediatric population. Recently, there has been increased interest in developing opioid-free anesthetic protocols that achieve these same goals without the risks associated with opioid use, such as postoperative nausea and vomiting (PONV), delayed discharges, and respiratory depression.
Methods: Seattle Children's Hospital implemented opioid-free anesthesia (OFA) for pediatric supracondylar fracture repairs in January 2021.
Breaking Down Complications With Locoregional Anesthesia: A Game-Changer for Pain Management in Pediatric Emergencies.
Cureus
December 2024
Anesthesia and Intensive Care Unit, Giuseppe Mazzini Hospital, Teramo, ITA.
The management of postoperative pain in pediatric patients undergoing emergency surgical procedures, particularly in non-pediatric hospitals, presents significant challenges due to the unique physiological requirements of children. The utilization of opioid analgesia may result in severe complications, necessitating a transition toward multimodal analgesia, which integrates various pain management strategies to enhance effectiveness while mitigating adverse effects. Locoregional anesthesia techniques, such as fascial plane blocks, provide targeted pain alleviation, reducing dependence on opioids.
View Article and Find Full Text PDFComparison of hemodynamic responses to nasal intubation in cancer patients receiving opioid-free general anesthesia versus standard regimen.
J Anaesthesiol Clin Pharmacol
November 2024
Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Background And Aims: Nasotracheal intubation evokes greater hemodynamic responses than oral intubation. We compared the heart rate (HR) and mean arterial pressure (MAP) responses following nasal intubation during opioid-free anesthesia (OFA) using intravenous lignocaine versus standard regimen using morphine in cancer patients undergoing tumor resection.
Material And Methods: This randomized, double-blinded study was conducted in 84 adults.
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