Pain management nursing : official journal of the American Society of Pain Management Nurses
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Postoperative pain is one of the most intensive problems experienced by patients undergoing coronary artery bypass graft surgery. The severity of pain after surgery hinders general activity, sleep, deep breathing, and sleep quality. ⋯ Although patients are satisfied with pain management after surgery, they continue to experience post-operative pain which interferes with activities of daily living.
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Chronic pain management is a major challenge for primary care providers (PCPs). PCPs manage many patients with chronic pain and other comorbidities including mental health problems like post-traumatic stress disorder (PTSD) and depression. Chronic pain and opioid problems are a national crisis, particularly among veterans (U.S. Department of Veterans Affairs, 2019). There are many veterans with chronic non-cancer pain who are being treated with opioids. Chronic opioid use has contributed to an epidemic of opioid-related adverse events (VA, 2017). Opioids not only result in poor pain control, but have associated risks such as misuse, overdose, and diversion which may be fatal (Frieden & Houry, 2016). ⋯ APRNs are in a key position to assess and treat patients based on current evidence while facilitating opioid titration. This initiative highlights that safe tapering of opioids is possible when utilizing a multidisciplinary approach for chronic pain management. Findings support the use of non-pharmacologic and non-opioid therapy for chronic pain management which can result in reduced patient-reported pain. Further research is warranted to examine both pharmacologic (non-opioid) and non-pharmacologic strategies that promote pain management while tapering opioids.
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Randomized Controlled Trial
Evaluation of Efficacy of Valsalva Maneuver During Peripheral Intravenous Cannulation on Pain.
AIMS: The aim of this study was to examine the effects of the Valsalva maneuver during peripheral intravenous catheter (PIVC) insertion on procedure-related pain. ⋯ Valsalva maneuver can be used as a non-pharmacologic method to reduce pain during PIVC placement.
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Heart rate variability biofeedback (HRVB) is a self-management strategy that guides individuals to breathe at a designated resonance frequency of the cardiovascular system. Resonant breathing may reduce FM-related symptoms as well as improve physical functioning and quality of life. Although prior research recommends HRVB for chronic pain, we found no studies testing the feasibility for individuals with FM regarding protocol adherence or acceptability of the treatment. ⋯ Results of this study suggest difficulties operating the emWave2 and scheduling challenges interfered with HRVB implementation. However, veterans reported self-awareness of the benefits of HRVB, positive physiological effects, and improved psychological effects. Future studies require a larger sample size to provide a deeper insight.
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Postoperative pain has a major influence on older adults' rehabilitation. There is a lack of knowledge regarding how older adults return to daily living after discharge. ⋯ No association was found between older adults with moderate to severe levels of pain during the first 5 days postoperatively and 1 year after surgery. Proactive follow-up strategies for older adults after discharge following THA may be indicated to promote optimal rehabilitation.