Articles: pain-management.
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Med. Clin. North Am. · May 1999
ReviewInterventional pain management. Appropriate when less invasive therapies fail to provide adequate analgesia.
Unrelieved chronic pain is costly to patients and society. Noninvasive and less costly therapies should be used before more invasive and more costly therapies. Therapies for pain control should be used according to a pain treatment continuum. Nerve-blocking techniques, neurolytic techniques, and implantable neuromodulatory technologies, such as SCC and spinal delivery of analgesics, are cost-effective when less invasive therapies fail to provide adequate analgesia.
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Med. Clin. North Am. · May 1999
ReviewPrimary care and pain medicine. A community solution to the public health problem of chronic pain.
The author emphasizes that pain is an important public health problem that demands attention. He discusses ineffective management and its causes, administrative and socioeconomic problems perpetuating poor care, problems in technology transfer, organizational models, specialists and subspecialists, and other topics.
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Pain control is vital to the quality of life of patients with cancer. From pain assessment and pharmacologic management to interventional management, special features of cancer pain are outlined in this article. Many evidence-based national and societal guidelines were developed during the past decade on cancer pain management. Proper and adequate management of cancer pain is strongly recommended by all the clinical practice guidelines.
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The purpose of this study was to determine which specific attributes of painful orofacial symptoms serve as predictors of health care utilization in a population based sample of elderly subjects. Furthermore, we documented patterns of health care utilization selection by type of health care provider. To our knowledge, these specific utilization patterns have never before been reported in the pain literature. ⋯ The overall number of visits was not predicted by pain intensity but by other qualities more associated with time or level of dysfunction caused by the symptom. We also found that elderly adults, typically seek care for toothache from a dentist and from physicians for painful orofacial symptoms not associated with the teeth or mouth. These decisions regarding the selection of a health care professional may, in part, be a function of financial and insurance considerations, anatomical site and perception of the role of dentistry in orofacial care.
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The purpose of this study was to describe nurses' perceptions of their practices in the assessment and management of pain in children. Questionnaires were distributed to 260 nurses in a pediatric hospital in the western United States. Results showed that nurses are not consistently assessing pain in children, and pain management practices are not based on systematic assessment. ⋯ Children experience a variety of painful procedures during hospitalization, but nurses reported that they are not consistently administering analgesics for painful procedures. Although rarely used, distraction and relaxation techniques were the most frequently reported nonpharmacological interventions. Although nurses did not feel that there were factors preventing them from assessing or managing pain in children, their practices revealed both that they are not using developmentally appropriate tools for assessing pain, and they have not maximized the use of management strategies for controlling pain.