Articles: pain-management.
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Reg Anesth Pain Med · Nov 2024
Transversus abdominis plane block in minimally invasive colon surgery: a multicenter three-arm randomized controlled superiority and non-inferiority clinical trial.
The transversus abdominis plane (TAP) block is the most widely used abdominal field block in colorectal surgery with a postoperative enhanced recovery pathway. We aimed to determine whether the laparoscopic-assisted and ultrasound-guided TAP (US-TAP) blocks provide superior pain relief compared with placebo. We separately investigated whether the laparoscopic-assisted technique was non-inferior to the ultrasound-guided technique in providing pain relief, with a non-inferiority margin of 10 mg morphine dose equivalents. ⋯ The L-TAP block was superior to placebo and non-inferior to the US-TAP block. However, neither met our predetermined estimate of the minimal clinically important difference of 10 mg morphine.
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Managing pain continues to be a difficult issue worldwide. Pain management has ethical connotations, with the potential to result in moral distress in nurses. The aim of this concept analysis is to analyze moral distress in pain management. ⋯ This concept analysis provides a foundation for future research examining moral distress in pain management.
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Recovery following cardiac surgery via sternotomy involves weaning from invasive mechanical ventilation, maintaining hemodynamic stability, and preventing complications. In the early postoperative period, a key priority is adequate pain control to allow patients to actively participate in exercise. The purpose of this study was to (i) describe analgesic prescribing and administration practices following cardiac surgery via sternotomy and (ii) explore patients' pain experience and how this impacted participation in early postoperative care. ⋯ To promote optimal recovery following cardiac surgery, nurses need to assess pain at both rest and movement and administer effective doses of as needed analgesia to manage the occurrence of breakthrough pain. Additionally, patients need to be more informed to understand the link between well controlled pain and their ability to participate in their recovery.
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Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means of an interdisciplinary training program (ITP) about chronic pain. ⋯ The knowledge and attitudes about pain scores improved at post-training (Δ = 9.04, 95% confidence interval 7.72-10.36) and at 6-month follow-up (Δ = 7.16, 95% confidence interval 5.73-8.59). After the training program, HCPs provided significantly more recommendations in accordance with clinical guidelines. Thus, an ITP can improve the biopsychosocial perspective of chronic pain management among HCPs in the short-term and mid-term.
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While the development of artificial intelligence (AI) technologies in medicine has been significant, their application to acute and chronic pain management has not been well characterized. This systematic review aims to provide an overview of the current state of AI in acute and chronic pain management. ⋯ This review characterizes current applications of AI for pain management and discusses barriers to their clinical integration. Our findings support continuing efforts directed towards establishing comprehensive systems that integrate AI throughout the patient care continuum.