Articles: pain-management.
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Effective therapy of chronic frequently recurring pain is a complex important problem from practical medical, social, and economic viewpoints. Organization of specialized "pain clinics" and pain control centers is discussed. These institutions will take care of patients with chronic pain syndromes. ⋯ The authors offer recommendations on the use of traditional and nontraditional methods of pain relief. New highly effective integrative diagnostic methods (computer pulsometry) and therapies (resonance electropuncture analgesia and therapy) are used in various pain syndromes, including chronic frequently relapsing, which are usually resistant to common methods. Integrative methods of clinical reflex therapy create conditions for replacing traumatic surgical and radiological methods used in the treatment of critically ill patients by methods of integrative medicine.
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Objective. Post-herniorrhaphy pain syndrome can be difficult to treat. The exact mechanism of pain is not always apparent. ⋯ Conclusion. Post-herniorrhaphy pain can have the same features of both nociceptive and neuropathic pain syndromes. In cases which have failed conservative therapy we believe that a trial of spinal cord stimulation is warranted as in other cases of neuropathic pain syndromes.
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Since the first report of alpha2-adrenoceptor agonists, the list of clinical indications for this class of drugs continues to expand. Alpha2-adrenoceptor agonists have several beneficial actions during the perioperative period. ⋯ Furthermore, alpha2-adrenoceptor agonists may offer benefits in the prophylaxis and treatment of perioperative myocardial ischaemia and their role in pain management and regional anaesthesia is increasing. The development of new, highly selective compounds which not only reduce anaesthetic requirements but induce anaesthesia by themselves may provide a new concept for the administration of anaesthesia.
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Repeated assessment of pain and other symptoms is required for quality assurance in palliative care. However, physical and cognitive impairment of the patients may impede the use of standardized questionnaires and documentation systems in palliative care setting. We developed a minimal documentation system (MIDOS) for the specific requirements in this setting. ⋯ We conclude that MIDOS is a valid instrument for self-assessment of the patient's symptoms and may be used to monitor the efficacy of symptom management.