Articles: pain-management-methods.
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Randomized Controlled Trial Comparative Study
A comparison of the analgesic efficacy of local infiltration analgesia vs. intrathecal morphine after total knee replacement: A randomised controlled trial.
Local infiltration analgesia (LIA) is an effective pain management technique following total knee arthroplasty (TKA). ⋯ We conclude that LIA conferred superior analgesia compared with intrathecal morphine 0.3 mg at 24 and 48 h following TKA.
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Providers who treat patients with chronic pain face a dual challenge: providing adequate access to opioid therapies for appropriate pain management while adopting strategies to minimize the risk for abuse. Commonly prescribed opioids have substantial abuse potential when administered intravenously, and extended-release (ER)/long-acting (LA) opioids may be targeted for IV abuse because of the higher per-dose medication level. The consequences of IV opioid abuse are severe and increase the risks for adverse outcomes, including mortality due to acute health events, serious infections, and deep vein thrombosis, to name a few. ⋯ Findings from in vitro laboratory tests of abuse deterrence for opioid ADFs are described herein, as are data from human abuse potential studies for IV abuse of those ADF products, for which such studies are feasible (ie, abuse-deterrent agonist-antagonist formulations). The available ADF opioids may decrease both the attractiveness and the feasibility of IV abuse. The adoption of ADF opioids represents one tactic for providing access to needed medication for patients with chronic pain, while potentially reducing the risk for opioid abuse, in a comprehensive effort to combat the opioid epidemic.
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Randomized Controlled Trial
Intravenous Lidocaine Provides Similar Analgesia to Intravenous Morphine for Undifferentiated Severe Pain in the Emergency Department: A Pilot, Unblinded Randomized Controlled Trial.
We compared the analgesic effects of intravenous (IV) lidocaine and IV morphine for the treatment of severe pain in the emergency department (ED). ⋯ We found similar pain relief and satisfaction in both study arms. Lidocaine arm participants had fewer side effects and required less morphine. Lidocaine is a potential opioid-sparing analgesic that deserves further study for severe pain in ED patients.
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Comparative Study
Patient-controlled oral analgesia at acute abdominal pain: A before-and-after intervention study of pain management during hospital stay.
To investigate the patient experience of pain management, when patient-controlled oral analgesia was compared with standard care for patients admitted to hospital with acute abdominal pain. The primary outcome measures were pain intensity and patient perception of care. ⋯ Patient-controlled oral analgesia did not improve patient experience of pain management for patients admitted to hospital with acute abdominal pain.
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Observational Study
A Practical Analgesia Approach to Fragility Hip Fracture: A Single-Center, Retrospective, Cohort Study on Femoral Nerve Block.
To determine whether an effective opioid-sparing pain control modality is desirable for an aging population. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.