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Molecular mechanisms of morphine action on the immune system
Zeťková, Anna ; Hejnová, Lucie (advisor) ; Vašek, Daniel (referee)
This paper focuses on the molecular effect of morphine, which is widely used for its analgesic and sedative properties. This makes it an important drug for the treatment of chronic and severe pain. In addition to its positive effects, the long-term administration of morphine in particular has its drawbacks, such as the rapid development of tolerance and dependence on it. Other negative effects include constipation, respiratory stagnation or vomiting. These effects are caused not only by the influence of morphine on nerve cells, but also on other cells of the body. This thesis is primarily concerned with the effect of morphine on microglia, which are not only involved in the immune response in the central nervous system, but also have an effect on pain perception or the development of tolerance. This is one of the main areas of research in the field of opioids, therefore, the aim of this thesis is to summarize the findings on the effect of morphine on microglia, which happens mainly through opioid receptors, toll-like receptors and purinoceptors.
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The analgosedation of a child patient in the pre-hospital care
DUCHOŇOVÁ, Hana
The topic of this bachelor thesis is "Analgesic sedation of a child patient in prehospital care". This work aims to map the awareness of paramedics from the South Bohemian region with the administration of analgesia to pediatric patients. In the theoretical part, the reader is acquainted with the characteristics of the age of the child and also with pharmacokinetic differences. Furthermore, the work describes the types of pain, which is followed by a chapter on pain assessment tools and then its therapy using a three-stage WHO analgesic ladder. The last and most extensive part describes in more detail the individual drugs, specifically their groups, method of administration, dosage, their use and comment. The practical part aims to find out whether paramedics in the South Bohemian region are aware of the administration of analgesia to pediatric patients. The research was carried out using a quantitative method, namely a questionnaire survey in the form of an electronic questionnaire, which contained 14 questions, where each question had only one correct answer. A total of 40 respondents working as paramedics in the South Bohemian Region took part in the survey. The research showed that the respondents in this area are sufficiently oriented, as the result was 90 % of correct answers. This fulfilled the hypothesis, where it was assumed that health professionals are oriented in this area to 80%. This fulfilled the hypothesis, where the correctness of the answers was assumed to be only 80 %.
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Alternative methods in managing postoperative pain in living donor renal transplantant recipients
Nová, Michaela ; Hocková, Jana (advisor) ; Dynáková, Šárka (referee)
The main criteria for managing good postoperative care include the effective and appropriate choice of pain therapy. Experiencing pain is a purely individual feeling for each of us, so it is very important to have adequate and sufficient analgesia during this period. Modern management of post-operative pain therapy uses preparations of various pharmacological groups that potentiate and thereby more effectively reduce pain. By this mechanism, we can reduce the total dose of analgesics given, and more particularly, reduce the dose of opioids that have a higher risk of side effects. In this project i want to show how the analgesic catheter could be useful as alternative possibility in algorithm therapy of postoperative pain. Analgesic catheter enable continual local anesthetics administration, exactly 0,5% bupivacaine, which is operating in surgical wound. Main goal of the study is to find out and verify if analgesic catheter is method which provides continual analgesia strong enough to results in lower use of opioids. The research data will be determined by quantitative research using a questionnaire survey. Non standardized self-production questionnaire. will be given in a paper form to non-medical healthcare staff, who perform nursing activities The spectrum of patients is very specific; they are...
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Use of adrenergic receptor alpha2-agonists in pain treatment
Soláriková, Ivana ; Vaculín, Šimon (advisor) ; Maršáková, Lenka (referee)
α2-adrenergic receptor agonists are adjuvant analgesics involved in the modulation and treatment of pain acting in the noradrenergic system. Binding of α2 agonists to receptors initiates a cascade of actions leading i.a. to antinociception. The most clinically applied analgesics of this type include clonidine, dexmedetomidine, and xylazine used in veterinary medicine. The ability to potentiate the effects of opioid and nonopioid analgesics and anesthetics leading to dose reduction is especially advantageous as it relieves unpleasant side effects associated with opioid use, and reduces the risk of tolerance development. They are effective in local anesthesia due to the peripheral site of action and do not cause characteristic, centrally mediated side effects of hemodynamic character. They are involved in the suppression of inflammatory response in the body by inhibiting the production of proinflammatory cytokines. Despite the wide range of action, α2 agonists appear to be safe in many different contraindications, such as sepsis, diabetes or pregnancy. Keywords: α2-adrenergic receptors, agonists, pain, analgesia, clonidine, dexmedetomidine, potentiation, adjuvant
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Comparison of postoperative analgesia in ICU
Trojanová, Eva ; Bruthans, Jan (advisor) ; Pavlíček, Bohumil (referee)
The thesis deals with comparing the postoperative analgesia with a focus on pacients after hip replacement surgery at the intensive care units. The quantitative study realized at the Fakultní nemocnice v Motole and Nemocnice Třebíč during November 2012 and February 2013. The main task of the theoretical part is to analyze the current trends in the field of post- operativeanalgesia by the patients undergoing hip joint surgery as well as the explanation the basicconcepts of this issue and overviewing the international postoperative pain treatments. The practical part is an objective comparison the postoperative analgesia byselected patients at the Fakultní nemocnice v Motole and Nemocnice Třebíč determined by questionnaire. The results of the questionnaire are processed into graphical representation and subsequently evaluated. The work serves to clarify the overall issue of post-operative analgesia. The focus is mainly on ensuring the quality of postoperative analgesia, the financial requirements administered analgesics and the possible complications associated with the use of analgesic therapy. Key words: Analgesia, pain, hip surgery, visual analogue scale, analgesics
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Assesment of quality of postoperative analgesic care
Rákosová, Andrea ; Burišková, Klára (advisor) ; Hakenová, Renata (referee)
Introduction: The acute postoperative pain management is recently a concern of many expert committees and professional associations. The evidence of an increased interest in this issue is the Practice Guidelines for Acute Pain Management released by American Pain Society. According to these recommendations, the pain should be monitored as a fifth vital function. As a logical consequence of modern trends of pain management, Czech Society of Anaesthesiology and Intensive Care Medicine issued guidelines for acute pain management in postoperative setting. This paper is an attempt to describe and evaluate the quality of postoperative analgetic care after total knee and hip replacements in a selected institution's department.………………………………..…………………………………… Methods: The aim of our empirical survey was to assess the level of quality of postoperative care and analgesia in the selected department. We focused mainly on the question of pain trivializing from the nurses side, their approach towards patients suffering from acute pain and, finally, the level of patient's awareness of pain intensity assessment systems and treatment options. Using the quantitative research methods, we evaluated the differences in perceiving of postoperative pain treatment quality from patient's and nurse's point of view. The survey...
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Assessment methods for measuring the depth of analgosedation in patients in intensive and resuscitation care and their practical application
Machačová, Jana ; Jaroměřský, Dušan (advisor) ; Kulířová, Veronika (referee)
Introduction: Prevention and treatment of pain or discomfort is an integral part of modern intensive care. Insufficient or, conversely, excessively deep sedation and analgesia are associated with a number of risks, such as prolonged hospitalization. For this reason, the use of scoring systems to monitor agitation and pain is currently recommended. Objectives and methodology: The aim of the work was to obtain data on the use of scoring systems to assess the pain and depth of sedation in intensive and resuscitation care workplaces in the Czech Republic and to evaluate the satisfaction of nurses with their use. The research was carried out using a quantitative method in the form of a semi-structured questionnaire of my own creation. The research sample consisted of station nurses and head nurses from anesthesiology and resuscitation departments and intensive care units. Results: The research survey involved 62 workplaces of intensive and resuscitation care in the Czech Republic. The existence of a sedation protocol was reported by 26 workplaces (42 %), the use of standardized scales to assess the depth of sedation was reported by 46 workplaces (74 %). Pain in ventilated patients is evaluated in all 62 workplaces (100 %). The most frequently used scale for assessing the depth of sedation is RSS, which...
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Alternative methods in managing postoperative pain in living donor renal transplantant recipients
Nová, Michaela ; Hocková, Jana (advisor) ; Dynáková, Šárka (referee)
The main criteria for managing good postoperative care include the effective and appropriate choice of pain therapy. Experiencing pain is a purely individual feeling for each of us, so it is very important to have adequate and sufficient analgesia during this period. Modern management of post-operative pain therapy uses preparations of various pharmacological groups that potentiate and thereby more effectively reduce pain. By this mechanism, we can reduce the total dose of analgesics given, and more particularly, reduce the dose of opioids that have a higher risk of side effects. In this project i want to show how the analgesic catheter could be useful as alternative possibility in algorithm therapy of postoperative pain. Analgesic catheter enable continual local anesthetics administration, exactly 0,5% bupivacaine, which is operating in surgical wound. Main goal of the study is to find out and verify if analgesic catheter is method which provides continual analgesia strong enough to results in lower use of opioids. The research data will be determined by quantitative research using a questionnaire survey. Non standardized self-production questionnaire. will be given in a paper form to non-medical healthcare staff, who perform nursing activities The spectrum of patients is very specific; they are...
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The specifics of nursing in the treatment of pain in patients after cardiosurgical operations
ZAJÍČKOVÁ, Tereza
Pain is a phenomenon perceived as an undesirable experience of physical and mental suffering that we want to avoid at any cost. It is common and expected though that during surgeries patients experience pain due to interrupting the integrity of skin and hypodermis by originating a surgical incision. Complex cardiac surgeries, which usually take several hours and create large cuts, require effective analgesic treatment during postoperative recovery ensuring proper pain relief. This bachelor thesis aims to examine the specifics of nursing within analgesic treatment of patients´pain after cardiac surgeries. A theoretical part focuses on general findings about pain, the ways of pain evaluation, the specifics of postoperative pain. This part also introduces the most common cardiac surgeries and pharmacologic and nonpharmacologic pain treatments. A practical part of the thesis consists of a quantitative research applying semi-structured interviews with ten nurses and ten patients of a cardiac surgical ward. Results show that nurses discover certain specifics in providing pain relief while nursing patients after cardiac surgeries. The research concerns not only with treatment of the pain from a surgical incision, but with treatment of secondary types of pain as well: back pain, painful cough, pain caused with a chest tube. In the interviews, nurses and patients identified a postoperative pain similarly, they identically described pain evaluation executed by nurses, and agreed on high standards of analgesic treatment on this specific ward. The bachelor thesis aspires to be a source of information for nursing students and a proper guide for incoming nurses who are about to be employed at a cardiac surgical ward.
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