Medico-legal Aspects of Pain Medicine

Racz, Gabor B.; Noe, Carl E.; Munglani, Rajesh

doi:10.5772/58754

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…However, the extensive thoraco-abdominal sympathetic chain block produced by TEA may have attenuated sympathetic activation due to viscera manipulation, Fig. 2 Pain scores (median and range) assessed using the short form glasgow compositive pain scale in the first 24 postoperative hours in dogs undergoing major thoracic and abdominal surgery in which TEA (thoracic epidural anaesthesia) and ITM (intrathecal morphine) was used to provide intraoperative analgesia resulting in a more stable anaesthesia [27,28]. This may explain the lower use of intraoperative fentanyl after surgical access to the body cavity was made.…”

Section: Discussionmentioning

confidence: 99%

Thoracic epidural anaesthesia vs intrathecal morphine in dogs undergoing major thoracic and abdominal surgery: clinical study

Lardone

Sarotti²,

Giacobino

et al. 2022

BMC Vet Res

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Background There is scant clinical research on neuraxial analgesia in dogs undergoing major surgery. With this study we compared the perioperative analgesic effects of thoracic epidural anaesthesia (TEA) and intrathecal morphine (ITM) in dogs scheduled for thoracic or cranial abdominal surgery. The dogs received methadone and dexmedetomidine, were anaesthetized with propofol maintained with sevoflurane, and randomly assigned to receive either TEA (ropivacaine 0.5% at 0.2 mg/kg and morphine 0.1 mg/kg administered at T12-T13) or ITM (morphine 30 μg/kg administered at L6-L7). Intraoperative rescue analgesia (iRA) was fentanyl 1 μg/kg administered if heart rate or mean arterial pressure increased by 30% above the pre-stimulation level. Glasgow Pain Composite Scale score (GPCS) dictated the use of postoperative rescue analgesia (pRA) with methadone 0.2 mg/kg. Results There was a statistically significant difference in iRA, median time to first fentanyl bolus, median fentanyl dose after surgical opening, and median GPCS score at 30 minutes (min), 1 ,2, 4, 6, and 8 hours (h) between the two groups (p<0.001; p<0.001; p<0.001; p<0.01; p<0.01; p<0.001; p<0.01; p=0.01; p=0.01, respectively). Fewer TEA than ITM group dogs required iRA during surgical opening and pRA: 5% (1/18) and 2/18 (11%), respectively, in the TEA and 83% (16/18) and 10/18 (55%), respectively, in the ITM group. Side effects were urinary retention in 3/18 (16%) TEA group dogs and 2/18 (11%) ITM group dogs and prolonged sedation in 2/18 (11%) in ITM group dogs. TEA and ITM were effective in managing perioperative pain in dogs undergoing thoracic or cranial abdominal surgery.

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Section: Discussionmentioning

confidence: 99%

Thoracic epidural anaesthesia vs intrathecal morphine in dogs undergoing major thoracic and abdominal surgery: clinical study

Lardone

Sarotti²,

Giacobino

et al. 2022

BMC Vet Res

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“…Patients with acute or chronic obstetric or nonobstetric pain should be informed on the mode and method of treatment, possible side effects, and effects of drugs or procedures on fetal growth and development (informed consent). The principles of perinatal pharmacology and toxicology should be respected, choosing the mode of treatment associated with the lowest rate of side effects and a minimally invasive procedure ( 1 - 3 ).…”

Section: Introductionmentioning

confidence: 99%

Medico- Legal Responsibility in Management of Acute and Chronic Pain in Obstetric

Habek

2019

ACC

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SUMMARYMedico-legal responsibility in the management of acute or chronic pain in broad sense implies acting by the rules of good clinical practice and reducing the potential treatment side effects and complications that may entail health impairment and possible legal proceedings. Patients with acute or chronic obstetric or nonobstetric pain should be informed on the mode and method of treatment, possible side effects, and effects of drugs or procedures on fetal growth and development (informed consent). The principles of perinatal pharmacology and toxicology should be respected, choosing the mode of treatment associated with the lowest rate of side effects and a minimally invasive procedure (Accordingly, medico-legal responsibility is a professional and deontological category that should be fostered and implemented in line with professional guidelines and safety for both patients and medical staff.)

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Malpractice and claims in interventional pain treatment

Martínez

García²

2014

Techniques in Regional Anesthesia and Pain Management

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Medico-legal Aspects of Pain Medicine

Cited by 3 publications

References 37 publications

Thoracic epidural anaesthesia vs intrathecal morphine in dogs undergoing major thoracic and abdominal surgery: clinical study

Thoracic epidural anaesthesia vs intrathecal morphine in dogs undergoing major thoracic and abdominal surgery: clinical study

Medico- Legal Responsibility in Management of Acute and Chronic Pain in Obstetric

Malpractice and claims in interventional pain treatment

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