Articles: pain-management-methods.
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High-quality evidence of analgesia and sedation management in pediatric intensive care units (PICUs) is lacking. ⋯ This study is the first survey conducted by physicians regarding pain and agitation management in PICUs in Japan, and the results revealed great diversity in practice. The implementation strategies to assess pain, delirium, and withdrawal syndrome, as well as to set goals regarding sedation level, are lacking. Protocols for analgesia and sedation management are uncommon.
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Randomized Controlled Trial
Multimodal Analgesic Regimen for Spine Surgery: A Randomized Placebo-controlled Trial.
Various multimodal analgesic approaches have been proposed for spine surgery. The authors evaluated the effect of using a combination of four nonopioid analgesics versus placebo on Quality of Recovery, postoperative opioid consumption, and pain scores. ⋯ An analgesic pathway based on preoperative acetaminophen and gabapentin, combined with intraoperative infusions of lidocaine and ketamine, did not improve recovery in patients who had multilevel spine surgery.
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Multicenter Study
Quantifying the use of opioids in the immediate postoperative period after endoscopic sinus surgery.
The opioid crisis is a public health emergency. There is limited evidence regarding how much opioid medication is necessary and which patients will require additional pain medication following endoscopic sinus surgery (ESS). The objective of this study was to quantify the use of opioids in the first 24 hours following ESS and determine the risk factors associated with increased need for opioid analgesia. ⋯ 4 Laryngoscope, 130:1122-1127, 2020.
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Med. Clin. North Am. · May 2020
Review Comparative StudyCannabis for Symptom Management in Older Adults.
The purpose of this article is to present evidence on the efficacy and safety of medical cannabis as a therapy for symptom management in palliative care. This article provides an overview of the evidence on the risks and benefits of using medical cannabis for the indications of chronic pain, cancer-related pain, cancer cachexia, dementia, and Alzheimer's disease. Currently, there is insufficient evidence to determine the effectiveness and safety of cannabinoids for most reviewed indications, with the exception of chronic pain. Future research is required before palliative care clinicians can make evidence-based decisions on the integration of medical cannabis as adjunct therapies.
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Med. Clin. North Am. · May 2020
Review Comparative StudyPain Management in Patients with Serious Illness.
Managing pain in patients with serious illness can be complex. However, pain is often a prominent symptom in patients with malignant and nonmalignant serious illness and providers have to be adept at balancing effective pain management and safety. ⋯ Opioids are not always appropriate but are still an important tool for managing pain. Basic opioid management and safe practices are essential when managing this population.