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Biomedical subjects

James Ducharme

Publications and source records attributed to James Ducharme.

5 recordsLinked to original sources
PubMed2005

The future of pain management in emergency medicine.

How have we as a profession, whose number-one goal is to decrease human suffering, made pain control such a poorly discussed issue in training? From day 1 of medical school, pain and suffering need to be discussed. No clinical area should be taught without discussion of this most common and most important symptom. Although we have shown that up to 70% of our patients have pain as a part of their presenting problem, hospitalized patients also have high rates of pain, often unrecognized. Barriers need to be identified and discussed. Alternatives to medications should be as much a part of our armamentarium as caring and compassion. The future of pain control depends on this paradigm shift.

Analgesia↗
PubMed2003

What is the best topical anesthetic for nasogastric insertion? A comparison of lidocaine gel, lidocaine spray, and atomized cocaine.

INTRODUCTION: Nasogastric intubation has been shown to be a painful procedure for patients. Previous studies have demonstrated the benefit of topical nasal anesthesia in decreasing the pain of this procedure. This study attempts to identify which of 3 topical anesthetic modalities would be preferred by patients. METHODS: This study had a double-blind, double-dummy randomized triple crossover design with 30 healthy volunteers as participants. Each participant had 3 nasogastric tubes inserted and acted as his or her own control for the 3 study medications: 1.5 mL 4% atomized lidocaine, 1.5 mL 4% atomized cocaine, and 5 mL 2% lidocaine gel. Participants scored pain of tube passage through the nostril as well as global discomfort. They were also asked to identify which agent they preferred. RESULTS: In our 30 subjects, although no statistically significant difference in nasal pain scores was found, "global discomfort" was less with the lidocaine gel (P =.017). Participants preferred the lidocaine gel over atomized cocaine (P <.00), but not to a statistically significant degree. DISCUSSION: Two percent lidocaine gel appeared to provide the best option for a topical anesthetic during nasogastric tube insertion.

Administration, Intranasal↗