Articles: pain-measurement.
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Pain is one of the most common symptoms experienced by patients in acute care hospitals and acutely ill patients experience both acute and chronic pain. Unrelieved pain can have a profound negative impact on individuals' functional status, well-being, quality of life, and satisfaction with care. For providers, managing pain can be challenging. While the numeric rating scale is widely accepted and used, it measures only pain intensity. CAPA® pain assessment offers an alternative approach in which providers have a conversation with patients about pain and how it impacts five key areas. ⋯ CAPA® is recommended as a supporting assessment to evaluate patients' pain experience in acute care.
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Despite strong evidence that repeated pain exposure in neonates is associated with adverse outcomes, pain assessment and management continues to be less than optimal in most neonatal intensive care units (NICUs). ⋯ Increased efforts are needed to promote consistent pain assessment and management to ensure optimal outcomes for vulnerable at risk neonates.
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Int J Environ Res Public Health · Sep 2019
ReviewDoes Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review.
Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. ⋯ Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption.
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Comparative Study Clinical Trial
Presenting Symptoms in Men and Women Diagnosed With Myocardial Infarction Using Sex-Specific Criteria.
Background Sex-specific criteria are recommended for the diagnosis of myocardial infarction, but the impact of these on presenting characteristics is unknown. Methods and Results We evaluated patient-reported symptoms in 1941 patients (39% women) with suspected acute coronary syndrome attending the emergency department in a substudy of a prospective trial. Standardized criteria defined typical and atypical presentations based on pain nature, location, radiation, and additional symptoms. ⋯ Conclusions Typical symptoms are more common and have greater predictive value in women than in men with myocardial infarction whether or not they are diagnosed using sex-specific criteria. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier NCT01852123.
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Anesthesia and analgesia · Sep 2019
Observational StudyWeeding Out the Problem: The Impact of Preoperative Cannabinoid Use on Pain in the Perioperative Period.
Recent cannabis use is associated with greater post-operative pain and poorer sleep, after major orthopedic surgery.
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