Articles: pain-clinics.
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Vitamin D deficiency has been associated with chronic non-specific musculoskeletal pain syndromes; however, studies are lacking with respect to its relationship with postoperative pain. We tested the hypothesis that a lower preoperative vitamin D level is associated with increased postoperative pain and/or opioid consumption in morbidly obese patients who had laparoscopic bariatric surgery. ⋯ We did not find any association between preoperative vitamin D levels and postoperative pain scores/opioid consumption in morbidly obese patients undergoing bariatric surgery.
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Eur J Phys Rehabil Med · Jun 2015
Randomized Controlled TrialEffect of adding one 15-minute-walk on the day of surgery to fast-track rehabilitation after total knee arthroplasty: a randomized, single-blind study.
Earlier and more intensive physiotherapy exercise after total knee arthroplasty (TKA) enhance recovery, but the best combination of intensity and duration has not been determined. ⋯ A 15-minute walk immediately after recovery from spinal anesthesia did not increase pain in patients with TKA. More intense exercise during this period might improve functional recovery without increasing pain.
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Acute postoperative pain is still inadequately managed, despite the presence of acute pain services (APSs). This study aimed to investigate the existence, structure, and responsibilities of Dutch APSs and to review the implementation of the Dutch Hospital Patient Safety Program (DHPSP). ⋯ Almost all hospitals have an APS. They differ in both the way they are locally organized, along with the activities they employ. Future research needs to compare the effect of patient and nonpatient-related activities of APSs on outcomes related to pain management.
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To document staffing (medical, nursing, allied health [AH], administrative) in Australian multidisciplinary persistent pain services and relate them to clinical activity levels. ⋯ Reasonable consistency was demonstrated in the range and mix of most disciplines employed, suggesting they represented workable clinical structures. The greater number of medical and nursing staff within Level 1 clinics may indicate a lower multidisciplinary focus, but this needs further exploration. As the first multidisciplinary staffing data for persistent pain clinics, this provides critical information for designing and implementing clinical services. Mapping against clinical outcomes to demonstrate the impact of staffing patterns on safe and efficacious treatment delivery is required.
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Review
Diclofenac sodium injection (akis(®), dicloin (®)): a review of its use in the management of pain.
A novel formulation of diclofenac sodium suitable for subcutaneous or intramuscular injection (Akis(®), Dicloin(®)) has been developed using the complexing agent hydroxypropyl-β-cyclodextrin (HPβCD) as a solubility enhancer. Diclofenac HPβCD is available in several European countries, where it is indicated for use in adults with acute forms of pain, including postoperative pain. Clinical trials have demonstrated the analgesic efficacy of diclofenac HPβCD in terms of relieving moderate to severe postoperative pain in patients undergoing dental surgery or minor orthopaedic surgery. ⋯ The local tolerability of diclofenac HPβCD was consistently rated as 'good' or 'excellent' across all studies. Subcutaneous administration of diclofenac is a valid alternative to intramuscular delivery, with the advantages of easier administration, the availability of additional body sites suitable for injection and the potential for self-administration. Thus, diclofenac HPβCD 25, 50 or 75 mg/mL solution for subcutaneous or intramuscular injection extends the treatment options available for use in the management of pain in adults.