Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Managing Postoperative Analgesic Failure: Tramadol Versus Morphine for Refractory Pain in the Post-Operative Recovery Unit.
This study aimed to discover whether co-analgesia with tramadol or additional morphine was more effective for patients who still had severe pain despite being given 10 mg intravenous morphine in the post-anesthesia care unit (PACU). ⋯ We found no difference between additional morphine and co-analgesia with tramadol in this study. Patients who don’t respond to reasonable doses of opioids in PACU are very likely to be unresponsive to further opioids, and other non-opioid analgesic techniques (such as regional anesthesia) should be considered early in this group of patients.
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Observational Study
The Effect of Initiatives to Overcome Language Barriers and Improve Attendance: A Cross-Sectional Analysis of Adherence in an Inner City Chronic Pain Clinic.
Language barriers can prevent pain physicians and patients from forming meaningful rapport and drive health care disparities. Non-adherence with scheduled pain clinic appointments deprives patients with chronic pain of needed specialist care. ⋯ The results of this retrospective cross-sectional analysis of patients’ adherence with scheduled appointments in an inner-city chronic pain clinic suggests that targeted initiatives including a pre-clinic reminder phone call in the patient’s own language may help to overcome language barriers and improve access to care.
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In 2015, the Michigan Department of Health and Human Services (MDHHS) was notified of an acute case of hepatitis C virus (HCV). The patient had no traditional HCV risk factors. The only known subcutaneous exposure was health care received at a pain management clinic. ⋯ Health care-associated transmission of HCV likely occurred at an outpatient pain management clinic; possibly the result of multiple patient use of single-dose vials. Because no other cases were discovered this may represent an isolated incident as opposed to a systematic breakdown in infection control standards. This circumstance highlights the need for continued vigilance and adherence to CDC’s Minimum Expectations for Safe Care in Outpatient Settings.