Articles: pain-management-methods.
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisAntidepressants for pain management in rheumatoid arthritis.
Pain management is a high priority for patients with rheumatoid arthritis (RA). Antidepressants are sometimes used as adjuvant agents to enhance pain relief, help with sleep and reduce depression. Such antidepressants include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), selective serotonin noradrenaline reuptake inhibitors (SNRIs) and norepinephrine reuptake inhibitors (NRIs). However, the prescription of antidepressants in this population remains controversial because of conflicting scientific evidence. ⋯ There is currently insufficient evidence to support the routine prescription of antidepressants as analgesics in patients with RA as no reliable conclusions about their efficacy can be drawn from eight placebo RCTs. The use of these agents may be associated with adverse events which are generally mild and do not lead to cessation of treatment. More high quality trials are needed in this area.
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Postherpetic neuralgia (PHN) is the most common complication following an acute varicella zoster virus infection. PHN often results in a chronic severe pain condition refractory to conservative pain management treatments. Peripheral nerve stimulation over the affected spinal nerve root may be an effective treatment option for patients with intractable PHN. ⋯ We describe a case of successful electrode placement at the C2 spinal level for the treatment of refractory PHN.
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Cornell J Law Public Policy · Jan 2011
Refractory pain, existential suffering, and palliative care: releasing an unbearable lightness of being.
Since the beginning of the hospice movement in 1967, "total pain management" has been the declared goal of hospice care. Palliating the whole person's physical, psychosocial, and spiritual states or conditions is central to managing the pain that induces suffering. At the end-stage of life, an inextricable component of the ethics of adjusted care requires recognition of a fundamental right to avoid cruel and unusual suffering from terminal illness. ⋯ Imbedded, necessarily, in this equation is the humane virtue of compassion, charity, mercy or agape. Assertions of state interest in safeguarding public morality by restricting intimate associational freedoms to accelerate death in a terminal illness are suspicious, if, indeed, not invalid. No terminally ill individual suffering from either intractable somatic or non-somatic pain, or both, should be forced to continue living.
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Asian Pac J Cancer P · Jan 2011
Exploration of cancer pain treatment by morphine infusion through an embedded device.
Cancer pain treatment with morphine presents particular problems in patients with renal failure needing haemodialysis. We here explore the various possibilities of intrathecal opioid administration for intractable chronic and acute cancer pain. ⋯ For over 3 decades, there have been numerous reports on non- nociceptive side effects associated with ever increasing long-term intrathecal morphine usage. Our review of the literature and our own experience suggests that a subarachnoid device allows good pain control effect after patient controlled intravenous infusion failure at the time of haemodialysis.
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisRelaxation techniques for pain management in labour.
Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of relaxation therapies for pain management in labour. ⋯ Relaxation and yoga may have a role with reducing pain, increasing satisfaction with pain relief and reducing the rate of assisted vaginal delivery. There was insufficient evidence for the role of music and audio-analgesia. However, there is a need for further research.