Articles: pain-management.
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Paediatric anaesthesia · Jul 2021
Safety of an improved pediatric epidural tunneling technique for catheter shear.
Epidural tunneling could help with prolonged catheterization and be effective in preventing infection and dislodgement. However, epidural tunneling techniques carry a risk of catheter shear or needlestick injuries. ⋯ Our improved epidural tunneling technique, which was designed for pediatric cases, could reduce the risk of catheter shear.
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Ongoing protests in Gaza have led to numerous injuries, including long-bone fractures. We investigated assessment of pain severity and strategies for pain management in the emergency department. As no local guidelines exist, delivered care was compared with the guidance of the UK National Institute for Health and Care Excellence (NICE). ⋯ None.
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Poor control of cancer pain is a major public health problem worldwide. Many potential barriers can lead to suboptimal treatment of cancer pain. One such barrier is inadequate measurement and assessment of cancer-related pain control. This study aimed to assess current pain control and management for hospitalized adult patients with cancer in the Gaza Strip. ⋯ None.
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Randomized Controlled Trial
Intranasal Ketamine as an Adjunct to Fentanyl for the Prehospital Treatment of Acute Traumatic Pain: Design and Rationale of a Randomized Controlled Trial.
Objective: Acute pain management is fundamental in prehospital trauma care. Early pain control may decrease the risk of developing post-traumatic stress disorder (PTSD) and chronic pain. Fentanyl and ketamine are frequently used off-label, but there is a paucity of comparative data to guide decision-making about treatment of prehospital severe, acute pain. ⋯ The outcomes in the follow-up study are satisfaction with life and development of PTSD or chronic pain at 90 days after injury. An intention-to-treat approach will be used. Conclusion: These studies will test the hypotheses that ketamine plus fentanyl, when compared to fentanyl alone, effectively manages pain, decreases opiate requirements, and decreases PTSD at 90 days.
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The 'Opioid Crisis', which originated in Western countries, has been misrepresented and is misinforming the global public. For 20 years, since the advent of the synthetic opioids, 25,000 Americans, on average, have died annually from opioid-related overdoses. The United States produces and consumes by far the greatest amounts of opioids. ⋯ SIGNIFICANCE: The opioid crisis is, more accurately, a multicomponent global crisis and one that is not fully apparent or well understood. Regulations of the wealthy and powerful to control a surfeit of opioids, which encourages misuse, cannot be allowed to govern legislation in the majority of countries worldwide where citizens have little or no access to opioids to reduce pain and suffering. International conventions must be revised to ensure an optimal balance that allows access to opioids for all those who need them.