Articles: pain-management.
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As interventional pain management has been growing rapidly worldwide and chronic pain management is provided by a diverse range of practitioners, malpractice litigation has increased. Therefore, we examined the characteristics of medical disputes related to chronic pain management from 2009 to 2019 in South Korea. In this retrospective study, we analyzed the Korean Society of Anesthesiologists database covering case files from July 2009 to June 2019. ⋯ The majority of invasive procedure-related cases (82.6%, 38/46) were determined as 'directly related to the procedure'. Of these, the 3 most common damaging events were bleeding, intrathecal injection of local anesthetics, and infectious complications (each n = 6). During a recent decade, there were several typical changes in the characteristics of medical dispute cases related to chronic pain management, including an increasing trend of cases for chronic pain management relative to surgical anesthesia-related cases, a higher severity of complications in cervical procedures, an increase in complex regional pain syndrome-related cases, and an increase in cases involving non-anesthesiologists.
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Chronic pain and insomnia have a complex, bidirectional relationship - addressing sleep complaints alongside pain may be key to alleviating patient-reported distress and disability. Healthcare professionals have consistently reported wanting to offer psychologically informed chronic pain management at the primary care level. Research in secondary care has demonstrated good treatment efficacy of hybrid CBT for chronic pain and insomnia. However, primary care is typically the main point of treatment entry, hence may be better situated to offer treatments using a multidisciplinary approach. In this study, primary care service providers' perception of feasibility for tackling pain-related insomnia in primary care was explored. ⋯ Primary care service providers from one locale advocate better, multidisciplinary treatment provision for chronic pain and insomnia. Findings suggest that situating this in primary care could be a feasible option, but this requires systemic support and specialist input as well as definitive trials for success.
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Musculoskeletal care · Oct 2021
ReviewGroup and individual telehealth for chronic musculoskeletal pain: A scoping review.
Musculoskeletal (MSK) pain presents a global challenge. Individual and group pain management programmes (PMPs) are recommended approaches for patients with chronic MSK disorders. With advances in remote healthcare capability, telehealth, and the recent COVID-19 pandemic, the importance of telehealth PMPs has become even more evident. Nevertheless, it is not known how patients perceive PMPs for their MSK complaint when delivered via telehealth. ⋯ Barriers and enablers to engagement in telehealth PMPs for patients with chronic MSK disorders have been identified. Peer support and group cohesiveness can be achieved remotely to enhance the patient experience. There is a critical need for further research in this area.
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Comparison between endosonographic ultrasonography (EUS)-guided celiac ganglia neurolysis (CGN) and EUS-guided celiac plexus neurolysis (CPN) in pain management for pancreatic cancer has engendered controversy. To analyze the effectiveness and safety of EUS-CGN and figure out whether EUS-CGN is better than EUS-CPN, a qualitative systematic review was conducted. ⋯ EUS-CGN can be safely performed while it may shorten survival. In terms of short-term pain response, EUS-CGN is better than EUS-CPN while no conclusion of long-term pain control can be drawn.
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Complex regional pain syndrome (CRPS) is a relatively rare, but debilitating condition that may occur after limb or peripheral nerve trauma. Typical symptoms of CRPS include swelling, allodynia, hyperalgesia, and skin temperature changes. Although a variety of pharmacological and non-pharmacological approaches are commonly used in caring for individuals with CRPS, they are frequently ineffective and often associated with side effects and/or additional risks. ⋯ These four patients all reported subjective improvement in their pain, function, and exercise tolerance in association with their DMO use. All patients demonstrated reduced use of analgesic medications. The pre- and post-DMO lower extremity functional scale showed clinically significant improvement in the two patients for which it was obtained.