Articles: pain-management-methods.
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Erector spinae plane (ESP) block is an effective regional analgesic technique for thoracic and abdominal pain. The volume of local anesthetic (LA) needed to produce sensory block in the spinal segment is unknown. ⋯ Acute pain, dermatomal spread, erector spine plane nerve block, thoracic pain, thoracic postoperative analgesia.
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Observational Study
A Comparison in Outcomes of Preoperative Single-shot versus Continuous Catheter Fascia Iliaca Regional Anesthesia in Geriatric Hip Fracture Patients.
Fascia iliaca nerve blocks relieve pain in geriatric hip fracture patients and can be administered via a single-shot or continuous catheter. We compared perioperative opioid consumption and pain scores between these two blocks. ⋯ We report no differences in opioid use and pain scores between single-shot and continuous catheter fascia iliaca nerve blocks. Both blocks similarly reduce preoperative opioid consumption.
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The American surgeon · Jun 2020
Observational StudyAssessment of Unused Opioids Following Ambulatory Surgery.
Surgery is a risk factor for opioid initiation and subsequent abuse. Discharge opioid prescription patterns after surgery are often varied and not evidence based, which may lead to unnecessary prescription of opioids. We aimed to assess opioid prescribing and unused opioid prescriptions in ambulatory surgery patients at our academic hospital. ⋯ Opioid prescribing and unused opioid prescriptions are prevalent in our hospital's ambulatory surgical population. Patients undergoing selected ambulatory surgical procedures may not require as much opioid as is currently being prescribed.
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Purpose: To prioritize outcome domains sensitive to the needs of the various stakeholders involved in rehabilitation programs designed for youth with pain-related disability using the International Classification of Function Child and Youth version. Materials and methods: A 5-step nominal group technique was conducted with 13 stakeholders, including two youth with pain-related disability, two parents, five clinicians, two teachers, and two healthcare managers. Once identified by content thematic analysis and International Classification of Function linking, 15 outcome domains were ranked. ⋯ The consensus processes employed allowed for the reconciliation of the different priorities, and the achievement of agreement on participation in life and its related activities as a key desired outcome of rehabilitation programs for youth with pain-related disability. The use of the ICF-CY framework allowed a broader conceptualization of the rehabilitation outcome domains, and the examination of areas beyond reduction of pain, disability and impairment to include functional aspects such as self-care, daily routine and mobility activities, and meaningful participation in life, fostering social roles and responsibilities, and school engagement. As participation in life and its related tasks and activities were key outcomes for all stakeholders, they should be the focus of clinicians' treatment.
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Multicenter Study
Opioid Stewardship Program and Postoperative Adverse Events: A Difference-in-differences Cohort Study.
A 6-month opioid use educational program consisting of webinars on pain assessment, postoperative and multimodal pain opioid management, safer opioid use, and preventing addiction coupled with on-site coaching and monthly assessments reports was implemented in 31 hospitals. The authors hypothesized the intervention would measurably reduce and/or prevent opioid-related harm among adult hospitalized patients compared to 33 nonintervention hospitals. ⋯ A 6-month opioid educational intervention did not reduce opioid adverse events or alter opioid use in hospitalized patients. The authors' findings suggest that despite opioid and multimodal analgesia awareness, limited-duration educational interventions do not substantially change the hospital use of opioid analgesics.