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1.
Clin J Pain ; 35(6): 487-496, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30985397

RESUMO

Management of acute pain in children is fundamental to our practice. Its myriad benefits include reduced suffering, improved patient satisfaction, more rapid recovery, and a reduced risk of developing postsurgical chronic pain. Although a multimodal analgesic approach is now routinely used, informed and judicious use of opioid receptor agonists remains crucial in this treatment paradigm, as long as the benefits and risks are fully understood. Further, an ongoing public health response to the current opioid crisis is required to help prevent new cases of opioid addiction, identify opioid-addicted individuals, and ensure access to effective opioid addiction treatment, while at the same time continuing to safely meet the needs of patients experiencing pain.


Assuntos
Dor Aguda/tratamento farmacológico , Analgésicos Opioides/uso terapêutico , Epidemia de Opioides , Manejo da Dor/métodos , Pediatria/tendências , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Transtornos Relacionados com Narcóticos/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico
2.
World J Gastrointest Endosc ; 2(4): 130-7, 2010 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-21160728

RESUMO

Endoscopic retrograde cholangiopancreatography is an important tool in the diagnosis and treatment of pancreatobiliary diseases. A critical step in this procedure is deep cannulation of the bile duct as failure of cannulation generally results in an aborted procedure and failed intervention. Expert endoscopists usually achieve a high rate of successful cannulation while those less experienced typically have a much lower rate and a greater incidence of complications. Prolonged attempts at cannulation can result in significant morbidity to patients, anxiety for endoscopists, unnecessary radiation exposure and inefficient patient care. Here we review the most common endoscopic techniques used to achieve selective biliary cannulation. Pharmacologic aids to cannulation are also discussed briefly in this review.

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