Articles: postoperative.
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Postoperative pain is a major problem following laparoscopic cholecystectomy, and there is no general agreement on the effective method of pain relief. Rectal morphine suppositories are one of the newly released morphine forms. The aim of this study is to compare the impact of suppository morphine with placebo on pain relief after laparoscopic cholecystectomy. ⋯ Suppository morphine administration is more effective than placebo to reduce pain and analgesic requirements after laparoscopic cholecystectomy.
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Postgraduate medicine · Jan 2016
ReviewOpioid abuse-deterrent strategies: role of clinicians in acute pain management.
Opioid abuse is a healthcare and societal problem that burdens individuals, their families and the healthcare professionals who care for them. Restricting access to opioid analgesics is one option to deter abuse, but this may prevent pain patients in need from obtaining effective analgesics. ⋯ In addition, state governments and payors have enacted monitoring programs, and pharmaceutical companies continue to develop abuse-deterrent opioid formulations. Strategies for clinicians to mitigate opioid abuse include comprehensive patient assessment and universal precautions (e.g. use of multimodal analgesia and abuse-deterrent opioid formulations, urine toxicology screening, participation in prescription drug monitoring and risk evaluation and mitigation strategy programs).
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Randomized Controlled Trial
Self-Managing Postoperative Pain with the Use of a Novel, Interactive Device: A Proof of Concept Study.
Background. Pain is commonly experienced following surgical procedures. Suboptimal management is multifactorial. ⋯ Discussion and Conclusion. This study demonstrates that patients used the Navimed to report pain and to help manage it. Further work is required to investigate the difference in pain scores reported and to develop more sophisticated software.
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Reg Anesth Pain Med · Jan 2016
Comparative StudyRegional Versus General Anesthesia and the Incidence of Unplanned Health Care Resource Utilization for Postoperative Pain After Wrist Fracture Surgery: Results From a Retrospective Quality Improvement Project.
The establishment at our center of a dedicated regional anesthesia service in 2008-2009 has resulted in a marked increase in single-shot brachial plexus blocks (sBPBs) for ambulatory wrist fracture surgery. Despite the documented benefits of regional over general anesthesia (GA), there has been a perceived increase among sBPB patients in postoperative return rates for pain at our institution. We conducted a retrospective quality improvement project to examine this. ⋯ Patients who received sBPBs for ambulatory wrist fracture surgery had a higher rate of unplanned health care resource utilization caused by pain after hospital discharge than those undergoing GA. These findings warrant confirmation in a prospective trial and emphasize the need for a defined postdischarge analgesic pathway as well as the potential merits of perineural home catheters.
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Recovery is an abstract quantity the definition of which varies according to the pre-dilection of individual institutions, clinicians or patients. While traditionally focused on immediate postoperative restitution of function and readiness for discharge, recovery assessment has progressively expanded its focus to include other clinically relevant time periods, each of which is influenced by specific factors. Assessment tools have progressed from assessing one dimension of recovery, such as physiological variables, to multidimensional assessment of physical, nociceptive, emotive, functional and cognitive performance. They should be validated ideally for repeat measures and should provide real-time recovery data, as recovery can be viewed as a continuous process.