FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2518379402> ?p ?o ?g. }

• W2518379402 endingPage "962" @default.
• W2518379402 startingPage "961" @default.
• W2518379402 abstract "Bruno Riou and Frédéric Aubrun accurately summarised the key advantages of intramuscular non-steroidal anti-inflammatory drugs (NSAIDs) over intravenous opioids, as shown by the results of our randomised clinical trial.1Pathan SA Mitra B Straney LD et al.Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial.Lancet. 2016; 387: 1999-2007Summary Full Text Full Text PDF PubMed Scopus (78) Google Scholar A standardised single dose of NSAID provides a ceiling effect, does not have a cumulative dose effect, and is associated with minimal adverse effects. By contrast, opioids are associated with enormous variability in their effect between individuals, demanding a personalised tailored approach to analgesia. Effective ongoing analgesia can be practically challenging to deliver in an emergency department (ED) with a diverse population and a high volume of patients being managed simultaneously.2Pines JM Hollander JE Emergency department crowding is associated with poor care for patients with severe pain.Ann Emerg Med. 2008; 51: 1-5Summary Full Text Full Text PDF PubMed Scopus (364) Google Scholar Obvious problems with opioids are the need for multiple dosages to achieve the desired effect, clinically significant dose-dependent side-effects, logistical delay involved in the administration and difficulties in continuing titration (with storage of half-used syringes with narcotics), risk of misuse, and potential for tolerance at the community level. Added to the inevitable periods of pain experienced by patients while being managed with titrated doses of intravenous opioids, all these issues provide compelling reasons for why morphine should not be used as first-line analgesia in acute pain management in a high-volume ED setting.3Ho KY Gan TJ Opioid-related adverse effects and treatment options.in: Sinatra RS de Leon-Casasola OA Ginsberg B Viscusi ER Acute pain management. Cambridge University Press, New York, NY2009: 406-415Crossref Google Scholar, 4O'Connor AB Zwemer FL Hays DP Feng C Outcomes after intravenous opioids in emergency patients: a prospective cohort analysis.Acad Emerg Med. 2009; 16: 477-487Crossref PubMed Scopus (29) Google Scholar, 5Lvovschi V Aubrun F Bonnet P et al.Intravenous morphine titration to treat severe pain in the ED.Am J Emerg Med. 2008; 26: 676-682Summary Full Text Full Text PDF PubMed Scopus (74) Google Scholar The argument that morphine could achieve similar or better results than diclofenac (or a similar NSAID) if tailored according to the individual patient requirements (titration strategy) or if delivered at a higher dose (eg, 0·15 mg/kg) is unfounded in the ED environment. Using a higher dose initially might be more effective but would increase the risk of higher side-effects without proven clinical superiority when greater than the 0·1 mg/kg dose.6Birnbaum A Esses D Bijur PE Holden L Gallagher EJ Randomized double-blind placebo-controlled trial of two intravenous morphine dosages (0·10 mg/kg and 0·15 mg/kg) in emergency department patients with moderate to severe acute pain.Ann Emerg Med. 2007; 49: 445-453Summary Full Text Full Text PDF PubMed Scopus (55) Google Scholar The ED environment demands an ideal emergency analgesic to be safe, quick, and easy to administer; requiring less staff time and resources; and with a single rather than titrated first dose. We do agree that morphine titration could be useful as rescue analgesia in the few patients who do not experience sustained relief after the initial dose of NSAIDs. More clinical trials are needed to test this stepwise model and validate the results in different populations from our study population. We declare no competing interests. Titrated doses are optimal for opioids in pain trialsWe read with interest the study by Sameer Pathan and colleagues (May 14, p 1999),1 which compared the non-steroidal anti-inflammatory drug (NSAID) diclofenac, intravenous morphine (0·1 mg/kg), and paracetamol in patients with renal colic. The investigators concluded that diclofenac offered the most effective analgesia. However, the way that opioids were administered was far from optimal and created a clear disadvantage in the morphine group, which precludes any definite conclusion. The choice of the appropriate dose of NSAID is simple because there is a ceiling effect; lower doses are recognised to be as efficient as higher doses. Full-Text PDF" @default.
• W2518379402 created "2016-09-16" @default.
• W2518379402 creator A5029425957 @default.
• W2518379402 creator A5047912658 @default.
• W2518379402 creator A5051182659 @default.
• W2518379402 date "2016-09-01" @default.
• W2518379402 modified "2023-09-27" @default.
• W2518379402 title "Titrated doses are optimal for opioids in pain trials – Authors' reply" @default.
• W2518379402 cites W2032881830 @default.
• W2518379402 cites W2034078955 @default.
• W2518379402 cites W2058298702 @default.
• W2518379402 cites W2099691297 @default.
• W2518379402 cites W2298227553 @default.
• W2518379402 cites W2494894756 @default.
• W2518379402 doi "https://doi.org/10.1016/s0140-6736(16)31494-5" @default.
• W2518379402 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/27598676" @default.
• W2518379402 hasPublicationYear "2016" @default.
• W2518379402 type Work @default.
• W2518379402 sameAs 2518379402 @default.
• W2518379402 citedByCount "3" @default.
• W2518379402 countsByYear W25183794022017 @default.
• W2518379402 countsByYear W25183794022018 @default.
• W2518379402 countsByYear W25183794022022 @default.
• W2518379402 crossrefType "journal-article" @default.
• W2518379402 hasAuthorship W2518379402A5029425957 @default.
• W2518379402 hasAuthorship W2518379402A5047912658 @default.
• W2518379402 hasAuthorship W2518379402A5051182659 @default.
• W2518379402 hasBestOaLocation W25183794021 @default.
• W2518379402 hasConcept C118552586 @default.
• W2518379402 hasConcept C126322002 @default.
• W2518379402 hasConcept C142724271 @default.
• W2518379402 hasConcept C162156334 @default.
• W2518379402 hasConcept C170493617 @default.
• W2518379402 hasConcept C177713679 @default.
• W2518379402 hasConcept C191290158 @default.
• W2518379402 hasConcept C197934379 @default.
• W2518379402 hasConcept C204787440 @default.
• W2518379402 hasConcept C2778140631 @default.
• W2518379402 hasConcept C2780724011 @default.
• W2518379402 hasConcept C2780820201 @default.
• W2518379402 hasConcept C2908647359 @default.
• W2518379402 hasConcept C42219234 @default.
• W2518379402 hasConcept C535046627 @default.
• W2518379402 hasConcept C71924100 @default.
• W2518379402 hasConcept C99454951 @default.
• W2518379402 hasConceptScore W2518379402C118552586 @default.
• W2518379402 hasConceptScore W2518379402C126322002 @default.
• W2518379402 hasConceptScore W2518379402C142724271 @default.
• W2518379402 hasConceptScore W2518379402C162156334 @default.
• W2518379402 hasConceptScore W2518379402C170493617 @default.
• W2518379402 hasConceptScore W2518379402C177713679 @default.
• W2518379402 hasConceptScore W2518379402C191290158 @default.
• W2518379402 hasConceptScore W2518379402C197934379 @default.
• W2518379402 hasConceptScore W2518379402C204787440 @default.
• W2518379402 hasConceptScore W2518379402C2778140631 @default.
• W2518379402 hasConceptScore W2518379402C2780724011 @default.
• W2518379402 hasConceptScore W2518379402C2780820201 @default.
• W2518379402 hasConceptScore W2518379402C2908647359 @default.
• W2518379402 hasConceptScore W2518379402C42219234 @default.
• W2518379402 hasConceptScore W2518379402C535046627 @default.
• W2518379402 hasConceptScore W2518379402C71924100 @default.
• W2518379402 hasConceptScore W2518379402C99454951 @default.
• W2518379402 hasIssue "10048" @default.
• W2518379402 hasLocation W25183794021 @default.
• W2518379402 hasLocation W25183794022 @default.
• W2518379402 hasOpenAccess W2518379402 @default.
• W2518379402 hasPrimaryLocation W25183794021 @default.
• W2518379402 hasRelatedWork W1988831358 @default.
• W2518379402 hasRelatedWork W1989049047 @default.
• W2518379402 hasRelatedWork W2281342253 @default.
• W2518379402 hasRelatedWork W2333886711 @default.
• W2518379402 hasRelatedWork W2338448033 @default.
• W2518379402 hasRelatedWork W2368964159 @default.
• W2518379402 hasRelatedWork W2390117242 @default.
• W2518379402 hasRelatedWork W2950866810 @default.
• W2518379402 hasRelatedWork W3031610140 @default.
• W2518379402 hasRelatedWork W4366996426 @default.
• W2518379402 hasVolume "388" @default.
• W2518379402 isParatext "false" @default.
• W2518379402 isRetracted "false" @default.
• W2518379402 magId "2518379402" @default.
• W2518379402 workType "article" @default.