Medikamente in der Schmerztherapie

Artner, J; Hofbauer, Hannes; Steffen, Peter R. P.

doi:10.1007/978-3-662-61692-5

Cited by 3 publications

(4 citation statements)

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“…It can be assumed that the respective medications taken have a symptom-reducing effect. In addition, a combination of two NSAIDs, which were taken most frequently by the respondents, is not recommended due to a small increase in analgesic effect but a notable increase in side effects [32]. The knowledge of Ds and DAs on this subject could explain why in most cases only one agent was taken.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of medication intake showed that Ds took their medication more irregularly but also more frequently as needed, depending on the region, while the DAs took their medication more frequently on a weekly basis. One reason for this is that the most commonly taken drugs from the NSAID class are not taken regularly over a long period of time because of the possible adverse effects; these include asthma attacks, increased risk of cardiovascular events or the loss of cytoprotective prostaglandins and the associated damage to the gastric and intestinal mucosa [33]. Since DAs took their medication more frequently on a weekly basis and Ds more frequently as needed, hypothesis 3 has to be rejected.…”

Section: Discussionmentioning

confidence: 99%

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The Intake of Pain Medication among Dentists and Dental Assistants with Musculoskeletal Disorders in Germany

et al. 2021

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Background: Dentists (Ds) and dental assistants (DAs) have a high lifetime prevalence of musculoskeletal disorders (MSDs). In this context, it is assumed that they have an increased intake of substances such as pain medication. Currently, there exist no data on the use of medication among Ds and DAs with MSDs in Germany. Methods: The online questionnaire (i.e., the Nordic Questionnaire) analysed the medical therapies used by 389 Ds (240 f/149 m) and 406 DAs (401 f/5 m) to treat their MSDs. Results: Ds (28.3–11.5%) and DAs (29.4–10.3%) with MSDs took medication depending on the affected body region. A trend between the Ds and DAs in the intake of drug therapy and the frequency was found for the neck region (Ds: 21.1%, DAs: 28.7%). A single medication was taken most frequently (Ds: 60.0–33.3%, DAs: 71.4–27.3%). The frequency of use varied greatly for both occupational groups depending on the region affected. Conclusion: Ds and DAs perceived the need for medical therapies because of their MSDs. Painkillers such as ibuprofen and systemic diclofenac were the medications most frequently taken by both occupational groups. The intake of pain killers, most notably for the neck, should prevent sick leave.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Intake of Pain Medication among Dentists and Dental Assistants with Musculoskeletal Disorders in Germany

et al. 2021

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“…The main analgesics administered were tramadol, tilidine, piritramide, oxycodone, and remifentanil. To make the different drugs comparable, a conversion to their morphine equivalents was performed based on (22,23) as follows: 1 mg morphine ≅ 0.1 mg tramadol/tilidine ≅ 0.7 mg piritramide ≅ 2 mg oxycodone ≅ 100 mg remifentanil/fentanyl ≅ 1,000 mg sufentanil. The average time the patients spent in intermediate care was about 22.8 h, the average number of analgesic administrations was 10.4 with an average dose of 5.45 mg (converted to morphine equivalents).…”

Section: Procedures and Morphine Equivalentsmentioning

confidence: 99%

The impact of analgesic on EMG and other biosignals in a postoperative setting

Gruss

Schmid²,

Walter³

et al. 2023

Front. Med.

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BackgroundIn the clinical context, the assessment of pain in patients with inadequate communication skills is standardly performed externally by trained medical staff. Automated pain recognition (APR) could make a significant contribution here. Hereby, pain responses are captured using mainly video cams and biosignal sensors. Primary, the automated monitoring of pain during the onset of analgesic sedation has the highest relevance in intensive care medicine. In this context, facial electromyography (EMG) represents an alternative to recording facial expressions via video in terms of data security. In the present study, specific physiological signals were analyzed to determine, whether a distinction can be made between pre-and post-analgesic administration in a postoperative setting. Explicitly, the significance of the facial EMG regarding the operationalization of the effect of analgesia was tested.MethodsN = 38 patients scheduled for surgical intervention where prospectively recruited. After the procedure the patients were transferred to intermediate care. Biosignals were recorded and all doses of analgesic sedations were carefully documented until they were transferred back to the general ward.ResultsAlmost every biosignal feature is able to distinguish significantly between ‘before’ and ‘after’ pain medication. We found the highest effect sizes (r = 0.56) for the facial EMG.ConclusionThe results of the present study, findings from research based on the BioVid and X-ITE pain datasets, staff and patient acceptance indicate that it would now be appropriate to develop an APR prototype.

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“…Indications include mild to moderate pain, postoperative pain, and tumor pain. The clinical duration of action is 4 to 6 h. The daily dosage is calculated as 10 to 15 mg/kg, with a maximum dose of 60 mg/kg [22]. Generally, adults are given 500 to 1000 mg intravenously every 6 h or a dose of 4 g per 24 h (continuous use) as postoperative analgesia.…”

Section: Analgesia and Sedation Analgesicsmentioning

confidence: 99%

Measurement of the nociceptive flexion reflex threshold in critically ill patients – a randomized observational pilot study

et al. 2021

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Background Pain detection and treatment is a major challenge in the care of critically ill patients, rendered more complex by the need to take into consideration the risk of insufficient or excessive analgesia. The nociceptive flexion reflex threshold (NFRT) has become the established basis for measuring the level of analgesia in the perioperative context. However, it remains unclear whether NFRT measurement can be usefully applied to mechanically ventilated, analgosedated critically ill patients who are unable to communicate. Therefore, the aim of the present study was to investigate whether there is an association between the NFRT measurement and the Behavioral Pain Scale (BPS) in critically ill, analgosedated, and mechanically ventilated patients and whether the NFRT measurement can also detect potential excessive analgesia. Methods This prospective, observational, randomized single-center pilot study included patients admitted to the surgical Intensive Care Unit of University Hospital Ulm, Germany, all of whom were analgosedated and intubated. Major exclusion criteria were defined as the need for the administration of neuromuscular blocking agents or neurological diseases associated with peripheral nerve conduction restriction. Initial NFRT and BPS measurements were conducted within 12 h after admission. A structured pain assessment was performed at least twice daily until extubation throughout the observation period thereafter (Group A: BPS + NFRT, Group B: BPS). Results 114 patients were included in the study. NFRT is associated negatively with BPS. NFRT was almost twice as high in patients with a Richmond Agitation Sedation Scale (RASS) score of -5 than in patients with a RASS score ≥ -4 (RASS -5 – NFRT: 59.40 vs. RASS -4 – NFRT: 29.00, p < 0.001). Conclusions NFRT measurement is associated negatively with the BPS in critically ill patients. NFRT measurement provides guidance for the evaluation of nociceptive processes in patients with RASS scores ≤ −4, in whom analgesia level is often difficult to assess. However, in order to identify excessive analgesia and derive therapeutic consequences, it is necessary to gradually decrease analgesics and sedatives until a stimulus threshold is reached at which the patient does not feel pain. Trial Registration Retrospectively registered in the German Clinical Trials Register, registration number DRKS00021149, date of registration: March 26, 2020. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021149.

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Medikamente in der Schmerztherapie

Cited by 3 publications

References 0 publications

The Intake of Pain Medication among Dentists and Dental Assistants with Musculoskeletal Disorders in Germany

The Intake of Pain Medication among Dentists and Dental Assistants with Musculoskeletal Disorders in Germany

The impact of analgesic on EMG and other biosignals in a postoperative setting

Measurement of the nociceptive flexion reflex threshold in critically ill patients – a randomized observational pilot study

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