Journal of perioperative practice
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The treatment of pain continues to be a major concern in the critically ill patient. Despite advances in pain management, a greater understanding of the mechanisms of pain and advanced methods of analgesic delivery, the treatment of pain is not always a priority on the intensive care unit. Difficulties with pain assessment, in the critically ill ventilated, sedated patient compound the problems of pain management. Physiological signs are difficult to interpret and psychological factors must be considered.
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Paravertebral blockade is a safe and effective technique for intraoperative and postoperative management of acute surgical pain. The block may be performed as a single injection or a catheter may be inserted to allow for the continuous or bolus administration of a long acting local anaesthetic. ⋯ There is little published about the care of patients receiving this form of analgesia. This article provides an overview of the technique of thoracic paravertebral analgesia, the choice of analgesics and side effects together with recommendations for patient care.
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Bedouin women tend to remain quiet and expressionless while giving birth despite reporting high levels of pain and fear (Harrison 1991). Culture undoubtedly influences pain perception and expression but there are dangers in making assumptions about particular groups. This article explores the underlying research and the complex clinical picture highlighting the need for cultural awareness--but ultimately we must care for the individual person in pain.