Pain management nursing : official journal of the American Society of Pain Management Nurses
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Nurses play a crucial role in the evaluation and treatment of pain in the critically ill patient. This responsibility is all the more critical with this particular population because many may not be able to self-report their pain level and the typical behavioral signs of pain may be subtle or absent. According to recent recommendations, vital signs should not be used as primary indicators of pain but rather considered as a cue to begin further assessment. ⋯ Current NIRS techniques have well recognized limitations which must be considered carefully during the measurement and interpretation of signals. Thus, its clinical use is yet to be fully established. Nonetheless, cerebral NIRS technique as an approach to assess brain activity in response to pain should not be abandoned.
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Multicenter Study
Mild, moderate, and severe pain in patients recovering from major abdominal surgery.
Pain interferes with various activities, such as coughing, deep breathing, and ambulation, designed to promote recovery and prevent complications after surgery. Determining appropriate cutpoints for mild, moderate, and severe pain is important, because specific interventions may be based on this classification. The purpose of this research was to determine optimal cutpoints for postoperative patients based on their worst and average pain during hospitalization and after discharge to home, and whether the optimal cutpoints distinguished patients with mild, moderate, or severe pain regarding patient outcomes. ⋯ A substantial proportion of patients experienced moderate to severe pain. The results suggest a narrow boundary between mild and severe pain that interferes with function. The findings indicate that clinicians should seek to aggressively manage postoperative pain ratings greater than 3.
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Acupressure is a complementary treatment that uses fingers and hands to stimulate acupoints and maintains the balance of energy. The objective of this study was to review the application of acupressure in managing different pains and the effectiveness of acupressure on relieving pain in various settings. A systematic review of English articles using the databases of MEDLINE, PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed using the search terms of "acupressure" and "pain." Studies during which acupressure was applied as an intervention and assessed for its effectiveness on relieving pain were selected. ⋯ Acupressure has been shown to be effective for relieving a variety of pains in different populations. The review begins to establish a credible evidence base for the use of acupressure in pain relief. The implication for health care providers would be incorporating acupressure into their practice as an alternative therapy to facilitate patients who suffer from pain.
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The use of behavioral and physiologic indicators is recommended for pain assessment in nonverbal patients. Traumatic brain injuries (TBI) can lead to neurologic changes and affect the way patients respond to pain. As such, commonly used indicators of pain may not apply to TBI patients. ⋯ Similarly to other populations, vital signs were identified as potential indicators of pain in TBI patients. Further research studying TBI patients and considering changes in level of consciousness, location/severity of brain injury, and administration of analgesic/sedative is needed. Until then, nurses should follow the current clinical recommendations.
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Fibromyalgia is a chronic musculoskeletal pain disorder that affects an estimated 5 million adults in the U. S. The hallmark is burning, searing, tingling, shooting, stabbing, deep aching, or sharp pain. ⋯ The paper concludes by considering the implications of the findings of the review for explanations of fibromyalgia pain by nurses working in multidisciplinary teams. The trend appears to be able to explain the cause of fibromyalgia pain in terms of sensitization per se. The recommended alternative is to explain fibromyalgia pain in terms of changes in pain sensitivity and the role of underlying neural and psychosocial mechanisms.