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Todd Jackson, Panpan Tian, Yang Wang, Tony Iezzi, Wenyi Xie
UNLABELLED: Presurgery emotional distress has had variable associations with outcomes of surgery in past narrative reviews. This meta-analysis was designed to evaluate the overall strengths of relations between presurgical emotional distress and key postsurgical pain outcomes (ie, pain intensity, analgesic use, functional impairment) and to identify moderators that might explain effect size heterogeneity between studies. PubMed, Web of Science, PsychINFO, Google Scholar, and Science Direct databases were searched to identify studies subjected to meta-analysis...
August 2016: Journal of Pain: Official Journal of the American Pain Society
E K Aasvang, T H Lunn, T B Hansen, P W Kristensen, S Solgaard, H Kehlet
BACKGROUND: Pre-operative opioid use has been suggested to increase post-operative pain and opioid consumption after total knee arthroplasty (TKA), but previous studies are either retrospective or inhomogeneous with regard to surgical procedures or control of analgesic regimes, or with few opioid-treated patients, hindering firm conclusions. METHODS: In a prospective observational study, we investigated the effect of > 4 weeks pre-operative opioid use [none vs...
April 2016: Acta Anaesthesiologica Scandinavica
Morad Chughtai, Julio J Jauregui, Jaydev B Mistry, Randa K Elmallah, Aloise M Diedrich, Peter M Bonutti, Ronald Delanois, Michael A Mont
INTRODUCTION: There is increasing pressure from Centers for Medicare and Medicaid Services (CMS) to report quality measures for all hospitalizations. These quality measures are determined based on results from satisfaction surveys, such as Press Ganey® (PG) (Press Ganey® Performance Solutions, Wakefield, Massachusetts). Included in this particular survey element are questions regarding staff, including nurses and doctors, as well as items such as pain control. The results of these surveys will dictate the amount doctors are compensated for their services...
April 2016: Surgical Technology International
Simon Haroutounian, Yael Ratz, Yehuda Ginosar, Karina Furmanov, Fayez Saifi, Ronit Meidan, Elyad Davidson
OBJECTIVES: The objective of this prospective, open-label study was to determine the long-term effect of medicinal cannabis treatment on pain and functional outcomes in participants with treatment-resistant chronic pain. PATIENTS AND METHODS: The primary outcome was the change in the pain symptom score on the S-TOPS (Treatment Outcomes in Pain Survey-Short Form) questionnaire at the 6-month follow-up in an intent-to-treat population. Secondary outcomes included the change in S-TOPS physical, social, and emotional disability scales, the pain severity, and pain interference on the Brief Pain Inventory, sleep problems, and the change in opioid consumption...
December 2016: Clinical Journal of Pain
Olfat Zekry, Stephen B Gibson, Arun Aggarwal
This study was designed to describe the efficacy and toxicity of subcutaneous ketamine infusions and sublingual ketamine lozenges for the treatment of chronic nonmalignant pain. Data were collected prospectively on 70 subjects managed in an academic, tertiary care hospital between 2007 and 2012 who received between 3 and 7 days of subanesthetic, subcutaneous ketamine infusion. Data were analyzed for efficacy, adverse effects, and reduction in use of opioid medication. We also analyzed whether subsequent treatment with sublingual ketamine lozenges resulted in longer-term efficacy of the beneficial effects of the initial ketamine infusion...
June 2016: Journal of Pain & Palliative Care Pharmacotherapy
Brian M Bruel, Allen W Burton
OBJECTIVE: The increasing incidence of cancer survivorship has shifted treatment of cancer-related pain from short-term analgesia to long-term chronic pain management. As a result, alternatives to oral analgesics, such as intrathecal therapy, may be beneficial for patients with cancer-related pain. The authors review the use of intrathecal therapy in the management of cancer-related pain. METHODS: The Medline database was searched for English-language articles that included "ziconotide" or "morphine" AND ("cancer" OR "malignant") AND "intrathecal" in title or abstract...
April 28, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Suresh Narayanan, Andrew Shannon, Subash Nandalan, Varun Jaitly, Shaun Greer
OBJECTIVE: Sedation for endoscopy carries an element of cardiorespiratory risk, more significant for certain procedures and in certain patient groups. Ketamine has features which make it an attractive agent for sedation during the higher risk endoscopy; the objectives of this pilot trial were to assess the effectiveness and tolerability of ketamine as a primary agent for sedation during endoscopy. METHODS: The study was a prospective randomized controlled trial, in which American Society of Anesthesiologists' (ASA) class 1-3 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) received either conventional sedation with midazolam and pethidine or a combination of midazolam and ketamine...
2015: Scandinavian Journal of Gastroenterology
Blake F Dear, Milena Gandy, Eyal Karin, Lauren G Staples, Luke Johnston, Vincent J Fogliati, Bethany M Wootton, Matthew D Terides, Rony Kayrouz, Kathryn Nicholson Perry, Louise Sharpe, Michael K Nicholas, Nickolai Titov
The present study evaluated an internet-delivered pain management program, the Pain Course, when provided with different levels of clinician support. Participants (n = 490) were randomised to 1 of 4 groups: (1) Regular Contact (n = 143), (2) Optional Contact (n = 141), (3) No Contact (n = 131), and (4) a treatment-as-usual Waitlist Control Group (n = 75). The treatment program was based on the principles of cognitive behaviour therapy and comprised 5 internet-delivered lessons provided over 8 weeks. The 3 Treatment Groups reported significant improvements (between-group Cohen's d; avg...
October 2015: Pain
D Reddi
Chronic postoperative pain is common. Nerve injury and inflammation promote chronic pain, the risk of which is influenced by patient factors, including psychological characteristics. Interventional trials to prevent chronic postoperative pain have been underpowered with inadequate patient follow-up. Ketamine may reduce chronic postoperative pain, although the optimum treatment duration and dose for different operations have yet to be identified. The evidence for gabapentin and pregabalin is encouraging but weak; further work is needed before these drugs can be recommended for the prevention of chronic pain...
January 2016: Anaesthesia
A A Klein, P Arnold, R M Bingham, K Brohi, R Clark, R Collis, R Gill, W McSporran, P Moor, R Rao Baikady, T Richards, S Shinde, S Stanworth, T S Walsh
Blood transfusion can be life-saving. Anaesthetists regularly request and administer blood components to their patients. All anaesthetists must be familiar with indications and appropriate use of blood and blood components and their alternatives, but close liaison with haematology specialists and their local blood sciences laboratory is encouraged. Considerable changes in approaches to optimal use of blood components, together with the use of alternative products, have become apparent over the past decade, leading to a need to update previous guidelines and adapt them for the use of anaesthetists working throughout the hospital system...
July 2016: Anaesthesia
Nora D Volkow, A Thomas McLellan
No abstract text is available yet for this article.
March 31, 2016: New England Journal of Medicine
(no author information available yet)
No abstract text is available yet for this article.
March 2016: EBioMedicine
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