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Pain Management (pain + management)
Kinds of Pain Management Terms modified by Pain Management Selected AbstractsComplementary and Integrative Medicine in Pain ManagementFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2009N Foster [source] Integrative Pain Medicine: The Science and Practice of Complementary and Alternative Medicine in Pain ManagementFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2009N Foster [source] Biomedical Acupuncture for Pain ManagementFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 4 2006R Guo [source] Evidence for Antinociceptive Activity of Botulinum Toxin Type A in Pain ManagementHEADACHE, Issue 2003K. Roger Aoki PhD The neurotoxin, botulinum toxin type A, has been used successfully, in some patients, as an analgesic for myofascial pain syndromes, migraine, and other headache types. The toxin inhibits the release of the neurotransmitter, acetylcholine, at the neuromuscular junction thereby inhibiting striated muscle contractions. In the majority of pain syndromes where botulinum toxin type A is effective, inhibiting muscle spasms is an important component of its activity. Even so, the reduction of pain often occurs before the decrease in muscle contractions suggesting that botulinum toxin type A has a more complex mechanism of action than initially hypothesized. Current data points to an antinociceptive effect of botulinum toxin type A that is separate from its neuromuscular activity. The common biochemical mechanism, however, remains the same between botulinum toxin type A's effect on the motor nerve or the sensory nerve: enzymatic blockade of neurotransmitter release. The antinociceptive effect of the toxin was reported to block substance P release using in vitro culture systems.1 The current investigation evaluated the in vivo mechanism of action for the antinociceptive action of botulinum toxin type A. In these studies, botulinum toxin type A was found to block the release of glutamate. Furthermore, Fos, a product of the immediate early gene, c- fos, expressed with neuronal stimuli was prevented upon peripheral exposure to the toxin. These findings suggest that botulinum toxin type A blocks peripheral sensitization and, indirectly, reduces central sensitization. The recent hypothesis that migraine involves both peripheral and central sensitization may help explain how botulinum toxin type A inhibits migraine pain by acting on these two pathways. Further research is needed to determine whether the antinociceptive mechanism mediated by botulinum toxin type A affects the neuronal signaling pathways that are activated during migraine. [source] Addiction-Related Assessment Tools and Pain Management: Instruments for Screening, Treatment Planning, and Monitoring CompliancePAIN MEDICINE, Issue 2008Steven D. Passik PhD ABSTRACT Objective., To review and critique the various assessment tools currently available to pain clinicians for assessing opioid use and abuse in patients with chronic noncancer pain to allow pain clinicians to make informed selections for their practices. Methods., A literature search on PubMed was conducted in June 2006 using the search terms opioid plus screening or assessment with or without the additional term risk, and opioid-related disorders/prevention and control in order to identify clinical studies published in English over the previous 10 years. Additional studies were identified using the PubMed link feature and Google. When abstracts described or referred to a tool for opioid abuse screening, the corresponding publication was acquired and reviewed for relevance to the pain treatment setting. Results., Forty-three publications were selected for review from the abstracts identified, and 19 were rejected because they did not describe a specific tool or provide adequate information regarding the screening tool used. The remaining 24 publications described relevant screening tools for opioid abuse risk and were reviewed. Conclusions., A variety of self-administered and physician-administered tools differing in their psychometrics and intended uses have been developed, but not all have been validated for use in chronic pain patients seen in a clinical practice setting. Some tools assess abuse potential in patients being considered for opioid therapy, whereas other tools screen for the presence of substance abuse. By recognizing the psychometrics of each tool, clinicians can select the ones most appropriate for their patient population and screening needs. [source] The Social Context of Pain ManagementPAIN MEDICINE, Issue 1 2007Raymond C. Tait PhD No abstract is available for this article. [source] Acute Pain Management: Current Best Evidence Provides Guide for Improved PracticePAIN MEDICINE, Issue 1 2006FANZCA, FFPMANZCA, MM(PM), Suellen M. Walker MBBS No abstract is available for this article. [source] Epidural and Intrathecal Cancer Pain Management: Prescriptive Care for Quality of LifePAIN MEDICINE, Issue 3 2004MPH Editor-in-Chief, Rollin M. Gallagher MD No abstract is available for this article. [source] Physician Variability in Pain Management: Are the JCAHO Standards Enough?PAIN MEDICINE, Issue 1 2003Rollin M. Gallagher MD No abstract is available for this article. [source] Pain Management in Primary Care: What Is the Role for Pain Medicine?PAIN MEDICINE, Issue 2 2002MPH Editor-in-Chief, Rollin M. Gallagher MD No abstract is available for this article. [source] Ethical Issues for Psychologists in Pain ManagementPAIN MEDICINE, Issue 2 2001Mary Lou Taylor PhD Pain management is relatively young as a specialty. Although increasing attention is being paid to issues such as pain at the end of life and pain in underserved populations, only recently has an open discussion of ethical issues in chronic pain treatment come to the fore. Psychologists specializing in pain management are faced with a myriad of ethical issues. Although many of these problems are similar to those faced by general clinical psychologists or other health psychologists, they are often made more complex by the multidisciplinary nature of pain management and by the psychologists' relationships to third-party payers (health maintenance organizations, workers' compensation), attorneys, or other agencies. An open forum exploring ethical issues is needed. This article outlines major ethical considerations faced by pain management psychologists, including patient autonomy and informed consent, confidentiality, reimbursement and dual relationships, patient abandonment, assessment for medical procedures, clinical research, and the interface of psychology and medicine. American Psychological Association ethical principles and principles of biomedical ethics need to be considered in ethical decision making. Further exploration and discussion of ethics for pain management psychologists are recommended. [source] Teaching Pain Management to Medical StudentsPAIN PRACTICE, Issue 2 2009James E. Heavner PhD No abstract is available for this article. [source] Interventional Pain Management: Past, Present, and Future.PAIN PRACTICE, Issue 4 2007Budapest, The Prithvi Raj Lecture: Presented at the 4th World Congress, World Institute of Pain First page of article [source] Overview of Pain ManagementPAIN PRACTICE, Issue 2004Jack D. Schim MD First page of article [source] Low-Tech, High-Touch,Pain Management with Simple MethodsPAIN PRACTICE, Issue 1 2003Ramani Vijayan1 First page of article [source] Taxonomy of pain. (Lehigh Valley Hospital, Center for Pain Management, Allentown, PA) Clin J Pain 2000;16:S114,S117.PAIN PRACTICE, Issue 2 2001Bruce Nicholson: This article discussed the way that research on the pathophysiology of chronic pain has started to challenge the traditional diagnostic and treatment paradigms for the patient with neuropathic pain. It stated that the heterogeneous nature of neuropathic pain indicated that more than one anatomic lesion is most likely responsible for the clinical presentation of a particular syndrome. Conclude that the current taxonomy often falls short of identifying the multifactorial nature of neuropathic pain syndromes and, therefore, may lead to imprecise management of those conditions. It is suggested that an integrated approach to the diagnosis and treatment of neuropathic pain that considers both etiologic factors and possible mechanisms will lead to more effective taxonomy, treatment paradigms, and outcomes. [source] Pain Management for Ulcerated HemangiomasPEDIATRIC DERMATOLOGY, Issue 6 2008Albert C. Yan M.D. First page of article [source] Pain Management in Patients with Substance Abuse: Treatment Challenges for Pain and Addiction SpecialistsTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2007Vania Modesto-Lowe MD No abstract is available for this article. [source] Pain Management in the Emergency Department: Current Landscape and Agenda for ResearchTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 4 2005Sandra H. Johnson No abstract is available for this article. [source] The Social, Professional, and Legal Framework for the Problem of Pain Management in Emergency MedicineTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 4 2005Sandra H. JohnsonArticle first published online: 24 JAN 200 First page of article [source] Consent and Ethics in Postoperative Pain ManagementANAESTHESIA, Issue 12 2002Michael Harmer No abstract is available for this article. [source] Pain Management in AnimalsAUSTRALIAN VETERINARY JOURNAL, Issue 12 2000SF Forsyth No abstract is available for this article. [source] The National Trend in Quality of Emergency Department Pain Management for Long Bone FracturesACADEMIC EMERGENCY MEDICINE, Issue 2 2007PA-C, Tamara S. Ritsema MPH Background Despite national attention, there is little evidence that the quality of emergency department (ED) pain management is improving. Objectives To compare the quality of ED pain management before and after implementation of the Joint Commission on the Accreditation of Healthcare Organizations' standards in 2001. Methods The authors performed a retrospective cohort study by using the National Hospital Ambulatory Medical Care Survey from 1998,2003. Patients who presented to the ED with a long bone fracture (femur, humerus, tibia, fibula, radius, or ulna) were compared. The authors extracted data on patient, visit, and hospital characteristics. The primary outcomes were the proportion of patients who received assessment of pain severity and who received analgesic treatment. Results There were 2,064 patients with a qualifying fracture in the study period, 834 from 1998,2000 and 1,230 from 2001,2003. Compared with the early period, a higher proportion of patients in the late period had their pain assessed (74% vs. 57%), received opiates (56% vs. 50%), and received any analgesic (76% vs. 56%). Patients in the late period had higher odds of receiving any analgesia (adjusted odds ratio [OR], 1.43) and opioid analgesia (adjusted OR, 1.27) compared with the early period. Patients in the middle age group (adjusted OR, 2.28) or those seen by physician assistants (adjusted OR, 2.05) were more likely, whereas those with Medicaid (adjusted OR, 0.58) and those in the Northeast were less likely, to receive opiates. Conclusions Although the quality of ED pain management for acute fractures appears to be improving, there is still room for further improvement. [source] Patients' experiences of hip fractureJOURNAL OF ADVANCED NURSING, Issue 4 2003Graeme Archibald BA MSc RN Background., Hip fracture is a major cause of mortality and morbidity, particularly among older people, but there is little information on how individuals experience this. Aims., This study was conducted to explore the experiences of individuals who had suffered a hip fracture. The aim was not to produce generalizable findings but, rather, to generate a rich description of the experience of incurring and recovering from a hip fracture, to inform nursing practice. Method., Phenomenological methodology was used. A purposeful sample of five older patients was interviewed, following a stay in a community hospital for rehabilitation after surgical repair of a hip fracture. The unstructured interviews were tape-recorded, transcribed verbatim and analysed for significant statements and meanings. Findings., Four major themes emerged: the injury experience, the pain experience, the recovery experience and the disability experience. The injury experience consisted of storytelling, recalling the experience of the injury itself. The pain experience consisted of coping with the pain. The recovery experience involved the operation, beginning the struggle of recovery, and regaining independence. The disability experience consisted of the disability itself, depending on others, and being housebound. Conclusions., Pain management, meeting psychological and physical needs for nursing care, planning for discharge, and ensuring a reasonable quality of life are areas for nursing care development. Consideration of appropriate settings for rehabilitation is needed and there should be further investigation into improving quality of life after discharge. [source] Management of post-operative bladder spasmJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2005D Chiang Objective: Pain management following bladder surgery in children is often complicated by bladder spasm. The overall severity of spasm can be reduced with opioids, anticholinergic medication and sedatives, although breakthrough spasms often occur. At the Royal Children's Hospital, Melbourne, intravesical bupivacaine has been used to manage postoperative bladder spasm to good effect. The administration of intravesical bupivacaine is analysed in this prospective audit of locally applied intravesical anaesthetic and compared with other methods. Method: From February to August 2003, histories of 58 patients who had intravesical bupivacaine were studied and compared with six other methods of management of postoperative bladder spasm. Conclusion: Data showed that epidural anaesthesia was the most effective treatment of pain, with a pain score reduction of 6.6, compared with a reduction of 6.1 with intravesical bupivacaine, and 4.5 using intravenous morphine. However, intravesical bupivacaine was the most effective method for the relief of bladder spasm. [source] Pain management in horses and farm animalsJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 4 2005Alexander Valverde DVM, DACVA Abstract Objective: This review discusses the different analgesic drugs and routes of administration used in large animals for acute pain management. General guidelines and doses are given to assist in choosing techniques that provide effective analgesia. Etiology: Noxious stimuli are perceived, recognized, and localized by specialized sensory systems located at spinal and supraspinal levels. Diagnosis: Localizing the source of the noxious stimulus as well as understanding the behavioral aspects and physiological changes that result from such insult is important to adequately diagnose and treat pain. Pain assessment is far from being definite and objective; not only are there species differences, but also individual variation. In addition, the behavioral and physiological manifestations vary with the acute or chronic nature of pain. Therapy: Pain management should include (1) selecting drugs that better control the type of pain elicited by the insult; (2) selecting techniques of analgesic drug administration that act on pathways or anatomical locations where the nociceptive information is being processed or originating from; (3) combining analgesic drugs that act on different pain pathways; and (4) provide the best possible comfort for the animal. Prognosis: Providing pain relief improves the animal's well being and outcome; however, interpreting and diagnosing pain remains difficult. Continuing research in pain management will contribute to the evaluation of the pathophysiology of pain, pain assessment, and newer analgesic drugs and techniques. [source] Ethical Issues for Psychologists in Pain ManagementPAIN MEDICINE, Issue 2 2001Mary Lou Taylor PhD Pain management is relatively young as a specialty. Although increasing attention is being paid to issues such as pain at the end of life and pain in underserved populations, only recently has an open discussion of ethical issues in chronic pain treatment come to the fore. Psychologists specializing in pain management are faced with a myriad of ethical issues. Although many of these problems are similar to those faced by general clinical psychologists or other health psychologists, they are often made more complex by the multidisciplinary nature of pain management and by the psychologists' relationships to third-party payers (health maintenance organizations, workers' compensation), attorneys, or other agencies. An open forum exploring ethical issues is needed. This article outlines major ethical considerations faced by pain management psychologists, including patient autonomy and informed consent, confidentiality, reimbursement and dual relationships, patient abandonment, assessment for medical procedures, clinical research, and the interface of psychology and medicine. American Psychological Association ethical principles and principles of biomedical ethics need to be considered in ethical decision making. Further exploration and discussion of ethics for pain management psychologists are recommended. [source] Pain management in children with and without cognitive impairment following spine fusion surgeryPEDIATRIC ANESTHESIA, Issue 4 2001Shobha Malviya MD Background:,We compared pain assessment and management practices in children with and without cognitive impairment (CI) undergoing spine fusion surgery. Methods:,The medical records of 42 children (19 with CI and 23 without) were reviewed and data related to demographics, surgery, pain assessment and management, and side-effects were recorded. Results:,Fewer children with CI were assessed for pain on postoperative days (POD) 0,4 compared to those without CI (P < 0.002). Self-report was used for 81% of pain assessments in children without CI, while a behavioural tool was used for 75% of assessments in cognitively impaired children. Children with CI received smaller total opioid doses on POD 1,3 compared to those without CI (P , 0.02). Furthermore, children without CI received patient/nurse-controlled analgesia for more postoperative days than children with CI (P=0.02). Conclusions:,Our data demonstrate a discrepancy in pain management practices in children with and without CI following spine fusion. [source] Outcomes After Intravenous Opioids in Emergency Patients: A Prospective Cohort AnalysisACADEMIC EMERGENCY MEDICINE, Issue 6 2009Alec B. O'Connor MD Abstract Objectives:, Pain management continues to be suboptimal in emergency departments (EDs). Several studies have documented failures in the processes of care, such as whether opioid analgesics were given. The objectives of this study were to measure the outcomes following administration of intravenous (IV) opioids and to identify clinical factors that may predict poor analgesic outcomes in these patients. Methods:, In this prospective cohort study, emergency patients were enrolled if they were prescribed IV morphine or hydromorphone (the most commonly used IV opioids in the study hospital) as their initial analgesic. Patients were surveyed at the time of opioid administration and 1 to 2 hours after the initial opioid dosage. They scored their pain using a verbal 0,10 pain scale. The following binary analgesic variables were primarily used to identify patients with poor analgesic outcomes: 1) a pain score reduction of less than 50%, 2) a postanalgesic pain score of 7 or greater (using the 0,10 numeric rating scale), and 3) the development of opioid-related side effects. Logistic regression analyses were used to study the effects of demographic, clinical, and treatment covariates on the outcome variables. Results:, A total of 2,414 were approached for enrollment, of whom 1,312 were ineligible (658 were identified more than 2 hours after IV opioid was administered and 341 received another analgesic before or with the IV opioid) and 369 declined to consent. A total of 691 patients with a median baseline pain score of 9 were included in the final analyses. Following treatment, 57% of the cohort failed to achieve a 50% pain score reduction, 36% had a pain score of 7 or greater, 48% wanted additional analgesics, and 23% developed opioid-related side effects. In the logistic regression analyses, the factors associated with poor analgesia (both <50% pain score reduction and postanalgesic pain score of ,7) were the use of long-acting opioids at home, administration of additional analgesics, provider concern for drug-seeking behavior, and older age. An initial pain score of 10 was also strongly associated with a postanalgesic pain score of ,7. African American patients who were not taking opioids at home were less likely to achieve a 50% pain score reduction than other patients, despite receiving similar initial and total equianalgesic dosages. None of the variables we assessed were significantly associated with the development of opioid-related side effects. Conclusions:, Poor analgesic outcomes were common in this cohort of ED patients prescribed IV opioids. Patients taking long-acting opioids, those thought to be drug-seeking, older patients, those with an initial pain score of 10, and possibly African American patients are at especially high risk of poor analgesia following IV opioid administration. [source] Pain management during eye examinations for retinopathy of prematurity: what about procedural adaptations to blunt the pain response?ACTA PAEDIATRICA, Issue 4 2010K Allegaert No abstract is available for this article. [source] | |||||||||||||||||||||||||||||||||||||