The Clinical journal of pain
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Review Meta Analysis
Analgesic Effects of Locally Administered Ketorolac-Based Analgesics after Breast Surgery: A Meta-Analysis of Randomized Controlled Trials.
Reducing postoperative pain following breast surgery is crucial for rapid recovery and shortening hospital stay. Ketorolac, a nonsteroidal anti-inflammatory drug, has been used as a postoperative analgesic in many surgical procedures. We conducted a systemic review and meta-analysis on the efficacy of locally administered ketorolac-based analgesics in managing pain after breast surgery. ⋯ The effects of ketorolac-based analgesics vary as per the surgery and disease type. Locally administered ketorolac-based analgesics decreased postoperative pain in breast surgery patients, and the effect of local ketorolac was better than local bupivacaine. Therefore, ketorolac-based analgesics demonstrate considerable local infiltration during pain management after breast surgery.
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The aim of this study was to identify associations between early care decisions and long-term opioid (LTO) use in opioid-naïve patients with a new physician consultation for low back pain (LBP) at which an opioid was prescribed. ⋯ Early care decisions were predictive of LTO use following a new LBP consultation at which opioids were prescribed. Our results support recommendations to avoid concurrent benzodiazepine prescribing and to consider other evidence-based pain treatments such as physical therapy early, particularly for patients at high risk for LTO use or misuse.
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Low back pain (LBP) is the most commonly reported chronic pain condition. In this study, a clinically relevant, induced-LBP paradigm was used to study sensory processing as a risk factor and predictor for LBP development in healthy people. Our aim was to examine sensory processing in those who do develop LBP and those who do not develop LBP with the paradigm, and to examine the relationships between scores on psychosocial questionnaires and sensory processing measures in these healthy people. ⋯ These results provide evidence that altered sensory processing was not present in healthy people and thus is not a risk factor for development of LBP in standing.
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Chronic pain exerts a pervasive negative influence on workers' productivity. However, a paucity of research has addressed the mechanisms underlying the pain → productivity relation. In the present study using intensive daily diary data, we examined whether working memory (WM) moderates the positive within-person associations between (1) morning pain intensity and (2) morning negative affect (NA) and later day pain's interference of work-goal (WG) pursuit. ⋯ WM appears to protect goal-relevant information from distractions due to negative affective arousal. The continued use of ecologically valid observational and intervention studies would shed further light on the influence of WM on the pursuit of valued work goals in the face of pain and negative affect.
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Previous research on pain memory provides inconsistent evidence about the accuracy of pain recall, and few studies have attempted to examine broad affective and contextual contributions to this phenomenon. The present research aimed to determine the accuracy of postoperative pain recall after 3 months, with respect to the context of the surgery and the congruence of affective states concurrent with the initial experience and its recall. The study also aimed to identify predictors of remembered pain by analyzing a range of sensory, cognitive, and affective factors. ⋯ The results of this study suggest that older orthopedic patients remember postoperative pain correctly after 3 months and that mood dependence effect may contribute to memory of pain. Pain recall after planned surgery seems to depend mainly on the actual experience, while following unplanned surgery it depends on affective factors. Present findings contribute to knowledge about pain memory in older adults and have implications for patients' recovery and best practice in perioperative hospital care.