Clinics in podiatric medicine and surgery
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Surgery is a circumstance in which we know that we will cause pain. Although most of our perioperative pain management interventions are symptomatic, several strategies can reduce and even prevent pain in the perioperative setting. Because the physiologic mechanisms of postoperative pain are understood, it is possible to interrupt these mechanisms before the patient actually becomes symptomatic. This article reviews the literature and presents these strategies with the hope of implementation of the readers.
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Clin Podiatr Med Surg · Jul 2008
ReviewLower extremity regional anesthesia with the low sciatic nerve block.
Regional anesthesia with local anesthetics is an important component of the perioperative pain management algorithm in the context of lower extremity orthopedic surgery. These techniques have proved to be consistent and effective in minimizing postoperative pain and narcotic usage, and in reducing the morbidity associated with lower extremity surgery. The mechanisms of local anesthetic agents as they relate to acute surgical pain are reviewed in this article, with an emphasis on the low sciatic nerve block. Administration techniques and the clinical experience of the author with this blockade are discussed.
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This article reinforces the clinical points of emphasis that have been stressed throughout this issue in a case scenario format. Common situations dealt with by physicians are examined to highlight the underlying physiology of the specific complaints and treatment interventions. The goal of this article is to present an evidenced-based review of pain management interventions in a format that allows for reader incorporation.
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Unfortunately, many physicians and patients only seek pharmacologic treatments to aid in pain relief; however, many nonpharmacologic interventions exist with excellent potential for pain treatment. This article reviews several of these strategies with an emphasis on clinical indications and expected outcomes. The topics of chronic pain psychology and prescription writing also are reviewed. As a medical provider, it is important to remain open minded to alternative approaches to pain control.
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The goal of this article is to provide an introductory look into current concepts regarding chronic regional pain syndrome. Great advances have been made over the last 15 years, but we are far from a complete understanding of this disorder. This article places great emphasis on early clinical recognition and treatment intervention.