Articles: acute-pain.
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Reg Anesth Pain Med · Jun 2022
Association of opioid exposure before surgery with opioid consumption after surgery.
To determine the effect of prescription opioid use in the year before surgery on opioid consumption after surgery. ⋯ Preoperative opioid use is associated with small increases in patient-reported opioid consumption after surgery for most patients, though greater differences exist for patients with chronic use. For most patients with preoperative opioid exposure, existing guidelines may meet their postoperative needs. However, guidelines may need tailoring for patients with chronic use, and providers should anticipate a higher likelihood of postoperative refills for all opioid-exposed patients.
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Preoperative treatment expectations have a significant influence on postoperative pain and treatment outcomes. Positive expectations are an important mechanism of the placebo effect and negative expectations are an important mechanism of the nocebo effect. ⋯ Valid and reliable measurement tools should be applied in clinical trials for a more robust investigation of treatment expectations. Further studies should address possible intervention options so that treatment expectations can also be incorporated into standard clinical care.
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Musculoskeletal pain (MSK) affects one out of three adults and is the most common source of significant long-term pain, physical disability, and under-treatment in the emergency department (ED). ⋯ We demonstrated that administration of an oral combination of VTS-Aspirin and ketamine to adult ED patients with acute MSK pain resulted in clinically significant pain relief in 80% of enrolled subjects.
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Virtual Reality Based Guided Meditation for Patients with Opioid Tolerance and Opioid Use Disorders.
The management of acute pain in patients with pre-existing opioid tolerance or opioid use disorders presents unique challenges. In light of the concerns regarding opioid use, safe and effective alternatives to opioid medications are of increasing interest. ⋯ This study demonstrates that the use of guided meditation through virtual reality can result in statistically significant reductions in patient-reported pain scores.
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Letter Randomized Controlled Trial
IV metoclopramide Vs IV ketorolac in the treatment of acute primary headaches: A randomized clinical trial.