Der Schmerz
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Postherpetic neuralgia is considered to be a neuropathic pain syndrome. Typically, patients experience pain in the dermatomes of skin lesions persisting for more than 3 months after skin restitution. About 10% of patients with herpes zoster develop postherpetic neuralgia. ⋯ Clinical studies did show pain relief in postherpetic neuralgia after administration of antidepressants, antiepileptic drugs, opioids, and topical capsaicin and lidocaine. Nevertheless, about one third of patients do not respond to conventional treatment. Given the fact that postherpetic neuralgia is considered to be a chronic pain disease, a multidisciplinary treatment approach is necessary.
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Comparative Study Pragmatic Clinical Trial
[Influence of intraoperative noise protection on postoperative pain : Demonstrated exemplified by total knee arthroplasty.]
It is known that implied memory of intraoperative noise influences postoperative pain. The aim of this study was to evaluate the influence of different intraoperative noise protection methods during total knee arthroplasty on postoperative pain scores. ⋯ Even though there were no significant effects of music or noise protection on postoperative pain scores, it can be concluded, as has been done by many other authors that music should be used in the perioperative setting for general patient comfort.
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Practice Guideline
[Austrian interdisciplinary recommendations on pediatric perioperative pain management : Background, aims, methods and key messages].
These recommendations were originally commissioned by the"Österreichische Gesellschaft für Anästhesiologie, Reanimation und Intensivmedizin" (ÖGARI, Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine). Against this background, Austrian experts from the disciplines anesthesiology, pain management, pediatrics and the "Berufsverband Kinderkrankenpflege" (Professional Association of Pediatric Nursing) have with legal support developed evidence-based and consensus recommendations for the clinical practice. ⋯ The complete recommendations on pediatric perioperative pain management consist of seven separate articles which each deal with special sub-topics with comments on and explanations of the key messages. The target groups of the recommendations are all medical personnel of the individual disciplines involved in the treatment of perioperative and posttraumatic pain for neonates, infants and children up to 18 years old.
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Non-pharmaceutical procedures are increasingly being used in pediatric pain therapy in addition to pharmaceutical procedures and have a supporting function. This article describes the non-pharmaceutical procedures which have an influence on perioperative and posttraumatic pain in children and adolescents. Prerequisites for every adequate pain therapy are affection, imparting a feeling of security, distraction and the creation of a child-oriented environment. ⋯ Psychological methods can facilitate coping with pain. In situations with mental and psychiatric comorbidities or psychosocial impairment, a psychologist should be consulted. Acupuncture and hypnosis are also a meaningful addition within the framework of multimodal pain therapy.
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Pharmaceuticals are not always licensed for all medically indicated areas and types of application. The off label use of pharmaceuticals is particularly common in pediatrics. The obligatory licensing of pharmaceuticals according to § 7 AMG (drug registration and administration act) only applies to the dispensing and provision but not for the use in patients, particularly in a perioperative setting. ⋯ Pharmaceuticals can only be used after obtaining appropriate informed consent. The off label use of medications is allowed and sometimes necessary under these prerequisites as long as the administration of the medication is medically indicated and shows promise of success. Furthermore, an application can be permissible for"curative intent".