Articles: pain-management-methods.
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Postoperative nausea and vomiting (PONV) and pain are two of the major concerns for patients presenting for surgery. The causes of PONV are multifactorial and can largely be categorized as patient risk factors, anaesthetic technique, and surgical procedure. Antiemetics work on several different receptor sites to prevent or treat PONV. ⋯ With the increasing understanding of the pathophysiology of acute pain, especially the occurrence of peripheral and central hypersensitization, it is unlikely that a single drug or intervention is sufficiently broad in its action to be adequately effective, especially with moderate or greater pain. Although morphine and its congeners are usually the foundation of pain management regimens, as their dose increases so does the incidence of side-effects. Thus, the approach for the management of acute postoperative pain is to use multiple drugs or modalities (e.g. regional anaesthesia) to maximize pain relief and reduce side-effects.
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Randomized Controlled Trial
Oral sucrose to decrease pain associated with arterial puncture in infants 30 to 36 weeks' gestation: a randomized clinical trial.
The purpose of this study was to determine the effect of oral sucrose solution on pain responses of neonates to arterial puncture compared with neonates who did not receive a sucrose solution. ⋯ This study found a significant reduction in the crying subscale of the Neonatal Infant Pain subscale immediately after the introduction of an arterial needle in neonates receiving a 24% sucrose solution, compared with those who did not receive sucrose solution. While prior studies found a similar reduction in pain scores after heel and venipuncture needlesticks, this is the first study evaluating a high concentration of oral sucrose to blunt the pain associated with an arterial puncture.
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The Internet is rapidly becoming a part of the pain practitioner's arsenal for bringing relief to patients. Along with the promise come a number of caveats for selecting the most appropriate technologies for a given practice. This article provides an overview of why the Internet holds potential for filling a gap in pain practice, reviews some of the fastest emerging uses of the Internet for pain, and identifies both merits and limitations the practitioner should consider when contemplating adopting an Internet technology for his or her practice.
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Pain is not only one of the most undesirable side effects of cancer but also one of its major complications. This study attempted to evaluate and describe the pain characteristics and pain control in patients with advanced cancer and to identify factors related to effective analgesic treatment. ⋯ Negative attitudes and feelings toward treatment combined with deficits in patient education/information seem to influence both pain response and therapy compliance suggesting the need for more comprehensive approach to pain management of cancer patients.
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Anesthesiology clinics · Dec 2011
Sedation and weaning from mechanical ventilation: linking spontaneous awakening trials and spontaneous breathing trials to improve patient outcomes.
The use of sedation has long been integrated into critical care. Because pain, discomfort, anxiety, and agitation are commonly experienced by critically ill patients, the use of medications to alleviate and control these symptoms will continue; however, data showing that prolonged use of sedating medications imparts harm to patients obligate physicians to use agents and methods of sedation that minimize these negative side effects. ⋯ Regardless of choice of sedating agent, and even when patient-targeted sedation protocols are used to minimize oversedation, the use of spontaneous awakening trials dramatically improves patient outcomes for critically ill patients. Intensive care physicians must continue to study the delivery of sedation in efforts to maximize patient comfort while minimizing patient harm.