Pain medicine : the official journal of the American Academy of Pain Medicine
-
Individuals seeking treatment for chronic pain in multidisciplinary pain management services are typically already on high doses of pain medications. This cross-sectional cohort study of patients with long-term chronic pain examined profiles of polypharmacy and pain medication-related harm exposure. ⋯ While treatment with multiple medications for synergistic or adjunctive effects may assist in medical management of chronic pain, this approach generates increased potential harm exposure. We show that the majority of detriment comes from medications other than opioids and highlight the importance of profiling all pain medications contributing to polypharmacy in clinical pain studies.
-
At present, the potential benefits of psychologically oriented approaches to pain management for patients waiting to undergo medical interventions, such as neuromodulation, remain unclear. Therefore, this study aimed to examine the results of an interdisciplinary treatment based on principles of Acceptance and Commitment Therapy (ACT) delivered to a group of patients being considered for a neuromodulation procedure. ⋯ People seeking medical interventions to reduce pain appear able to benefit from an interdisciplinary treatment aimed to improve daily functioning and mental health through increased psychological flexibility.
-
This study was designed to describe the efficacy and toxicity of intravenous (i.v.) lidocaine infusions for the treatment of neuropathic pain initially administered at a flat-rate trial dose of 500 mg over 30 minutes. ⋯ The flat-dose trial used under the University of Wisconsin Health protocol for i.v. lidocaine administration did not cause serious adverse events, but few patients who responded to this trial dose tolerated subsequent infusions at the trial rate. Due to the lack of serious adverse events, administering an aggressive trial dose to elicit an analgesic response appears to be rational. If patients show a benefit from the trial dose, the need for reductions in infusion rate of subsequent doses should be anticipated.
-
Observational Study
Age- and procedure-specific differences of epidural analgesia in children--a database analysis.
Several audits demonstrated the safety of epidural catheters in children undergoing surgery. Within the present data analysis, we investigated whether older compared with younger children and children with specific types of surgical procedures might report higher pain scores. ⋯ This database analysis demonstrated that older children and children undergoing thoracic or spine surgery reported significant higher pain scores most likely because they received less additional opioids. Therefore, a more "aggressive" pain treatment (including opioids on demand under appropriate monitoring) might further improve postoperative care.