Articles: pain-management-methods.
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Guidelines on postoperative pain management recommend inclusion of patient and caregiver education on opioid safety. Patient education materials (PEMs) should be written at or below a sixth grade reading level. We designed this study to compare the readability of online PEMs related to postoperative opioid management produced by institutions with and without a regional anesthesiology and acute pain medicine (RAAPM) fellowship. ⋯ Available online PEMs related to opioid management are beyond the recommended reading level, but readability metrics for online PEMs do not differ between fellowship and nonfellowship groups. More than two-thirds of RAAPM fellowship programs in North America are lacking readable online PEMs on safe postoperative opioid management.
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Chronic pancreatitis is a common cause of recurrent chronic abdominal pain that utilizes significant health care resources. Pain in chronic pancreatitis can be of two types. Visceral pain occurs during ongoing pancreatic inflammation. Once pancreatic inflammation subsides, the pain generator can move to the abdominal wall as a result of viscerosomatic convergence and present as abdominal myofascial pain syndrome. Subcostal transversus abdominis plane block is an abdominal plane block that has been proven effective in upper abdominal pain of somatic origin. ⋯ Subcostal transversus abdominis plane block may be an option in the management of abdominal myofascial pain syndrome secondary to chronic pancreatitis. The block is ineffective in producing clinically significant pain relief in the presence of ongoing pancreatic inflammation.
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Clin. Orthop. Relat. Res. · Jan 2020
How Does Perioperative Ketorolac Affect Opioid Consumption and Pain Management After Ankle Fracture Surgery?
The investigation of nonnarcotic drug regimens for postoperative pain management is important in addressing the opioid epidemic. NSAIDs can be a powerful adjunct in managing postoperative pain, but the possibility of delayed bone healing is a major concern for orthopaedic surgeons. Our recent retrospective study on ketorolac administration demonstrated that the NSAID is not associated with an increased risk of delayed union or nonunion after ankle fracture surgery. ⋯ Level I, therapeutic study.
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Observational Study
Integrating Adjuvant Analgesics into Perioperative Pain Practice: Results from an Academic Medical Center.
Opioid-sparing postoperative pain management therapies are important considering the opioid epidemic. Total knee arthroplasty (TKA) is a common and painful procedure accounting for a large number of opioid prescriptions. Adjuvant analgesics, nonopioid drugs with primary indications other than pain, have shown beneficial pain management and opioid-sparing effects following TKA in clinical trials. We evaluated the adjuvant analgesic gabapentin for its usage patterns and its effects on opioid use, pain, and readmissions. ⋯ When assessed in a real-world setting over a large cohort of TKA patients, gabapentin is an effective pain management therapy that is associated with reduced opioid consumption-a national priority in this time of opioid crisis-while maintaining the same quality of pain management.
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Physiother Theory Pract · Jan 2020
Randomized Controlled TrialPain management using a multimodal physiotherapy program including a biobehavioral approach for chronic nonspecific neck pain: a randomized controlled trial.
Objective: To determine the effectiveness of a therapeutic patient education (TPE) intervention based on a biobehavioral approach combined with manual therapy (MT) to reduce pain in patients with chronic nonspecific neck pain (CNSNP). In addition, this study intended to assess the effectiveness of a multimodal physiotherapy program including TPE to reduce pain in patients with CNSNP. Design: Single-blind randomized controlled trial. ⋯ Results: Statistically significant differences in pain intensity were found when Exp2 was compared with Exp1 and the control group at 4 months (p = 0.015 and p = 0.001, respectively), but no difference was found between Exp1 and the control group at the same follow-up period (p = 0.86). Exp2 showed statistically significant differences in all of the secondary outcomes except for pain catastrophizing when compared with the control group at 4 months. Conclusions: The Exp2 group was more effective than Exp1 and the control group in terms of reducing pain intensity at 4 months; at post-treatment, only Exp2 was more effective than the control group.