Articles: pain-management-methods.
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A short cut review was carried out to establish whether intra-articular injection of local anaesthetic is an effective alternative to intravenous analgesia with or without sedation to facilitate reduction of acute shoulder dislocations. Eleven studies were considered relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these studies are tabulated. The clinical bottom line is that intra-articular injection of local anaesthetic is a safe and effective method of providing procedural analgesia for the reduction of acute shoulder dislocations.
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Clin. Orthop. Relat. Res. · Nov 2020
Randomized Controlled TrialDoes Surgical-site Multimodal Drug Injection After Palmar Plating of Distal Radius Fractures Improve Pain Scores?
Although palmar locked plating is a stable fixation method frequently used to treat unstable distal radius fractures (DRFs), surgical treatment may be painful, and so interventions to decrease that pain might improve our patients' experiences with surgery. Some surgeons use local multimodal drug injections to decrease postoperative pain after lower-extremity arthroplasty, but little is known about the effectiveness of a local multimodal drug injection in patients who undergo palmar plating for DRFs. ⋯ Level I, therapeutic study.
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Chronic pain syndromes are poorly understood and challenging to treat. However, intrathecal drug delivery systems (IDDS) have been shown to have good efficacy in treating various pain subtypes and patient populations. The success of IDDS interventions is largely dependent on consideration of and adherence to varying practice patterns. ⋯ Incorporation of the principles found in this evidence-based narrative, which is comprised of the highest level of evidence supportive of various facets of IDDS practice management, is essential to optimize outcomes, treatment efficacy, and safety profiles.
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Postgraduate medicine · Nov 2020
Editorial ReviewInterventional pain management in patients with cancer-related pain.
Invasive interventional procedures for managing pain in cancer patients are often underutilized following the popularization of the WHO analgesic ladder. The procedures that were successfully used until then were relegated away from mainstream palliative care practice, with the advent of newer opioids and adjuvants. Even though nerve blocks, intrathecal pumps and spinal cord stimulation were reintroduced as the fourth step of the WHO ladder, often referrals for these procedures are too late to produce a meaningful effect on quality of life. ⋯ ITDDs, neuromodulation and ever-increasing use of procedures routinely used in treating chronic nonmalignant pain would be the mainstay of interventional management until AI and nanotechnology would open doors for novel treatment options. Interventions should not be used as a last resort after multiple failed attempts at opioid therapy, but as an integral part of a management strategy including medical management, psychological and emotional welfare, and supportive care of the patient in a holistic manner. The curriculum of specialists should include appropriate training to safely perform and produce better quality evidence to validate the efficacy and safety of these challenging procedures.
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Review
BET 2: Is virtual reality effective in reducing adult pain perception during medical procedures?
A short-cut review of the available medical literature was carried out to establish whether virtual reality was an effective method for pain control during medical procedures. After abstract review, fifteen papers were found to answer this clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that there is insufficient high-quality research to answer this question.