Pain medicine : the official journal of the American Academy of Pain Medicine
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In recent years, there has been increased attention to pain management after surgery in the hospital setting along with financial enticement from the US government. The aim of this study is to evaluate the current efficacy of postoperative pain management. ⋯ The incidence of severe-to-extreme pain in patients before and after discharge following inpatient surgery is 12-13%, and this is a reduction from 10 years ago.
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Randomized Controlled Trial
Comparative Analgesic Efficacy of Oxycodone/Acetaminophen vs Codeine/Acetaminophen for Short-Term Pain Management Following ED Discharge.
To test the hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen following emergency department (ED) discharge. ⋯ Our hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen was rejected. Although pain within each group was reduced by more than half, the between-group difference was not significant. Pending independent validation, these unexpected findings suggest that codeine/acetaminophen, a Schedule III agent, may be a clinically reasonable outpatient opioid alternative to oxycodone/acetaminophen, a more tightly restricted Schedule II agent thought to be more prone to misuse.
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Review
An Expedited Diagnostic Algorithm for Lumbosacral Pain: "The Best Likelihood Scenario Approach".
The logic behind diagnostic blocks is very straightforward. What has not been determined is the way diagnostic blocks can be best used. ⋯ "The Best Likelihood Scenario" might improve diagnostic accuracy while decreasing societal costs.
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Review Meta Analysis
Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials.
There has been no attempt to date to synthesize the available evidence for the efficacy of ginger for treating primary dysmenorrhea. This systematic review evaluates the current evidence for the effectiveness of ginger for treating primary dysmenorrhea. ⋯ Collectively these RCTs provide suggestive evidence for the effectiveness of 750-2000 mg ginger powder during the first 3-4 days of menstrual cycle for primary dysmenorrhea.
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Controlled Clinical Trial
Pain Duration and Resolution following Surgery: An Inception Cohort Study.
Preoperative determinants of pain duration following surgery are poorly understood. We identified preoperative predictors of prolonged pain after surgery in a mixed surgical cohort. ⋯ Greater preoperative self-perceived risk of addiction, and lower anxiety sensitivity predicted a slower rate of pain resolution following surgery. Each of these factors was a better predictor of pain duration than preoperative depressive symptoms, post-traumatic stress disorder symptoms, past substance use, fear of pain, gender, age, preoperative pain, or preoperative opioid use.