Substituting Acetaminophen for Fentanyl Feasible in PCI for STEMI

In patients with STEMI given crushed ticagrelor before PCI, using IV acetaminophen instead of IV fentanyl as a painkiller did not increase pain levels or platelet reactivity and prevented delay of ticagrelor's effects, researchers... read more

Substituting Acetaminophen for Fentanyl Feasible in PCI for STEMI

Is Locoregional Anesthesia a Functional Option for Major Abdominal Surgeries in the COVID-19 Era?

Based on our preliminary case series, awake open surgery has resulted feasible and safe. This approach has allowed to perform undelayable major abdominal surgeries on fragile patients when intensive care beds were not available.... read more

Is Locoregional Anesthesia a Functional Option for Major Abdominal Surgeries in the COVID-19 Era?

Sudden Abdominal Pain with a Palpable Mass

Rectus sheath hematoma (RSH) is a rare cause of abdominal pain that is often overlooked when patients present for evaluation. The disease can mimic almost any other type of abdominal pathology, and thus the diagnosis is frequently... read more

Sudden Abdominal Pain with a Palpable Mass

A Prospective Observational Study of High-Dose Intrathecal Diamorphine in Laparoscopic Bariatric Surgery

We have demonstrated that neuraxial blockade is a simple, practical, and feasible technique to adopt. Our case series demonstrated a high level of patient acceptability. 50 patients were included. 11 patients (22%) had... read more

A Prospective Observational Study of High-Dose Intrathecal Diamorphine in Laparoscopic Bariatric Surgery

The ABCDE Bundle Associated with Significant Reductions in Duration of Mechanical Ventilation

The focus on long-term consequences of critical illness has intensified with increasing ICU utilization and survivorship. Post Intensive Care Syndrome (PICS) is increasingly recognized and has profound and long-lasting negative... read more

The ABCDE Bundle Associated with Significant Reductions in Duration of Mechanical Ventilation

Critical Care Opioids Impact in the 21st Century

Critical Care is impacted by opioids in multiple ways. Not only do they form the backbone of managing pain and sedation in the intensive care unit (ICU), the burgeoning opioid epidemic also feeds into opioid-related ICU admissions.... read more

Critical Care Opioids Impact in the 21st Century

Sedation and Analgesia in the ICU

Sedation and analgesia have high importance in patient-centered care. Patients in the ICU are seriously ill and often suffer from anxiety, agitation, and pain. There is sometimes a need to use deep and prolonged sedation,... read more

Sedation and Analgesia in the ICU

Assessment of Variability in End-of-Life Care Delivery in ICUs in the United States

This study suggests most decedents in the ICU avoid CPR at EOL, have family present at their bedside, and are closely assessed for pain. However, the delivery of EOL care varies widely among units in the United States, including... read more

Assessment of Variability in End-of-Life Care Delivery in ICUs in the United States

No Reason to Choose Tramadol over Morphine

Tramadol is an opioid, but it does not bind directly to opioid receptors (or it binds so weakly that it might as well not bind at all). Its opioid action is the result of the metabolite O-desmethyltramadol, which means... read more

No Reason to Choose Tramadol over Morphine

Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions

Centralized pain syndromes are associated with changes within the central nervous system that amplify peripheral input and/or generate the perception of pain in the absence of a noxious stimulus. Examples of idiopathic... read more

Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions

Determinants of Health-Related Quality of Life After ICU

Preexisting comorbidity counts, but not severity of ICU illness, are strongly associated with health-related quality of life and physical symptoms in the year following critical illness. We prospectively collected data... read more

Determinants of Health-Related Quality of Life After ICU

Abdominal Compartment Syndrome

Abdominal compartment syndrome (ACS) is defined by sustained intra-abdominal pressure (IAP) > 20 mm Hg with associated organ injury. The condition was first described in 1863, but not significantly discussed until the 1990s.... read more

Abdominal Compartment Syndrome

Subanesthetic Ketamine Infusions for the Management of Pediatric Pain in Non‐critical Care Settings

Ketamine can effectively be used as part of a multimodal analgesic regimen in pediatric patients in non‐critical care settings. Our five‐year experience using low‐dose ketamine infusions highlights an acceptable side... read more

Subanesthetic Ketamine Infusions for the Management of Pediatric Pain in Non‐critical Care Settings

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Pain in the PICU: How and What Are We Doing?

Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units (PICU) experience pain and the practices being used to lessen pain. Critically... read more

Pain in the PICU: How and What Are We Doing?

Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged From a Trauma Service

The aims of this study were to evaluate the effects on opioid medication prescribing, patient opioid safety education, and prescribing of naloxone following implementation of a Safer Opioid Prescribing Protocol (SOPP) as... read more

Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged From a Trauma Service

Evaluation of Medetomidine-ketamine and Atipamezole for Reversible Anesthesia of Free-ranging Gray Wolves

Twenty-eight anesthetic events were carried out on 24 free-ranging Scandinavian gray wolves (Canis lupus) by darting from a helicopter with 5 mg medetomidine and 250 mg ketamine during winter in 2002 and 2003. Mean±SD doses... read more

Evaluation of Medetomidine-ketamine and Atipamezole for Reversible Anesthesia of Free-ranging Gray Wolves

Ketamine In Acute and Chronic Pain Management

The view of chronic pain as a symptom of a disease, rather than a disease state itself, has contributed to neglect in treating this condition. Although it is generally acknowledged that patients with chronic pain use significantly... read more

Ketamine In Acute and Chronic Pain Management

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals

The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance... read more

Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals

Comparison of Two Lidocaine Administration Techniques on Perceived Pain From Bedside Procedures

Bedside procedures are exceedingly common. Data regarding the severity of procedural pain and strategies to mitigate it are important for the informed consent process and patient satisfaction. Overall, pain reported from... read more

Comparison of Two Lidocaine Administration Techniques on Perceived Pain From Bedside Procedures