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multimodal pain management

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https://www.readbyqxmd.com/read/28100440/it-s-about-me-patients-experiences-of-patient-participation-in-the-web-behavior-change-program-for-activity-in-combination-with-multimodal-pain-rehabilitation
#1
Catharina Nordin, Peter Michaelson, Margareta K Eriksson, Gunvor Gard
BACKGROUND: Patients' participation in their health care is recognized as a key component in high-quality health care. Persons with persistent pain are recommended treatments with a cognitive approach from a biopsychosocial explanation of pain, in which a patient's active participation in their rehabilitation is in focus. Web-based interventions for pain management have the potential to increase patient participation by enabling persons to play a more active role in rehabilitation. However, little is known about patients' experiences of patient participation in Web-based interventions in clinical practice...
January 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#2
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28075425/management-of-fibromyalgia-practical-guides-from-recent-evidence-based-guidelines
#3
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus-based guidelines from Canada, Germany, Israel and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic work-up of patients with chronic widespread pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires at the first medical evaluation a complete history, medical examination and some laboratory tests (complete blood count, C-reactive protein, serum calcium, creatine phosphokinase, thyroid stimulating hormone, 25-OH vitamin D) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28074359/pharmacological-management-of-chronic-pelvic-pain-in-women
#4
REVIEW
Erin T Carey, Sara R Till, Sawsan As-Sanie
Chronic pelvic pain (CPP) is a multifaceted condition that often has both peripheral and central generators of pain. An understanding of neurobiology and neuropsychology of CPP should guide management. Successful treatment of CPP is typically multimodal, and pharmacologic treatment strategies include analgesics, hormonal suppression, anesthetics, antidepressants, membrane stabilizers, and anxiolytics. Evidence for these and other emerging pharmacologic therapies is presented in this article.
January 10, 2017: Drugs
https://www.readbyqxmd.com/read/28064297/a-clinical-audit-of-interventional-pain-procedures-performed-as-part-of-the-newly-initiated-pain-service-in-a-local-neurosurgical-centre
#5
H C Khoo, B H Soon, A S Jaafar, A Abu Bakar, F Fadzil, K Palaniandy, S Paramasvaran, Y C Choy, C J Toh
Interventional Pain Procedures (IPPs) is a relatively new treatment modality for chronic pain in Malaysia. The Interventional Pain Service (IPS) newly set up in our institution is led by a pain neurosurgeon and provides a whole package of multimodal pain management including different range of IPPs. This clinical audit is to examine the quality of IPPs performed within the IPS in our institution since its initiation. A total of 87 IPPs were performed on 56 chronic pain patients over 3-year duration. As high as 81...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28049215/surgical-management-of-endometriosis-in-patients-with-chronic-pelvic-pain
#6
Rebecca Flyckt, Suejin Kim, Tommaso Falcone
Surgical approaches to endometriosis patients with chronic pelvic pain are multimodal and require individualization. Laparoscopic approaches are preferred over laparotomy when conservatively treating endometriosis via excision or ablation/fulguration of lesions. The available data support cystectomy over fenestration or fulguration for endometriomas; however, there may be associated decreases in ovarian reserve with endometrioma treatment. Presacral neurectomy may be useful in patients with midline pain and LUNA is not effective for the treatment of pelvic pain related to endometriosis...
January 3, 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28039022/a-single-blind-randomized-control-trial-of-adjunctive-transcranial-direct-current-stimulation-tdcs-for-chronic-pain-among-patients-receiving-specialized-inpatient-multimodal-pain-management
#7
G Janice Jimenez-Torres, Benjamin L Weinstein, Cory R Walker, J Christopher Fowler, Philippa Ashford, Jeffrey J Borckardt, Alok Madan
Available treatments for chronic pain (CP) are modestly effective or associated with iatrogenic harm. Transcranial direct current stimulation (tDCS) is a minimally-invasive brain stimulation technique that may be an effective, adjunctive treatment to non-opioid therapies. In this randomized control trial (RCT), we compare adjunctive active versus sham tDCS among patients in a multimodal inpatient pain management program. The primary objectives of the RCT are to improve pain tolerance and subjective pain experience METHODS AND DESIGN: Patients admitted to the Pain Management Program at The Menninger Clinic in Houston, Texas are eligible for this trial...
December 27, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28008470/uptake-of-enhanced-recovery-practices-by-sages-members-a-survey
#8
Deborah S Keller, Conor P Delaney, Anthony J Senagore, Liane S Feldman
BACKGROUND: The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. METHODS: An online survey designed by SMART committee members to define SAGES member's awareness and use of enhanced recovery principles and practice was emailed to all SAGES members...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28008467/readmissions-after-laparoscopic-cholecystectomy-in-a-uk-district-general-hospital
#9
Olugbenga Awolaran, Tabitha Gana, Nehemiah Samuel, Kenneth Oaikhinan
INTRODUCTION: Laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic gallstones and its practice as day case where possible is considered the standard over the last decade. However, readmission after surgery is recognised as a new problem. AIM: The aim of this cohort observational study was to investigate the readmission rate in a district general hospital and identify the causes of readmission in order to explore ways by which this can be reduced or managed more cost effectively...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28005125/the-role-of-liposomal-bupivacaine-in-value-based-care
#10
Richard Iorio
Multimodal pain control strategies are crucial in reducing opioid use and delivering effective pain management to facilitate improved surgical outcomes. The utility of liposomal bupivacaine in enabling effective pain control in multimodal strategies has been demonstrated in several studies, but others have found the value of liposomal bupivacaine in such approaches to be insignificant. At New York University Langone Medical Center, liposomal bupivacaine injection and femoral nerve block were compared in their delivery of efficacious and cost-effective multimodal analgesia among patients undergoing total joint arthroplasty (TJA)...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005124/comprehensive-care-for-joint-replacement-cjr-bundle-expense-in-perioperative-pain-management
#11
Susan D Bear
The implementaion of the Comprehensive Care for Joint Replacement (CJR) model has necessitated value-focused care for a 90-day period. Pain management in joint arthroplasty therefore represents a focused opportunity to achieve lasting change in the delivery of care. To be successful, orthopedic surgeons must integrate approaches that take into account administration route and therapy duration, and various combinations thereof, to achieve improved longer term outcomes for joint arthroplasty patients. In addition, pain management choices must be based on value and not on simple costs, as patient satisfaction scores affect CJR repayments...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005123/addressing-the-opioid-epidemic-with-multimodal-pain-management
#12
Michael A Kelly
The opioid epidemic has become a national public health and safety problem affecting both adults and adolescents. There is little doubt that this epidemic is rooted in the need for pain control after surgery and that orthopedic surgeons have in part contributed to opioid overprescription. Indeed, opioid abuse, misuse, and diversion are associated with increased hospitalizations, emergency department visits, and associated health care costs. In addition, postoperative exposure to opioids correlates with long-term use and abuse...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005122/opioid-sparing-pain-control-in-outpatient-total-joint-arthroplasty
#13
John W Barrington
Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27990189/effects-of-modification-of-pain-protocol-on-incidence-of-post-operative-nausea-and-vomiting
#14
Ran Schwarzkopf, Nimrod Snir, Zachary T Sharfman, Joseph B Rinehart, Michael-David Calderon, Esther Bahn, Brian Harrington, Kyle Ahn
BACKGROUND: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27984226/intraperitoneal-instillation-of-lidocaine-improves-postoperative-analgesia-at-cesarean-delivery-a-randomized-double-blind-placebo-controlled-trial
#15
Ruchira Patel, Jose C A Carvalho, Kristi Downey, Marcelo Kanczuk, Paul Bernstein, Naveed Siddiqui
BACKGROUND: Cesarean delivery is a commonly performed procedure worldwide. Despite improvements in balanced multimodal analgesia, there remains a proportion of women for whom postoperative pain relief and patient satisfaction are still inadequate. Intraperitoneal instillation of local anesthetic has been shown to be effective in reducing postoperative pain after abdominal surgery. We sought to investigate the effect of intraperitoneal instillation of lidocaine on postcesarean delivery pain as part of a multimodal analgesia regimen...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27965852/testing-the-feasibility-of-a-knowledge-translation-intervention-designed-to-improve-chiropractic-care-for-adults-with-neck-pain-disorders-study-protocol-for-a-pilot-cluster-randomized-controlled-trial
#16
Prakash Dhopte, Sara Ahmed, Nancy Mayo, Simon French, Jeffrey A Quon, André Bussières
BACKGROUND: Neck pain in adults is common and a leading cause of physical disability. Recently, a guideline was developed for the management of non-specific neck pain (NSNP) with an aim to improve the quality of the delivery of chiropractic care. One key guideline recommendation is to undertake multimodal care for patients with NSNP. The aim of this pilot study is to determine the feasibility of implementing a multifaceted knowledge translation intervention by promoting the use of multimodal care by chiropractors managing patients with NSNP...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27960229/automated-telephone-communication-systems-for-preventive-healthcare-and-management-of-long-term-conditions
#17
REVIEW
Pawel Posadzki, Nikolaos Mastellos, Rebecca Ryan, Laura H Gunn, Lambert M Felix, Yannis Pappas, Marie-Pierre Gagnon, Steven A Julious, Liming Xiang, Brian Oldenburg, Josip Car
BACKGROUND: Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention...
14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27943118/hospitalization-costs-for-patients-undergoing-orthopedic-surgery-treated-with-intravenous-acetaminophen-iv-apap-plus-other-iv-analgesics-or-iv-opioid-monotherapy-for-postoperative-pain
#18
Brett A Maiese, An T Pham, Manasee V Shah, Michael T Eaddy, Orsolya E Lunacsek, George J Wan
INTRODUCTION: To assess the impact on hospitalization costs of multimodal analgesia (MMA), including intravenous acetaminophen (IV-APAP), versus IV opioid monotherapy for postoperative pain management in patients undergoing orthopedic surgery. METHODS: Utilizing the Truven Health MarketScan(®) Hospital Drug Database (HDD), patients undergoing total knee arthroplasty (TKA), total hip arthroplasty (THA), or surgical repair of hip fracture between 1/1/2011 and 8/31/2014 were separated into postoperative pain management groups: MMA with IV-APAP plus other IV analgesics (IV-APAP group) or an IV opioid monotherapy group...
December 10, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27940762/pediatric-chronic-pain-biopsychosocial-assessment-and-formulation
#19
REVIEW
Christina Liossi, Richard F Howard
Chronic pain in children is an increasingly recognized clinical problem with alarmingly high prevalence rates found in some populations. Although it is not understood why some children experience high levels of pain, the subjective experience of chronic pain (including its site, intensity, quality, unpleasantness, and associated suffering) has long been believed to result from interactions between multiple contributors, including nociceptive, affective, sociocultural, behavioral, and cognitive. Regardless of whether the antecedent of chronic pain is known or unknown, similar patterns of symptoms, behaviors, and disability are often seen...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27938361/evaluation-of-the-efficacy-of-a-short-course-personalized-self-management-and-intensive-spa-therapy-intervention-as-active-prevention-of-musculoskeletal-disorders-of-the-upper-extremities-muska-a-research-protocol-for-a-randomized-controlled-trial
#20
Charlotte Lanhers, Bruno Pereira, Chloé Gay, Christian Hérisson, Christine Levyckyj, Arnaud Dupeyron, Emmanuel Coudeyre
BACKGROUND: Musculoskeletal disorders (MSDs) constitute a major occupational health problem in the working population, substantially impacting the quality of life of employees. They also cause considerable economic cost to the healthcare system, with, notably, the reimbursement of treatments and compensation for lost income. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although prevalence varies depending on the region considered and the method of assessment, a prevalence of 30% is found in different epidemiological studies...
December 9, 2016: BMC Musculoskeletal Disorders
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