Pain research and treatment
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Peripheral nerve blocks for postoperative analgesia have improved block success, but analgesia efficacy has been limited by the short duration of traditional local anesthetics. The results of randomized trials comparing liposome bupivacaine with conventional local anesthetic formulations (e.g., plain bupivacaine and ropivacaine) have generated conflicting results. This study was conducted to systematically review the effectiveness of analgesic efficacy of liposome bupivacaine infiltration at the surgical site versus plain local anesthetic bupivacaine or ropivacaine in patients undergoing surgery. ⋯ Our results suggest that liposome bupivacaine does not have an analgesic advantage when compared to plain local anesthetics at the surgical site for patients undergoing surgical procedures.
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Pain in people with dementia (PWD) is underassessed and undertreated. Treatment of pain in people with dementia goes awry because of poor assessment, poor treatment, and factors related to nursing decision-making skills. Several theoretical models addressed the role of nurses' critical thinking and decision-making skills in pain treatment, like the cognitive continuum theory (CCT) and the adaptive pain management (APT). ⋯ Gilmore-Bykovskyi and Bowers developed the RCP, which incorporates the concept of uncertainty and how it relates to the problem of unrelieved pain in PWD. The RCP model has the potential to provide good understanding of the problem of unrelieved pain in people with dementia. It also could help to develop a research study that brings comfort to an often neglected and vulnerable population.
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High rates of opioid use for chronic noncancer pain (CNCP) have been reported worldwide, despite its association with adverse events, inappropriate use, and limited analgesic effect. Opioid-induced constipation (OIC) is the most prevalent and disabling adverse effect associated with opioid therapy. Our aim was to assess the incidence, health related quality of life (HRQOL), and disability in OIC patients. ⋯ Constipation is a common adverse event among opioid users with major functional and quality of life impairment. These findings emphasise the need of OIC adequate assessment and management.
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Transnasal sphenopalatine ganglion block is emerging as is an attractive and effective treatment modality for acute migraine headaches, cluster headache, trigeminal neuralgia, and several other conditions. We assessed the efficacy and safety of this treatment using the Sphenocath® device. 55 patients with acute migraine headaches underwent this procedure, receiving 2 ml of 2% lidocaine in each nostril. Pain numeric rating scale (baseline, 15 minutes, 2 hours, and 24 hours) and patient global impression of change (2 hours and 24 hours after treatment) were recorded. ⋯ Most patients rated the results as very good or good. The procedure was well-tolerated with few adverse events. This treatment is emerging as an effective and safe option for management of acute migraine attacks.