Hmm

Nice

Nice

❤❤❤❤❤

Stop being aholes and prescribe ULDN (ultra low dose naltrexone) for all the opioid patients that you’re cutting off. It will reset tolerance back to start dose or close to. And most importantly it relieves most if not all the “nerve” type pain from the hyperalgesia that you’ve already caused most of them by having reduced their MME years ago…. It’s possible that dextromethorphan could do a similar thing, ketamine is believed to also effect similar parts of the system- but I personally have seen the effects of ULDN that’s 1 microgram -4 micrograms per day…. One mcg with each opioid dose or whatever…. Patient will quickly reduce MME willingly with little to no withdrawal effects or increase in pain. Then let them keep taking the combo. In nature chronic severe pain is NOT A THING. The animal dies. The body freaks out in response to chronic pain bcuz it’s trying to keep the human in bed. The pain regulatory system is convinced we are deathly injured or in imminent danger…. It’s doing whatever it can to stop us from further injury. Since we are civilized animals we want to allow chronically ill and damaged people to continue living so we have to supplement the endorphin deficiency in the safest and most efficient ways…. MICRODOSING naltrexone powder can help. But honestly letting chronically ill people have access to UNLIMITED amounts of opioids wasn’t causing the problems with opioids the world sees now. I was at my best when I could call my doctor for break thru Percocet any time and get a refill. I have a complicated extremely painful condition that in the wild would’ve had me killed at birth probably… Or I would’ve ate poppy plants and felt fine and acted like a normal member of the society…. Whatever… im just saying that fentanyl is the problem. Prescription opioids were over prescribed and that did cause some abuse but that’s been more than taken care of years ago. Drs know now to use caution and care… But when it’s known and proven that a patient is all but cured by taking high levels of opioids then that should be allowed. And with additions of glia cell regulators like ULDN, dextromethorphan we can hopefully keep the doses far lower. But allow the patients to decide. This world is silly… Our body produces endorphins and we KNOW they are safer than any otc pain relievers… But to avoid drug addicts possibly getting high we’re gonna force all chronically suffering patients to drink bottles of ibuprofen & Tylenol each week…? And surgery without opioids just bcuz they may need to take it for a few weeks and may cause the changes that would cause hyperalgesia if the pain and the prescription lasted long term…? When most post surgical pain isn’t expected to last long enough for the hyperalgesia to happen…? Y’all are silly. If it’s just the addiction you’re worried about then screen for that. Blah blah blah …

How do intelligent medical professionals or scientists take these studies seriously. Pain score changes are NOT accurately measured based off of answers given to physicians or thru intake surveys. Chronic pain patients often can’t put a number to our pain as it changes based on movement, mental stress, room temperature etc.. Many of us also learn that if we say the wrong number the insurance company can say the medication isn’t working and stop covering that medication. Those studies are a mess. And the joke of an MME that was used for the main human study of OIHA was literally what caused the hyperalgesia. Under treated pain is what creates the sensitization/ fibromyalgia/CRPS etc. It causes essentially an overall endorphin deficiency. The body can not make enough endorphins to adress the chronic pain and the normal stimuli. So it causes a loop of deficits. The negligible amount of endogenous opioids found in blood levels of chronic pain patients, taking Opioid pain medication, triggers a decrease in production of endogenous (endorphins) morphine and the receptors. The system gets confused and makes a mess. Patients did great at high levels of opioid medication as long as tolerance was followed and pain was fully controlled. Hyperalgesia became a problem from under treated chronic pain. The G protein coupling switches after chronic pain or long term opioid exposure…. Blah blah blah

This honor was in recognition of the influence Harry had in the subject of anesthesia. Harry is Tom’s dad.

Hyperalgesia isn't from opiates! Look at the data! What bullshit! The problem is we can't get our meds or they're cut down and not managed. 0.002% of all patients?? This is desperate from the CDC trying to walk back their disasterous stupidity

I was lucky I could see that my son was coming and my husband wouldn’t be in our lives but we are in a green and lovely pasture, more happy than ever! I was at the hospital on the most emotional day of my life after a missed miscarriage because of what my husband had done to me 2 weeks prior to that date. I felt what he did was not fair to me. But on that table in a subconscious mind, I worked it all out I guess! I solved the whole situation by creating a scenario where I got my son back in 2 years, taught the biggest lesson to that man by taking him to another world and he left on his own, and then I realised it was very important for me to be in that situation so I work things out. I’m not sure if there is a way of deep meditation to get into that state. But that is the most beautiful way to go and work things out and come back to normal life to make things happen the way you want it. Fast forward 5 years from that date, all that I saw in my near future has come true in real life. I had the best job, made money on my own, bought houses and felt like I was able to do miracles through prayer, year after year I got what I wanted as I knew deep inside what I saw was getting into reality. I want to go back to that state again. Does it have time limit? I would love some anaesthesia to work out the next five years but the brain should go through trauma to get to the survival state. And we need to choose to come back and do what we see. Also, I’m able to have a unique ability since then to predict near future events before they just occur (like within a week or day).

What is used instead of Ketamine for systemic pain control in opioid free general anesthesia in people unable to take it due to major adverse reactions like Ketamine induced hypertensive crisis?

Way toooooo many ums and uhs. Uh, uh, um, um

Hi

Thanks for sharing 🙏🙏🙏

Use only intrathecal morfin, fentanyl in SAB combined with premed dexametasone post op ketorolac, Parasetamol, metoclopramid is enough for pain and vomit post op Sectio.

I use combine spinal with sedation propofol for lower operation and tiva TCI propofol and remifentanil for upper operation.

We'd prefer our doctors believe in fibromyalgia right? Support groups suggest you ask them . My initial physician didn't. Said it doesn't show up on labs or imaging . The problem with me getting angry. This same doctor would treat my caudia equina issue with two needle procedures over ten days . This easily could have turned into be a life time of adhesive arachnoiditis. Asking about believing in FM is misleading. That's not a point to make a judgement .

great introl.... I have just started applying AI to intensive care at KI

I use Tiva combine with SAB for one day care operation with spontaneus breath. And SAB combined with intubation Propofol + N20 to give periodic apnea for RIRS to shoot the urine tract stone is only 5 dolars for propofol versus isoflurane 160 dolars for 4 hours operation in indonesia

The thrill of life 🐉is to scape other people imposing their proposes to your life! And if they don't let you free, your ADRENALINE WILL give them an ULTIMATE FIGHT! Aggression and violence is as essential as Femininity and bliss to BREAK AWAY

Rohit*0Use the edit icon to pin, add or delete clips.,+1998!(#)

proud of my cousin

At least in days when indian articles were rarely accepted in Anesthesia And Analgesia, I am proud to see our professor as in the CHAIR.. sir I am proud of you!! Dr TP Tantry. Mangalore…

This maybe for some but not for all!

😇 Promo-SM!!!

Thank you all for your time in providing this insightful and lucid discussion of recent developments in perioperative organ protection. I learned a lot and, as with any quality discussion, I am left with more questions than I started with. I eagerly await the results of your future research endeavors!

Pive half life

Mdma cant really be abused like say heroin. There is only so much serotonin in the brain so doing it day after day would loose its effets and deplete serotonin.

Respect

Very helpful for paediatric anaesthesia.. Thank you very much

Great to see ketamine mentioned in this presentation. Used 3 minutes pre-incision 50 mg ketamine since 1992 followed by local analgesia for more than 6,000 outpatients without a single pain or PONV hospital admission. Aside from natural body orifice surgery, all other surgeries go through the skin & subcutaneous spaces. Regional anesthesia with tumescent solution is possible for all surgeries. doi: 10.1046/j.1524-4725.2000.00074.x. #goldilocksfoundation

Hi! I am a young engineering student , researching on the same subject. Could you provide here the complete talk , it would be really useful.

Great

Fascinating stuff, thanks.

Yes, all nociception monitors have limitations. And it is important to recognise those. But do not forget the current method of the anaesthetist using surrogate markers is exceptionally poor at quantifying nociception and than administering analgesia. It is literally like flipping a coin. Since I have already transitioned to Opioid Free Anaesthesia/Analgesia I trial the ANI presently to titrate my adjuvant analgesia. Presently I am more confident in my opioid free multimodal adjuvant anaesthesia/analgesia technique than the nociception monitors. I use all multimodal adjuvants i.e lignocaine, Mg, esmolol, dexmedetomidine, ketamine started pre-emptively before LA infiltration, LA +/- regional either major neuraxial or peripheral blocks with propofol TIVA +/- low dose volatiles <0.3 MAC in long cases for propofol sparing leading to rapid emergence.Presently my current success rate with OFA through-out the whole perioperative period is just over 90%. I use EEG guided depth of anaesthesia for every case (presence of moderate amplitudes, variability, SEF<22Hz, slow waves , sleep spindles & always aim to avoid burst suppression) and also use the DSA which is essential when using multimodal adjuvant anaesthesia/analgesia as each hypnotic drug has its own drug signature. I sincerely hope the use of the DSA is widely available to precisely tailor the multimodal adjuvant anaesthesia/analgesia.

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I’m a new IONM tech. This was very helpful. Thank you.

amazing stuff

So glad to be able to see this video from the session I attended back in May in MTL!!! Thank you IARS!

Always a pleasure to meet and discuss the anesthesia specialty with so many talented researchers at this meeting. See everyone in San Francisco for 2020!