3 The role of the nurse in post-operative pain therapy

1995 ◽  
Vol 9 (3) ◽  
pp. 461-467 ◽  
Author(s):  
S. Hofer ◽  
H. Högström
Keyword(s):  
Pain Therapy ◽  
Post Operative Pain

scholarly journals Pain therapy to reduce perioperative complications

2019 ◽  
Vol 4 (4) ◽  
pp. 158-166
Author(s):  
Stephan M. Freys ◽  
Esther Pogatzki-Zahn
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Acute Pain ◽  
Surgical Procedure ◽  
Pain Therapy ◽  
Recovery Period ◽  
Acute Pain Therapy

AbstractThe incidence rates of adverse events secondary to any operation are a well-known problem in any surgical field. One outstanding example of such adverse events is postoperative pain. Thus, the incidence of acute postoperative pain following any surgical procedure and its treatment are central issues for every surgeon. In the times of Enhanced Recovery After Surgery (ERAS) programs, acute pain therapy became an increasingly well investigated and accepted aspect in almost all surgical subspecialties. However, if it comes to the reduction of postoperative complications, in the actual context of postoperative pain, surgeons tend to focus on the operative process rather than on the perioperative procedures. Undoubtedly, postoperative pain became an important factor with regard to the quality of surgical care: both, the extent and the quality of the surgical procedure and the extent and the quality of the analgesic technique are decisive issues for a successful pain management. There is growing evidence that supports the role of acute pain therapy in reducing postoperative morbidity, and it has been demonstrated that high pain scores postoperatively may contribute to a complicated postoperative course. This overview comprises the current knowledge on the role of acute pain therapy with regard to the occurrence of postoperative complications. Most of the knowledge is derived from studies that primarily focus on the type and quality of postoperative pain therapy in relation to specific surgical procedures and only secondary on complications. As far as existent, data that report on the recovery period after surgery, on the rehabilitation status, on perioperative morbidity, on the development of chronic pain after surgery, and on possible solutions of the latter problem with the institution of transitional pain services will be presented.

scholarly journals A brief literature review on the management of post-haemorrhoidectomy pain

2011 ◽  
Vol 1 (2) ◽  
pp. 32 ◽  
Author(s):  
Mohammed Mohsin Uzzaman ◽  
Muhammed Rafay Sameem Siddiqui
Keyword(s):  
Pain Relief ◽  
Literature Review ◽  
Literature Search ◽  
Surgical Techniques ◽  
Cochrane Library ◽  
Post Operative Pain ◽  
Symptomatic Control

The most commonly encountered complication after haemorrhoidectomy is post-operative pain. Relief of this pain may aid earlier recovery. A literature search was performed examining the different surgical and medical agents for the relief of post haemorrhoidectomy pain using Pubmed, MEDLINE, EMBASE, CINAHL and Cochrane library databases. Pain can be relieved by surgical or medical agents. Surgery incorporates a risk of incontinence. A number of studies examine the role of medical agents.A variety of surgical techniques and medical agents are available to the clinician in the treatment of post haemorrhoidectomy pain. Tailored management to individual patients should ensure appropriate symptomatic control and prompt recovery.

New Frontiers in Colorectal Cancer Surgery

2012 ◽  
Vol 5 (6) ◽  
pp. 340-344
Author(s):  
Tahsin A. Alam ◽  
Tas Qureshi
Keyword(s):  
Health Care Professionals ◽  
Enhanced Recovery ◽  
Normal Activity ◽  
Community Health Care ◽  
Colorectal Cancer Surgery ◽  
Post Operative Pain ◽  
Before And After ◽  
The Uk ◽  
Discharge From Hospital

Bowel cancer is a leading cause of cancer-related death in the UK. For many years, treatment of this condition was largely unchanged and involved radical surgery, using long midline incisions and typically requiring a lengthy stay in hospital. In the last few years, there has been a quiet revolution in how patients undergoing surgery for this condition are managed. In this article, we provide an overview on how the introduction of laparoscopic surgery allied with enhanced recovery programmes has resulted in less post-operative pain, earlier return to normal activity and earlier discharge from hospital. We also discuss the increasing role of community health care professionals, and GPs in particular, in supporting these patients both before and after their time in hospital.

The role of pannexin 1 in chemotherapy-induced peripheral neuropathy (CIPN).

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 6-6
Author(s):  
Adam Sterman ◽  
Regina Hanstein ◽  
David C. Spray
Keyword(s):  
Pain Therapy ◽  
Field Tests ◽  
Behavioral Changes ◽  
Satellite Glial Cells ◽  
Pannexin 1 ◽  
Tactile Threshold ◽  
Dose Limiting Toxicity ◽  
Specific Deletion ◽  
Von Frey Filaments

6 Background: CIPN is a debilitating side effect and dose limiting toxicity of anticancer drug therapies. CIPN induces pathological changes in dorsal root ganglia (DRG), leading to increased cross-talk between sensory neurons and satellite glial cells (SGCs), specifically ATP mediated SGC-neuron signaling. We therefore investigated CIPN in mice with neuron- or glia-specific deletion of the ATP-releasing channel Pannexin 1 (Panx 1). Methods: To induce CIPN, mice were given two i.p. oxaliplatin (oxa) injections two days apart. Controls received saline (sal). We used C57Bl6 wildtype and transgenic mice with neuron- or glia-specific Panx1 deletion (NFHcre or GFAPcre:Panx1F/F) and littermate controls (Panx1F/F), 7-11 per group. Tactile sensitivity of the hindpaws was assessed prior to and every week after injections for 3 weeks using von Frey filaments. The number of paw withdrawals to 10 stimulations with each filament and pain thresholds (corresponding to filament that elicits 8/10 responses) were recorded. Overall mouse condition was assessed using Open Field Tests. Results: C57Bl6 mice developed transient tactile hypersensitivity after oxa injection, which was most prominent at day 9 and ceased at day 21. Oxa-injected mice had lower tactile thresholds (at 9 days: sal 5.5±0.3g vs. oxa 2.7±0.4g, p < 0.001) and higher response rates to filaments compared to sal-injected controls (p < 0.05), but revealed no changes in any other behavior. Mice with glia-specific Panx1 deletion did not display significant tactile hypersensitivity at any time after oxa (tactile threshold at 9 days: sal 5.5±0.3g vs. oxa 5.8±0.2g), whereas oxa induced tactile hypersensitivity did occur in mice with neuron-specific Panx1 deletion (at 9 days: sal 6±0g vs. oxa 1.3±0g, p < 0.0001) and Panx1F/F littermates (at 9 days: sal 6.0±0g vs. oxa 1.3±0.1g, p < 0.0001). Conclusions: We found that oxaliplatin induces transient CIPN, but no other behavioral changes in wildtype mice. Deletion of the ATP-releasing channel Panx1 in glia, but not in neurons, prevented CIPN development. This points to a new molecule (Panx1) and a new cell type (glia) as potential novel targets for pain therapy.

Role of subtotal tonsillectomy (‘tonsillotomy’) in children with sleep disordered breathing

2013 ◽  
Vol 128 (S1) ◽  
pp. S3-S7 ◽  
Author(s):  
J M Wood ◽  
M Cho ◽  
A S Carney
Keyword(s):  
Sleep Disordered Breathing ◽  
Neurocognitive Function ◽  
Medline Database ◽  
Post Operative Pain ◽  
Operative Complications ◽  
Comparable Effect ◽  
Key Terms ◽  
Intracapsular Tonsillectomy ◽  
Disordered Breathing

AbstractIntroduction:Sleep disordered breathing in children causes disturbance in behaviour and also in cardiorespiratory and neurocognitive function. Subtotal tonsillectomy (‘tonsillotomy’) has been performed to treat sleep disordered breathing, with outcomes comparable to established therapies such as total tonsillectomy or adenoidectomy. This review critically assesses the role of subtotal tonsillectomy in a paediatric setting.Method:The Medline database (1966 to October 2012) was electronically searched using key terms including subtotal or intracapsular tonsillectomy, tonsillotomy, tonsillectomy, paediatrics, and sleep disordered breathing.Results:Eighteen papers were identified and reviewed. Subtotal tonsillectomy would appear to have an efficacy equal to that of total tonsillectomy for the treatment of sleep disordered breathing, and has significant benefits in reducing post-operative pain and analgesia use. Subtotal tonsillectomy patients appear to have less frequent post-operative haemorrhage compared with total tonsillectomy patients.Conclusion:In children, subtotal tonsillectomy is associated with fewer post-operative complications whilst having a comparable effect in improving sleep disordered breathing, compared with total tonsillectomy.

scholarly journals Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach

2016 ◽  
Vol Volume 9 ◽  
pp. 1179-1189 ◽  
Author(s):  
Manuela De Gregori ◽  
Carolina Muscoli ◽  
Michael Schatman ◽  
Tiziana Stallone ◽  
Fabio Intelligente ◽  
...  
Keyword(s):  
Pain Therapy ◽  
Nutritional Supplements ◽  
Personalized Nutrition

Endogenous opioids in placebo-induced analgesia

2018 ◽  
Author(s):  
Véronique A. Taylor ◽  
Pierre Rainville
Keyword(s):  
Pain Modulation ◽  
Endogenous Opioids ◽  
Anterior Cingulate ◽  
Placebo Analgesia ◽  
Psychological Determinants ◽  
Post Operative Pain ◽  
Conditioned Learning ◽  
Descending Pain Modulation ◽  
Pharmacological Manipulations

Placebos achieve scientifically proven pain-relieving effects yet are inactive substances for the treatment of pain. Levine, Gordon, and Fields were the first to demonstrate the role of endogenous opioids in placebo-induced analgesia during dental post-operative pain. Several studies using pharmacological manipulations and/or neuroimaging techniques confirmed their findings that placebo analgesia is reversible by naloxone, and also identified brain pathways involved in opioidergic neurotransmission during placebo analgesia (prefrontal regions rich in opioid receptors such as the anterior cingulate cortex, presumably initiating descending pain modulation through downstream projections to the brainstem). Fifty years of research in pharmacology and neurobiology have contributed to the identification of physical as well as psychological determinants of placebo analgesia. Expectations of pain relief are maintained by conditioned learning and reward-related processes, reflected by interactions between different neurotransmitters (opioids, dopamine, endocannabinoids) in a variety of brain circuits related to executive/cognitive processes as well as affect and reward.

Mitigating the Shadow of the Worldwide Opioid Crisis: A Review for the Foot and Ankle Specialist

2019 ◽  
Vol 13 (3) ◽  
pp. 242-248
Author(s):  
Robert G. Smith
Keyword(s):  
Pain Management ◽  
Lower Extremity ◽  
Pain Therapy ◽  
Opioid Analgesics ◽  
The United States ◽  
Opioid Therapy ◽  
Foot And Ankle ◽  
Conflicting Information ◽  
Free Environment

The foot and ankle physician is no stranger to the difficulties in achieving optimal pain therapy. There remains much confusion and conflicting information available to nonspecialist prescribers regarding opioid therapy as well as great deal of fear or opiophobia during the prescribing and monitoring of opioids worldwide. The role of the lower extremity specialist provider is to responsibly provide pain management to their patients in an error-free environment. The purpose of this article is to explore the central theme of responsible opioid pain management worldwide. This review focuses on the prescribing strategies of opioid analgesics to treat lower-extremity pain. Pharmacology of opioid agents and opioid prescribing strategies will be presented. Then, the concept of multimodal pain relief criteria for selecting appropriate opioid analgesics and use of adjunctive therapies to prevent opioid misuse as presented in the current medical literature is reported. Finally, a commentary and discussion centered on the actions of pharmaceutical companies of promoting their opioid products and the negative outcomes of their actions in the United States that may go worldwide if behaviors of these companies are not recognized by the foot and ankle specialist.

Role of pre-operative serum magnesium (Mg) concentration on post-operative pain intensity and opioid usage in gynecologic surgery.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20673-e20673
Author(s):  
Laleh Azari ◽  
Sundae Stelts ◽  
Joseph T Santoso ◽  
Mehmet Kocak
Keyword(s):  
Pain Intensity ◽  
Serum Magnesium ◽  
Rank Correlation ◽  
University Hospital ◽  
Gynecologic Surgery ◽  
Opioid Use ◽  
Spearman’S Rank Correlation ◽  
Pain Scores ◽  
Post Operative Pain

e20673 Background: Hypomagnesemia is a common problem, occurring in nearly 12% of hospitalized patients. Due to the link of hypomagnesemia with surgery and the potential antinociceptive effects of Mg multiple trials have been conducted. Unfortunately, the role of IV and epidural Mg supplementation in pain management perioperatively remains controversial. An unanswered question from the literature to date is whether low serum Mg concentrations correlate with pain intensity. This review of patients undergoing gynecological surgeries examines whether pre-operative serum Mg level can affect pain scores and opioid use postoperatively. Methods: This was a retrospective study of the electronic medical record at Methodist University Hospital from October 1st, 2011 to July 31st, 2012. Included for analysis are all cases that underwent a gynecologic surgery and were performed under one attending surgeon. Each patient included in the study had perioperative serum Mg levels, resting and moving pain intensity scores, and amount of opioids used. Patients were excluded for any of the following criteria: missing data, discharge in less than 24 hours, robotic surgery, and use of ketamine in anesthesia. Statistical analysis included descriptive statistics, Spearman’s rank correlation coefficient, and logistic regression. Results: The analysis included 121 patients; 54% were Caucasian, the mean age was 51.7 years and 89% of surgeries were for oncologic indications. Pre-operative serum Mg level was not significantly associated with resting or moving pain intensity scores on post operative day (POD) 1 (p=0.66; p=0.68) or POD 2 (p=0.58, p=0.83). Pre-operative Mg level was not significantly associated with opioid use on POD 1 or 2. Two variables had a possible correlation with opioid usage, on average older patients used a lower level of opioid on average and patients with higher BMI used a higher level of opioids. Conclusions: Preoperative magnesium level has no correlation with pain scores or opioid use. While repletion maybe warranted and magnesium supplementation has minimal toxicity and cost, effect on post-operative pain is uncertain. Larger randomized trials may be warranted.

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