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multimodal pain management

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https://www.readbyqxmd.com/read/28928570/gabapentinoids-as-a-part-of-multi-modal-drug-regime-for-pain-relief-following-laproscopic-cholecystectomy-a-randomized-study
#1
Anjali Kochhar, Kanika Chouhan, Pratibha Panjiar, Homay Vajifdar
BACKGROUND: Gabapentinoids have been used as preemptive analgesics for pain management following laparoscopic cholecystectomy. Recently, multimodal analgesic techniques have been found superior to preemptive analgesia alone. AIM: The aim of this study is to evaluate and compare a single preoperative dose of pregabalin 150 mg and gabapentin 300 mg for pain relief following laparoscopic cholecystectomy as a part of multimodal drug regime. SETTINGS AND DESIGN: This randomized, single-blind study was conducted after Ethical Committee approval and written informed consent from the patients...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#2
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28919091/intravenous-acetaminophen-as-an-adjunct-to-multimodal-analgesia-after-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#3
REVIEW
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to investigate the impact of additional intravenous acetaminophen for pain management after total joint arthroplasty (TJA). METHODS: We conducted electronic searches of Medline (1966-2017.07), PubMed (1966-2017.07), Embase (1980-2017.07), ScienceDirect (1985-2017.07) and the Cochrane Library. Randomized controlled trials (RCTs) and non-RCTs were included. The quality assessments were performed according to the Cochrane systematic review method...
September 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28912633/a-preliminary-case-series-evaluating-the-safety-and-immediate-to-short-term-clinical-benefits-of-joint-mobilization-in-hemophilic-arthritis-of-the-lower-limb
#4
Emma Scaddan, John Rowell, Shaun O'Leary
OBJECTIVES: Arthritis resulting from recurrent intra-articular bleeding in individuals with hemophilia can be severely debilitating due to joint pain and stiffness with subsequent loss of mobility and function. Very limited studies have investigated the potential benefits of joint mobilization for this condition. This case series is a preliminary investigation of safety, as well as immediate and short-term clinical benefits, associated with gentle knee and ankle joint mobilization in people with hemophilic arthropathy...
September 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/28900573/the-effects-of-a-multimodal-rehabilitation-program-on-pain-kinesiophobia-and-function-in-a-runner-with-patellofemoral-pain
#5
Samuele Passigli, Pietro Capacci, Emanuele Volpi
BACKGROUND AND PURPOSE: Multimodal interventions possess the strongest evidence in the long-term management of patellofemoral pain, but despite receiving evidence-based treatments that are initially effective many patients report recurrent or persistent symptoms for years after the initial diagnosis. Untreated psychological factors could be a possible explanation for persistent symptoms and poor treatment outcome. The purpose of this case report was to describe and evaluate the effects of a multimodal rehabilitation program that included pain education, a graded program of lower limb strengthening, and running retraining on pain, kinesiophobia, and function in a runner with patellofemoral pain...
August 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28890830/cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-combined-with-two-stage-hepatectomy-for-multiple-and-bilobar-desmoplastic-small-round-cell-tumor-liver-metastases
#6
Alejandro Cracco, Mayank Roy, Conrad H Simpfendorfer
Desmoplastic small round cell tumor (DSRCT) is a rare mesenchymal tumor usually affecting young patients. Local dissemination is common, and liver is the most common site for extraperitoneal metastases. Multimodal management has been shown to be the most effective treatment. Some authors consider liver metastases especially bi-lobar disease as a contraindication for surgical resection. We present a case of a DSRCT with bi-lobar metastases in an adult patient who underwent multi-modal management along with hepatectomy...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28888299/principles-of-burn-pain-management
#7
REVIEW
Dominika Lipowska James, Maryam Jowza
This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28881883/the-clinical-significance-of-hypercontractile-peristalsis-comparison-of-high-resolution-manometric-features-demographics-symptom-presentation-and-response-to-therapy-in-patients-with-jackhammer-esophagus-versus-nutcracker-esophagus
#8
M T Al-Qaisi, H A Siddiki, M D Crowell, G E Burdick, D E Fleischer, F C Ramirez, M F Vela
The Chicago Classification version 3.0 (CC v 3.0) defines hypercontractile peristalsis as Jackhammer esophagus (JE); Nutcracker esophagus (NE) is no longer recognized. Data regarding patient characteristics and treatment response for JE versus NE are limited. We aimed to compare demographic characteristics, high resolution manometry (HRM) features, clinical presentation, management strategies, and treatment outcomes in patients with JE versus NE. We performed a retrospective analysis of adult patients diagnosed with NE (CC v 2...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28875041/palmitoylethanolamide-in-the-treatment-of-failed-back-surgery-syndrome
#9
Antonella Paladini, Giustino Varrassi, Giuseppe Bentivegna, Sandro Carletti, Alba Piroli, Stefano Coaccioli
INTRODUCTION: This observational study was designed to evaluate the efficacy of ultramicronized palmitoylethanolamide (um-PEA) (Normast®) administration, as add-on therapy for chronic pain, in the management of pain-resistant patients affected by failed back surgery syndrome. METHODS: A total of 35 patients were treated with tapentadol (TPD) and pregabalin (PGB). One month after the start of standard treatment, um-PEA was added for the next two months. Pain was evaluated by the Visual Analogue Scale (VAS) at the time of enrollment (T0) and after one (T1), two (T2), and three (T3) months...
2017: Pain Research and Treatment
https://www.readbyqxmd.com/read/28870309/multimodal-analgesia-in-foot-and-ankle-surgery
#10
REVIEW
Jessica M Kohring, Nathan G Orgain
Progress in surgical acute pain management has allowed most foot and ankle surgery to be performed in ambulatory outpatient surgical centers. Multimodal analgesia focuses on improving postoperative pain by combining pharmacologic and other modalities, addressing multiple pain mechanisms and receptor pathways while reducing adverse effects through lower doses of oral medications. Local anesthesia techniques provide excellent pain relief with few adverse events. Multimodal analgesia in foot and ankle surgery provides superior pain relief, and reduced opioid dependence and opioid-related side effects, improving patient satisfaction, safety, and timely return to function...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870307/perioperative-pain-management-in-pediatric-spine-surgery
#11
REVIEW
Benjamin W Sheffer, Derek M Kelly, Leslie N Rhodes, Jeffrey R Sawyer
Pain management after spinal deformity correction surgery for scoliosis in the pediatric population can be difficult. Deformity correction with posterior spinal fusion causes significant tissue trauma. Historically, pain control has been achieved with intravenous opiates. Opiates provide excellent analgesic effect; however, they have serious consequences when used alone. In adult total joint arthroplasty, multimodal pain control has become an increasingly common method to achieve pain control without these sequelae...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870306/pediatric-perioperative-pain-management
#12
REVIEW
Kaela H Frizzell, Priscilla K Cavanaugh, Martin J Herman
Effective perioperative pain control in pediatric patients undergoing orthopedic surgery remains a challenge. Developing a successful pain control regimen begins preoperatively with assessment of the patient and discussion with the patient and family regarding expectations. Perioperative pain control regimens are customized based on the type of surgery, patient characteristics, and anticipated severity and duration of the postoperative pain. Recent study focuses on multimodal strategies and regional anesthesia options, allowing for decreased opioid use...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870302/perioperative-pain-management-in-hip-and-knee-arthroplasty
#13
REVIEW
Christian J Gaffney, Christopher E Pelt, Jeremy M Gililland, Christopher L Peters
Total hip and knee arthroplasty is associated with significant perioperative pain, which can adversely affect recovery by increasing risk of complications, length of stay, and cost. Historically, opioids were the mainstay of perioperative pain control. However, opioids are associated with significant downsides. Preemptive use of a multimodal pain management approach has become the standard of care to manage pain after hip and knee arthroplasty. Multimodal pain management uses oral medicines, peripheral nerve blocks, intra-articular injections, and other tools to reduce the need for opioids...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870301/perioperative-pain-management-and-anesthesia-a-critical-component-to-rapid-recovery-total-joint-arthroplasty
#14
REVIEW
Matthew W Russo, Nancy L Parks, William G Hamilton
Multimodal pain management has become the standard of care following total hip and knee replacement. The advantages include decreasing opioid consumption and its associated side effects, facilitating earlier mobilization, and faster return to function. An effective rapid recovery protocol includes the use of multiple different types of medications targeting each area of the pain pathway, preemptive analgesia, regional nerve blockade, and local infiltration analgesia.
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28869145/the-early-diagnosis-and-management-of-mixed-delirium-in-a-patient-placed-on-ecmo-and-with-difficult-sedation-a-case-report
#15
María Acevedo-Nuevo, Maria Teresa González-Gil, Miguel Ángel Romera-Ortega, Ignacio Latorre-Marco, Maria Dolores Rodríguez-Huerta
Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula)...
August 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28860845/dexmedetomidine-in-perioperative-acute-pain-management-a-non-opioid-adjuvant-analgesic
#16
REVIEW
Chaoliang Tang, Zhongyuan Xia
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28860819/clinicopathologic-characteristics-therapy-and-outcomes-of-patients-with-primary-ureteral-small-cell-carcinoma-a-case-series-and-systematic-review-of-the-literature
#17
Wenlong Zhong, Rongcheng Lin, Lei Zhang, Chengyue Jin, Xuesong Li, Qun He, Kan Gong, Zhisong He, Liqun Zhou
PURPOSE: The aim of this case series was to review the standard diagnosis and treatment procedures of primary small cell carcinoma (SCC) in our institution and discuss the clinicopathologic characteristics, treatments and outcomes of patients with primary ureteral SCC. PATIENTS AND METHODS: Patients diagnosed with ureteral SCC in Peking University First Hospital, Beijing, China, from January 2007 to December 2016 were included. In addition, we performed a systematic literature review, in October 2016, on case reports and case series of ureteral SCC...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28853055/quantification-of-the-pharmacodynamic-interaction-of-morphine-and-gabapentin-using-a-response-surface-approach
#18
Theodoros Papathanasiou, Rasmus Vestergaard Juul, Charlotte Gabel-Jensen, Mads Kreilgaard, Anne-Marie Heegaard, Trine Meldgaard Lund
The combination of morphine and gabapentin has shown to be promising for managing postoperative pain but finding the right dose for the combination has proven to be a challenge. The purpose of this study was to quantitatively characterize the pharmacodynamic interaction between the two drugs and to identify the optimal concentration-effect relationship of the combination. Information regarding plasma concentrations and von Frey withdrawal thresholds following incisional surgery on Sprague Dawley rats, after administration of morphine, gabapentin, or their combination was available from published studies...
August 29, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#19
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28851418/survey-of-integrative-lumbar-spinal-stenosis-treatment-in-korean-medicine-doctors-preliminary-data-for-clinical-practice-guidelines
#20
Yoon Jae Lee, Joon-Shik Shin, Jinho Lee, Me-Riong Kim, Yong-Jun Ahn, Ye-Sle Shin, Ki Byung Park, Byung-Cheul Shin, Myeong Soo Lee, Joo-Hee Kim, Jae-Heung Cho, In-Hyuk Ha
BACKGROUND: Considering that large variations exist amongst practitioners in lumbar disorder management and the significant costs that lumbar disorders incur, determining clinical practice patterns to provide preliminary data for standardization should be given higher priority. Lumbar spinal stenosis (LSS) is commonly treated using integrative non-surgical methods by Korean medicine doctors (KMDs) in Korea, and this is the first study to assess current Korean medicine practice trends for LSS...
August 29, 2017: BMC Complementary and Alternative Medicine
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