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https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#1
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29742787/-organisation-of-perioperative-pain-management
#2
Winfried Meißner, Joachim Erlenwein, Ulrike Stamer
Organisational issues of acute pain management are as important as details of pharmacologic treatments or regional analgesia. Lothar Lachgas is a young intern in the department of anaesthesiology of a German hospital. This overview illuminates organisation of perioperative pain management based on his virtual experiences and questions: pain assessment and documentation, patient information and education, tasks of an Acute Pain Service.
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29737920/does-promethazine-shorten-the-length-of-stay-in-the-post-anesthesia-care-unit
#3
Jonathan P Eskander, Yury Rapoport, Elyse Cornett, Sonja Gennuso, Michael Franklin, Alan D Kaye, Charles J Fox
The combination of promethazine and opioids is known to have an opioid-sparing effect, thereby facilitating a reduction in total patient opioid consumption. In recent years, this practice has fallen out of favor in many healthcare facilities, except primarily in the post anesthesia care unit (PACU). The goal of this study was to highlight the potential of promethazine as a direct or indirect adjuvant medication in acute pain management. The present investigation was undertaken with a case series of adult female patients who underwent open total abdominal hysterectomies...
January 1, 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29727003/safety-in-acute-pain-medicine-pharmacologic-considerations-and-the-impact-of-systems-based-gaps
#4
Toby N Weingarten, Andreas H Taenzer, Nabil M Elkassabany, Linda Le Wendling, Olga Nin, Michael L Kent
Objective: In the setting of an expanding prevalence of acute pain medicine services and the aggressive use of multimodal analgesia, an overview of systems-based safety gaps and safety concerns in the setting of aggressive multimodal analgesia is provided below. Setting: Expert commentary. Methods: Recent evidence focused on systems-based gaps in acute pain medicine is discussed. A focused literature review was conducted to assess safety concerns related to commonly used multimodal pharmacologic agents (opioids, nonsteroidal anti-inflammatory drugs, gabapentanoids, ketamine, acetaminophen) in the setting of inpatient acute pain management...
May 2, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#5
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29708926/pain-management-after-photorefractive-keratectomy
#6
Oren Golan, J Bradley Randleman
PURPOSE OF REVIEW: To review current concepts regarding the mechanisms of postoperative pain after photorefractive keratectomy (PRK) and review available treatment options. RECENT FINDINGS: Many clinical studies have established the safety and efficacy of different topical and systematic therapeutic agents and techniques for the treatment of postoperative pain after PRK, especially topical nonsteroidal anti inflammatory agents and oral nonsteroidal and narcotic medications...
April 27, 2018: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29696126/acute-pain-management-in-emergency-department-low-dose-ketamine-versus-morphine-a-randomized-clinical-trial
#7
Babak Mahshidfar, Mani Mofidi, Maryam Fattahi, Davood Farsi, Peyman Hafezi Moghadam, Saeed Abbasi, Mahdi Rezai
Background: Ketamine, as an opium alternative, has been proposed for pain relief in the emergency department (ED). Objectives: This study was carried out to compare low dose ketamine (LDK) with morphine for pain relief in trauma patients. Methods: In this randomized double-blinded clinical trial, 300 trauma patients from the ED of 2 teaching hospitals in Tehran, Iran were enrolled and randomly divided into 2 equal groups. The 1st group received 0...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29696110/subcostal-transverse-abdominis-plane-block-for-acute-pain-management-a-review
#8
REVIEW
Jose M Soliz, Ian Lipski, Shannon Hancher-Hodges, Barbra Bryce Speer, Keyuri Popat
The subcostal transverse abdominis plane (SCTAP) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin. There is a growing consensus that the SCTAP block provides better analgesia for upper abdominal incisions than the traditional transverse abdominis plane block. In addition, when used as part of a four-quadrant transverse abdominis plane block, the SCTAP block may provide adequate analgesia for major abdominal surgery. The purpose of this review is to discuss the SCTAP block, including its indications, technique, local anesthetic solutions, and outcomes...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29675049/administration-of-intravenous-morphine-for-acute-pain-in-the-emergency-department-inflicts-an-economic-burden-in-europe
#9
Montserrat Casamayor, Karen DiDonato, Marc Hennebert, Luca Brazzi, Gregor Prosen
Background: Acute pain is among the leading causes of referral to the emergency department (ED) in industrialized countries. Its management mainly depends on intensity. Moderate-to-severe pain is treated with intravenous (IV) administered opioids, of which morphine is the most commonly used in the ED. We have estimated the burden of IV administration of morphine in the five key European countries (EU5) using a micro-costing approach. Scope: A structured literature review was conducted to identify clinical guidelines for acute pain management in EU5 and clinical studies conducted in the ED setting...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29649890/what-parenteral-opioids-to-use-in-face-of-shortages-of-morphine-hydromorphone-and-fentanyl
#10
Mellar P Davis, Mary Lynn McPherson, Zankhana Mehta, Bertrand Behm, Carlos Fernandez
Parenteral potent opioid availability is becoming an issue in acute pain management. Two opioids, nalbuphine and buprenorphine, are available which can be substituted for hydromorphone, fentanyl, and morphine. There are advantages and disadvantages in using these 2 opioids which are discussed, and potential dosing strategies are outlined.
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29624188/safe-opioid-prescribing-for-acute-noncancer-pain-in-hospitalized-adults-a-systematic-review-of-existing-guidelines
#11
Shoshana J Herzig, Susan L Calcaterra, Hilary J Mosher, Matthew V Ronan, Nicole Van Groningen, Lili Shek, Anthony Loffredo, Michelle Keller, Anupam B Jena, Teryl K Nuckols
BACKGROUND: Pain is common among hospitalized patients. Inpatient prescribing of opioids is not without risk. Acute pain management guidelines could inform safe prescribing of opioids in the hospital and limit associated unintended consequences. PURPOSE: To evaluate the quality and content of existing guidelines for acute, noncancer pain management. DATA SOURCES: The National Guideline Clearinghouse, MEDLINE via PubMed, websites of relevant specialty societies and other organizations, and selected international search engines...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578089/research-agenda-for-the-prevention-of-pain-and-its-impact-report-of-the-work-group-on-the-prevention-of-acute-and-chronic-pain-of-the-federal-pain-research-strategy
#12
Robert J Gatchel, David B Reuben, Simon Dagenais, Dennis C Turk, Roger Chou, Andrew Hershey, Gregory Hicks, John C Licciardone, Susan D Horn
Following the 2011 Institute of Medicine report on chronic pain, the Interagency Pain Research Coordinating Committee (IPRCC) was created to enhance research efforts among federal agencies. The IPRCC and Office of Pain Policy at the NIH collaborated to identify gaps in knowledge and address them via a Federal Pain Research Strategy (FPRS). The FPRS appointed Interdisciplinary Work Groups (WGs) to make research recommendations in 5 areas: prevention of acute and chronic pain; acute pain and acute pain management; transition from acute to chronic pain; chronic pain and chronic pain management; and disparities in pain and pain care; cross-cutting issues were also considered...
March 22, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29576108/efficacy-and-adverse-effects-of-buprenorphine-in-acute-pain-management-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#13
REVIEW
L D White, A Hodge, R Vlok, G Hurtado, K Eastern, T M Melhuish
Buprenorphine appears to have a ceiling effect on respiratory depression, but not analgesia in healthy young patients. However, the efficacy and side-effects of buprenorphine in the setting of acute pain are poorly characterized. The aim of this study was to characterize the analgesic efficacy and adverse effects of buprenorphine compared with morphine in the acute pain setting. A systematic review of five databases was performed. Randomised controlled trials (RCTs) comparing buprenorphine with morphine in acute pain management were included...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29514333/buprenorphine-maintenance-subjects-are-hyperalgesic-and-have-no-antinociceptive-response-to-a-very-high-morphine-dose
#14
Peter Athanasos, Walter Ling, Felix Bochner, Jason M White, Andrew A Somogyi
Objective: Acute pain management in opioid-dependent persons is complicated because of tolerance and opioid-induced hyperalgesia. Very high doses of morphine are ineffective in overcoming opioid-induced hyperalgesia and providing antinociception to methadone-maintained patients in an experimental setting. Whether the same occurs in buprenorphine-maintained subjects is unknown. Design: Randomized double-blind placebo-controlled. Subjects were tested on two occasions, at least five days apart, once with intravenous morphine and once with intravenous saline...
March 5, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29510816/adjuvant-analgesics-for-spine-surgery
#15
Rikke Vibeke Nielsen
Increasing evidence indicate that pain is insufficiently treated following surgical procedures. It is essential that pain treatment is effective with a minimum of side effects in order to promote postoperative rehabilitation. Multimodal analgesia is most likely an important strategy in reducing postoperative pain. Combinations of different analgesics with different mechanisms of action may have an additive analgesic effect with fewer side effects compared to using a single drug. However, there is still a pronounced lack of documentation for the effect and side effects of these multimodal analgesic regimes...
March 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29479910/postoperative-pain-management-after-carpal-tunnel-syndrome-surgical-treatment-comparing-practice-with-guidelines
#16
Ivan Utrobičić, Frane Utrobičić, Ivona Prološčić, Toni Utrobičić, Milka Jerić, Antonia Jeličić Kadić, Livia Puljak
The management of postoperative pain after carpal tunnel syndrome surgical treatment at a tertiary hospital was analyzed and compared with the guidelines for perioperative pain management. This retrospective study included 579 patients operated on for carpal tunnel syndrome at the Split University Hospital Center in Split, Croatia. The following key data were collected from patient medical records: age, gender, type and dosage of premedication, type and dosage of anesthesia, type and dosage of postoperative analgesia per each postoperative day...
September 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29464223/determinants-of-inappropriate-acute-pain-management-in-old-people-unable-to-communicate-verbally-in-the-emergency-department
#17
REVIEW
Attilio Allione, Emanuele Pivetta, Elisa Pizzolato, Bartolomeo Lorenzati, Fulvio Pomero, Letizia Barutta, Giuseppe Lauria, Bruno Tartaglino
Objectives: Poor pain management is relevant among individuals unable to communicate verbally (UCV). Analgesia may be due to three determinants: patients' status, physician's characteristics and pain etiology. Our aim is to investigate the association between prescription of ED pain treatment and these determinants. Materials and Methods: An observational prospective study including UCV patients was conducted. Severity of pain was evaluated by ALGOPLUS Scale and a score P ≥ 2 out of 5 on the pain scale was retained as the threshold for the presence of acute pain in elderly UCV patients...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29432292/acute-pain-management-in-children-challenges-and-recent-improvements
#18
Catherine E Ferland, Eduardo Vega, Pablo M Ingelmo
PURPOSE OF REVIEW: The evidence regarding the efficacy of analgesics available to guide postoperative pain treatment in pediatric patients is limited. Opioid medications are very often an important component of pediatric postoperative pain treatment but have been associated with perioperative complications. We will focus on initiatives aiming to provide effective treatment minimizing the use of opioids and preventing the long-term consequences of pain. RECENT FINDINGS: Interpatient variability in postoperative pain is currently managed by applying protocols or by trial and error, thus often leading to patients being either undertreated or overtreated...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29423891/-acute-pain-management-in-patients-with-drug-dependence-syndrome
#19
J Quinlan, F Cox
No abstract text is available yet for this article.
April 2018: Der Schmerz
https://www.readbyqxmd.com/read/29416466/exacerbation-of-chronic-pain-after-dental-extractions-in-a-patient-with-post-treatment-lyme-disease-syndrome
#20
Stephanie Lim, Sakura Kinjo
A subset of patients who had Lyme disease experience postinfectious signs or symptoms called post-treatment Lyme disease syndrome (PTLDS). PTLDS is a chronic condition including pain in joints and muscles, neurological symptoms including demyelinating diseases, peripheral neuropathy, headaches, sleep disturbances, fatigue, and cardiac conditions. We report a case of difficult acute pain management in a patient with PTLDS who underwent dental extractions and required admission to an intensive care unit for pain control...
January 2018: Saudi Journal of Anaesthesia
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