Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Case Reports
Regional anesthesia does not consistently block ischemic pain: two further cases and a review of the literature.
Ischemic pain is complex and poorly understood. There is controversy regarding whether or not regional anesthetic techniques block ischemic pain. We present two further cases where regional anesthesia did not block ischemic pain despite adequate motor and sensory block. ⋯ The two cases support the growing body of evidence that ischemic pain is largely unaffected by regional anesthesia, even with adequate sensory and motor block. The prevailing understanding regarding peripheral nerve blocks in patients in danger of developing compartment syndrome should be reconsidered.
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We sought to identify primary care providers' interest in, as well as perceived barriers and facilitators to, using novel telemedicine technologies (e.g., smartphones) for managing chronic non-cancer pain (CNCP) in older adults. ⋯ Primary care providers are interested in applying telemedicine when caring for older adults with CNCP. Although they perceived multiple barriers to device implementation, they offered innovative solutions to address these barriers. Providers felt that novel telemedicine technologies may improve the management of CNCP but wanted evidence that the devices were both cost- and time-efficient, and led to improved patient outcomes before adopting their use in practice.
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The concept of neuromodulation via the use of spinal cord stimulators (SCS) was first established over forty years ago. Since then, its popularity has grown as numerous studies have demonstrated its utility to reduce chronic pain, improve patient function, and reduce long-term health care costs. The aim of this study was to update the pain medicine community on the evolution of SCS practice trends in academic centers. ⋯ Standardized SCS training is imperative as the implementation of neuromodulation therapy continues to increase.
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No standard definition exists for the concept "persistent pain self-management" or how it should be defined in relation to older adults. Poorly defined concepts can result in misunderstandings in the clinical setting and can hinder research through difficulties identifying or measuring the concept. ⋯ Our findings have clarified existing use and understanding regarding the concept of older adults' persistent pain self-management. We have identified three areas for future development: refinement of the attributes of this concept within the context of older adults, an exploration of how providers can overcome difficulties supporting older adults' persistent pain self-management, and a clarification of the overall theoretical framework of older adults' persistent pain self-management.