Articles: pain-management-methods.
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J Trauma Acute Care Surg · Nov 2019
Randomized Controlled TrialKetamine infusion for pain control in elderly patients with multiple rib fractures: Results of a randomized controlled trial.
Rib fractures are associated with increased mortality, particularly in the elderly. While opiate-based pain regimens remain the cornerstone of rib fracture management, issues related to opioids have driven research into alternative analgesics. Adjunctive ketamine use in lieu of opioids continues to increase but little evidence exists to support its efficacy or safety within the elderly trauma population. ⋯ Therapeutic, level I.
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The aim of this study was to determine if any of the factors recorded on a standard clinical history of a patient considered for spinal cord stimulation (SCS) would be associated with reduction or cessation of opioids following implantation. ⋯ The elimination of opioid dependence following initiation of SCS therapy is highly dependent on the daily dose.
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Opioid prescriptions and subsequent opioid-related deaths have increased substantially in the past several decades. Orthopedic surgery ranks among the highest of all specialties with respect to the amount of opioids prescribed. We present here the outcomes of our opioid-sparing pain management pilot protocol for total hip arthroplasty (THA). ⋯ The results of this study suggest that an opioid-sparing protocol reduces opioid consumption and provides equivalent pain management and patient-reported outcomes during the 90-day THA episode of care relative to a traditional opioid-based regimen. These findings may help decrease the risk of adverse events associated with postoperative opioid use and provide a means of decreasing the opioid footprint in clinical practice.
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Randomized Controlled Trial
Pain Management with ROP Position in Turkish Preterm Infants During Eye Examinations: A Randomized Controlled Trial.
The purpose of this study was to evaluate the effects of infant positioning on pain, heart rate, oxygen saturation and crying time during examination. ⋯ ROP position is a practical and effective non-pharmacological method during eye examinations by neonatal nurses.
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J Pain Symptom Manage · Nov 2019
Barriers to accessing internationally controlled essential medicines in Uganda: A qualitative study.
Access to internationally controlled essential medicines is a problem worldwide. More than five billion people cannot access opioids for pain and palliative care or do not have access to surgical care or anesthetics, 25 million people living with epilepsy do not have access to their medicines, and 120,000 women die annually owing to postpartum hemorrhage. In Uganda, access to controlled medicines is also problematic, but a lack of data on factors that influence access exists. ⋯ The findings of this research indicate that to improve access to internationally controlled essential medicines in Uganda, health system strengthening is needed on multiple fronts. Active engagement and concerted efforts are needed from all stakeholders to ensure access and prevent abuse.