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multimodal pain management

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https://www.readbyqxmd.com/read/29316592/the-addition-of-diclofenac-to-a-multimodal-pain-control-regimen-decreases-postoperative-pain-and-opioid-consumption
#1
Nicole E George, Cheryle Gurk-Turner, Jennifer I Etcheson, Chukwuweike U Gwam, Randal De Souza, Spencer S Smith, James Nace, Ronald E Delanois
INTRODUCTION: Total knee arthroplasty (TKA) is a commonly-performed orthopaedic procedure in the United States. However, inadequate postoperative pain management following TKA has been associated with a number of negative consequences, including chronic postoperative pain requiring long-term opioid use. Multimodal pain control is a recently-popularized means of maximizing analgesia and postoperative outcomes. We aimed to evaluate the outcomes of a multimodal pain regimen incorporating diclofenac, including: 1) length of stay (LOS); 2) pain intensity; and 3) opioid consumption in primary TKA patients...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29300708/medial-open-transversus-abdominis-plane-motap-catheters-reduce-opioid-requirements-and-improve-pain-control-following-open-liver-resection-a-multicenter-blinded-randomized-controlled-trial
#2
Paul Jack Karanicolas, Sean Cleary, Paul McHardy, Alex Kiss, Jason Sawyer, Ramy Behman, Salima Ladak, Stuart A McCluskey, Coimbatore Srinivas, Joel Katz, Natalie Coburn, Calvin Law, Alice C Wei, Paul Greig, Julie Hallet, Hance Clarke
OBJECTIVE: Conventional management of pain following open liver resection involves intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. The objective of this trial was to assess the efficacy of a regional technique called Medial Open Transversus Abdominis Plane (MOTAP) catheter analgesia compared with IV PCA. METHODS: This was a blinded, randomized, controlled parallel-arm trial conducted at 2 high-volume centers. Patients undergoing liver resection through a subcostal incision were enrolled...
January 3, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29279873/wandering-double-j-stent-in-the-retroperitoneum-a-case-report
#3
Sridhar Panaiyadiyan, Abhishek Shukla, Brusabhanu Nayak, Prabhjot Singh, Ashish Kumar Saini
Background: Double-J (DJ) stent is an integral part of urologic practice. DJ stents can have numerous complications such as persistent irritative symptoms, encrustations, and up and down migrations within the pelvicaliceal system (PCS), but displacement outside the urinary tract is rare. We are presenting a unique case of DJ stent lying outside the PCS for more than a decade. Case Presentation: A 46-year-old female presented with left flank pain and dysuria. She had undergone percutaneous nephrolithotomy in the left side 11 years ago...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29276466/rehabilitative-principles-in-the-management-of-thoracolumbar-syndrome-a-case-report
#4
Mathew E DiMond
Objective: The purpose of this case report was to describe the chiropractic management of thoracolumbar syndrome using multimodal therapies. Clinical Features: A 33-year-old woman with 3 weeks of back pain presented to a chiropractic clinic. Nerve tension tests and local tenderness were present in a pattern described by Maigne, and she was diagnosed with thoracolumbar syndrome (Maigne syndrome) at her initial visit. Intervention and Outcomes: The Oswestry Disability Index for low back pain (62%), STarT low back screen tool for clinical outcomes (6 points total, with a 2-point subscale), numeric pain rating scale (6/10 constant, 10/10 with provocation), and test-retest exercise audits were outcome measures...
December 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29251636/ce-managing-postoperative-pain
#5
Renee C B Manworren, Debra B Gordon, Robert Montgomery
: Acute postoperative pain remains undertreated despite the dramatic increase in opioid prescribing in the United States over the past 20 years. Inadequately relieved postoperative pain may be a risk factor for persistent postoperative pain, chronic pain, and disability. In an effort to promote evidence-based strategies for optimal postoperative pain management, the American Pain Society published a new postoperative pain management guideline in 2016. Its 32 recommendations for interdisciplinary and multimodal postoperative pain management are stratified according to risks and benefits, based on varying levels of evidence...
January 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29249862/celiac-plexus-block-and-neurolysis-in-the-management-of-chronic-upper-abdominal-pain
#6
REVIEW
Joshua Cornman-Homonoff, Daniel J Holzwanger, Kyungmouk S Lee, David C Madoff, David Li
Chronic upper abdominal pain occurs as a complication of various malignant and benign diseases including pancreatic cancer and chronic pancreatitis, and when present may contribute to lower quality of life and higher mortality. Though various pain management strategies are available as part of a multimodal approach, they are often incompletely effective and accompanied by side effects. Pain originating in upper abdominal viscera is transmitted through the celiac plexus, which is an autonomic plexus located in the retroperitoneum at the root of the celiac trunk...
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29245223/effect-of-preoperative-pregabalin-as-an-adjunct-to-a-multimodal-analgesic-regimen-in-video-assisted-thoracoscopic-surgery-a-randomized-controlled-trial
#7
RANDOMIZED CONTROLLED TRIAL
Jong Chan Kim, Sunghye Byun, Seongsu Kim, Seon-Yi Lee, Joo Hyung Lee, Sowoon Ahn
BACKGROUND: Depending on the type of injury, the pain mechanisms are multifactorial. Preoperative pregabalin administrations as an adjunct to a multimodal postoperative pain management strategy have been tested in various surgical settings. The purpose of current study was to evaluate the effects of preoperative pregabalin administration on postoperative pain intensity and rescue analgesic requirement following video-assisted thoracoscopic surgery (VATS). METHODS: Sixty adult patients undergoing VATS were randomly assigned either to receive pregabalin 150 mg (Pregabalin group) or placebo (Control group) 1 hour before anesthesia...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240019/integrating-patient-controlled-analgesia-using-implanted-intrathecal-pumps-for-postoperative-pain-management-a-case-report
#8
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
December 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29238829/the-role-of-gabapentin-in-multimodal-postoperative-pain-management
#9
Michael A Ashburn, Lee A Fleisher
No abstract text is available yet for this article.
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29236967/postoperative-analgesia-after-pulmonary-resection-with-a-focus-on-video-assisted-thoracoscopic-surgery
#10
Marzia Umari, Valentina Carpanese, Valeria Moro, Gaia Baldo, Stefano Addesa, Enrico Lena, Stefano Lena, Umberto Lucangelo
Video-assisted thoracoscopic surgery is a widespread technique that has been linked to improved postoperative respiratory function, reduced hospital length of stay and a higher level of tolerability for the patients. Acute postoperative pain is of considerable significance, and the late development of neuropathic pain syndrome is also an issue. As anaesthesiologists, we have investigated the available evidence to optimize postoperative pain management. An opioid-sparing multimodal approach is highly recommended...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29226029/diagnosis-and-treatment-of-ocular-pain-the-ophthalmologist-s-perspective
#11
REVIEW
Deborah S Jacobs
Purpose of Review: The aim of this review is to help ophthalmologists and other clinicians understand and treat ocular neuropathic pain. Recent Findings: Advances in the field of neurophysiology of ocular sensations explain why some cases of dry eye may represent a pain syndrome rather than a problem related to tear status. Principles related to management of pain syndromes such as persistent post-operative pain and complex regional pain syndrome are relevant to the care of these patients...
2017: Current Ophthalmology Reports
https://www.readbyqxmd.com/read/29225793/recent-advances-in-acute-pain-management-understanding-the-mechanisms-of-acute-pain-the-prescription-of-opioids-and-the-role-of-multimodal-pain-therapy
#12
REVIEW
Richa Wardhan, Jacques Chelly
In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the "opioid epidemic". In this regard, we propose that a fundamental principle in acute pain management is identifying patients who are most at risk and providing an "opioid free anesthesia and postoperative analgesia"...
2017: F1000Research
https://www.readbyqxmd.com/read/29222302/pain-measurement-tools-in-sickle-cell-disease-where-are-we-now
#13
REVIEW
Deepika S Darbari, Amanda M Brandow
Pain is a complex multidimensional experience and the most common morbidity in patients with sickle cell disease (SCD). Tools to assess pain can be of use not only to guide pain treatment but also to provide insight into underlying pain neurobiology. Mechanisms of pain in SCD are multifactorial and are not completely elucidated. Although vaso-occlusion of microcirculation by sickled red cells is believed to be the underlying mechanism of acute vaso-occlusive pain, mechanisms for chronic pain and the transition from acute to chronic pain are under investigation...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29210970/evaluating-the-implementation-of-a-preemptive-multimodal-analgesia-protocol-in-a-plastic-surgery-office
#14
COMPARATIVE STUDY
Brandi Tinsbloom, Virginia C Muckler, William T Stoeckel, Robert L Whitehurst, Brett Morgan
Many patients undergoing plastic surgery experience significant pain postoperatively. The use of preemptive, multimodal analgesia techniques to reduce postoperative pain has been widely described in the literature. This quality improvement project evaluated the implementation of a preemptive, multimodal analgesia protocol in an office-based plastic surgery facility to decrease postoperative pain, decrease postoperative opioid consumption, decrease postanesthesia care time, and increase patient satisfaction...
October 2017: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/29204950/-physiotherapy-in-pain-medicine-further-treatment-after-a-multimodal-pain-therapy-program
#15
Elisabeth Dean
BACKGROUND: Chronic pain is a global health challenge for both the individual patient and the healthcare community. Multimodal Pain Management, as one of the possible therapies for patients with chronic pain, provides a comprehensive tool that places equally high demands on therapists and patients and is consistently recommended. METHOD: In a monocentric cross-sectional study, patients who had previously participated in a multi-modal pain therapy program lasting several weeks were asked about the follow-up recommendations of the interdisciplinary team of the Pain Management Clinic...
December 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#16
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29191649/multilevel-thoracic-paravertebral-block-using-ropivacaine-with-without-dexmedetomidine-in-video-assisted-thoracoscopic-surgery
#17
Jianghui Xu, Xiaoyu Yang, Xiaobing Hu, Xiaofeng Chen, Jun Zhang, Yingwei Wang
OBJECTIVES: Thoracic paravertebral block (TPVB) is reported to have advantages in postoperative pain management in unilateral thoracic surgeries. Previous studies have demonstrated that dexmedetomidine could be used as an adjuvant to local anesthetics, with the aim of prolonging the duration of neural blockade. However, little is known about whether such a combination could improve the quality of postoperative analgesia compared with local anesthetic only when TPVB is used for patients undergoing video-assisted thoracoscopic surgery (VATS)...
June 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29184697/clinical-presentation-diagnosis-classification-and-management-of-peritoneal-mesothelioma-a-review
#18
REVIEW
Alfonso García-Fadrique, Akash Mehta, Faheez Mohamed, Sanjeev Dayal, Tom Cecil, Brendan J Moran
Peritoneal mesothelioma (PM) is an uncommon but a serious, and often, fatal primary peritoneal tumour, with increasing incidence worldwide. Conventional systemic chemotherapy, generally based on experience with pleural mesothelioma, usually has disappointing results considering PM as a terminal condition. Patients usually present with non-specific symptoms of abdominal distension and pain making the diagnosis challenging. As PM is confined to the abdomen for all, or much, of its clinical course, a multimodality treatment combining cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a new standard of care, and has been reported to achieve promising survival outcomes and local disease control in selected patients with PM...
October 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29183690/home-based-intravenous-analgesia-with-elastomeric-pump-as-an-outpatient-procedure-for-pain-control-after-anterior-cruciate-ligament-repair
#19
J Villalba, J Peñalver, P Torner, M Serra, J Planell
OBJECTIVE: To follow up pain in the immediate postoperative period, using an elastomeric pump in anterior cruciate ligament surgery. MATERIAL AND METHODS: 309 patients who had undergone anterior cruciate ligament repair with bone-tendon-bone allograft. Pain control was assessed with a visual analogue scale (VAS) during the immediate postoperative period, in the postoperative care unit, in the recovery room, and after the first 24-48-72hours following home discharge...
November 25, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29181262/exercise-manual-therapy-and-postural-re-education-for-uncontrolled-ear-twitching-and-related-impairments-after-whiplash-injury-a-case-report
#20
Kelsey Flanders, Heather Feldner
Background and Purpose: Whiplash Associated Disorders and the interventions used to remediate them are well documented in physical therapy literature. However, specific interventions for spasms of the neck musculature that also involve constant ear twitching have yet to be addressed. The purpose of this case report is twofold. First, to describe comprehensive physical therapy management and outcomes for a subject with uncontrolled ear twitching and related musculoskeletal impairments, and second, to discuss the physical therapist's approach to evidence-based care when faced with a paucity of literature addressing physical therapy interventions for subjects with uncontrolled ear twitching...
October 2017: International Journal of Sports Physical Therapy
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