Articles: pain-management-methods.
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Review Meta Analysis Comparative Study
Intranasal ketamine for acute pain management in children: A systematic review and meta-analysis.
To assess the efficacy and safety of intranasal analgesic-dose ketamine as compared to intranasal fentanyl for pediatric acute pain. ⋯ Intranasal analgesic-dose ketamine may be considered as an alternative to opioids for acute pain management in children. Its accepted use will depend on the tolerability of non-serious adverse events and the desire to avoid opioids.
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J Pain Palliat Care Pharmacother · Sep 2020
The Clinical Pharmacist's Role in Perioperative Surgical Pain Management.
The purpose of this quality improvement initiative was to demonstrate the value of having a clinical pain pharmacist in transitional perioperative pain management. Patients were referred to the pain pharmacist prior to elective surgery. The pharmacist worked with the patients to develop an individualized perioperative analgesic plan and provided education regarding surgery. ⋯ Greater than 90% of patients reported they were "very appreciative" of the pharmacist talking to them about a pain management plan both before surgery and after discharge. One hundred percent of referring providers who responded to the survey reported they were satisfied with the pharmacist role in perioperative pain management. Pain management pharmacy specialists contribute to positive pain management outcomes for patients and surgical provider satisfaction.
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J Pain Palliat Care Pharmacother · Sep 2020
Improving Pain Management with Pharmacogenomics: A General Introduction.
Tailoring an individual patient's pain treatment is paramount to decreasing patient suffering and diminishing morbidity. Performing pharmacogenomic (PGx) testing can help guide prescribing decisions for current and future medication therapy by assisting dosage adjustments to increase therapeutic efficacy, decrease adverse drug reactions and avoid potentially ineffective medications. Pharmacogenomics is the study of inherited genetic information that influences drug response. ⋯ Genes of interest associated with pain medications include cytochrome P450 (CYP) enzymes, OPRM1, COMT, ABCB1, UGT, COX, OPRK1, OPRD1. To properly use PGx results in clinical application requires the healthcare provider to distinguish the difference between types of PGx tests, interpret test results, be familiar with PGx databases to use for prescribing guidance, and evaluate the level of evidence for specific gene-drug associations. This article introduces these concepts to assist the healthcare provider with incorporating PGx into practice to improve pain management.
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Meta Analysis Comparative Study
Comparison of Spinal Cord Stimulation Waveforms for Treating Chronic Low Back Pain: Systematic Review and Meta-Analysis.
The treatment of chronic refractory low back pain (LBP) is challenging. Conservative and pharmacologic options have demonstrated limited efficacy. Spinal cord stimulation (SCS) has been shown to be effective in reducing chronic LBP in various contexts. With emerging SCS technologies, the collective evidence of novel waveforms relative to traditional tonic stimulation for treating chronic LBP has yet to be clearly characterized. ⋯ Burst stimulation is superior to tonic stimulation for treating chronic LBP. However, superiority among other waveforms has yet to be clearly established given some heterogeneity and limitations in evidence. Given the relative novelty of burst and HF SCS waveforms, evidence of longitudinal efficacy is needed.
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Coronavirus disease 2019 has severely affected public health. Under social distancing and lockdown policies, patients with musculoskeletal pain have fewer opportunities than usual to receive routine medical care for pain management in hospitals. Therefore, we provided some suggestions for such patients to manage musculoskeletal pain and techniques that may be performed at home during this period.