The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Continuous epidural analgesic infusion is widely recognized to be helpful for pain relief in the patient with cancer pain, but it can be as beneficial for the patient with non-cancer pain. Cancer pain patients have been offered long-term epidural infusion for relief of chronic pain, but non-cancer pain patients have less frequently been provided the same opportunities for pain relief. Both patient outcome and cost-effectiveness must dictate treatments offered as alternatives to long-term use of oral or injectables, nonsteroidal anti-inflammatories and muscle relaxants. ⋯ Epidural infusion is a safe and effective route of pain relief if the medical criteria as been met for choosing the patients receiving the treatment, and if the caregivers understand the treatment and expected outcomes. This article discusses anatomic considerations in drug selection, physiology, patient selection, neuropharmacology and patient care for epidural infusion. This article is designed to assist the nurse in accomplishing the patient and physician goals in this treatment modality for chronic non-cancer pain.
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Neuroscience intensive care unit (NICU) patients are frequently transported out of the critical care environment for diagnostic and interventional procedures. Four hundred and seventy-one such transports from seventeen clinical centers were studied to identify the characteristics of intrahospital transport. ⋯ Results validate that intrahospital transport of NICU patients is both time and labor intensive. The study also suggests that the optimal process for safe and efficient transport is yet to be designed.
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Spinal cord stimulation (SCS) became available in the 1970s as a treatment option for patients with constant or recurring pain. This invasive procedure is performed after all other efforts have failed to prove effective in controlling pain. ⋯ Nursing care is guided by a specific plan of care for the SCS patient population. A patient population-specific standard may be useful.
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Surgical intervention is an acceptable treatment modality for children with intractable epilepsy. However, many children require a complicated evaluation process that involves placement of intracranial electrodes for purpose of extraoperative recording. The management of the child undergoing extraoperative electroencephalography (EEG) monitoring requires active participation by the nursing staff. An understanding of the electrode placement and functional mapping, proper preparation of the child and family and early detection of complications by nursing staff members is necessary to ensure a successful and safe evaluation.
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Survivors of spinal cord injury (SCI) have a range of sensory experiences following the trauma. Acute pain commonly accompanies the injury and recedes as healing occurs. Following the initial event, most spinal cord-injured individuals experience phantom sensations and many suffer chronic pain. ⋯ Ironically, it is experienced in regions of the body that are anesthetic or possess diminished or altered sensation as a consequence of the injury. The qualitative features of the pain have been linked to structural and functional alterations that have been documented in peripheral and central neural structures following SCI. An understanding of these unique relationships provides direction for future research.