Current pain and headache reports
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The present investigation explores multi-agent systems, their function in cancer pain management, and how they might enhance patient care. Since cancer is a complex disease, technology can help doctors and patients coordinate care and communicate effectively. Even when a patient has a dedicated team, treatment may be fragmented. Multi-agent systems (MAS) are one component of technology that is making progress for cancer patients. Wireless sensory networks (WSN) and body area sensory networks (BASN) are examples of MAS. ⋯ Technology is advancing the care of patients, not only in everyday clinical practice, but also in creating accessible communication between patients and provider. Many hospitals have utilized electronic medical records (EHR), but recent advancements allowed the pre-existing infrastructure to network with personal devices creating a more congruent form of communications. Better communication can better organize pain management, leading to better clinical outcomes for patients, integrating body sensors, such as smart watch, or using self-reporting apps. Certain software applications are also used to help providers in early detections of some cancers, having accurate results. The integration of technology in the field of cancer management helps create an organized structure for cancer patients trying to understand/manage their complex diagnosis. The systems for the various healthcare entities can receive and access frequently updated information that can better provide better coverage of the patient's pain and still be within the legalities as it pertains to opioid medications. The systems include the EHR communicating with the information provided by the patient's cellular devices and then communicating with the healthcare team to determine the next step in management. This all happens automatically with much physical input from the patient decreasing the amount of effort from the patient and hopefully decreasing the number of patients' loss to follow-up.
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Curr Pain Headache Rep · Sep 2023
ReviewPostoperative Rebound Pain: Our Current Understanding About the Role of Regional Anesthesia and Multimodal Approaches in Prevention and Treatment.
Rebound pain (RP) is a common occurrence after peripheral nerve block placement, especially when blocks are used for orthopedic surgery. This literature review focuses on the incidence and risk factors for RP as well as preventative and treatment strategies. ⋯ The addition of adjuvants to a block, when appropriate, and starting patients on oral analgesics prior to sensory resolution are reasonable approaches. Using continuous nerve block techniques can provide extended analgesia through the immediate postoperative phase when pain is the most intense. Peripheral nerve blocks (PNBs) are associated with RP, a frequent phenomenon that must be recognized and addressed to prevent short-term pain and patient dissatisfaction, as well as long-term complications and avoidable hospital resource utilization. Knowledge about the advantages and limitations of PNBs allows the anesthesiologists to anticipate, intervene, and hopefully mitigate or avoid the phenomenon of RP.
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Curr Pain Headache Rep · Sep 2023
ReviewTherapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives.
Postherpetic neuralgia is an annoying pain that mainly affects older people. In order to give patients more options, this review summarizes the pharmacological and interventional treatments for postherpetic neuralgia and updates the research on the efficacy, thereby providing doctors with more treatment options. The adverse effects and effective doses of its various treatments are also presented so that the therapy can be prescribed according to their concrete physical conditions. In a word, this review is dedicated to providing a comprehensive overview of the treatment options for postherpetic neuralgia and offering patients more choices. ⋯ Combinational therapy is more excellent than monotherapy. The local anesthesia and gabapentin comprised outstanding compatibility. In addition, two therapeutic tools for PHN patients, especially for the intractable ones, electroacupuncture (EA), and osteopathic manipulative treatment (OMT), show their efficacy and become potential options to alleviate pain. In terms of treatment, guidelines recommend patients use tricyclic antidepressants (TCAs), gabapentin, pregabalin, and 5% lidocaine patches as the first-line medications, and gabapentin is investigated most, especially the gabapentin enacarbil (GEn). And drug efficacy can be limited by adverse effects and tolerated doses. Interventional treatments, with their invasiveness and operational difficulty, are usually considered for intractable patients. Combinational therapies may be used when a single therapy cannot achieve the desired effect. Therapies such as OMT and EA have also been proposed to palliate pain in some cases, and future directions of treatment may be investigated in Chinese medicine and acupuncture.
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Curr Pain Headache Rep · Sep 2023
ReviewThe Acute Perioperative Pain Service: Impact, Organization, and Future Directions.
The Acute Perioperative Pain Service has been established as a relatively new but important concept and service in clinical patient care. Many surgical institutions have dedicated inpatient acute pain services with variable compositions. This review aims to investigate the purpose, clinical and economic implications, and future direction of the Acute Perioperative Pain Service (APPS). ⋯ There is growing evidence of the multiple benefits of a dedicated APPS, especially pertaining to patients at higher risk of poorly controlled postoperative pain. Healthcare providers furthermore realize the importance of the perioperative pain management continuity of care, consisting of preoperative pain evaluations and post-discharge follow-up in an outpatient pain management setting, in coordination with the primary teams. The Transitional Pain Service (TPS) has emerged as the next step in this evolution and has been successfully implemented at various medical centers. With the growing number of surgical procedures and the increasing complexity of the patient population, effective management of acute postoperative pain continues to be challenging, despite ongoing advances in clinical care, analgesic modalities, and research. The APPS is becoming the clinical standard of care for managing postoperative pain, and its role continues to expand worldwide.
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This review evaluates disparities in acute postoperative pain management with regard to gender, race, socioeconomic status, age, and language. Strategies for addressing bias are also discussed. ⋯ Inequities in acute postoperative pain management may lead to longer hospital stays and adverse health outcomes. Recent literature suggests that there are disparities in acute pain management related to patient gender, race, and age. Interventions to address these disparities are reviewed but require further investigation. Recent literature highlights inequities in postoperative pain management, particularly in relation to gender, race, and age. There is a need for continued research in this area. Strategies such as implicit bias training and using culturally competent pain measurement scales may help reduce these disparities. Continued efforts by both providers and institutions to address and eliminate biases in postoperative pain management are needed to ensure better health outcomes.