Articles: acute-pain.
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Randomized Controlled Trial
Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial.
We aimed to assess and compare the analgesic efficacies and adverse effects of ketamine administered through a breath-actuated nebulizer at 3 different dosing regimens for emergency department patients presenting with acute and chronic painful conditions. ⋯ We found no difference between all 3 doses of ketamine administered through breath-actuated nebulizer for short-term treatment of moderate to severe pain in the emergency department.
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Randomized Controlled Trial Comparative Study
Comparing two doses of intramuscular ketorolac for treatment of acute musculoskeletal pain in a military emergency department.
The goal of the study was to assess a low-dose versus a high-dose of intramuscular (IM) ketorolac for non-inferiority in adults with acute MSK pain in an emergency department (ED). ⋯ A 15 mg dose of IM ketorolac was found to be non-inferior to a 60 mg dose for acute MSK pain in adults presenting to the ED. Discontinuing the practice of ordering 60 mg doses of IM ketorolac in place of a lower dose for acute MSK pain should be considered.
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Multicenter Study
Opioid Analgesics and Persistent Pain After an Acute Pain Emergency Department Visit: Evidence from a Cohort of Suspected Urolithiasis Patients.
Severe acute pain is still commonly treated with opioid analgesics in the United States, but this practice could prolong the duration of pain. ⋯ Opioid analgesic prescription doubled the odds of persistent pain among ED patients with suspected urolithiasis. Limiting opioid analgesic prescribing at ED discharge for these patients might prevent persistent pain in addition to limiting access to these medications.
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Oxycodone pharmacokinetics have been described in premature neonates through to obese adults. Covariate influences have been accounted for using allometry (size) and maturation of oxycodone clearance with age. The target concentration is dependent on pain intensity that may differ over pain duration or between individuals. ⋯ Simulation was used to suggest loading and maintenance doses to attain an oxycodone concentration of 35 mcg.L-1 predicted in adults. Although the covariates age and weight contribute 92% variability for clearance, there remains variability accounting for 16% of concentrations outside the target range. Duration of analgesic effect after ceasing infusion is anticipated to be longer in neonates where context-sensitive halftime is greater than older children and adults.
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Australas Emerg Care · Dec 2021
An initial psychometric evaluation of the APS-POQ-R in acute pain presenting to the emergency department.
The purpose of this study was to examine the psychometric properties of a modified version of the American Pain Societies - Patient Outcome Questionnaire - Revised edition in adult patients presenting with acute pain to the emergency department. ⋯ The Questionnaire demonstrated construct validity in these patients. Exploratory factor analysis demonstrated five constructs. The tool demonstrated discriminatory ability based on patient urgency, and subscale measurement was associated with patient satisfaction with care CONCLUSIONS: The Questionnaire has demonstrable construct validity in adult patients presenting with acute pain to the ED.