Articles: pain-management-methods.
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Randomized Controlled Trial Comparative Study
[Postoperative pain management in video-assisted thoracic surgery using a continuous unilateral intercostal analgesia].
Optimal pain management after video-assisted thoracic surgery (VATS) remains an open issue. We prospectively studied the analgesic effect of intercostal analgegia (ICA) by comparison with epidural analgesia. ⋯ In patients with coagulopathy, multimodal approach using intercostal analgesia supplemented by intravenous patient-controlled analgesia may be an alternative to epidural analgesia for postoperative pain management.
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Randomized Controlled Trial Comparative Study
Lumbar interlaminar epidural injections are superior to caudal epidural injections in managing lumbar central spinal stenosis.
Epidural injections are performed to manage lumbar central spinal stenosis pain utilizing caudal, interlaminar, and transforaminal approaches. The literature on the efficacy of epidural injections in managing lumbar central spinal stenosis pain is sparse; lacking multiple, high quality randomized trials with long-term follow-up. ⋯ The results of this assessment showed significant improvement in patients suffering with chronic lumbar spinal stenosis with caudal and interlaminar epidural approaches with local anesthetic only, or with steroids in a long-term follow-up of up to 2 years, in contemporary interventional pain management setting, with the interlaminar approach providing significantly better results.
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Randomized Controlled Trial Multicenter Study
Impact of a stepwise protocol for treating pain on pain intensity in nursing home patients with dementia: A cluster randomized trial.
Pain is frequent and distressing in people with dementia, but no randomized controlled trials have evaluated the effect of analgesic treatment on pain intensity as a key outcome. ⋯ Pain medication significantly improved pain in the intervention group, with indications that acetaminophen also improved ADL function.
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Randomized Controlled Trial
Teaching Parents to Manage Pain During Infant Immunizations: Laying the Foundation for Better Pain Management Practices.
To evaluate knowledge uptake from a parent-directed factsheet about managing pain during infant vaccinations, and the added influence of a pretest. ⋯ The factsheet led to acute gains in knowledge and knowledge gains persisted after 2 months. Acutely, knowledge was bolstered by the pretest. These results can be used to guide future research and implementation of the factsheet.
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Randomized Controlled Trial
Low-dose Ketamine Improves Pain Relief in Patients Receiving Intravenous Opioids for Acute Pain in the Emergency Department: Results of a Randomized, Double-blind, Clinical Trial.
Low-dose ketamine has been used perioperatively for pain control and may be a useful adjunct to intravenous (IV) opioids in the control of acute pain in the emergency department (ED). The aim of this study was to determine the effectiveness of low-dose ketamine as an adjunct to morphine versus standard care with morphine alone for the treatment of acute moderate to severe pain among ED patients. ⋯ Low-dose ketamine is a viable analgesic adjunct to morphine for the treatment of moderate to severe acute pain. Dosing of 0.3 mg/kg is possibly more effective than 0.15 mg/kg, but may be associated with minor adverse events. Future studies should evaluate additional outcomes, optimum dosing, and use in specific populations.