Multimodal Pain Management Strategies for Office-Based and Ambulatory Procedures

Background Adequate pain control is critical after outpatient surgery where patients are not as closely monitored. A multimodal pain management regimen was compared to a conventional pain management method in patients undergoing operative fixation for distal radius fractures. We hypothesized that there would be a decrease in the amount of narcotics used by the multimodal group compared to the conventional pain management group, and that there would be no difference in bone healing postoperatively. Methods Forty-two patients were randomized into 2 groups based on pain protocols. Group 1, the control, received a regional block, acetaminophen, and oxycodone. Group 2 received a multimodal pain regimen consisting of daily doses of pregabalin, celecoxib, and acetaminophen up until postoperative day (POD) #3. They also received a regional block with oxycodone for breakthrough pain. Results From POD#3 to week 1, there was a significant increase in oxycodone use in the study group correlating with the point in time when the multimodal regimen was discontinued. The shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) scores taken at 2 weeks postoperation showed a significantly lower average score in the study group compared to the control. There was no difference in bone healing. Conclusions The 2 regimens yielded similar pain control after surgery. The rebound increase in narcotic use after the multimodal regimen was discontinued, and significant difference in QuickDASH scores seen at 2 weeks postoperatively supported that multimodal regimens may not necessarily lead to decreased narcotic use in outpatient upper extremity surgery, but in the short term are shown to improve functional status.

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International survey: real-world pain management strategies

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1183 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Hagen ◽

A Georgescu

Keyword(s):

Pain Management ◽

Real World ◽

Pain Control ◽

Online Survey ◽

Management Strategies ◽

Pain Medication ◽

International Survey ◽

Nationally Representative ◽

Online Panels ◽

Control Pain

Abstract Background Pain is a nearly universal experience, but little is known about how people treat pain. This international survey assessed real-world pain management strategies. Methods From 13-31 January, 2020, an online survey funded by GSK Consumer Healthcare was conducted in local languages in Australia, Brazil, Canada, China, Colombia, France, Germany, India, Italy, Japan, Saudi Arabia, Malaysia, Mexico, Poland, Russia, Spain, Sweden, UK, and USA. Adults were recruited from online panels of people who agreed to participate in surveys. Quotas ensured nationally representative online populations based on age, gender, and region. Results Of 19,000 people (1000/country) who completed the survey, 18,602 (98%) had ever experienced physical pain; 76% said they would like to control their pain better. Presented with 17 pain-management strategies and asked to select the ones they use in the order of use, respondents chose an average of 4 strategies each. The most commonly selected strategies were pain medication (65%), rest/sleep (54%), consult a doctor (31%), physical therapy (31%), and nonpharmacologic action (eg, heat/cold application; 29%). Of those who use pain medication, 56% take some other action first. Only 36% of those who treat pain do so immediately; 56% first wait to see if it will resolve spontaneously. Top reasons for waiting include a desire to avoid medication (37%); willingness to tolerate less severe pain (33%); concerns about side effects (21%) or dependency (21%); and wanting to avoid a doctor's visit unless pain is severe or persistent (21%). Nearly half (42%) of those who take action to control pain have visited ≥1 healthcare professional (doctor 31%; pharmacist 18%; other 17%) about pain. Conclusions This large global survey shows that people employ a range of strategies to manage pain but still wish for better pain control. Although pain medication is the most commonly used strategy, many people postpone or avoid its use. Key messages More than three-quarters (76%) of respondents across countries seek better pain control. Pain medication and rest/sleep consultation are the most common pain management strategies. More than half of respondents (56%) wait to see if pain will resolve spontaneously before taking any action, and 56% of those who use pain medication try some other approach first.

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Pain management strategies in orthopedic extremity trauma

International Anesthesiology Clinics ◽

10.1097/aia.0000000000000319 ◽

2021 ◽

Vol 59 (2) ◽

pp. 48-57

Author(s):

Nicholas Waler ◽

Magdalena Anitescu

Keyword(s):

Pain Management ◽

Management Strategies ◽

Extremity Trauma

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Pain management strategies in adults with haemophilia: a retrospective study

Haemophilia ◽

10.1111/hae.12753 ◽

2015 ◽

Vol 21 (6) ◽

pp. e487-e489

Author(s):

X. Wang ◽

M. Yang ◽

S. Jackson

Keyword(s):

Retrospective Study ◽

Pain Management ◽

Management Strategies ◽

Haemophilia A

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Pain experience, pain management strategies and satisfaction of hospitalized trauma patients in Indonesia

Journal of Nursing Education and Practice ◽

10.5430/jnep.v8n1p79 ◽

2017 ◽

Vol 8 (1) ◽

pp. 79

Author(s):

Deya Prastika ◽

Luppana Kitrungrote ◽

Jintana Damkliang

Keyword(s):

Pain Management ◽

Pain Intensity ◽

Management Strategies ◽

Healthcare Providers ◽

Pain Interference ◽

Trauma Patients ◽

Pain Experience ◽

Analgesic Drugs ◽

Effective Strategies ◽

Experience Pain

Although trauma is a common cause of greater pain and interference on daily activities, little is known about pain experience, pain management strategies and pain management outcomes in hospitalized trauma patients in Indonesia. This descriptive study aimed (1) to assess the pain experience, (2) to describe pain management strategies, and (3) to describe satisfaction with pain management conducted by healthcare providers as perceived by trauma patients. A total of 154 hospitalized trauma patients from a teaching hospital in Indonesia were recruited from January to March 2016. Data were analyzed using descriptive and inferential statistics. The study found that most of the hospitalized trauma patients had single extremity fractures (56.49%) and mild head injury (20.13%). They have experienced a mild to moderate level of pain intensity and pain interference during the first three days of admission. These pain intensity and pain interference levels were found to be significantly decreased from the first to the third day. The pain management strategies often used by the healthcare providers were showing interest and asking about pain, assessing the outcomes after receiving analgesic drugs, and giving information about pain. The pain management strategies often used by patients were praying (86.36%), slow and deep breathing (77.27%), and reciting Dzikir (meditation) (68.18%). Patients reported that performing Dzikir and praying were the effective strategies to reduce their pain. The patients rated moderate to high levels of satisfaction with pain management conducted by healthcare providers. Therefore, combinations analgesic drugs with praying and performing Dzikir related to cultural contexts are crucial to alleviate pain among hospitalized trauma patients in Indonesia.

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