Articles: pain-management-methods.
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Review Meta Analysis
Opioid Analgesia for Acute Abdominal Pain in Children: A Systematic Review and Meta-analysis.
There are long-held concerns that analgesia in patients with acute abdominal pain may obscure the physical examination and lead to missing a diagnosis of appendicitis. Despite evidence to the contrary, analgesia continues to be underutilized and suboptimally dosed in children with acute abdominal pain. The objective of this systematic review and meta-analysis was to determine if opioids provide analgesia without an increase in side effects and appendicitis-related complications. ⋯ The use of opioids in undifferentiated acute abdominal pain in children is associated with no difference in pain scores and an increased risk of mild side effects. However, there is no increased risk of perforation or abscess. The overall quality of evidence is low, suggesting the need for larger, high-quality trials that are powered to detect both serious complications of appendicitis and determine the most efficacious opioid dosing for children.
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Cochrane Db Syst Rev · Oct 2014
Review Meta AnalysisEarly versus late initiation of epidural analgesia for labour.
High level evidence does not show any clinically meaningful difference for early vs late labour epidural analgesia, whether on maternal or neonatal outcomes.
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Reg Anesth Pain Med · Sep 2014
Review Meta AnalysisUltrasound-Guided Interventional Procedures in Pain Medicine: A Review of Anatomy, Sonoanatomy, and Procedures. Part V: Knee Joint.
Ultrasound-guided injection in pain medicine is emerging as a popular technique for pain intervention. It can be applied to the intra-articular injection of the knee joint. The first objective of this review was to describe and summarize the anatomy and sonoanatomy of the knee and associated structures relevant for intra-articular injection. The second objective was to examine the feasibility, accuracy, and effectiveness of injections as well as injection techniques.
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Review Meta Analysis
Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents.
To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy. ⋯ Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved.