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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

585
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
585
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

620
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
620
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

416
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
416
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

429
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
429
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

439
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
439
Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action01:17

Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action

1.8K
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
1.8K

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Intracranial Pharmacotherapy and Pain Assays in Rodents
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ASPMN Position Statement: Authorized Agent Controlled Analgesia.

Michelle Czarnecki1, Maureen F Cooney2, Elsa Wuhrman3

  • 1Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Milwaukee, Wisconsin.

Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses
|April 23, 2024
PubMed
Summary
This summary is machine-generated.

The American Society for Pain Management Nursing (ASPMN) supports authorized agent-controlled analgesia (AACA) for patients unable to use patient-controlled analgesia (PCA). ASPMN discourages "PCA by Proxy" and provides updated recommendations for safe AACA implementation.

Keywords:
PCAPCA by proxyParent/Nurse Controlled AnalgesiaPatient Controlled Analgesia

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Area of Science:

  • Pain Management Nursing
  • Pharmacology
  • Patient Safety

Background:

  • Patient-controlled analgesia (PCA) is a common method for managing pain.
  • Some patients cannot independently operate PCA devices due to various limitations.
  • Authorized agent-controlled analgesia (AACA) offers an alternative for these patients.

Purpose of the Study:

  • To update the position statement on AACA by the American Society of Pain Management Nursing (ASPMN).
  • To review current evidence supporting AACA.
  • To provide clinical practice recommendations for AACA implementation.

Main Methods:

  • Review of existing literature and evidence on AACA.
  • Analysis of current practices and guidelines related to AACA.
  • Development of updated recommendations based on evidence.

Main Results:

  • ASPMN continues to support AACA for patients unable to use PCA independently.
  • ASPMN explicitly does not support "PCA by Proxy" by unauthorized individuals.
  • Updated evidence review and clinical recommendations are provided.

Conclusions:

  • AACA is a viable strategy for effective pain management in select patient populations.
  • Careful selection and education of authorized agents are crucial for safe AACA.
  • Diligent patient assessment and medication management are essential components of AACA.