Articles: pain-management.
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Critically ill pediatric patients are frequently exposed to acute, established, and chronic pain as a result of their disease processes or intensive care therapies. Despite the availability of many drugs and techniques for providing analgesia, these painful conditions are not adequately treated in a large proportion of children. ⋯ We propose that adequate and early analgesic interventions will minimize patient's discomfort, maintain metabolic homeostasis, and improve a patient's tolerance of intensive care unit therapies and nursing interventions. Adequate analgesia can be provided to even the sickest child using the drugs, techniques, and novel approaches reviewed.
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There is still a significant lack of treatment and rehabilitation facilities for chronic pain patients in Germany today. Most of all the treatment of low back pain and widespread pain syndromes or panalgesia is time consuming and complicated. The main problem of anaesthesiological pain clinics is the increase of these complex pain syndromes in the last years. ⋯ It is now clear that no one discipline or mode will suffice. Only a multidisciplinary and intensive approach will prevail, as discussed in this article. Unfortunately these multidisciplinary pain units are nearly not existing in Germany just as little as control of the effectiveness of pain treatment.
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Axone (Dartmouth, N.S.) · Jun 1997
The treatment of chronic pain by epidural spinal cord stimulation--a 15 year follow up; present status.
Pain is necessary for survival but chronic pain is disabling and causes significant health and economic problems. This study provides an understanding of the future for spinal cord stimulation. Stimulation by means of chronically implanted electrodes, was carried out in 200 patients with pain of varied benign organic etiology. ⋯ Pain due to cauda equina injury, paraplegic pain and phantom limb pain responded poorly. Complications included wound infection, displaced or fracture electrode, and fibrosis at the stimulating tip. Spinal cord stimulation has proven to be effective in the treatment of chronic benign pain.
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Practice Guideline Guideline
Use of pediatric sedation and analgesia. American College of Emergency Physicians.
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A major drawback of currently available spinal cord stimulation (SCS) systems for the management of chronic intractable pain, especially of widespread pain patterns as in reflex sympathetic dystrophy, is the generally limited paresthesia coverage. The aim of this study is to analyze the origin of this problem and to provide solutions. ⋯ Paresthesia coverage and pain management by SCS can be improved when using electrodes as proposed.