Pain medicine : the official journal of the American Academy of Pain Medicine
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Our study examined the effect of health care workers' personal characteristics on how they perceive and intend to treat patients' pain in the intensive care unit. Though pain perceptions have been well established from the patient's perspective, less is known about how variations in health care workers may affect their perceptions of pain. ⋯ Health care providers' race, age, level of education, and medical subspecialty were significant factors affecting their perceptions of pain management and intended treatment.
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Observational Study
Self-loathing aspects of depression reduce postoperative opioid cessation rate.
We previously reported that increased preoperative Beck Depression Inventory II (BDI-II) scores were associated with a 47% (95% CI 24%-64%) reduction in the rate of opioid cessation following surgery. We aimed to identify the underlying factors of the BDI-II (affective/cognitive vs somatic) associated with a decreased rate of opioid cessation after surgery. ⋯ Our results identify a set of negative cognitions predicting prolonged time to postoperative opioid cessation. Somatic symptoms captured by the BDI-II were not primarily responsible for the association between preoperative BDI-II scores and postoperative prolonged opioid use.
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Comparative Study Observational Study
Postoperative pain in complex ophthalmic surgical procedures: comparing practice with guidelines.
To analyze the management of postoperative pain after complex ophthalmic surgery and to compare it to the guidelines. ⋯ Postoperative pain management and perioperative care of patients undergoing major ophthalmic surgery indicates lack of attention towards pain intensity and postoperative analgesia. Appropriate interventions should be employed to improve postoperative pain management, to facilitate patient recovery.
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Case Reports
Resolution of migraine-like headache by coil embolization of a primitive trigeminal artery aneurysm.
We report a rare case of migraine-like headache associated with an unruptured primitive trigeminal artery (PTA) aneurysm with a coincident finding of anterior cerebral artery (ACA) fenestration. We discuss the possible mechanism of the headache and review the relevant literature. ⋯ Both primitive trigeminal artery aneurysm and fenestration of the cerebrovascular system are rare developmental anomalies. The PTA courses alongside and is in anatomical proximity to the trigeminal nerve. Therefore, PTA aneurysms are more likely to cause symptoms, due to compression of the trigeminal nerve. The trigeminovascular system has been implicated in the genesis of migraine headaches. We propose the high-velocity pulsatile flow through the aneurysm across the surface of the trigeminal nerve as the etiology of the migraine-like headaches. Endovascular embolization might be a preferred procedure for dealing with patients in this setting.