Articles: pain-clinics.
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Pain is classified into physical and psychological pain. Physical pain is nociceptive, inflammatory, or neuropathic. Pain can be categorized into acute or chronic pain depending on the duration of pain and mechanism of onset. ⋯ Chronic pain is caused by incurable conditions or requires a long time to heal and is persistent: it includes chronic nociceptive pain, established neuropathic pain, and psychogenic pain. The therapeutic strategies for pain depend on the underlying pathological conditions: (1) For nociceptive pain, analgesics, narcotic analgesics, and nerve block are indicated. (2) For neuropathic pain, supplementary analgesics, but not analgesics, are indicated, and some narcotic analgesics are also effective: the recommended supplementary analgesics include calcium channel alpha-2-delta ligands, tricyclic antidepressants (TCAs), and serotonin-noradrenaline reuptake inhibitors (SNRIs). (3) For psychogenic pain, analgesics and nerve block are not indicated, except in the setting of a placebo effect: in paticular, narcotic analgesics should not be used. Psychological therapy, tranquilizer administration, cognitive behavior therapy, and patient education are indicated for this kind of pain.
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The aim of this investigation was to describe the effects of standardization and central control of the processes involved in postoperative pain management from patient and employee perspectives. ⋯ The quality of care was improved by standardization of the postoperative pain management. The legal and practical ability of the nursing stuff to administer pain medication within well-defined margins reduced the dependence on the ward doctor and at the same time patient pain levels. Patients received analgesics more quickly and experienced increased effectiveness. These results should be an incentive to reconsider the importance of the organization of postoperative pain management, because the quality of care with all potential medical and economic advantages, can be easily optimized by such simple mechanisms. They also show that the quality assessment of acute pain and the selection of appropriate indicators need further development.
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Pediatric pain services were first established in larger pediatric centers over two decades ago. Children's acute pain was poorly managed at the time owing to misconceptions, safety concerns, and variability in practice. While many larger pediatric centers now have acute pain services, there remains a need for better pain management in facilities and geographic locations with fewer resources. ⋯ It is not feasible or necessary for every hospital to manage all. Establishing the scope of practice (based on case mix and caseload) in any given hospital will determine which resources are desired. Country-specific standards, local staffing, and fiscal constraints will influence which resources are available.
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Rev Esp Anestesiol Reanim · Oct 2012
[A survey on the use of fluoroscopy in the treatment of pain: do we perform it correctly?].
Fluoroscopy is technique that is commonly used for procedures in the treatment of pain, but despite its importance in healthcare, many specialists do not know how to use it. We conducted a national survey to evaluate its use. ⋯ There is a lack of information on the handling of the fluoroscope in the area of pain treatment, and this usually leads to the adoption of insufficient radiation protection measures. The treatments are usually performed in the operating theatre. More than half the specialists perform less 10 procedures per week with x-rays. The control and follow-up of radiation values is insufficient, as is the information and protection offered to the patient.
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The purpose of this project was to determine whether machine-learning classifiers could predict which patients would require a preoperative acute pain service (APS) consultation. ⋯ Using historical data, machine-learning classifiers can predict which surgical cases should prompt a preoperative request for an APS consultation. Dimensional reduction improved computational efficiency and preserved predictive performance.