808 resultados para Preemptive analgesia
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In real-time systems, there are two distinct trends for scheduling task sets on unicore systems: non-preemptive and preemptive scheduling. Non-preemptive scheduling is obviously not subject to any preemption delay but its schedulability may be quite poor, whereas fully preemptive scheduling is subject to preemption delay, but benefits from a higher flexibility in the scheduling decisions. The time-delay involved by task preemptions is a major source of pessimism in the analysis of the task Worst-Case Execution Time (WCET) in real-time systems. Preemptive scheduling policies including non-preemptive regions are a hybrid solution between non-preemptive and fully preemptive scheduling paradigms, which enables to conjugate both world's benefits. In this paper, we exploit the connection between the progression of a task in its operations, and the knowledge of the preemption delays as a function of its progression. The pessimism in the preemption delay estimation is then reduced in comparison to state of the art methods, due to the increase in information available in the analysis.
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In embedded systems, the timing behaviour of the control mechanisms are sometimes of critical importance for the operational safety. These high criticality systems require strict compliance with the offline predicted task execution time. The execution of a task when subject to preemption may vary significantly in comparison to its non-preemptive execution. Hence, when preemptive scheduling is required to operate the workload, preemption delay estimation is of paramount importance. In this paper a preemption delay estimation method for floating non-preemptive scheduling policies is presented. This work builds on [1], extending the model and optimising it considerably. The preemption delay function is subject to a major tightness improvement, considering the WCET analysis context. Moreover more information is provided as well in the form of an extrinsic cache misses function, which enables the method to provide a solution in situations where the non-preemptive regions sizes are small. Finally experimental results from the implementation of the proposed solutions in Heptane are provided for real benchmarks which validate the significance of this work.
The utilization bound of non-preemptive rate-monotonic scheduling in controller area networks is 25%
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Consider a distributed computer system comprising many computer nodes, each interconnected with a controller area network (CAN) bus. We prove that if priorities to message streams are assigned using rate-monotonic (RM) and if the requested capacity of the CAN bus does not exceed 25% then all deadlines are met.
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This paper studies static-priority preemptive scheduling on a multiprocessor using partitioned scheduling. We propose a new scheduling algorithm and prove that if the proposed algorithm is used and if less than 50% of the capacity is requested then all deadlines are met. It is known that for every static-priority multiprocessor scheduling algorithm, there is a task set that misses a deadline although the requested capacity is arbitrary close to 50%.
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BACKGROUND: Patient-controlled epidural analgesia with low concentrations of anesthetics is effective in reducing labor pain. The aim of this study was to assess and compare two ultra-low dose regimens of ropivacaine and sufentanil (0.1% ropivacaine plus 0.5 μg.ml-1 sufentanil vs. 0.06% ropivacaine plus 0.5 μg.ml-1 sufentanil) on the intervals between boluses and the duration of labor. MATERIAL AND METHODS: In this non-randomized prospective study, conducted between January and July 2010, two groups of parturients received patient-controlled epidural analgesia: Group I (n = 58; 1 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil) and Group II (n = 57; 0.6 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil). Rescue doses of ropivacaine at the concentration of the assigned group without sufentanil were administered as necessary. Pain, local anesthetic requirements, neuraxial blockade characteristics, labor and neonatal outcomes, and maternal satisfaction were recorded. RESULTS: The ropivacaine dose was greater in Group I (9.5 [7.7-12.7] mg.h-1 vs. 6.1 [5.1-9.8 mg.h-1], p < 0.001). A time increase between each bolus was observed in Group I (beta = 32.61 min, 95% CI [25.39; 39.82], p < 0.001), whereas a time decrease was observed in Group II (beta = -1.40 min, 95% CI [-2.44; -0.36], p = 0.009). The duration of the second stage of labor in Group I was significantly longer than that in Group II (78 min vs. 65 min, p < 0.001). CONCLUSIONS: Parturients receiving 0.06% ropivacaine exhibited less evidence of cumulative effects and exhibited faster second stage progression than those who received 0.1% ropivacaine.
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Faute de droits d'auteurs pour les captures d'écrans, mon document ne contient pas d'images. Si vous voudriez consulter ma thèse avec les images, veuillez me contacter.
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In this thesis we have studied a few models involving self-generation of priorities. Priority queues have been extensively discussed in literature. However, these are situations involving priority assigned to (or possessed by) customers at the time of their arrival. Nevertheless, customers generating into priority is a common phenomena. Such situations especially arise at a physicians clinic, aircrafts hovering over airport running out of fuel but waiting for clearance to land and in several communication systems. Quantification of these are very little seen in literature except for those cited in some of the work indicated in the introduction. Our attempt is to quantify a few of such problems. In doing so, we have also generalized the classical priority queues by introducing priority generation ( going to higher priorities and during waiting). Systematically we have proceeded from single server queue to multi server queue. We also introduced customers with repeated attempts (retrial) generating priorities. All models that were analyzed in this thesis involve nonpreemptive service. Since the models are not analytically tractable, a large number of numerical illustrations were produced in each chapter to get a feel about the working of the systems.
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In Germany and other European countries piglets are routinely castrated in order to avoid the occurrence of boar taint, an off-flavour and off-odour of pork. Sensory perception of boar taint varies; however, it is regarded as very unpleasant by many people. Surgical castration which is an effective means against boar taint has commonly been performed without anaesthesia or analgesia within the piglets’ first seven days of life. Piglet castration without anaesthesia has been heavily criticised, as the assumption that young piglets perceive less pain than older animals cannot be supported by scientific evidence. Consequently, surgical castration is only allowed with anaesthesia and/or analgesia in organic farming throughout the European Union since January 2012. Abandoning piglet castration without pain relief requires the implementation of alternative methods which improve animal welfare while maintaining sensory meat quality. There are three relevant alternatives: castration with anaesthesia and/or analgesia to reduce pain, a vaccination against boar taint (immunocastration) and the fattening of uncastrated male pigs (fattening of boars) combined with measures to reduce and detect boar taint in meat. Consumers’ attitudes and opinions regarding the alternatives are an important factor with regard to the implementation of alternatives, as they are finally supposed to buy the meat. The objective of this dissertation was to explore organic consumers’ attitudes, preferences and willingness-to-pay regarding piglet castration without pain relief and the three alternatives. Important aspects for the evaluation of the alternatives and influencing factors (e.g. information, taste) on preferences and willingness-to-pay should also be identified. In autumn 2009 nine focus group discussions were conducted each followed by a Vickrey auction including a tasting of boar salami. Overall, 89 consumers of organic pork participated in the study. Information on piglet castration and alternatives (in three variants) was provided as a basis for discussion. The focus group data were analysed using qualitative content analysis. In order to compare the focus group results with those from the auctions, an innovative approach applying an adapted scoring model to further analyse the data set was used. The majority of participants were not aware that piglets are castrated without anaesthesia in organic farming. They reacted shocked and disappointed on learning about this practice which did not fit into their image of animal welfare standards in organic farming. Overall, the results show, that for consumers of organic pork castration with anaesthesia and analgesia as well as the fattening of boars may be acceptable alternatives in organic farming. Considering the strong food safety concerns regarding immunocastration, acceptance of this alternative may be questioned. Communication regarding alternatives to piglet castration without anaesthesia and analgesia should take into account that the relevance of the aspects animal welfare, food safety, taste and costs differs between alternatives. Furthermore, it seems advisable not to address an unappetizing topic like piglet castration directly at the point of sale so as not to deter consumers from buying organic pork. The issue of piglet castration demonstrates exemplarily that it is important for the organic sector to implement and maintain high animal welfare standards and communicate them in an appropriate way, thereby trying to prevent strong discrepancies between consumers’ expectations regarding animal husbandry in organic farming and actual conditions. So, disappointment of consumers and a loss of image due to negative reports about animal welfare issues can be avoided.
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Comparar el número de imágenes tomadas entre un grupo de pacientes con apendicitis aguda que recibieron analgesia antes del diagnóstico definitivo versus un grupo de pacientes sin esta intervención, que acudieron al servicio de urgencias de adultos del Hospital Universitario Fundación Santa Fe de Bogotá, entre enero y diciembre de 2006. Materiales y Métodos. Estudio tipo cohorte retrospectiva en el que se tomaran los pacientes del censo de un año y se medirán las variables descritas, los resultados fueron analizados por el paquete estadístico SPSS versión 19. Se tomó como valor de significancia 0,05. Resultados. El 40% recibieron analgésia temprana. No se encontró diferencia estadísticamente significativa entre el número de ecografías tomadas en los pacientes con y sin analgesia (p = 0,016) 49,2% vs 50,8% respectivamente, mientras que el número de TAC de abdomen fue mayor en el grupo que no recibió analgesia (56,8% vs 43,2%) pero sin significancia estadística, p = 0,507. Conclusiones. El uso de analgesia temprana en urgencias en pacientes con dolor abdominal por apendicitis aguda no se asocia con aumento en la toma de ecografía como método diagnóstico, asociación que no fue demostrable para la tomografía axial computarizada. El grupo de pacientes que recibió analgesia presentó menor tiempo de estancia en urgencias sin conducta quirúrgica definida.
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Introducción: el dolor postoperatorio supone un reto para todo anestesiólogo, en los últimos años se ha propuesto el Gabapentin preoperatorio como una buena opción paraanalgesia postoperatoria sin efectos secundarios. Metodología: se realizó una revisión sistemática incluyendo ensayos clínicos controlados realizados en pacientes adultos sometidos a diferentes tipos de cirugía. Se hizo una búsqueda en las bases de datos (PUBMED, EMBASE, LILACS, SCIELO), utilizando los términos “gabapentin”, “postoperative pain”, se extrajeron datos con los estudios incluidos. Resultados: se encontraron un total de 155 artículos, 16 de ellos cumplieron criterios de inclusión. Todos fueron evidencia tipo Ib. Las dosis utilizadas de gabapentin estuvieron entre 300 mg y 1200 mg y el intervalo de administración se encontró entre dos y una hora antes de cirugía, Hay una diferencia estadísticamente significativa en el manejo del dolor con el uso de Gabapentin preoperatorio (p<0,01) comparado contra placebo evaluado en el postoperatorio inmediato, a las 12 horas y 24 horas; así como tendencia a menor uso de opioides y menor náusea y vómito postoperatorio, Discusión: los resultados concuerdan con otros estudios similares realizados previamente y soportan el efecto del Gabapentin como analgésico directo y no solo como coadyuvante del manejo del dolor. Aún falta determinar cuál es la dosis más efectiva, aunque hasta la fecha el gabapentin supone menos efectos adversos, igualmente falta determinar si el efecto de menor nausea y vomito postoperatorio se relaciona con un efecto directo del gabapentin o por ahorro en consumo de opioides.Metodología Se realizó una revisión sistemática incluyendo ensayos clínicos controlados realizados en pacientes adultos sometidos a diferentes tipos de cirugía. Se hizo una búsqueda en las bases de datos (PUBMED, EMBASE, LILACS, SCIELO), utilizando los términos “gabapentin”, “postoperative pain”, se extrajeron datos con los estudios incluidos. ResultadosSe encontraron un total de 155 artículos, 16 de ellos cumplieron criterios de inclusión. Todos fueron evidencia tipo Ib. Las dosis utilizadas de gabapentin estuvieron entre 300 mg y 1200 mg y el intervalo de administración se encontró entre dos y una hora antes de cirugía, Hay una diferencia estadísticamente significativa en el manejo del dolor con el uso de Gabapentin preoperatorio (p<0,01) comparado contra placebo evaluado en el postoperatorio inmediato, a las 12 horas y 24 horas; así como tendencia a menor uso de opioides y menor náusea y vómito postoperatorio, DiscusiónLos resultados concuerdan con otros estudios similares realizados previamente y soportan el efecto del Gabapentin como analgésico directo y no solo como coadyuvante del manejo del dolor. Aún falta determinar cual es la dosis más efectiva, aunque hasta la fecha el gabapentin supone menos efectos adversos, igualmente falta determinar si el efecto de menor nausea y vomito postoperatorio se relaciona con un efecto directo del gabapentin o por ahorro en consumo de opioides.
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Las cirugías reconstructivas múltiples de miembros inferiores son intervenciones quirúrgicas que implican un difícil manejo analgésico en el postoperatorio, actualmente la técnica analgésica usada es la analgesia peridural; sin embargo los efectos adversos asociados a esta no la hacen una técnica ideal para manejo de dolor. Los bloqueos de nervio periférico han aparecido como una alternativa para el manejo del dolor; pero no se ha difundido ampliamente su uso. Se pretende evaluar la disminución de efectos adversos con el uso de bloqueos de nervio periférico sobre la analgesia epidural. Este estudio piloto inicial se realizo para verificar efectividad técnicas a usar y problemas que se pudieran presentar. Se aplico el protocolo en 23 pacientes que fueron llevados a cirugía de miembros inferiores, se dividieron en 2 grupos 11 recibieron bloqueos de nervio periférico y 12 analgesia epidural. Se les realizo seguimiento por 48 horas y se evaluó el control del dolor, consumo de opioides y efectos adversos. El tiempo de colocación del bloqueo fue similar en ambos grupos, el grupo de bloqueos presento menos episodios de dolor y menos episodios de dolor severo. No se presento retención urinaria en ningún paciente pero en el grupo de epidural se presento mayor incidencia de nausea y vomito (60% vs 45%). Se encontró que los bloqueos de nervio periférico son una adecuada opción para el manejo del dolor en este tipo de cirugías; y al parecer disminuye la incidencia de eventos adversos asociados a la analgesia epidural.
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Patients with cholestatic disease exhibit pruritus and analgesia, but the mechanisms underlying these symptoms are unknown. We report that bile acids, which are elevated in the circulation and tissues during cholestasis, cause itch and analgesia by activating the GPCR TGR5. TGR5 was detected in peptidergic neurons of mouse dorsal root ganglia and spinal cord that transmit itch and pain, and in dermal macrophages that contain opioids. Bile acids and a TGR5-selective agonist induced hyperexcitability of dorsal root ganglia neurons and stimulated the release of the itch and analgesia transmitters gastrin-releasing peptide and leucine-enkephalin. Intradermal injection of bile acids and a TGR5-selective agonist stimulated scratching behavior by gastrin-releasing peptide- and opioid-dependent mechanisms in mice. Scratching was attenuated in Tgr5-KO mice but exacerbated in Tgr5-Tg mice (overexpressing mouse TGR5), which exhibited spontaneous pruritus. Intraplantar and intrathecal injection of bile acids caused analgesia to mechanical stimulation of the paw by an opioid-dependent mechanism. Both peripheral and central mechanisms of analgesia were absent from Tgr5-KO mice. Thus, bile acids activate TGR5 on sensory nerves, stimulating the release of neuropeptides in the spinal cord that transmit itch and analgesia. These mechanisms could contribute to pruritus and painless jaundice that occur during cholestatic liver diseases.
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This study evaluated the analgesia effects of the epidural administration of 0.1 mg/kg bodyweight (BW) of morphine or 5 mu g/kg BW of buprenorphine in ponies with radiocarpal joint synovitis. Six ponies were submitted to 3 epidural treatments: the control group (C) received 0.15 mL/kg BW of a 0.9% sodium chloride (NaCl) solution; group M was administered 0.1 mg/kg BW of morphine; and group B was administered 5 mu g/kg BW of buprenorphine, both diluted in 0.9% NaCl to a total volume of 0.15 mL/kg BW administered epidurally at 10 s/mL. The synovitis model was induced by injecting 0.5 ng of lipopolysaccharide (LPS) in the left or right radiocarpal joint. An epidural catheter was later introduced in the lumbosacral space and advanced up to the thoracolumbar level. The treatment started 6 h after synovitis induction. Lameness, maximum angle of carpal flexion, heart rate, systolic arterial pressure, respiratory rate, temperature, and intestinal motility were evaluated before LPS injection (baseline), 6 h after LPS injection (time 0), and 0.5, 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24 h after treatments. Although the model of synovitis produced clear clinical signs of inflammation, the lameness scores in group C were different from the baseline for only up to 12 h. Both morphine and buprenorphine showed a reduction in the degree of lameness starting at 0.5 and 6 h, respectively. Reduced intestinal motility was observed at 0.5 h in group M and at 0.5 to 1 h in group B. Epidural morphine was a more effective analgesic that lasted for more than 12 h and without side effects. It was concluded that morphine would be a valuable analgesic option to alleviate joint pain in the thoracic limbs in ponies.
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Morphine is one of the most prescribed and effective drugs used for the treatment of acute and chronic pain conditions. In addition to its central effects, morphine can also produce peripheral analgesia. However, the mechanisms underlying this peripheral action of morphine have not yet been fully elucidated. Here, we show that the peripheral antinociceptive effect of morphine is lost in neuronal nitric-oxide synthase null mice and that morphine induces the production of nitric oxide in primary nociceptive neurons. The activation of the nitric-oxide pathway by morphine was dependent on an initial stimulation of PI3K gamma/AKT protein kinase B (AKT) and culminated in increasedactivation of K(ATP) channels. In the latter, this intracellular signaling pathway might cause a hyperpolarization of nociceptive neurons, and it is fundamental for the direct blockade of inflammatory pain by morphine. This understanding offers new targets for analgesic drug development.