Concluding statement - neuropharmacological basis and clinical rationale for control of transdermal buprenorphine as a step II analgesic.
Abstract
In this commentary on the medical use and regulation of transdermal buprenorphine we bring together our complimentary perspectives on the neuropharmacology of analgesics (Dr. Henningfield) and clinical medicine to address the needs of people with pain (Dr. Sun). Together, the neuropharmacology of buprenorphine, the clinical and abuse deterring benefits of the 7-day transdermal formulation, the low rates of harmful use and abuse detected in post-marketing surveillance studies, and the desirable clinical benefits in the elderly, in persons with compromised kidney function, and other populations supp...
Source: Acta Anaesthesiologica Taiwanica - June 8, 2015 Category: Anesthesiology Authors: Henningfield JE, Sun WZ Tags: Acta Anaesthesiol Taiwan Source Type: research
Update on administration of anesthetics and psychoactive drugs for pain management in China.
Abstract
Anesthetics and psychoactive drugs could relieve diseases, if used properly. However, they can cause dependency, and their misuse or abuse could adversely affect people's health and social stability. For a long time, the Chinese government has been reinforcing the regulation on anesthetics and psychoactive drugs to ensure their legal and proper usage, and to prevent abuse. The state council issued 'the regulations on the administration of anesthetic drugs and psychotropic drugs' in 2005, based on which a legal system was established for administration of anesthetics and psychoactive drugs with the...
Source: Acta Anaesthesiologica Taiwanica - June 8, 2015 Category: Anesthesiology Authors: Gu W Tags: Acta Anaesthesiol Taiwan Source Type: research
Pain management experience at a central Taiwan medical center.
Abstract
Pain management is typically more developed in western countries compared to Asia. From the accreditation standard of the Joint Commission International (JCI), there is a broad scope for pain management. In 2008, our medical center established the pain management policy, and the goal is to be a pain-free medical facility. The Framework of Pain Management Policy including: 1. the rights of patients and family members 2. Employee education 3. Assessment of pain (screening, evaluating, monitoring) 4. Patient care of pain. After implementation of pain management program, the compliance of pain assessm...
Source: Acta Anaesthesiologica Taiwanica - June 7, 2015 Category: Anesthesiology Authors: Tsao SL, Hsieh YJ Tags: Acta Anaesthesiol Taiwan Source Type: research
Undertreatment of caner pain.
Abstract
Pain is a burdensome symptom that can commonly exist chronically along the cancer trajectory. Uncontrolled pain will impact on cancer patients' quality of life, even further negatively affect cancer survivors' employment. Based on systemic reviews of studies for past 10 years, the paper reported that although there is enormous advancement on the knowledge of cancer pain and pain management, studies still documented undertreatment of cancer pain globally. Additionally, pain distress a significant portion of cancer survivors. The pain in cancer survivors distinct from the pain related with cancer, i...
Source: Acta Anaesthesiologica Taiwanica - June 7, 2015 Category: Anesthesiology Authors: Wang CH, Lee SY Tags: Acta Anaesthesiol Taiwan Source Type: research
Current controlled drug regulation in Taiwan.
Abstract
In order to strengthen the management system of medical and scientific use of controlled drugs, Taiwan government referred to the three major drug control treaties of United Nation to formulate the "Controlled Drugs Act" in 1999. There are three kinds of system to manage controlled drugs, including (1) Schedule Management, (2) Licensing Regulation Management and (3) Diversion Control Management, such as the reporting and auditing systems. In this article, the management system of controlled drugs will be discussed thoroughly. Under the "Controlled Drugs Act", the controlled drugs are scheduled by ...
Source: Acta Anaesthesiologica Taiwanica - June 5, 2015 Category: Anesthesiology Authors: Wu SI, Tsay WI, Wu MH Tags: Acta Anaesthesiol Taiwan Source Type: research
Pharmacoepidemiology of chronic noncancer pain patients requiring chronic opioid therapy: A nationwide population-based study.
CONCLUSION: COT-requiring CNCP patients were easily associated with adverse socioeconomic liabilities and often visited emergency department as well as pain clinics. Morphine was the main opioid used for their chronic pain. Transfer of COT-requiring CNCP patients to appropriate departments is strongly recommended for efficient long-term pharmacotherapy for their chronic pain.
PMID: 26026843 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)
Source: Acta Anaesthesiologica Taiwanica - May 27, 2015 Category: Anesthesiology Authors: Chang SC, Ma CC, Lee CT, Hsieh SW Tags: Acta Anaesthesiol Taiwan Source Type: research
Using a modified syringe technique to adjust the intracuff pressure of a laryngeal mask airway.
This report aimed to assess the efficacy of a modified syringe technique to adjust the intracuff pressure of an LMA. In a preclinical study, commercially available 20-mL syringes were attached to the pilot balloon of LMAs with different preset intracuff pressures (40 cmH2O, 50 cmH2O, 60 cmH2O, 70 cmH2O, 80 cmH2O, 100 cmH2O, and 120 cmH2O). After attachment, the syringe plunger was allowed to passively rebound. If no rebound of the plunger was observed after attachment, 1 mL of air was withdrawn and the plunger was allowed to passively rebound again. This technique allowed the plunger to overcome static friction and...
Source: Acta Anaesthesiologica Taiwanica - May 8, 2015 Category: Anesthesiology Authors: Hung KC, Chen WH, Shih YH, Yeh LR Tags: Acta Anaesthesiol Taiwan Source Type: research
Tiny tweaks, big changes: An alternative strategy to empower ethical culture of human research in anesthesia (A Taiwan Acta Anesthesiologica Taiwanica-Ethics Review Task Force Report).
Abstract
For this guidance article, the Ethics Review Task Force (ERTF) of the Journal reviewed and discussed the ethics issues related to publication of human research in the field of anesthesia. ERTF first introduced international ethics principles and minimal requirements of reporting of ethics practices, followed by discussing the universal problems of publication ethics. ERTF then compared the accountability and methodology of several medical journals in assuring authors' ethics compliance. Using the Taiwan Institutional Review Board system as an example, ERTF expressed the importance of institutional...
Source: Acta Anaesthesiologica Taiwanica - April 10, 2015 Category: Anesthesiology Authors: Luk HN, Ennever JF, Day YJ, Wong CS, Sun WZ Tags: Acta Anaesthesiol Taiwan Source Type: research
Clinical implication of perioperative inflammatory cytokine alteration.
Abstract
Cytokines are key modulators of inflammatory responses, and play an important role in the defense and repair mechanisms following trauma. After traumatic injury, an immuno-inflammatory response is initiated immediately, and cytokines rapidly appear and function as a regulator of immunity. In pathologic conditions, imbalanced cytokines may provide systemic inflammatory responses or immunosuppression. Expression of perioperative cytokines vary by different intensities of surgical trauma and types of anesthesia and anesthetic agents. Inflammatory cytokines play important roles in postoperative organ ...
Source: Acta Anaesthesiologica Taiwanica - March 30, 2015 Category: Anesthesiology Authors: Hsing CH, Wang JJ Tags: Acta Anaesthesiol Taiwan Source Type: research
Platonin preserves blood-brain barrier integrity in septic rats.
CONCLUSION: Platonin could attenuate sepsis-induced BBB integrity loss in rats.
PMID: 25791838 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)
Source: Acta Anaesthesiologica Taiwanica - March 17, 2015 Category: Anesthesiology Authors: Yeh CT, Kao MC, Chen CH, Huang CJ Tags: Acta Anaesthesiol Taiwan Source Type: research
A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study.
CONCLUSION: For parturients with labor epidural analgesia needing CS, the use of SA led to shorter anesthetic time and lower postoperative pain scores, with lower morphine doses compared with EA. However, the high failure rate with both neuraxial techniques needs to be addressed.
PMID: 25736588 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)
Source: Acta Anaesthesiologica Taiwanica - February 27, 2015 Category: Anesthesiology Authors: Huang CH, Hsieh YJ, Wei KH, Sun WZ, Tsao SL Tags: Acta Anaesthesiol Taiwan Source Type: research
A randomized trial to compare the Truview picture capture device, C-MAC laryngoscope, and Macintosh laryngoscope in pediatric airway management.
CONCLUSION: The Truview PCD offers the best laryngeal view, although it takes a longer time for intubation. The C-MAC laryngoscope provides similar laryngeal views as the Macintosh blade, and is an excellent teaching aid.
PMID: 25703544 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)
Source: Acta Anaesthesiologica Taiwanica - February 19, 2015 Category: Anesthesiology Authors: Singh R, Kumar N, Jain A Tags: Acta Anaesthesiol Taiwan Source Type: research
A rare case of pneumocephalus and pneumorrhachis after epidural anesthesia.
We report a rare case of simultaneous pneumocephalus and pneumorrhachis in a patient after undergoing epidural anesthesia. The patient lost consciousness and received emergent external ventricular drainage for pneumocephalus in another medical center. The patient was clear after external ventricular drain placement until 4 days later, when sudden onset of subdural hemorrhage occurred and an emergent craniectomy was performed. The patient passed away 2 days after craniectomy, due to multiorgan failure. Pneumocephalus with or without pneumorrhachis should be kept in mind when there is a sudden change of consciousness or pers...
Source: Acta Anaesthesiologica Taiwanica - February 18, 2015 Category: Anesthesiology Authors: Hsieh XX, Hsieh SW, Lu CH, Wu ZF, Ju DT, Huh B, Wang JC, Kuo CY Tags: Acta Anaesthesiol Taiwan Source Type: research
Objective and subjective comparison of the visibility of three echogenic needles and a nonechogenic needle on older ultrasound devices.
CONCLUSION: The results of our study indicate that the BB and UN needles are more visible than nonechogenic needles in an ultrasound phantom, even on older devices.
PMID: 25662188 [PubMed - as supplied by publisher] (Source: Acta Anaesthesiologica Taiwanica)
Source: Acta Anaesthesiologica Taiwanica - February 3, 2015 Category: Anesthesiology Authors: Nakagawa K, Kamiya T, Arakawa K, Akiyama S, Sakai K Tags: Acta Anaesthesiol Taiwan Source Type: research
Fibrinolysis after reperfusion of liver graft.
Abstract
From September 2012 to March 2013, a total of 63 adult-to-adult living donor liver transplantations were performed at our institution. All the patients were monitored for their coagulation functions using rotation thromboelastometry (ROTEM, Tem Innovations GmbH) during the procedure at the following points: preoperative baseline, 5 minutes, 30 minutes, and 120 minutes, respectively, after reperfusion of the liver graft. A total of 84.13% of cases (n = 53) revealed fibrinolysis after reperfusion of the graft and the condition was reversed after 30 minutes without any need for additional treat...
Source: Acta Anaesthesiologica Taiwanica - January 31, 2015 Category: Anesthesiology Authors: Poon KS, Chen CC, Thorat A, Chiang YY, Jeng LB, Yang HR, Chen TH, Yeh CC, Chen KB Tags: Acta Anaesthesiol Taiwan Source Type: research
