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Pain Management Ethics

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https://www.readbyqxmd.com/read/29331966/effectiveness-and-safety-of-oral-sedation-in-adult-patients-undergoing-dental-procedures-protocol-for-a-systematic-review
#1
Jimmy de Oliveira Araújo, Rogério Heládio Lopes Motta, Cristiane de Cássia Bergamaschi, Caio Chaves Guimarães, Juliana Cama Ramacciato, Natalia Karol de Andrade, Mabel Fernandes Fiqueiró, Luciane Cruz Lopes
INTRODUCTION: The management of anxious patients undergoing dental procedures is still a challenge in clinical practice. Despite a wide variety of drugs for oral sedation in adult patients, there are relatively few systematic reviews that compare the effectiveness and safety of different drugs administered via this route. Thus, this study will evaluate the effectiveness and safety of oral sedation with benzodiazepines and other agents to patients undergoing dental surgical procedures...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331965/right-iliac-fossa-pain-treatment-rift-study-protocol-for-an-international-multicentre-prospective-observational-study
#2
Dmitri Nepogodiev
INTRODUCTION: Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29282267/stepped-care-approach-for-medial-tibiofemoral-osteoarthritis-streamline-protocol-for-a-randomised-controlled-trial
#3
Sarah Rubia Robbins, Luciano Ricardo S Melo, Hema Urban, Leticia A Deveza, Rebecca Asher, Victoria L Johnson, David J Hunter
INTRODUCTION: Current guidelines recommend tailored interventions to optimise knee osteoarthritis (OA) management. However, models of care still have a 'one size fits all' approach, which is suboptimal as it ignores patient heterogeneity. This study aims to compare a stepped care strategy with standard care for overweight and obese persons with medial tibiofemoral OA. METHODS AND ANALYSIS: Participants will be randomised into two groups (85 each). The intervention will receive a diet and exercise programme for 18 weeks in the first step of the study...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29258805/american-society-for-pain-management-nursing-and-hospice-and-palliative-nurses-association-position-statement-pain-management-at-the-end-of-life
#4
Patrick Coyne, Carol Mulvenon, Judith A Paice
Pain at the end of life continues to be of great concern as it may be unrecognized or untreated. Although nurses have an ethical obligation to reduce suffering, barriers remain regarding appropriate and adequate pain management at the end of life. This joint position statement from the American Society for Pain Management Nursing and Hospice and Palliative Nurses Association contains recommendations for nurses, prescribers, and institutions that would improve pain management for this vulnerable population.
December 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29258584/lymphocyte-opioid-receptors-as-innovative-biomarkers-of-osteoarthritic-pain-for-the-assessment-and-risk-management-of-opioid-tailored-therapy-before-hip-surgery-to-prevent-chronic-pain-and-opioid-tolerance-addiction-development-opmarkart-opioids-markers-arthroprosthesis
#5
Valentina Malafoglia, Monica Celi, Carolina Muscoli, Sara Ilari, Filomena Lauro, Luigino Antonio Giancotti, Chiara Morabito, Maurizio Feola, Umberto Tarantino, William Raffaeli
BACKGROUND: The incidence of post-surgical chronic pain ranges between 20% and 40% in Europe. Osteoarthritis pain after prosthesis implantation is one of the most severe secondary syndromes, depending not only on surgery but also on organic changes before and after joints replacement. No data are available about risk factors. An excessive inflammatory response plays a central role but a best therapy is not defined yet. It is not clear whether opioid administration could influence post-surgical pain and lead to tolerance or addiction...
December 19, 2017: Trials
https://www.readbyqxmd.com/read/29229658/effectiveness-of-acupuncture-for-cancer-pain-protocol-for-an-umbrella-review-and-meta-analyses-of-controlled-trials
#6
Yihan He, Yihong Liu, Brian H May, Anthony Lin Zhang, Haibo Zhang, ChuanJian Lu, Lihong Yang, Xinfeng Guo, Charlie Changli Xue
INTRODUCTION: The National Comprehensive Cancer Network guidelines for adult cancer pain indicate that acupuncture and related therapies may be valuable additions to pharmacological interventions for pain management. Of the systematic reviews related to this topic, some concluded that acupuncture was promising for alleviating cancer pain, while others argued that the evidence was insufficient to support its effectiveness. METHODS AND ANALYSIS: This review will consist of three components: (1) synthesis of findings from existing systematic reviews; (2) updated meta-analyses of randomised clinical trials and (3) analyses of results of other types of clinical studies...
December 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29210286/morality-in-clinical-space-treatment-of-youngsters-with-functional-somatic-symptoms-in-a-western-clinical-context
#7
Sara Seerup Laursen, Birgitte Dehlholm-Lambertsen, Egon Stenager, Helle Johannessen
This paper explores the moral implications of treatment of young people with functional somatic symptoms. Based on an ethnographic field study at a Danish pain clinic for youngsters (age 8 to 18), the paper seeks to unearth the cultural, moral values that clinical practice steers by and upholds, and the implications this has for the assessment and management of ill body-selves. Through an exposition of the general practice of the clinic and an investigation of two specific cases of youngsters, it is found that the assessment of symptoms and selves and the goals of treatment are informed by cultural ideals of 'the good self' and 'the good life' in which agency and work ethic - both pertaining to the notion of individual responsibility - figure as prevalent virtues...
December 6, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/29207792/clinical-evaluation-of-efficacy-and-performance-of-all-poly-tibial-freedom%C3%A2-total-knee-system-for-treating-osteoarthritis-patients-three-year-follow-up-study
#8
Avatar Singh, Kanwar Kulwinder Singh
Introduction: Advancement in technology in terms of design and building materials has made Total Knee Replacement (TKR) a highly effective, safe, and predictable orthopedic procedure. Aim: To review the clinical outcomes for efficacy and performance of Freedom Total Knee System for the management of Osteoarthritis (OA), at a minimum of three years follow up. Materials and Methods: For this retrospective, post-marketing study, clinical data of patients treated with Freedom Total Knee System was retrieved from the clinical records after approval from the Institutional Ethics Committee ...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29197397/the-heat-goes-away-sexual-disorders-of-married-women-with-female-genital-mutilation-cutting-in-kenya
#9
Tammary Esho, Samuel Kimani, Isaac Nyamongo, Violet Kimani, Samuel Muniu, Christine Kigondu, Patrick Ndavi, Jaldesa Guyo
BACKGROUND: Female genital mutilation/cutting (FGM/C) has been implicated in sexual complications among women, although there is paucity of research evidence on sexual experiences among married women who have undergone this cultural practice. The aim of this study was to investigate the sexual experiences among married women in Mauche Ward, Nakuru County. METHODS: Quantitative and qualitative data collection methods were used. Quantitative data were obtained from 318 married women selected through multistage sampling...
December 2, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29150727/measuring-emotional-intelligence-enhances-the-psychological-evaluation-of-chronic-pain
#10
Eva M Doherty, Rosemary Walsh, Leanne Andrews, Susan McPherson
The assessment of emotional factors, in addition to other psychosocial factors, has been recommended as a means of identifying individuals with chronic pain who may not respond to certain pain treatments. Systematic reviews of the evidence regarding the prediction of responsiveness to a treatment called the spinal cord stimulator (SCS) have yielded inconclusive results. Emotional intelligence is a term which refers to the ability to identify and manage emotions in oneself and others and has been shown to be inversely associated with emotional distress and acute pain...
December 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29146651/prevalence-of-pregnancy-related-pelvic-girdle-pain-and-associated-factors-in-australia-a-cross-sectional-study-protocol
#11
Dragana Ceprnja, Lucinda Chipchase, Amitabh Gupta
INTRODUCTION: Pregnancy-related pelvic girdle pain (PPGP) is a common musculoskeletal disorder. Women with PPGP report difficulty performing everyday functional activities, such as standing and walking. However, the magnitude of the problem remains unknown in Australia. It is important to determine how many women are affected by this condition and the factors associated with PPGP as this will direct healthcare services to being able to better manage women during pregnancy. Thus, this study aims to determine the prevalence of PPGP and associated factors in a Western Sydney population...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#12
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29107306/pharmacologic-interventions-for-pain-management
#13
REVIEW
Francisca Cisneros Farrar, Danielle White, Linda Darnell
Serious life-threatening respiratory depression may occur with pharmacologic pain intervention. The nurse has an ethical and legal duty to provide safe, quality, and accountable pain management. The nurse must acquire self-efficacy for the administration of pain medications for critically ill patients to prevent serious side effects and adverse reactions. This article presents a clinical toolkit for acute pain pharmacologic management by presenting professional guidelines, evidence-based pain assessment tools, common pain medication therapy, and focused monitoring specific to the drug...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29102985/study-protocol-for-a-randomised-controlled-trial-of-ultrasound-guided-pulsed-radiofrequency-of-the-genicular-nerves-in-the-treatment-of-patients-with-osteoarthritis-knee-pain
#14
Javier Mata, Pedro Valentí, Beatriz Hernández, Bartolome Mir, Jose Luis Aguilar
INTRODUCTION: The goals for the management of patients with osteoarthritis (OA) of the knee are to control pain and to minimise disability. Because the number of patients will increase as the population ages, alternative approaches to alleviate their joint pain other than conventional treatments are necessary. The purpose of this article is to present a refined protocol to determine if there is long-term improvement in pain and function after ultrasound-guided pulsed radiofrequency treatment of the genicular nerves (GNs) in patients with chronic painful knee OA...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29046774/role-of-whatsapp-based-discussions-in-improving-residents-knowledge-of-post-operative-pain-management-a-pilot-study
#15
Sumitra G Bakshi, Pranay Bhawalkar
BACKGROUND: To provide a platform for the dissemination of basic knowledge of pain management, a WhatsApp group was created by residents and consultants. Common clinical scenarios, resident queries, and important instructions to be followed by residents with respect to running the Acute Pain Service were discussed in the group. This study evaluates the benefits of this interaction. METHODS: This study was approved by the hospital ethics board and was registered with the Clinical Trial Registry of India...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29042375/non-invasive-brain-stimulation-interventions-for-management-of-chronic-central-neuropathic-pain-a-scoping-review-protocol
#16
Mei Lin Chen, Lin Yao, Jennifer Boger, Kathryn Mercer, Benjamin Thompson, Ning Jiang
INTRODUCTION: Pain can affect people regardless of age, gender or ethnicity. Chronic central neuropathic pain (CCNP) is a debilitating condition that affects populations such as stroke survivors, amputees, spinal cord injury patients and patients with multiple sclerosis, with prevalence rates between 30% and 80%. This condition can be caused by a lesion or disease affecting the somatosensory system. CCNP is notoriously drug resistant, and few effective CCNP treatment or management strategies exist...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29034363/nocebo-effects-in-clinical-studies-hints-for-pain-therapy
#17
Regine Klinger, Maxie Blasini, Julia Schmitz, Luana Colloca
INTRODUCTION: Nocebo-induced algesic responses occurring within clinical contexts present a challenge for health care practitioners working in the field of pain medicine. OBJECTIVES: Following the recent research on algesic nocebo effects, the scope of this review is to develop ethically acceptable strategies to help avoid, or at least reduce, nocebo responses within clinical settings. METHODS: We reviewed relevant clinical studies that depict how patient-practitioner interactions may contribute to the reduction of nocebo responses...
March 2017: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/28991063/dose-response-curves-for-intrathecal-bupivacaine-levobupivacaine-and-ropivacaine-given-for-labor-analgesia-in-nulliparous-women
#18
Warwick D Ngan Kee, Floria F Ng, Kim S Khaw, Shannon P Y Tang, Alison G P Koo
BACKGROUND AND OBJECTIVES: Bupivacaine, levobupivacaine, and ropivacaine are often given intrathecally for labor analgesia, but limited data are available for their dose-response properties in this context. The objective of this study was to describe the dose-response curves of these local anesthetics when given intrathecally for labor analgesia, to determine values for D50 (dose producing a 50% response) and to compare the calculated values of D50 for levobupivacaine and ropivacaine with those for bupivacaine...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28988103/opioid-tapering-in-patients-with-prescription-opioid-use-disorder-a-retrospective-study
#19
Kehua Zhou, Peng Jia, Swati Bhargava, Yong Zhang, Taslima Reza, Yuan Bo Peng, Gary G Wang
BACKGROUND AND AIMS: Opioid use disorder (OUD) refers to a maladaptive pattern of opioid use leading to clinically significant impairment or distress. OUD causes, and vice versa, misuses and abuse of opioid medications. Clinicians face daily challenges to treat patients with prescription opioid use disorder. An evidence-based management for people who are already addicted to opioids has been identified as the national priority in the US; however, options are limited in clinical practices...
October 4, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28979824/when-the-opioid-medications-go-missing-confidentiality-and-safety-in-adolescents
#20
Muhammad Hassan Majeed
Patients receiving end-of-life or palliative care usually possess an ample supply of opioid pain medications to help alleviate their pain. The risk of these drugs being diverted is high because such patients often have an excess of these medications, and because they are typically unable to manage medications themselves. For example, adolescents might steal these medications for recreational use. The author presents a case in which a minor admitted stealing and using opioid pain medication belonging to her mother, who was in hospice home care...
May 2017: Innovations in Clinical Neuroscience
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