The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Intraperitoneal lidocaine instillation and postcesarean pain after parietal peritoneal closure: a randomized double blind placebo-controlled trial.
To evaluate the effects of intraperitoneal instillation of lidocaine on postcesarean pain in patients with pariental periotoneal closure. ⋯ Intraperitoneal instillation of 200 mg of lidocaine decreased the incidence and scores of postcesarean pain when the parietal peritoneum was sutured. Further studies in a setting offering more effective acute pain control protocols, preferably with patient-controlled analgesia, are recommended to assess the use of lidocaine before it can be widely practiced.
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Costs of compensated work loss for low back pain have risen dramatically. Current healthcare management of this condition may contribute to this trend. Researchers are currently investigating the degree to which healthcare practitioners' attitudes and beliefs may influence their patient management. Measures used to assess healthcare practitioners' attitudes and beliefs have often been adapted from patient tools. The degree to which they have been assessed for use with different populations varies. ⋯ Statistical methods used suggest that the measure demonstrates good reliability with a GP population. The influence of training on attitudes and beliefs of GPs is discussed.
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Sickle cell disease-related pain is difficult to treat adequately. Pain secondary to vasoocclusive episodes (VOE) may be unresponsive to high-dose intravenous opiates. Alternative treatment options for VOE are needed. We sought to review our experience with low-dose ketamine for children hospitalized with VOE. ⋯ Further research into ketamine for vasoocclusive pain is warranted.
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Randomized Controlled Trial
A randomized clinical trial of the efficacy of scheduled dosing of acetaminophen and hydrocodone for the management of postoperative pain in children after tonsillectomy.
To determine the effectiveness of around-the-clock (ATC) analgesic administration, with or without nurse coaching, compared with standard care with as needed (PRN) dosing in children undergoing outpatient tonsillectomy. ⋯ Scheduled dosing of acetaminophen and hydrocodone is more effective than PRN dosing in reducing pain intensity in children after tonsillectomy. Nurse coaching does not impact parent's adherence to ATC dosing.
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Objectives:Despite efforts to improve acute postoperative pain management, a substantial number of patients still experience moderate to severe pain during the immediate postoperative days. The purpose of the present study was to identify predictors of moderate to severe acute postoperative pain. ⋯ Discussion: Several predictive factors of postoperative pain were identified in this study. These factors could be taken into account in postoperative pain management.