Articles: pain-management-methods.
-
To review current opioid guidelines, public policy, and legal challenges that can threaten optimal management of cancer pain. ⋯ To provide excellent care, nurses must understand current policies affecting delivery of pain care to oncology patients and serve as patient advocates in the evolving policy debates.
-
Observational Study
Sublingual sufentanil tablet system for postoperative analgesia after gynecological surgery.
Gynecological procedures are among the most frequent surgical interventions, and effective postoperative analgesia is associated with improved patient comfort. Despite the efficacy of neuraxial analgesia, limitations and potential complications have led to seek new strategies for pain relief. A novel, pre-programmed, non-invasive, hand-held system (Sufentanil Sublingual Tablet System [SSTS]) displayed good results in the orthopedic setting. However, it has never been applied in gynecological procedures. ⋯ SSTS may be an interesting option for postoperative analgesia in gynecologic procedures. The efficacy in the management of dynamic pain is an interesting outcome that needs to be compared with the other standards of pain management, such as neuraxial techniques. Rigorous studies are required to give conclusive evidence, but this is the first report, to our knowledge, of SSTS use in open gynecologic procedures. Our preliminary experience encourages the routine application of SSTS in gynecologic surgery and will help designing future randomized controlled trials on the topic.
-
Neuroscience bulletin · Jun 2019
ReviewSpinal Cord Stimulation for Pain Treatment After Spinal Cord Injury.
In addition to restoration of bladder, bowel, and motor functions, alleviating the accompanying debilitating pain is equally important for improving the quality of life of patients with spinal cord injury (SCI). Currently, however, the treatment of chronic pain after SCI remains a largely unmet need. Electrical spinal cord stimulation (SCS) has been used to manage a variety of chronic pain conditions that are refractory to pharmacotherapy. ⋯ We begin with an overview of its manifestations, classification, potential underlying etiology, and current challenges for its treatment. The clinical evidence for using SCS in SCI pain is then reviewed. Finally, future perspectives of pre-clinical research and clinical study of SCS for SCI pain treatment are discussed.
-
Clinical Trial
Decreasing Pain Ratings in Chronic Arm Pain Through Changing a Virtual Body: Different Strategies for Different Pain Types.
Modifying the visual aspect of a virtual arm that is felt as one's own using immersive virtual reality (VR) modifies pain threshold in healthy subjects, but does it modify pain ratings in chronic pain patients? Our aim was to investigate whether varying properties of a virtual arm co-located with the real arm modulated pain ratings in patients with chronic arm/hand pain because of complex regional pain syndrome (CRPS) type I (without nerve injury) or peripheral nerve injury (PNI). CRPS (n = 9) and PNI (n = 10) patients were immersed in VR and the virtual arm was shown at 4 transparency levels (transparency test) and 3 sizes (size test). We evaluated pain ratings throughout the conditions and assessed the virtual experience, finding that patients with chronic pain can achieve levels of ownership and agency over a virtual arm similar to healthy participants. ⋯ We discuss this through the interactions between body image and pain perception. PERSPECTIVE: "Embodiment" in VR is useful to decrease pain ratings in chronic pain patients, but the best strategy needs to be tuned to the pain etiology. This approach could potentially help patients with chronic pain and clinicians who seek alternatives to pain management for patients.
-
To evaluate the current evidence regarding the effectiveness of non-opioid interventions for the therapeutic management of pain in head and neck cancer patients with oral mucositis resulting from radiotherapy only or chemoradiotherapy. ⋯ Non-opioid interventions, including topical doxepin, amitriptyline, diclofenac and benzydamine, were found to provide relief of pain due to mucositis, and when effective may allow for reduction in the use of opioids in pain management.