Extubation time, hemodynamic stability, and postoperative pain control in patients undergoing coronary artery bypass surgery: an evaluation of fentanyl, remifentanil, and nonsteroidal antiinflammatory drugs with propofol for perioperative and postoperative management

Maddali, Madan Mohan; Kurian, Elizabeth; Fahr, Jutta

doi:10.1016/j.jclinane.2006.03.022

Cited by 45 publications

(30 citation statements)

References 11 publications

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“…3. Rationale: For non-neuropathic pain, evidence supports using an opiate-based regimen to decrease pain intensity (87,90,91,(122)(123)(124)(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)(135)(136). Question: Should procedure-related pain be treated preemptively in adult ICU patients?…”

Section: Dosing Side Effects and Other Informationmentioning

confidence: 99%

“…Treatment of Pain a. For non-neuropathic pain, nonopioids such as IV acetaminophen (87), oral, IV, or rectal cyclooxygenase inhibitors (122,123,135), or IV ketamine (132,137) can be used in addition to opioids. (actionable) Answer: We recommend that preemptive analgesia and/ or nonpharmacologic interventions (e.g., relaxation) be administered to alleviate pain in adult ICU patients prior to chest tube removal (+1C).…”

Section: Dosing Side Effects and Other Informationmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Barr

Fraser

Puntillo

et al. 2013

Critical Care Medicine

3,135

3,013

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Section: Dosing Side Effects and Other Informationmentioning

confidence: 99%

Section: Dosing Side Effects and Other Informationmentioning

confidence: 99%

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Barr

Fraser

Puntillo

et al. 2013

Critical Care Medicine

3,135

3,013

View full text Add to dashboard Cite

show abstract

“…Non-opioid analgesics can be used in the ICU including orally or intravenously administered acetaminophen [41]; intravenously administered ketamine [42]; intravenously administered nefopam [43, 44] (thought to inhibit reuptake of dopamine, norepinephrine, and serotonin; used primarily in Europe); and orally, intravenously, and rectally administered cyclooxygenase inhibitors [45], although the last of these are limited by their side effect profile. Use of these medications in conjunction with opioids may decrease the overall quantity of opioids administered and the incidence and severity of opioid-related side effects [7].…”

Section: What Are Current Strategies For Managing Symptoms During Crimentioning

confidence: 99%

Palliative care in the ICU: relief of pain, dyspnea, and thirst—A report from the IPAL-ICU Advisory Board

Puntillo¹,

et al. 2013

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Purpose Pain, dyspnea, and thirst are three of the most prevalent, intense, and distressing symptoms of intensive care unit (ICU) patients. In this report, the interdisciplinary Advisory Board of the Improving Palliative Care in the ICU(IPAL-ICU) Project brings together expertise in both critical care and palliative care along with current information to address challenges in assessment and management. Methods We conducted a comprehensive review of literature focusing on intensive care and palliative care research related to palliation of pain, dyspnea, and thirst. Results Evidence-based methods to assess pain are the enlarged 0–10 Numeric Rating Scale (NRS) for ICU patients able to self-report and the Critical Care Pain Observation Tool or Behavior Pain Scale for patients who cannot report symptoms verbally or non-verbally. The Respiratory Distress Observation Scale is the only known behavioral scale for assessment of dyspnea, and thirst is evaluated by patient self-report using an 0–10 NRS. Opioids remain the mainstay for pain management, and all available intravenous opioids, when titrated to similar pain intensity end points, are equally effective. Dyspnea is treated (with or without invasive or noninvasive mechanical ventilation) by optimizing the underlying etiological condition, patient positioning and, sometimes, supplemental oxygen. Several oral interventions are recommended to alleviate thirst. Systematized improvement efforts addressing symptom management and assessment can be implemented in ICUs. Conclusions Relief of symptom distress is a key component of critical care for all ICU patients, regardless of condition or prognosis. Evidence-based approaches for assessment and treatment together with well-designed work systems can help ensure comfort and related favorable outcomes for the critically ill.

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“…NSAIDs reduce opioid requirements, in turn reducing the incidence and severity of opioid-induced side effects, such as sedation and respiratory depression [3]. Additionally, diclofenac, as part of a perioperative regimen in patients undergoing coronary artery bypass surgery, has shown reduced use of inotropes and a shorter time to extubation versus regimens relying solely on opioids for postoperative analgesia [4]. Parenteral NSAIDs may be particularly useful in outpatient surgical procedures where an expeditious recovery is desirable, in critically ill patients requiring multimodal analgesia, and where oral administration is not feasible, eg, in patients with postoperative ileus.…”

Section: Introductionmentioning

confidence: 99%

Platelet function following administration of a novel formulation of intravenous diclofenac sodium versus active comparators: a randomized, single dose, crossover study in healthy male volunteers

Bauer

Gerson²,

Wright³

et al. 2010

Journal of Clinical Anesthesia

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Extubation time, hemodynamic stability, and postoperative pain control in patients undergoing coronary artery bypass surgery: an evaluation of fentanyl, remifentanil, and nonsteroidal antiinflammatory drugs with propofol for perioperative and postoperative management

Cited by 45 publications

References 11 publications

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Palliative care in the ICU: relief of pain, dyspnea, and thirst—A report from the IPAL-ICU Advisory Board

Platelet function following administration of a novel formulation of intravenous diclofenac sodium versus active comparators: a randomized, single dose, crossover study in healthy male volunteers

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