Der Schmerz
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Cannabis is the most frequently used recreational drug worldwide. Moreover, the use of cannabinoids for medical purposes is also constantly growing and medical cannabis products are legalised by an increasing number of countries. ⋯ Besides the significantly increased requirement for propofol and fentanyl during anesthesia and for postoperative analgesia, a higher risk for tachycardia, pulmonary and cardiovascular complications was observed. With respect to these data, the authors recommend asking patients pre-operatively about recreational or medical cannabis use or cannabinoid-based medication.
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The corona pandemic has led to a number of restrictions and prohibitions, which in turn place large psychosocial or spiritual burdens on patients with COVID-19, their families and relatives and the treating personnel in the healthcare system. Patients with COVID-19 are not allowed to receive visitors and many hospitals and nursing homes have completely banned visitors. Many support services have been reduced or stopped completely. ⋯ Families should also be enabled to say goodbye to the deceased with adequate protective equipment or should be offered alternative real or virtual options for remembrance and commemoration. Health care professionals coping with the exceptional stress should be continuously supported. This requires clear communication and leadership structures, communication training, psychosocial support, but most of all optimal framework conditions for the clinical work.
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Pain caused by the sacroiliac joint (SIG) makes up a relevant proportion of lumbar back pain and can have a variety of specific and non-specific causes. The SIG represents the central link between the spine and the lower extremity. It is characterized by high stability and low mobility. ⋯ More specifically, movement and provocation tests as well as infiltrations are carried out. General information and conservative therapeutic methods represent the first-line therapies. Interventional and surgical procedures can help in the case of chronification.
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The Bregma test as an investigation of sensorimotor deficits has not yet been broadly applied. It is considered to be a test for the presentation of general sensorimotor abilities in a standing position. Pain patients often show disorders in physical perception and movement. ⋯ Increased body perception disorders are known in chronic pain patients. The Bregma test is able to detect at least some of the patients with sensorimotor deficits. Chronic pain patients significantly differ from healthy or other patient groups. The deficits in the controllability of myofascial tissue (coordination) can also be improved during a 4-week IMST.
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People have the need to find explanations for the events that occur in their lives. This is especially true when it comes to experiences that impact a person's entire existence and endanger their self-esteem and sense of identity. Chronic pain is one such experience. The search for the cause behind such pain is primarily motivated by the expectation that once the cause of the pain has been identified, an effective pain-alleviating therapy should ensue. Due to the numerous advances in the last several decades towards understanding the fundamental mechanisms governing the origins and processing as well as the treatment of pain, such expectations towards medicine can frequently be met; however, in many cases the experiences of chronic pain remain difficult to explain and, above all, very difficult to manage. ⋯ The following changes in perspective are recommended: the search for the past-centered why should make way for the future-oriented quest for the what for of continuing to live a life with chronic pain.