Articles: pain-management-methods.
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Opioid-free perioperative approaches hold promise to reduce opioid use after surgery and their associated side effects. Here, we report the perioperative analgesic plan of a patient who requested opioid-free care for an open partial hepatectomy. ⋯ However, as in this case, placing an epidural is not always an option due to contraindications such as infection, coagulopathy, or patient refusal. Our multimodal management plan provided an alternative opioid-free, epidural-free perioperative strategy that may prove useful for other patients undergoing similar surgeries.
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Best Pract Res Clin Anaesthesiol · Jun 2020
ReviewGenomics testing and personalized medicine in the preoperative setting: Can it change outcomes in postoperative pain management?
Postoperative pain and opioid use are major challenges in perioperative medicine. Pain perception and its response to opioid use are multi-faceted and include pharmacological, psychological, and genetic components. Precision medicine is a unique approach to individualized health care in which decisions in management are based on genetics, lifestyle, and environment of each person. ⋯ Although there is currently not enough evidence for making recommendations about genetic testing to guide pain management in the acute care setting, there are some known polymorphisms that play a role in surgical pain and opioid-related postoperative adverse outcomes. In this review, we describe the potential use of pharmacogenomics (PGx) for improving perioperative pain management. We first review a number of genotypes that have shown correlations with pain and opioid use and then describe the importance of PGx-guided analgesic protocols and implementation of screening in a preoperative evaluation clinical setting.
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One of the most common problems in children that pain can not be managed adequately by the health workers. Knowledge level of nurses is an important factor in effective pain management. ⋯ The students were determined to have a moderate PPMK level and get the lowest scores, particularly from the pain control.
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Pain is one of the most common and undesired symptoms in cancer patients, affecting patients' physical and psychological well-being. Barriers to effective pain management in cancer patients need to be identified and addressed by clinicians. ⋯ Tailoring culturally appropriate educational programs regarding effective cancer pain management could facilitate pain management among patients with cancer.