Pain practice : the official journal of World Institute of Pain
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Chronic pain is of concern to health professionals, patients, society, and negatively impacts quality of life (QoL). The present epidemiologic study identified point prevalence of chronic pain in India, impact on individual's QoL, unveiling current pain treatment practices, and levels of satisfaction with treatment. ⋯ A significant population of India suffers from chronic pain, and their QoL is affected leading to disability. A proportion of respondents receiving pain treatment were taking nonprescription medications with a majority of respondents on NSAIDs. A very few were consulting pain management specialists.
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Randomized Controlled Trial
Effects of Intra-Operative Ketamine Administration on Postoperative Catheter-Related Bladder Discomfort: A Double-Blind Clinical Trial.
Urinary catheterization during surgery frequently leads to unfavorable signs and symptoms (ie urgency, discomfort, frequency) during recovery. These signs and symptoms are collectively called catheter-related bladder discomfort (CRBD). We hypothesized that preemptive IV ketamine administration prior to intra-operative catheterization would reduce the incidence of CRBD in the postoperative period when compared to placebo. ⋯ Preemptive administration of IV ketamine (0.5 mg/kg) can reduce incidence and severity of CRBD in the early postoperative period.
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The management of pain patients with analgesics is challenging, with one of the risks being overdose with prescribed medications and death. In this study, we examined relationships between pain and pain catastrophizing, and past history of intentional overdoses and suicide attempts. ⋯ Although we cannot discern causal relationships, findings indicate that patients with pain complaints and pain catastrophizing have a greater likelihood of having past histories of intentional overdoses and suicide attempts. We discuss the potential implications of these findings.
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This study was conducted to provide information regarding prevalence of pain, type of provider managing pain, and use of Internet for information regarding pain, among patients coming for presurgical anesthesia consultation at a major academic institution. ⋯ Patients are presenting for surgery with significant pre-operative pain issues. Knowing this information pre-operatively will help healthcare personnel manage postsurgical pain more effectively. Patients are also using the Internet to obtain information regarding pain. As providers, there may be value to directing patients to reliable information online during consultation. As all physicians will eventually be managing chronic pain in their patients, pain education should be given priority in medical school curriculum.
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Diabetic lumbosacral radiculoplexus neuropathy (DLRPN) is a rare painful peripheral neuropathic complication of diabetes mellitus. The clinical features of DLRPN include severe neuropathic pain, weakness, atrophy, and sensory loss in the lower limbs with asymmetrical distribution. Nerve ischemia due to inflammation and microvasculitis has been suggested as the pathophysiological mechanism for DLRPN. ⋯ We measured serum cytokines before and after IVIg; serum tumor necrosis factor α was increased when the patient reported pain and normalized after IVIg in parallel with pain improvement. Our data extend the notion that some types of pain, including peripheral neuropathic pain, may respond to IVIg and give some clue on the mechanism of this therapeutic effect. They are also consistent with the suggested role of the immune system in the pathophysiology of neuropathic pain and offer support to the hypothesis that cytokines may contribute to the pathogenesis of neuropathic pain.