Articles: pain-management.
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patient-controlled analgesia PCA is a rapidly spreading approach to the management of post-operative pain. The suitability of this method for the morbidly obese patient undergoing bariatric surgery has not yet been determined. ⋯ use of PCA in patients undergoing bariatric surgery has obvious advantages and appears to be a safe procedure.
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J Obstet Gynecol Neonatal Nurs · Feb 1995
Randomized Controlled Trial Clinical TrialFacilitated tucking: a nonpharmacologic comfort measure for pain in preterm neonates.
To identify the effectiveness of "facilitated tucking," a nonpharmacologic nursing intervention, as a comfort measure in modulating preterm neonates' physiologic and behavioral responses to minor pain. ⋯ Facilitated tucking is an effective comfort measure in attenuating premature neonates' psychologic and behavioral responses to minor pain.
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Pain relief for the cancer patient in the hospice setting is almost always achievable. Cancer pain is caused by tumor growth and by psychosocial and spiritual factors. Opioid drugs are the mainstay of effective treatment. ⋯ Nonsteroidal anti-inflammatory drugs and adjuvant analgesics are synergistic with opioids in providing analgesia and allow lower opioid doses and fewer side effects. Ten to 15 percent of hospice patients will require regional anesthesia for pain relief. The hospice team of physicians, nurses, social workers, chaplains, aides, and volunteers is more effective than any single health care provider in achieving optimal pain relief and comfort.
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Spinal cord stimulation in ischemic pain conditions has proved to be an effective method of treatment for many patients. The indications are ischemic pain in the extremities from peripheral vascular disease and angina pectoris. The long-term results show that the response rate for ischemic pain is 70% to 90%, while the corresponding results for neuropathic pain average approximately 50% to 70%, which actually makes ischemic pain a very good indication for SCS. ⋯ For angina pectoris, SCS by now has become a routine supplementary method to conventional medical and surgical treatment. The technique is clinically effective, and several studies have shown decreased myocardial ischemia and decreased anginal pain during treatment. It is probable that the use of SCS in refractory angina will increase considerably in the 1990s.
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Review Multicenter Study Clinical Trial
[Chronic spinal cord stimulation in the treatment of neurogenic pain. Cooperative and retrospective study on 20 years of follow-up].
The aim of this investigation is to evaluate the long-term spinal cord stimulation (SCS) efficacy and safety, with a 20-years study concerning 692 patients (series I: 279, series II: 413). The series concern 304 arachno-epidural fibrosis, 152 peripheral nerve lesions, 25 amputations pain, 17 plexus brachial lesions, 101 spinal cord lesions, 22 cancer pain, and 71 vascular pain. A multidisciplinary chronic pain evaluation must exclude contra-indications (nociceptive pain, serious drug habituations, psychological problems, unresolved issues or secondary pain). ⋯ Analysing the results etiologically confirms the therapeutic value of SCS for neurogenic pain secondary to partial deafferentation. For upper limb pain, ipsilateral radicular stimulation is preferable. When the nerve lesion extends to the pre-ganglionic portion (brachial plexus avulsion, herpes zoster) or in cases of pain of spinal or cerebral origin, thalamic stimulation must be considered, after failure of SCS.