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Pain Management

Elena P Calandre, Fernando Rico-Villademoros, Mahmoud Slim
No abstract text is available yet for this article.
October 10, 2016: Pain Management
Imma Beneitez, Rubén Nieto
Pain is a biopsychosocial phenomenon and should be assessed and managed from this perspective. However, the dualistic mind-body perspective is still present and affects the way this health situation is addressed. Following this approach, pain can either be attributed to an identifiable cause or considered as 'psychological' pain, for which there is neither an identifiable cause nor adequate treatment. Faced with this situation, first, we introduce some concepts that have been used (and are still frequently being used) to refer to pain with no identifiable cause...
October 7, 2016: Pain Management
Mark I Johnson, Gareth Jones
No abstract text is available yet for this article.
September 19, 2016: Pain Management
Giustino Varrassi, Antonella Paladini
Professor Giustino Varrassi and Antonella Paladini speak to Jade Parker, Commissioning Editor: Professor Giustino Varrassi is Full Professor of Anesthesiology and Pain Medicine in the LUdeS University, Valletta, Malta. He graduated at the Medical School of the University 'La Sapienza' (Rome, Italy) in 1973, and became board certified in Anesthesiology and Intensive Care in 1976 and in Pneumology in 1978, both in the same Medical School. He is currently President of the European League Against Pain and of the Paolo Procacci Foundation, and is a founding member of both of these...
September 19, 2016: Pain Management
James K Hamill, Jonathan Mair, Hannah B Steedman, Andrew Liley, Andrew G Hill
AIM: To determine the 'inter-rater' and test-retest reliability of a pain location tool for children. MATERIALS & METHODS: In children aged 5-14 years who had undergone a laparoscopic operation, pain scores at each of seven abdominal locations, and at the shoulder tip, were recorded at baseline and after a 5- and 30-min interval. RESULTS: Intraclass correlation coefficients were predominantly in the 'moderate' to 'substantial' range for both 'inter-rater' and test-retest reliability...
September 12, 2016: Pain Management
Simon Hayhoe
Insomnia is the forgotten partner to many medical problems, not least chronic pain where interference with sleep is a common complaint. However, the relationship is complex: lack of sleep can exacerbate pain through increase in proinflammatory cytokine production. Acupuncture is observed clinically to improve sleeping in chronic pain patients, but reviews are unable firmly to recommend acupuncture for insomnia as many trials are methodologically inadequate, despite most being acupuncture positive. However, there is strong evidence for relief in several chronic pain problems and improvement in these is likely also to restore normal sleeping...
August 31, 2016: Pain Management
Bernard P Schachtel, Adrian Shephard, Timothy Shea, Kathleen Sanner, Laurie Savino, Jeanne Rezuke, Emily Schachtel, Sue Aspley
AIM: This study assessed multiple doses of flurbiprofen 8.75 mg lozenges for the relief of three prominent symptoms of acute pharyngitis: pain intensity (primary end point), difficulty swallowing and swollen throat. PATIENTS & METHODS: A total of 204 patients (102 in each group) with confirmed pharyngitis (onset ≤4 days) were randomly assigned to take up to five flurbiprofen or placebo lozenges every 3-6 h, for 7 days. Using validated rating scales (sore throat pain intensity, difficulty swallowing and swollen throat) patients rated their symptoms for the duration of the study...
November 2016: Pain Management
Tracey Pons, Edward A Shipton
No abstract text is available yet for this article.
November 2016: Pain Management
Seetharaman Hariharan
No abstract text is available yet for this article.
November 2016: Pain Management
Ammar Salti, Ali Alabady, Mohammed M Al-Falaki, Tahcin A Ibrahim, Nicholas B Scott, Salim T Sherllalah, Stephan A Schug
Postoperative pain is a considerable issue in the Gulf region; however, at present there is a lack of comprehensive guidelines addressing postoperative pain management in the region. Therefore, an expert panel of pain specialists convened to address this issue and a set of key recommendations has been developed pertinent to the practice of postoperative pain management in the Gulf region (Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, the United Arab Emirates and Yemen). These recommendations take into consideration the unique variation in cultural, religious and societal beliefs found in the region, as well as varying accessibility to pain medications, thereby aiming to serve as evidence-based guidance on the best practice management of postoperative pain in the Gulf region...
November 2016: Pain Management
Gloria S Cheng, Brian M Ilfeld
An online database search with subsequent article review was performed in order to review the various analgesic modalities for breast cancer surgery. Of 514 abstracts, 284 full-length manuscripts were reviewed. The effect of pharmacologic interventions is varied (NSAIDS, opioids, anticonvulsants, ketamine, lidocaine). Likewise, data from high-quality randomized, controlled studies on wound infiltration (including liposome encapsulated) and infusion of local anesthetic are minimal and conflicting. Conversely, abundant evidence demonstrates paravertebral blocks and thoracic epidural infusions provide effective analgesia and minimize opioid requirements, while decreasing opioid-related side effects in the immediate postoperative period...
November 2016: Pain Management
Catherine J Datto, Robert J LoCasale, Mary Kay Margolis, Christine L Thompson, Karin S Coyne
AIM: To determine laxative utilization over time among chronic noncancer pain patients with opioid-induced constipation (OIC). SETTING: A prospective longitudinal study conducted in the USA, Canada, Germany and UK. METHODS: Patients on daily opioid therapy for treatment of chronic noncancer pain with OIC were recruited from clinics to complete a survey at Baseline and weeks 2, 4, 6, 8, 12, 16, 20 and 24. RESULTS: 489 patients completed baseline with 452 completing one or more follow-up visits...
November 2016: Pain Management
Ganesan Baranidharan, John Titterington
Traditional (40-50 Hz) spinal column stimulation is an efficacious and widely accepted treatment for chronic neuropathic pain conditions. However, there are major challenges including its ineffectiveness for axial back pain, the burden of paresthesia-related discomfort and difficulties producing indisputable research. Recently, there have been the major technological innovations of high-frequency and burst stimulation. Studies have shown these to provide improved analgesia even for axial pain without the problems associated with paresthesia...
November 2016: Pain Management
Bianca M Kuehler, Susan R Childs
Bianca Kuehler and Susan Childs speak to Jade Parker, Commissioning Editor: Dr Bianca Kuehler initially qualified in Germany as an anesthetist in 1993 and is on the specialist register in the UK. After moving to the UK she obtained a Diploma in Occupational Health to supplement the understanding and implication of chronic pain on the work environment. She is very interested in multidisciplinary approaches in treatment of chronic and acute pain patients and, therefore, working closely with Dr Childs opened a plethora of opportunities to develop new services including a fibromyalgia clinic and a specialist clinic for patients who are survivors of torture...
October 2016: Pain Management
Mark I Johnson, Matt Hudson
No abstract text is available yet for this article.
October 2016: Pain Management
Kartavya Sharma, Vibhash D Sharma
We report a case of a 48-year-old man with chronic back pain attributed to discogenic lumbar radiculopathy who underwent a fluoroscopy-guided L2-3 interlaminar epidural steroid injection. 4 h later, he developed acute paraparesis, sensory loss below T10 level and urinary retention. MRI of the thoracic spine revealed diffuse abnormal T2/FLAIR signal and extensive vascular flow voids. A spinal dural arteriovenous fistula was confirmed on spinal angiography. Embolization of the spinal dural arteriovenous fistula resulted in significant improvement of symptoms...
October 2016: Pain Management
Alexander Huang, Abid Azam, Shira Segal, Kevin Pivovarov, Gali Katznelson, Salima Sj Ladak, Alex Mu, Aliza Weinrib, Joel Katz, Hance Clarke
AIM: To identify the 3-month incidence of chronic postsurgical pain and long-term opioid use in patients at the Toronto General Hospital. METHODS: 200 consecutive patients presenting for elective major surgery completed standardized questionnaires by telephone at 3 months after surgery. RESULTS: 51 patients reported a preoperative chronic pain condition, with 12 taking opioids preoperatively. 3 months after surgery 35% of patients reported having surgical site pain and 13...
October 2016: Pain Management
Anne E Olesen, Adam D Farmer, Søren S Olesen, Qasim Aziz, Asbjørn M Drewes
Despite marked differences in underlying pathophysiology, the current management of visceral pain largely follows the guidelines derived from the somatic pain literature. The effective management of patients with chronic visceral pain should be multifaceted, including both pharmacological and psychological interventions, thereby providing a mechanism-orientated approach to treatment. Patients can frequently become disenfranchised, and subsequently disengaged, with healthcare providers leading to repeated consultations...
October 2016: Pain Management
Ramon Go, Yolanda Y Huang, Paul D Weyker, Christopher Aj Webb
As the American healthcare system continues to evolve and reimbursement becomes tied to value-based incentive programs, perioperative pain management will become increasingly important. Regional anesthetic techniques are only one component of a successful multimodal pain regimen. In recent years, the use of peripheral and paraneuraxial blocks to provide chest wall and abdominal analgesia has gained popularity. When used within a multimodal regimen, truncal blocks may provide similar analgesia when compared with other regional anesthetic techniques...
October 2016: Pain Management
David K Lam
Most cancer patients experience severe pain during their disease course, and the management of cancer pain is a major challenge for patients and the healthcare team. Many diverse translational models of cancer pain in recent years have improved our understanding of cancer-related pain. Cancer and associated cells in the cancer microenvironment may release various peripheral mediators, including ATP, formaldehyde, protons, proteases, endothelin, bradykinin, TNF and NGF, that result in the activation and/or sensitization of peripheral and central neurons, that contribute to the clinical manifestations of cancer-related pain...
October 2016: Pain Management
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