Articles: pain-management-methods.
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Radiofrequency ablation (RFA) and spinal cord stimulation (SCS) are 2 common modalities used in management of various pain conditions. RFA generates heat and an electromagnetic field that can theoretically interfere with the functionality and longevity of the SCS device. This is problematic for patients who need RFA and have previously undergone implantation of an SCS device. ⋯ We also present device-specific industry guidelines and recommendations for performing RFA in patients following SCS device implantation.
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Mayo Clinic proceedings · Apr 2020
ReviewOpioids in Older Adults: Indications, Prescribing, Complications, and Alternative Therapies for Primary Care.
The fact that opioids are valuable tools for the management of pain has been known and used for thousands of years. Currently, millions of Americans are treated annually with opioids, and many of these patients are elderly. ⋯ An understanding of how to select appropriate medications for the management of pain and of the myriad of alternatives available for pain management is vital to the care of older patients. This article presents a review, for primary care providers, of issues unique to opioid management in older adults.
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To examine the frequency and severity of pain and use of pain therapies among long-term care residents with moderate to severe dementia and to explore the factors associated with increased pain severity. ⋯ Using a comprehensive pain assessment protocol, we found that most nursing home residents with moderate to severe dementia had mild usual, intermittent pain and the vast majority received at least one pain therapy in the previous week. Although these findings reflect improvements in pain management compared with older studies, there is still room for improvement in that 45% of the sample experienced moderate to severe pain at some point in the previous week. J Am Geriatr Soc 68:794-802, 2020.
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Drug Alcohol Depend · Apr 2020
Pragmatic Clinical TrialIndependent association of tobacco use with opioid use disorder in patients of European ancestry with chronic non-cancer pain.
The harms associated with prescription opioid abuse have become a public health crisis. There is a need for evidence-based objective markers of the risk of opioid use disorder (OUD) in patients with pain receiving opioid treatment. The objective of this study was to evaluate the independent association of tobacco use and OUD in patients with chronic non-cancer pain. ⋯ Current tobacco use is significantly associated with OUD in patients with chronic pain receiving long-term opioid therapy.
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Opioid analgesic misuse and abuse has given rise to an epidemic that has added to an increase in opioid-related overdoses and deaths. Adults with persistent noncancer pain (PNCP) are primarily treated with opioid analgesics. Many remain on these medications long term. Most of these patients are unaware of other effective measures for managing PNCP, such as nonpharmacologic modalities (NPMs). This lack of familiarity with NPMs presents a key contributor to the problem of NPM underuse among adult PNCP patients. This integrative review sought to identify key factors that contribute to NPMs underuse and the effect of education on patients' adoption or use for PNCP management. ⋯ Findings suggest that patient education about NPMs has the potential to motivate patients to try these modalities, which may increase overall use of NPMs for PCNP. Nurses could play a vital role in ensuring evidence-based NPMs are introduced to PNCP patients, which could increase patients' use of these measures and improve outcomes.