Articles: pain-management.
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Critically ill patients experience many unpleasant and frightening events while in an ICU. Appropriate concern for pain, discomfort, and anxiety is required from caregivers. The use of reassuring mannerisms, honest communication, and analgesics and sedatives, especially during therapeutic paralysis, improves patient comfort and reduces the morbidity rate. This article reviews the therapeutic options for sedation and experience with these agents in the critically ill.
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Stereotact Funct Neurosurg · Jan 1994
Multicenter StudyItalian multicentric study on pain treatment with epidural spinal cord stimulation.
A multicentric study on the treatment of nonmalignant chronic pain with epidural spinal cord stimulation (SCS) has been carried out in 32 Italian centers devoted to pain therapy. Neurosurgical and anesthesiology units participated in this retrospective study. 410 of the eligible patients were enrolled in the protocol: 48% were male, 52% female. All patients underwent a screening test period (average 21 days) and 74% underwent the definitive implant. ⋯ These results were favorable (i.e. excellent or good; more than 50% reduction of pain) in 87% of the patients at the 3-month follow-up, 75% at the 6-month follow-up, 69% at the 1-year follow-up, and 58% at the 2-year follow-up. Complication rate was: dislocation of the electrocatheter 4%, technical problems 3%, infections of the system 2%. The results will be discussed in correlation with the different etiologies of the nonmalignant chronic pain syndrome.
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Important differences become evident in a comparison of cancer pain between children and adults. Management of pain in children is commonly multidisciplinary, is less dependent on invasive measures and relies more on systemic therapy. Children are not little adults: their immaturity, developing cognition and dependence all influence their experience and interpretation of pain. ⋯ We are opposed to euthanasia. Psychosocial and cultural issues all influence the family's experience of palliative care. Further research is necessary in all of these areas.(ABSTRACT TRUNCATED)
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J Pain Symptom Manage · Jan 1994
Assessment of patient satisfaction utilizing the American Pain Society's Quality Assurance Standards on acute and cancer-related pain.
An evaluation of patient satisfaction with pain management is one component of a total quality assurance program on pain management recommended by the American Pain Society. This study utilized the patient satisfaction survey recommended by the Quality Assurance Committee of the American Pain Society and was conducted in an acute care, municipal hospital. ⋯ Data from the survey suggest that while patients experienced moderate-to-severe pain and had to wait relatively long periods of time for pain medications, in most cases they were satisfied with their overall pain management. Recommendations for conducting patient satisfaction surveys of pain management in acute care settings are reviewed, and methods for interpreting data from these types of surveys are discussed.
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Pain is a common, distressing symptom experienced by cancer patients and their family caregivers. An important aspect of coping with cancer pain is the ability to make meaning of the experience. ⋯ It also presents an integrated approach to assisting patients and their family caregivers with the meaning-making process associated with cancer pain. Approaches to intervening are integrated within a model developed through previous research.