Articles: pain-management.
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Studies on the effectiveness of pain management have uniformly concluded that health care providers underestimate or undertreat pain. In the emergency department (ED) in which this study was conducted, physicians receive formal didactic and bedside teaching on pain recognition and management in order to heighten the awareness of patients' need for pain control. The purpose of this study was to determine if this outpatient pain management of patients with acute, painful conditions is better than that reported in the medical literature. ⋯ Patient satisfaction with pain control was higher (91%) than that reported in the medical literature. Also, pain medication was provided more frequently by this study's ED (95%). Education on pain awareness and treatment is a way to improve pain management.
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Arch Phys Med Rehabil · Nov 1998
High-frequency transcutaneous electrical nerve stimulation alters thermal but not mechanical allodynia following chronic constriction injury of the rat sciatic nerve.
To determine if daily transcutaneous electrical nerve stimulation (TENS) can alter the thermal and mechanical allodynia that develops after chronic constriction injury (CCI) to the right sciatic nerve of rats. ⋯ It appears that daily TENS can prevent thermal but not mechanical allodynia in this model. However, early intervention with the treatment is critical if it is to be effective at all.
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Spinal cord stimulation (SCS) has been used for more than 30 years now, and although it has shown to be effective under certain well-described conditions of chronic pain, conclusive evidence on its effectiveness is still sparse. There is a need for more prospective and methodological good studies, in order to prove SCS efficacy for new or still questionable indications and to reveal prognostic factors for successful application. ⋯ In contrast to the early years when SCS was applied by independent physicians exploring the field of neurostimulation, the importance of information exchange and coordination of studies has now been recognized. Recent technical improvements of SCS devices may positively influence clinical outcome.
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Thirty older adults, without chronic pain, were interviewed about the acute pain reduction strategies that they used at home and strategies that they might use if hospitalized. Verbatim transcripts from the audiotapes were content analyzed. ⋯ If hospitalized, 16 (53.3%) would request analgesics; four (13.3%) would talk with a health care provider; five (16.7%) would continue their own pain reduction strategies; four (13.3%) provided no pain reduction strategies. Results suggest that many older adults possess pain reduction strategies that may be helpful to incorporate in their pain management when hospitalized.
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Recent advances in the application of regional anesthesia to the care of patients undergoing shoulder surgery are discussed. New techniques for the management of postoperative pain are highlighted, with an emphasis on interscalene patient-controlled analgesia and suprascapular block. ⋯ Intraoperative hypotension and bradycardia caused by activation of the Bezold-Jarisch reflex is considered. The ongoing debate regarding the use of paresthesia versus nerve-stimulator techniques is examined.