Articles: acute-pain.
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Best Pract Res Clin Anaesthesiol · Sep 2019
ReviewA survey of postoperative pain treatments and unmet needs.
More than 300 million patients undergo surgery worldwide each year. Pain associated with these procedures is associated with short- and long-term negative sequelae for patients, healthcare providers, and healthcare systems. The following chapter is a review of the reality of postoperative pain management in everyday clinical routine based on survey- and registry-derived data with a focus on care in adults. ⋯ Pain assessment is not effectively implemented in many hospitals and should consider cultural differences. Few data exist on the situation of pain management in low- and middle-income countries, indicating lack of resources and available medication in many of these areas. Certain types of surgery as well as demographic and clinical factors are associated with increased risk of severe postoperative pain.
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J Subst Abuse Treat · Sep 2019
Randomized Controlled TrialEffects of ascending buprenorphine doses on measures of experimental pain: A pilot study.
Buprenorphine is widely used in the treatment of opioid use disorder and pain management. Little is known about the analgesic effects of high-dose sublingual buprenorphine, particularly in doses of >8 mg. The aim of this study was to examine the effect of ascending doses of buprenorphine upon acute pain measures in patients stabilized on buprenorphine as treatment for opioid dependence. ⋯ This pilot study suggests that a ceiling effect on analgesia may be observed in people maintained on buprenorphine, though larger studies may confirm this finding. Clinical Trial Number: ACTRN12614001038684.
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Millions of Americans are affected by acute or chronic pain every year. This study investigates opioid prescription patterns for acute and chronic pain management among U.S. Medicaid patients. ⋯ More than half of Medicaid beneficiaries receiving an opioid for pain management do so for orthopedic- and dental-related reasons, with emergency department providers more likely to prescribe opioids. Modifications to the guidelines addressing temporary acute pain management practices with opioids would be likely to benefit emergency department providers the most.
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Int. J. Clin. Pract. · Aug 2019
Clinical utility and economic burden of routine serum lipase determination in the Emergency Department.
Serum lipase is a rapid and reliable laboratory test central to diagnosing acute pancreatitis (AP). Routine use in the emergency department (ED) setting for all cases of abdominal pain or as part of a standard laboratory biochemical profile may lead to unnecessary expenses. ⋯ Serum lipase is widely overutilised in the emergency setting resulting in unnecessary expenses and investigations. Evidence-based review of clinical guidelines and more restrictive testing can result in substantial cost savings and improved patient care.