Topics Discussed: acetaminophen; american society of anesthesiologists physical status classification; analgesics, non-narcotic; anesthesia and analgesia; anesthesia, topical; anesthetic agent monitoring; anesthetics; bupivacaine; chloral hydrate; codeine; cries pain scale; dexmedetomidine; diazepam; emla; etomidate; faces pain rating scale; fentanyl; flacc scale; hydrocodone; hydromorphone; ibuprofen; indomethacin; ketamine; ketorolac; lidocaine; lorazepam; mallampati score; methadone; midazolam; morphine; naproxen; opioid analgesics; oxycodone; pain; pain management; pain measurement; pain scale; patient-controlled analgesia; pentobarbital; propofol; sedation procedure.
Excerpt:"As defined by International Association for the Study of Pain: "An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage"(Ped Clin N Am 2006;53:279)
- Formulations containing epinephrine should NOT be used in terminal capillary circulations (eg, pinna, digits, nose, penis, and other areas of end-capillary circulation).
- Opioid analgesics: For moderate to severe pain if pain scales above 6; bind m-receptors in the CNS.
- Opiates may cause severe respiratory depression, hypotension, CNS depression, bladder retention, ileus, pruritus, nausea and vomiting.
- Opiate antagonist Naloxone: For intoxication, use 0.1 mg/kg up to 2 mg IV/IM; for respiratory depression, use 0.01 mg/kg, which may be repeated every 2 to 3 minutes up to 0.05 mg/kg if needed.
- Sedation occurs along a spectrum, and patients can move through all degrees of sedation (anxiolysis moderate sedation deep sedation general anesthesia) easily without affecting their vital signs.
- The depth of sedation should be monitored regularly with verbal and tactile stimuli because a patient's ability to protect the airway becomes increasingly more impaired with increasing levels of..."
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