Articles: pain-management-methods.
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Observational Study
Postdischarge Pain Management After Thoracic Surgery: A Patient-Centered Approach.
Postoperative analgesia is paramount to recovery after thoracic surgery, and opioids play an invaluable role in this process. However, current 1-size-fits-all prescribing practices produce large quantities of unused opioids, thereby increasing the risk of nonmedical use and overdose. This study hypothesized that patient and perioperative characteristics, including 24-hour before-discharge opioid intake, could inform more appropriate postdischarge prescriptions after thoracic surgery. ⋯ Assessment of 24-hour before-discharge opioid intake may inform patient requirements after discharge. Opioid prescriptions after thoracic surgery can thereby be targeted on the basis of anticipated needs.
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Meta Analysis
The Effect of Nonpharmacological Interventions on Managing Symptom Clusters Among Cancer Patients: A Systematic Review.
Cancer patients often experience multiple concurrent and related symptoms, or symptom clusters. Research increasingly indicates that targeting a symptom cluster as an overall entity instead of individual symptoms could be more effective and efficient in improving patients' quality of life. Various nonpharmacological interventions are used to manage symptom clusters in cancer patients during and after treatment, but the effect of such interventions is uncertain. ⋯ Nonpharmacological interventions are shown to be effective in managing cancer-associated symptom clusters and could be considered as part of the existing healthcare services for cancer patients.
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Postgraduate medicine · Nov 2020
Editorial ReviewInterventional pain management in patients with cancer-related pain.
Invasive interventional procedures for managing pain in cancer patients are often underutilized following the popularization of the WHO analgesic ladder. The procedures that were successfully used until then were relegated away from mainstream palliative care practice, with the advent of newer opioids and adjuvants. Even though nerve blocks, intrathecal pumps and spinal cord stimulation were reintroduced as the fourth step of the WHO ladder, often referrals for these procedures are too late to produce a meaningful effect on quality of life. ⋯ ITDDs, neuromodulation and ever-increasing use of procedures routinely used in treating chronic nonmalignant pain would be the mainstay of interventional management until AI and nanotechnology would open doors for novel treatment options. Interventions should not be used as a last resort after multiple failed attempts at opioid therapy, but as an integral part of a management strategy including medical management, psychological and emotional welfare, and supportive care of the patient in a holistic manner. The curriculum of specialists should include appropriate training to safely perform and produce better quality evidence to validate the efficacy and safety of these challenging procedures.
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Review
BET 2: Is virtual reality effective in reducing adult pain perception during medical procedures?
A short-cut review of the available medical literature was carried out to establish whether virtual reality was an effective method for pain control during medical procedures. After abstract review, fifteen papers were found to answer this clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that there is insufficient high-quality research to answer this question.
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Total knee arthroplasty is a common and successful treatment modality for knee arthritis that is refractory to conservative management strategies. Over 600,000 arthroplasties are performed per year in the United States, and this number is expected to increase in the coming years. Unfortunately, 8% to 34% of patients experience chronic pain after having a total knee arthroplasty. ⋯ In this article, we outline the work-up of a painful total knee arthroplasty. Then we provide a thorough review of interventional pain management strategies and highlight the pertinent literature. Lastly, we hypothesize future developments in the field that may provide better outcomes for patients suffering from painful total knee arthroplasty.