Articles: pain-management-methods.
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Anesthesia and analgesia · Mar 2021
Changes in Pain Medicine Training Programs Associated with COVID-19: Survey Results.
The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis of unprecedented proportions that has altered the practice of medicine. The pandemic has required pain clinics to transition from in-person visits to telemedicine, postpone procedures, and cancel face-to-face educational sessions. There are no data on how fellowship programs have adapted. ⋯ We found a shift to online alternatives for clinical care and education, with correlations between per capita infection rates, and clinical care demands and redeployment, but not with overall trainee anxiety levels. It is likely that medicine in general, and pain medicine in particular, will change after COVID-19, with greater emphasis on telemedicine, virtual education, and greater national and international cooperation. Physicians should be prepared for these changes.
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The aim of this registry study was the prospective evaluation of the efficacy of Pycnogenol® in idiopathic fibromyalgia (FM), over 4 weeks in comparison with the standard management (SM). ⋯ Pycnogenol® supplementation appears to control and reduce the intensity of common symptoms and complaints - especially pain-related - associated with FM. Pycnogenol® could be a 'soft', safe supplementation and prevention method to manage the symptoms of most of these patients, even for longer periods, reducing the need for drugs.
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Observational Study
Adherence to stepped care for management of musculoskeletal knee pain leads to lower healthcare utilization, costs, and recurrence.
This study aimed to report compliance with stepped care management of patellofemoral pain and determine whether adherence to stepped care results in decreased recurrence and lower health care utilization. ⋯ These findings demonstrate the value of following stepped care guidelines for pain management in patients with patellofemoral pain.
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J. Pediatr. Hematol. Oncol. · Mar 2021
Multimodal Analgesic Plan for Children Undergoing Chimeric 14.18 Immunotherapy.
Immunotherapy with the chimeric 14.18 anti-GD2 antibody (ch14.18) is associated with severe neuropathic pain. Different analgesic modalities have been employed, but pain management remains challenging and side effects such as desaturation, bradycardia, and hypotension have been reported. ⋯ Morphine consumption was similar to other studies. Our results suggest that this regimen may be a valid analgesic option in children undergoing ch14.18 infusion.
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Multimodal pain management strategies are critical in total knee arthroplasty (TKA). There has recently been a shift toward opioid sparing protocols, yet most publications continue to use narcotics in the perioperative period. Periarticular injections are a popular adjunct but studies regarding the optimal medications have high variability making it difficult to choose the optimal medication. ⋯ Although we saw trends for improvements in group LB, these were small and not clinically meaningful. It appears that both injections were effective. There is a significant cost difference and medications should be chosen based on surgeon preference and institutional needs.