Articles: pain-management.
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The ultimate goal of pain research is to provide effective routes for pain relief. Nevertheless, the perception pain relief as a change in pain intensity and un-/pleasantness has only been rarely investigated. It has been demonstrated that pain relief has rewarding and reinforcing properties, but it remains unknown whether the perception of pain relief changes when pain reductions occur repeatedly. Further, it remains an open question whether the perception of pain relief depends on the controllability of the preceding pain. ⋯ When in pain, pain relief can become an all-dominate goal. The perception of such pain relief can vary depending on external and internal characteristics and thus modulate, e.g., requests for pain killers in clinical settings. Here, we show that perceived intensity and pleasantness of pain relief changes with repetitions and whether the preceding pain is perceived as uncontrollable. Such mechanistic knowledge needs to be considered to maximize the effects of pain relief as a rewarding and reinforcing stimulus.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Perioperative Pain Management - Patient Information, Informed Consent and Discharge Management].
Many surgical procedures are followed by postoperative pain. Acute pain should be treated optimally for medical and ethical reasons. Different psychological, physical, interventional and pharmacological methods are employed in a procedure specific and institution specific matter. ⋯ To address these issues adjustments in informed consent and patient information and education are necessary. This includes also the information and education of caregivers. This article describes the legal framework, technical solutions and the impact of placebo and nocebo effects on doctor-patient communication.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Pain Management in Non-surgical Inpatients - Treatment Approaches and Competence for Pain Services].
The number of non-surgical patients in the hospital setting with pain due to medical conditions or comorbidities and/or invasive procedures or treatments is high. Compared to perioperative pain management, the portion of patients and/or conditions that require more than an approach focused on pharmacological treatment of nociceptive pain is considerably higher. Rather, treatment often requires the differentiated use of co-analgesics, non-pharmacological treatments, physiotherapy, occupational therapy, psychological assessment and interventsions and educational approaches, ideally in the form of closely coordinated interdisciplinary treatment. The assessment and treatment of acute and especially chronic pain should follow the biopsychosocial concept of pain, especially if risk factors for chronification have been identified, if patients receive high-dose therapy with analgesics or have preexisting a chronic pain disorder.
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Multicenter Study
Treatment of Acute Pain in Adults With Sickle Cell Disease in an Infusion Center Versus the Emergency Department : A Multicenter Prospective Cohort Study.
Patients with sickle cell disease (SCD) have vaso-occlusive crises (VOCs). Infusion centers (ICs) are alternatives to emergency department (ED) care and may improve patient outcomes. ⋯ Patient-Centered Outcomes Research Institute.
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Thorac Cardiovasc Surg · Sep 2021
Postoperative Thoracic Pain Treatment: Serratus Anterior or Erector Spinae Plane Block?
Thoracic surgery is one of the most painful surgeries. Effective analgesia is important in postoperative pain management. In this study, we aimed to compare the two new fascial block techniques. ⋯ ESPB was more effective compared with SAPB in postoperative thoracic pain management.