Acute Pain Medicine

2019 ◽  
Keyword(s):  
Acute Pain ◽  
Treatment Options ◽  
Multimodal Analgesia ◽  
Anesthetic Techniques ◽  
Pharmacologic Treatment ◽  
Large Array ◽  
Pain Medicine ◽  
Regional Anesthetic

Acute Pain Medicine tackles a large array of diagnostic and treatment consideration across a variety of surgical and nonsurgical acute pain conditions. It reviews a variety of acute pain–modulating factors followed by interventional and pharmacologic treatment options. For each applicable condition, perineural and neuraxial considerations are given when appropriate along with nociceptive anatomic complements. Pharmacologic modalities are described, stressing the use of multimodal analgesia and a variety of opioid-based options if necessary. The book reviews cases that commonly are associated with significant acute pain but also highlight the role of acute pain medicine physicians in the postdischarge phase. Finally, the book includes a critical update of the Military Advanced Regional Anesthesia and Analgesia handbook. This update serves as an essential bedside tool in the performance of regional anesthetic techniques and their corresponding anatomic considerations.

Adherence in Pain Medicine

2017 ◽  
Author(s):  
Michael E. Schatman ◽  
Oscar J. Benitez
Keyword(s):  
Treatment Adherence ◽  
Treatment Options ◽  
Point Of View ◽  
Clinical Psychologists ◽  
Pain Medicine ◽  
Adherence To Treatment

This chapter reviews adherence to treatment options in pain medicine from the clinician’s point of view. Adherence is discussed in the context of principle-based ethics through the four tenets of autonomy, nonmaleficence, beneficence, and justice. Treatment adherence for pain medicine on the part of the clinician transcends mere compliance with opioid prescriptions and policies. Adherence is addressed as a broad-based approach that can be clinically appropriate when principle-based ethics are followed. The shortage of clinical therapists and the corresponding role of clinical psychologists are discussed. Ways to find a balance between the issues of abuse and underprescribing are also addressed.

Economics of Acute Pain Medicine

2019 ◽  
pp. 10-22
Author(s):  
Brian E. Harrington ◽  
Edward R. Mariano
Keyword(s):  
Program Development ◽  
Acute Pain ◽  
Quality Care ◽  
Multimodal Analgesia ◽  
The United States ◽  
Pain Medicine ◽  
Future Directions ◽  
Healthcare Settings ◽  
Core Concepts ◽  
Economic Considerations

Appropriate resource allocation is vital for the successful delivery of acute pain medicine services. This chapter describes core concepts in acute pain medicine (such as use of multimodal analgesia and pain protocols) and reviews the economic considerations regarding acute pain medicine program development and implementation, including consideration of value-based models that are intended to promote efficient, high-quality care at a lower cost. Notably, while many of the principles may be universally applicable, the underlying context regards deployment of acute pain medicine programs within healthcare settings in the United States. The chapter concludes with a section on future directions in acute pain medicine.

The role of multimodal analgesia in preventing the development of chronic postsurgical pain and reducing postoperative opioid use

2018 ◽  
Vol 14 (6) ◽  
pp. 453-461 ◽  
Author(s):  
Wenling Jian, MD ◽  
Damoon Rejaei, MD ◽  
Ahmed Shihab, MD ◽  
Theodore A. Alston, MD, PhD ◽  
Jingping Wang, MD, PhD
Keyword(s):  
Multimodal Analgesia ◽  
Anesthetic Techniques ◽  
Opioid Use ◽  
Postsurgical Pain ◽  
Chronic Postsurgical Pain ◽  
Patients At Risk ◽  
Chronic Opioid Use ◽  
The Relationship

Chronic postsurgical pain (CPSP) is a possible complication of various surgical procedures, which can impair patients' quality of life while also contributing to chronic opioid use. Multiple biopsychosocial factors put patients at risk for CPSP. Multimodal analgesia with the use of various pharmacologic and regional anesthetic techniques can help reduce the incidence and severity of CPSP. However, the relationship between various perioperative analgesic strategies and the development of CPSP is not fully understood. Although the use of multimodal analgesia will not automatically prevent CPSP and/or prolonged opioid consumption, there is potential to do so, especially by means of regional techniques.

The Role of Regional Anesthesia under Field Conditions

1990 ◽  
Vol 5 (4) ◽  
pp. 349-352 ◽  
Author(s):  
Thomas Klöss ◽  
Gunther Lenz ◽  
Heidi Schwandt-Boden ◽  
Johannes Bauer ◽  
Raimund Stehle
Keyword(s):  
International Committee ◽  
Red Cross ◽  
Anesthetic Techniques ◽  
Field Hospital ◽  
Local Infiltration ◽  
Surgical Field ◽  
Local Infiltration Anesthesia ◽  
Infiltration Anesthesia ◽  
Regional Anesthetic

AbstractThe authors, who served as anesthesiologists for 15 months at an International Committee of the Red Cross (ICRC) surgical field hospital in a Cambodian refugee camp, report their anesthesiologic experience with 2,906 patients. In spite of preferential use of regional anesthetic techniques, general anesthesia was required in 68% of the cases. Local infiltration anesthesia was applied in 21% of the cases, conduction anesthesia in 3%, and spinal anesthesia in 8%.

Treatment Options in COVID-19: The Role of Bioavailable Antiviral Ribonucleoside Analog on NHC in vitro

2020 ◽  
Author(s):  
Lara Bittmann
Keyword(s):  
World Health Organization ◽  
Clinical Picture ◽  
Treatment Options ◽  
World Health ◽  
Wuhan City ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization

On December 31, 2019, WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China. A novel coronavirus was identified as the cause by Chinese authorities on January 7, 2020 and was provisionally named "2019-nCoV". This new Coronavirus causes a clinical picture which has received now the name COVID-19. The virus has spread subsequently worldwide and was explained on the 11th of March, 2020 by the World Health Organization to the pandemic.

Role of Paracetamol in Acute Pain Management

Drugs ◽  
2003 ◽  
Vol 63 (Special Issue 2) ◽  
pp. 15-21 ◽  
Author(s):  
Henrik Kehlet ◽  
Mads Utke Werner
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Acute Pain Management

Microbiota, Immune System and Autism Spectrum Disorders: An Integrative Model towards Novel Treatment Options

2020 ◽  
Vol 27 (31) ◽  
pp. 5119-5136 ◽  
Author(s):  
Barbara Carpita ◽  
Donatella Marazziti ◽  
Lionella Palego ◽  
Gino Giannaccini ◽  
Laura Betti ◽  
...  
Keyword(s):  
Immune System ◽  
Familial Aggregation ◽  
Treatment Options ◽  
Autism Spectrum ◽  
Integrative Model ◽  
Neural Basis ◽  
Integrative Framework ◽  
Intermediate Phenotypes ◽  
Close Relatives

Background: Autism Spectrum Disorder (ASD) is a condition strongly associated with genetic predisposition and familial aggregation. Among ASD patients, different levels of symptoms severity are detectable, while the presence of intermediate autism phenotypes in close relatives of ASD probands is also known in literature. Recently, increasing attention has been paid to environmental factors that might play a role in modulating the relationship between genomic risk and development and severity of ASD. Within this framework, an increasing body of evidence has stressed a possible role of both gut microbiota and inflammation in the pathophysiology of neurodevelopment. The aim of this paper is to review findings about the link between microbiota dysbiosis, inflammation and ASD. Methods: Articles ranging from 1990 to 2018 were identified on PUBMED and Google Scholar databases, with keyword combinations as: microbiota, immune system, inflammation, ASD, autism, broad autism phenotype, adult. Results: Recent evidence suggests that microbiota alterations, immune system and neurodevelopment may be deeply intertwined, shaping each other during early life. However, results from both animal models and human samples are still heterogeneous, while few studies focused on adult patients and ASD intermediate phenotypes. Conclusion: A better understanding of these pathways, within an integrative framework between central and peripheral systems, might not only shed more light on neural basis of ASD symptoms, clarifying brain pathophysiology, but it may also allow to develop new therapeutic strategies for these disorders, still poorly responsive to available treatments.

Considering a Potential Role of Linalool as a Mood Stabilizer for Bipolar Disorder

2020 ◽  
Vol 26 (40) ◽  
pp. 5128-5133
Author(s):  
Kate Levenberg ◽  
Wade Edris ◽  
Martha Levine ◽  
Daniel R. George
Keyword(s):  
Bipolar Disorder ◽  
Treatment Options ◽  
Mood Stabilizer ◽  
Well Being ◽  
Epidemiologic Studies ◽  
Treatment Regimens ◽  
Bipolar Spectrum Disorders ◽  
Short And Long Term

Epidemiologic studies suggest that the lifetime prevalence of bipolar spectrum disorders ranges from 2.8 to 6.5 percent of the population. To decrease morbidity and mortality associated with disease progression, pharmacologic intervention is indicated for the majority of these patients. While a number of effective treatment regimens exist, many conventional medications have significant side effect profiles that adversely impact patients’ short and long-term well-being. It is thus important to continue advancing and improving therapeutic options available to patients. This paper reviews the limitations of current treatments and examines the chemical compound Linalool, an alcohol found in many plant species, that may serve as an effective mood stabilizer. While relatively little is known about Linalool and bipolar disorder, the compound has been shown to have antiepileptic, anti-inflammatory, anxiolytic, anti-depressive, and neurotrophic effects, with mechanisms that are comparable to current bipolar disorder treatment options.

Benign Intracranial Lesions - Radiotherapy: An Overview of Treatment Options, Indications and Therapeutic Results

2020 ◽  
Vol 15 (2) ◽  
pp. 93-121
Author(s):  
Vasileios Tzikoulis ◽  
Areti Gkantaifi ◽  
Filippo Alongi ◽  
Nikolaos Tsoukalas ◽  
Haytham Hamed Saraireh ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Treatment Modality ◽  
Radiation Effects ◽  
Treatment Options ◽  
Proton Beam Therapy ◽  
Tumor Control ◽  
Control Growth ◽  
Effective Treatment Modality ◽  
Intracranial Lesions

Background: Radiation Therapy (RT) is an established treatment option for benign intracranial lesions. The aim of this study is to display an update on the role of RT concerning the most frequent benign brain lesions and tumors. Methods: Published articles about RT and meningiomas, Vestibular Schwannomas (VSs), Pituitary Adenomas (PAs), Arteriovenous Malformations (AVMs) and craniopharyngiomas were reviewed and extracted data were used. Results: In meningiomas RT is applied as an adjuvant therapy, in case of patientrefusing surgery or in unresectable tumors. The available techniques are External Beam RT (EBRT) and stereotactic ones such as Stereotactic Radiosurgery (SRS), Fractionated Stereotactic RT (FSRT), Intensity Modulated RT (IMRT) and proton-beam therapy. The same indications are considered in PAs, in which SRS and FSRT achieve excellent tumor control rate (92-100%), acceptable hormone remission rates (>50%) and decreased Adverse Radiation Effects (AREs). Upon tumor growth or neurological deterioration, RT emerges as alone or adjuvant treatment against VSs, with SRS, FSRT, EBRT or protonbeam therapy presenting excellent tumor control growth (>90%), facial nerve (84-100%), trigeminal nerve (74-99%) and hearing (>50%) preservation. SRS poses an effective treatment modality of certain AVMs, demonstrating a 3-year obliteration rate of 80%. Lastly, a combination of microsurgery and RT presents equal local control and 5-year survival rate (>90%) but improved toxicity profile compared to total resection in case of craniopharyngiomas. Conclusion: RT comprises an effective treatment modality of benign brain and intracranial lesions. By minimizing its AREs with optimal use, RT projects as a potent tool against such diseases.

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