Articles: pain-management-methods.
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Review Meta Analysis
A systematic review and meta-analysis of caudal blockade versus alternative analgesic strategies for pediatric inguinal hernia repair.
The optimal analgesic strategy for pediatric inguinal hernia repair (IHR) remains undefined. We evaluated the available evidence comparing caudal blockade to alternative analgesic strategies in achieving post-operative analgesia. ⋯ There is no demonstrable difference in post-operative pain scores or rescue analgesia when comparing caudal blockade with alternative pain management strategies after pediatric IHR. This equipoise suggests that caudal blockade may be obviated for lower risk and less time-consuming maneuvers in patients barring supplementary indications for pain control.
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Am J Health Syst Pharm · May 2013
ReviewRole of dexmedetomidine in adults in the intensive care unit: an update.
The role of dexmedetomidine for the management of pain, agitation, and delirium in adult patients in the intensive care unit (ICU) is reviewed and updated. ⋯ In medical-surgical ICUs, dexmedetomidine may be a viable non-benzodiazepine option for patients with a need for light sedation. In cardiac surgery patients, dexmedetomidine appears to offer no advantage over propofol as the initial sedative. The role of dexmedetomidine in unique patient populations such as neurosurgical, trauma, and obstetrics is yet to be established.
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To discuss challenges in the pharmacologic management of osteoarthritis (OA) pain. ⋯ The safety and efficacy concerns associated with currently available OA treatment options establish a need to develop new treatment strategies. Disease-modifying agents and novel drug formulations are currently under investigation. As these new pharmacologic options evolve, their adoption may lower risk and improve clinical outcomes.
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Expert Opin Pharmacother · May 2013
ReviewMilnacipran for fibromyalgia: a useful addition to the treatment armamentarium.
Antidepressants are used to treat a variety of chronic pain conditions including peripheral neuropathy, headache, and more recently, fibromyalgia. The antidepressant milnacipran blocks the reuptake of norepinephrine and serotonin and is used for the management of fibromyalgia. ⋯ Milnacipran provides modest fibromyalgia pain relief and is best used as part of a multidisciplinary treatment approach. While milnacipran was not studied in fibromyalgia patients with major depression, it may be a wise choice for fibromyalgia patients with depressive symptoms and patients for whom sedation, dizziness, edema or weight gain with gabapentin and pregabalin is a problem. Milnacipran has been found to be beneficial for treating some troublesome fibromyalgia-associated symptoms, including fatigue and cognitive dysfunction.
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Expert Rev Neurother · May 2013
ReviewNovel findings in pain processing pathways: implications for miRNAs as future therapeutic targets.
miRNAs are small noncoding RNAs that are important players in development, as well as in a number of physiological and pathophysiological processes. Due to their regulatory role in protein expression, it has been assumed that they are associated with peripheral and central sensitization mechanisms in the nervous system after nociceptive insults. ⋯ First reports mostly focused on miRNA regulations in different pain states while studies examining the functional role of individual miRNAs are only now arising. In this review, the authors summarize the current knowledge and progress in miRNA research in pain and discuss their potential role as therapeutic antinociceptive targets.