Articles: pain-management-methods.
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Review
The efficacy and safety of antidepressants in inflammatory arthritis: a Cochrane systematic review.
To determine the efficacy and safety of antidepressants in pain management in patients with inflammatory arthritis (IA). ⋯ Based upon 9 trials of high or unclear risk of bias, it is not possible to draw firm conclusions about the efficacy of TCA as analgesics for patients with IA. The use of these agents may be associated with adverse events that are generally mild and do not lead to cessation of treatment. High-quality trials are needed in this area.
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To systematically review the efficacy and safety of on-demand versus continuous use of nonsteroidal antiinflammatory drugs (NSAID) in patients with inflammatory arthritis and to assess if longterm continuous treatment with NSAID in comparison with NSAID treatment on-demand reduces radiographic progression. ⋯ Based on a single study, there does not seem to be a statistical difference in efficacy between the on-demand versus continuous use of NSAID in the context of ankylosing spondylitis. There were no studies in patients with rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis. Research is needed to study the risk-benefit ratio of continuous versus on-demand use of NSAID.
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Pain represents the most frequent symptom faced by general practitioners and is associated with 60% of neurological troubles. Pain consists in a conscious, subjective, unpleasant and protective sensory experience transmitted by thermoalgic pathways in the central nervous system (nociceptive pain). Lesioning of peripheral or central sensory pathways can also generate pain associated with hypoesthesia (phantom or neuropathic pain). ⋯ However, the technique, when not sufficiently selective, can generate a neuropathic pain and then a short-lating pain relief. Increasing knowledge on pathophysiological mechanisms of pain allowed surgery to interfere with the functioning of the sensory circuits without lesioning and to modulate neuronal activity in order to reduce pain (neuromodulation). Non-lesioning modulating techniques (then reversible) appeared (deep brain stimulation, epidural spinal cord or motor cortex stimulation, intrathecal infusion, radiosurgery) and are currently applied to efficiently alleviate neuropathic pain.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2012
Review[Systemic and regional analgesia in patients undergoing major thoracic surgery].
Effective, aggressive treatment of pain accompanied with thoracic surgery is important and beneficial for patients, since severe postoperative pulmonary complications and long-term pain will be reduced. In this systematic issue evidence-based strategies in preventing and treating pain after thoracic surgery will be reviewed.