Articles: pain-management-methods.
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Randomized Controlled Trial
Fascia iliaca block in the emergency department for hip fracture: a randomized, controlled, double-blind trial.
Hip fracture causes moderate to severe pain and while fascia iliaca block has been reported to provide analgesic benefit, most previous trials were unblinded, with subsequent high risks of performance, selection and detection biases. In this randomized, control double-blind trial, we tested the hypothesis that a fascia iliaca block provides effective analgesia for patients suffering from hip fracture. ⋯ Fascia iliaca block following anatomic landmarks may not provide supplementary analgesia for patients suffering from hip fracture, when low pain scores are reported after prehospital morphine. Additional larger trials will help reach definitive conclusion.
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Between 2009 and 2011 a series of 26 articles on evidence-based medicine for interventional pain medicine according to clinical diagnoses were published. The high number of publications since the last literature search justified an update. ⋯ This article summarizes the evolution of the quality of evidence and the strength of recommendations for the interventional pain treatment options for 28 clinical pain diagnoses.
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Aim: To explore the overall effectiveness of interdisciplinary intensive outpatient treatment programs in adults with chronic pain. The secondary aim was to examine the effect of the intervention on individual outcome measures including pain intensity, pain catastrophizing, depressive symptoms, quality of life and describe its effect on medication use. ⋯ Results: A total of 13 peer-reviewed studies were included in analysis: one randomized controlled trial and 12 observational studies. Conclusion: Although interdisciplinary intensive outpatient programs for chronic pain have only been examined in a limited number of studies, trends suggest that participation in these programs may improve physical, emotional, social and mental health as measured by quality of life measures, while decreasing pain intensity, pain catastrophizing and depressive symptoms in a population with diverse diagnoses.
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Minerva anestesiologica · Jul 2019
ReviewAcute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations.
Pain is the most common complaint amongst trauma patients throughout the perioperative period. Multimodal analgesia is currently being regarded the mainstay, with regional anesthesia techniques constituting an integral part of it. ⋯ In this review, we set out to provide several examples of injuries, to elucidate the precise anatomy of fractured bones (osteotomes), and to elaborate on certain peripheral nerve blocks employed in pain management of trauma patients. Controversies/special considerations pertaining to peripheral nerve blocks also dictate thorough analysis: as such, acute compartment syndrome, acute peripheral nerve injuries, regional anesthesia in awake or anesthetized patients, continuous peripheral nerve blocks, positioning limitations and, finally, ultrasound imaging versus neurostimulation techniques are extensively reviewed.
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The Journal of pediatrics · Jul 2019
Low Usage of Analgesics for Pediatric Concussion-Related Pain in US Emergency Departments Between 2007 and 2015.
To estimate the proportion of pediatric patients with a concussion who received analgesia when presenting with pain to US emergency departments, and to describe the analgesics used. ⋯ Analgesic medications seem to be underused in the treatment of pediatric concussion-related pain. Following acetaminophen and nonsteroidal anti-inflammatories, opioids, which are not recommended for this condition, were the most frequently prescribed analgesics. Further research should establish optimal, consistent, and responsible pain management strategies for pediatric concussions.