Articles: pain-management-methods.
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Effective pain management following total knee arthroplasty (TKA) is fundamental in achieving positive rehabilitation outcomes. The purpose of our study was to investigate post operative pain management in relation to short term functional mobility in an intervention group receiving concomitant use of an IV narcotic PCA and a continuous infusion of local anaesthetic via a femoral nerve catheter (CFNC), compared to a group receiving narcotic PCA alone. This was a preliminary study conducted to establish an appropriate design for a larger investigative study. ⋯ In this small preliminary study improved TUG performance at Day 4 post op was not influenced by the use of a CFNC but was positively correlated with male gender, preoperative performance, time elapsed since last oral analgesia and pain score. However AROM was decreased in the CFNC group suggesting further research on the relationship between CFNCs, local anaesthetic concentration and quadriceps strength should be incorporated in the follow up study's design.
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Death at the beginning of life is tragic but not uncommon in neonatal intensive care units. In Portugal, few studies have examined the circumstances surrounding the final moments of neonates. We evaluated the care given to neonates and their families in terminal situations and the changes that had occurred one decade later. ⋯ Despite an increase in the withholding and withdrawing of therapeutic activities and improvements in pain management and family support, many neonates still receive curative and aggressive practices at the end of life.
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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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A young man with acute maxillofacial injuries and a tracheotomy in intense pain was denied pain relief for several days. Intermittent suctioning of the trachea was agonizing. He became psychologically affected to such an extent that he was totally focused on his pain and suffering and unable to make intelligent decisions regarding his future treatment. ⋯ A doctor called in to counsel him found that pain was his predominant problem and treated it. The patient was magically transformed to a sensible person, now thinking straight and promptly consenting for surgery. The author, a doctor himself, learned from this experience what a devastating experience pain can have on the person, that one should look for pain to find it, that most of the time pain can be relieved by simple means, and that relief from pain changes the whole attitude of the sufferer.