Articles: acute-pain.
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J Coll Physicians Surg Pak · Oct 2022
Randomized Controlled TrialAbdominal Pain Management and Point-of-care Ultrasound in the Emergency Department: A Randomised, Prospective, Controlled Study.
To determine the effect of point-of-care ultrasound (POCUS) performed during the initial evaluation phase of patients with acute abdominal pain. ⋯ Abdominal pain, Cost, Emergency department, Length of stay, Point-of-care ultrasound.
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The purpose of this systematic review is to examine the delivery and clinical efficacy of virtual reality (VR) therapeutics for acute pain management in adults and identify practical considerations of VR deployment, as well as current gaps in the literature. ⋯ This systematic review found VR to be an effective tool for acute pain management. Findings from this review also underscore the importance of addressing the patient's sense of presence and levels of immersion, interaction, and interest when deploying VR. Future VR studies should consider incorporation of anxiety, presence, and VR side effect measures in addition to acute pain metrics.
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The opioid crisis has changed the culture and expectations of pain management, elevating the importance of nonpharmacologic pain interventions (NPIs) into multimodal pain management programs. Little is known about use of NPIs in hospitalized patients. ⋯ Results suggest that patients and nurses may benefit from education about using NPIs in acute care. Nurses have a critical role influencing positive pain-related outcomes, and tablet technology can enhance patient use of NPIs during hospitalization.
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Cholecystectomy is the intervention of choice for treating acute cholecystitis; when conservative management does not work, it operates on the patient outside the critical condition. It can be performed together with or after endoscopic papillotomy through endoscopic retrograde cholangiopancreatography (ERCP) when it is concurrent with a situation of cholechodocolithiasis or when there is compression and consequent increase in pressure in the bile duct caused by a calculus jammed in the vesicular infundibulum (Mirizzi's syndrome), with or without jaundice, fever, and pain in the right hypochondrium (Charcot's Triad), which can progress to sepsis of biliary origin. This review aims to assess whether the timing of cholecystectomy (before or after ERCP) interferes with the postoperative period and clinical outcome in patients with acute cholecystitis. ⋯ International Prospective Registry of Systematic Reviews (PROSPERO) CRD42021290726.
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Observational Study
The influence of involving patients in postoperative pain treatment decisions on pain-related patient-reported outcomes: A STROBE-compliant registering observational study.
The evidence regarding the influence of allowing patients to participate in postoperative pain treatment decisions on acute pain management is contradictory. This study aimed to identify the role of patient participation in influencing pain-related patient-reported outcomes (PROs). This is a cross-sectional study. ⋯ There was no significant difference between the groups in the desire for more pain treatment either before (25.4% vs 28.2%, risk ratio [95% CI]: 0.90 [0.77, 1.05], P = .18) or after matching (26.7% vs 28.8%, risk ratio [95% CI]: 0.93 [0.79, 1.10], P = .43). After matching, patients in the participation group reported significantly better PROs, including pain intensity (less time spent in severe pain [P < .01]), emotional impairment (less anxiety [P < .01]), interference with function (less interference with sleep [P < .01]), adverse effects (less drowsiness [P = .01]), and patient perception (more pain relief [P < .01] and more satisfaction [P < .01]), than the nonparticipation group. Patient participation in pain treatment decisions was associated with improved pain experience but failed to mitigate the desire for more treatment.