Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of ketorolac, a non-steroidal anti-inflammatory drug, in the management of moderate to severe pain in adults, has led us to conduct a trial of this analgesic in children following tonsillectomy. Children were randomized to receive intramuscular (i.m.) ketorolac (1 mg/kg, EXP group, n = 45) or saline (CTL group, n = 42) at the completion of surgery. Intravenous (i.v.) fentanyl (0.5 micrograms/kg/dose) was administered in repeated doses postoperatively. Pain intensity was measured using both the Oucher and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) to allow for comparison between self-report and behavioral measures of pain intensity. Severity of postoperative bleeding was measured using a 4-point rating scale. The EXP group had a significant reduction in total fentanyl dose (mean: 35.9 micrograms) compared to the CTL group (mean: 48.3 micrograms, t = -2.21, P < 0.03). There was a statistically significant decrease in pre-fentanyl CHEOPS scores in the Post-Anesthesia Care Unit (PACU) in the ketorolac group (F (2, 30) = 5.34, P < 0.01), but not in the saline group (F (2.24) = 2.46, P > 0.05). In the first hour postoperatively, the CHEOPS demonstrated significant decreases in pain intensity scores in response to opioids, in both groups. In the PACU, children were unable to provide a self-report of pain intensity potentially due to a variety of factors (e.g., emergence delirium, agitation, excitement, sedation, and/or pain). However, during the remainder of the postoperative stay, the photographic scale of the Oucher was a more valid measure of pain intensity than the CHEOPS.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analgesic efficacy and safety of single-dose intramuscular ketorolac for postoperative pain management in children following tonsillectomy. 764 38

The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort (CRBD) after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale: (1) no pain, (2) mild pain (revealed only by interviewing the patient), (3) moderate (a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation) and (4) severe discomfort (agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra). Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD (mild CRBD: 40.5%; moderate or severe CRBD: 44.0%) at day 1, while 31.9% developed CRBD (mild CRBD: 29.3%; moderate or severe CRBD: 2.6%) at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI (1.1-5.6), P<0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI (0.1-0.6), P<0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI (1.2-8.9), P<0.05] and history of catheterization [OR=0.5, 95%CI (0.2-0.9), P<0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP(B)=3.074, 95%CI (1.3-7.4), P<0.05] and the history of catheterization [EXP(B)=2.458, 95%CI (1.1-5.9), P<0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.
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PMID:Predictors of catheter-related bladder discomfort after urological surgery. 2513 27