Articles: pain.
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Pain is a major challenge for patients with rheumatoid arthritis (RA), with many people suffering chronic pain. Current RA management guidelines focus on assessing and reducing disease activity using disease-modifying anti-rheumatic drugs (DMARDs). Consequently, pain care is often suboptimal, with growing evidence that analgesics are widely prescribed to patients with RA, despite potential toxicities and limited evidence for efficacy. Our review provides an overview of pharmacological treatments for pain in patients with RA, summarising their efficacy and use. ⋯ In patients with active RA, DMARDs have efficacy at reducing pain, supporting the role of treat-to-target strategies. Despite limited evidence that analgesics improve pain in patients with RA, these medicines are widely prescribed. The reasons for this are unclear. We consider that closing this evidence-to-practice gap requires qualitative research exploring the drivers of this practice, high-quality trials of analgesic efficacy in contemporary RA populations, alongside an increased focus on pain management (including pharmacological and non-pharmacological options) within RA guidelines.
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Cochrane Db Syst Rev · Jan 2025
Dexmedetomidine for analgesia and sedation for procedural pain or discomfort in newborn infants.
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of dexmedetomidine compared with opioids, non-opioids and placebo in providing sedation and analgesia for procedural pain in newborn infants.
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Randomized Controlled Trial
Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial.
Prospective trial evidence is lacking regarding the application of enhanced recovery after surgery (ERAS) in transvaginal pelvic floor reconstruction surgery among older patients. Our study aimed to investigate whether implementing the ERAS protocol could enhance post-operative recovery in this patient population. ⋯ Implementation of the ERAS protocol can expedite post-operative recovery in older patients undergoing transvaginal pelvic floor reconstruction surgery, achieve opioid-sparing, alleviate pain post-operatively, and decrease the incidence of complications.
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Scand J Trauma Resus · Jan 2025
Observational StudySignificant room for improvement in the prehospital assessment and treatment of acute abdominal pain: a retrospective observational study.
Acute abdominal pain (AAP) is a common reason for calling emergency medical services (EMS). Despite the widely acknowledged importance of effective prehospital pain management, described by patients as crucial regardless of any other factor, studies on prehospital pain management in AAP patients are limited and suggest room for improvement. This is particularly relevant given the long-standing controversy surrounding the use of analgesia in AAP patients before a final diagnosis is made, which may still influence the prehospital pain management. ⋯ Significant room for improvement in the prehospital management of acute abdominal pain was found. The proportions of pain assessment, treatment and reassessment were low with nine out of ten patients leaving prehospital care with unknown, moderate or severe pain. Among the cases where pain assessment, treatment and reassessment were made and recorded, four out of five patients experienced significant pain relief, indicating the potential of better prehospital pain management.
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Childhood vaccines are a vital procedure for preventing infectious diseases and are a regular component of a child's medical care. However, vaccines are among the first and most frequently encountered painful procedures that can cause indicators of anxiety in relation to immunizations. This study aimed to identify and assess the impact of the ShotBlockerⓇ and BuzzyⓇ approaches on pain, anxiety and satisfaction with the tetanus-diphtheria vaccine in school-aged children. ⋯ The use of BuzzyⓇ and ShotBlockerⓇ has been demonstrated to be beneficial in reducing the pain and anxiety associated with tetanus-diphtheria vaccine injections in 13-year-old children. Furthermore, these methods can be employed frequently during vaccination to enhance children's satisfaction.