Oxford Textbook of Paediatric Pain

2013 ◽  
Keyword(s):  
Pain Management ◽  
Pain Control ◽  
Complementary Therapies ◽  
Children And Youth ◽  
Evidence Based ◽  
Long Term Effects ◽  
Comprehensive Understanding ◽  
Case Examples ◽  
Sociodemographic Differences

The Oxford Textbook of Paediatric Pain brings together an international team of experts to provide an authoritative and comprehensive textbook on all aspects of pain in infants, children and youth. Divided into nine sections, this resource analyses pain as a multifactorial problem and gives the reader a comprehensive understanding of this challenging subject. Topics covered include the biological, social, and psychological basis of pain, pain in specific populations, pain measurement, pharmacology, psychosocial and physical interventions, complementary therapies, education, and ethics of pain control in youths, children, and infants. Evidence-based chapters look in depth at areas ranging from the long-term effects of the pain in children, to sociodemographic differences in paediatric pain management. Case examples and online materials including scales, worksheets, and videos are provided to aid learning and illustrate the application of knowledge.

Oxford Textbook of Pediatric Pain

2021 ◽  
Keyword(s):  
Early Life ◽  
Complementary Therapy ◽  
Children And Youth ◽  
Evidence Based ◽  
Pediatric Pain ◽  
Long Term Effects ◽  
Comprehensive Understanding ◽  
Case Examples ◽  
Practice Gap

Our understanding of how pain in early life differs to that in maturity is continuing to increase and develop, using a mixture of approaches from basic science, clinical science, and implementation science. The new edition of the Oxford Textbook of Pediatric Pain brings together an international team of experts to provide an authoritative and comprehensive textbook on all aspects of pain in infants, children, and youth. Divided into nine sections, the textbook analyses pain as a multifactorial problem to give the reader a comprehensive understanding of this challenging subject. Evidence-based chapters look in depth at topics ranging from the long-term effects of the pain in children, to complementary therapy in paediatric pain. The text addresses the knowledge-to-practice gap through individual and organizational implementation, and facilitation strategies. Case examples and perspective boxes are provided to aid learning and illustrate the application of knowledge.

Acute paediatric pain management

2017 ◽  
Author(s):  
Tom G. Hansen
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Acute Pain ◽  
Regional Anaesthesia ◽  
Pain Threshold ◽  
Age Groups ◽  
Postoperative Pain Management ◽  
Psychological Needs ◽  
Long Term Effects

Paediatric pain management has made great strides in the past few decades in the understanding of developmental neurobiology, developmental pharmacology, the use of analgesics in children, the use of regional techniques in children, and of the psychological needs of children in pain. The consequences of a painful experience on the young nervous system are so significant that long-term effects can occur, resulting in behavioural changes and a lowered pain threshold for months after a painful event. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain are constantly being refined, with newer drugs being used alone and in combination with other drugs, and continue to be explored. Systemic opioids, paracetamol, non-steroidal anti-inflammatories, and regional anaesthesia alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are often best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The safe and effective management of pain in children includes the prevention, recognition, and assessment of pain; early and individualized treatment; and evaluation of the efficacy of treatment. This chapter discusses selected topics in paediatric acute pain management, with more specific emphasis placed on pharmacology and regional anaesthesia in the treatment of acute postoperative pain management.

Tapering off long-term methadone: A case study

2019 ◽  
Vol 15 (4) ◽  
pp. 345-348 ◽  
Author(s):  
Kehua Zhou, MD, DPT, LAc ◽  
Leslie Frankish, BS ◽  
Gary G. Wang, MD, PhD
Keyword(s):  
Pain Management ◽  
Patient Education ◽  
Adverse Effects ◽  
Musculoskeletal Pain ◽  
Pain Control ◽  
Opioid Tapering ◽  
One Year ◽  
Good Pain Control

Opioid tapering may be necessary for patients on long-term opioids. Here, the authors presented a patient who had uncontrolled chronic musculoskeletal pain while on chronic methadone. Upon methadone tapering, the patient had been taking methadone for longer than six years and had severe methadone-related adverse effects. Using multidisciplinary interventions of patient education and counseling, physical interventions, and nonopioid medications, patient’s methadone was discontinued after longer than one year tapering with relatively good pain control. The tapering process highlights the importance of pain management during opioid tapering using multidisciplinary interventions to prevent and treat opioid withdrawal and pain relapses.

Strategies to Avoid Replication Failure With Evidence-Based Prevention Interventions: Case Examples From the Strengthening Families Program

2018 ◽  
Vol 43 (2) ◽  
pp. 75-89 ◽  
Author(s):  
Karol L. Kumpfer ◽  
Lawrence M. Scheier ◽  
Jaynie Brown
Keyword(s):  
Parenting Practices ◽  
Evidence Based ◽  
Long Term Effects ◽  
Health Crisis ◽  
Case Examples ◽  
Developmental Problems ◽  
Strengthening Families Program ◽  
The Right ◽  
Strengthening Families ◽  
Replication Failure

Research has found disturbing long-term effects of poor parenting on children’s behavioral health including addiction, delinquency, depression/anxiety, and poorer health as adults. Poor parenting practices thus contribute substantially to the health crisis in America. However, skilled, nurturing parents, or caretakers can help youth avoid these developmental problems. A number of family and parenting evidence-based interventions (EBIs) that teach parenting skills are now available for dissemination. Unfortunately, replications of EBIs do not always produce the original positive results. Organizations that seek to use family EBIs to improve parenting and family skills need to avoid practices that create replication failure. We examine several possible factors that contribute to replication failure using examples from five replications of the EBI “Iowa Strengthening Families Program for ages 10–14.” We then share six strategies conducive to avoid replication failures including (1) choosing the right program and implementation strategy for the population, (2) administering the right “dosage,” (3) choosing and properly training implementers, (4) maintaining program integrity and adherence, (5) ensuring cultural sensitivity, and (6) ensuring accurate and complete reporting of evaluation results. These guidelines can advance prevention science to meet the demands of a growing public health agenda.

Multidisciplinary conference to standardize survivorship care.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 17-17
Author(s):  
Beth Rudge ◽  
Megan Lanigan ◽  
Theresa M. Lee ◽  
Lisa Torp ◽  
Kit Yu Lu
Keyword(s):  
Breast Cancer ◽  
Clinical Experience ◽  
Nurse Practitioners ◽  
Side Effect ◽  
Genetic Counselor ◽  
Evidence Based ◽  
Survivorship Care ◽  
Long Term Effects ◽  
Multidisciplinary Conference

17 Background: Survivors of breast cancer can face a multitude of long term and late effects after completing active treatment. Recommendations for side effect management can vary widely based on professional society guidelines, a provider’s clinical experience, and patient preference. When providing survivorship care in a multidisciplinary institution, maintaining consistent recommendations between providers and disciplines can be a daunting challenge. A cohesive approach is extremely important for a satisfying patient-clinician relationship and for patient safety. Our objective is to create standardized management of breast cancer survivorship issues. Methods: A quarterly Survivorship Multidisciplinary Conference (SMC) was initiated for case review and education on side effect management. The multidisciplinary group included medical and radiation oncologists, surgeons, nurse practitioners, nurse navigators, dieticians, physical therapists, social workers, spiritual care, and a genetic counselor. We used an evidence-based approach, including ASCO and NCCN guidelines as well as published peer-reviewed recommendations to create a treatment consensus for side effect management. Clinicians attending SMC were surveyed regarding their approach to late and long term effects of breast cancer pre- and post-SMC and their overall satisfaction with the conference. Results: Prior to involvement in SMC, most providers based their treatment of side effects on their own professional society’s guidelines and their personal clinical experience. After implementing SMC, 60% of providers reported a change in their practice and there was a 37.5% reported increase in the use of ASCO and NCCN survivorship guidelines across disciplines. 94% of providers reported the SMC is effective in providing evidence based guidelines. Providers also reported a high level of satisfaction and that SMC provided opportunity for a more collaborative multidisciplinary approach. Conclusions: Survivorship Multidisciplinary Conference brings multiple specialties together for review of evidence-based approaches to survivorship care, increasing consistency in management of survivors' late and long term effects after completing breast cancer treatment.

Pain management in major paediatric trauma and burns

2013 ◽  
pp. 171-174
Author(s):  
Greta M. Palmer ◽  
Franz E. Babl
Keyword(s):  
Pain Management ◽  
Evidence Based ◽  
Post Traumatic Stress ◽  
Pharmacological Interventions ◽  
Post Discharge ◽  
Emergency Department Care ◽  
Paediatric Trauma ◽  
Post Traumatic ◽  
Care Ward

Pain management in major paediatric trauma and burns is challenging. It involves many phases including pre-hospital and emergency department care, ward management frequently including intensive care, and multiple operative and procedural interventions (as inpatients and later outpatients). Distress, anxiety, post-traumatic stress disorder (from the primary event and the ensuing in-hospital and post-discharge course), itch, neuropathic pain (in addition to pain of nociceptive origin), and sleep disorders frequently affect major trauma and burns victims and can persist long term. An evidence-based discussion follows of the pharmacological and non-pharmacological interventions employed during these various phases to address pain and the associated issues in these patients.

Long-Term Analgesia following a Single Application of Fentanyl Transdermal Solution in Pigs

2021 ◽  
pp. 1-6
Author(s):  
Rebecca Goutchtat ◽  
Mikael Chetboun ◽  
Jean-François Wiart ◽  
Jean-Michel Gaulier ◽  
François Pattou ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Control ◽  
Surgical Intervention ◽  
Animal Research ◽  
Single Application ◽  
Perioperative Pain ◽  
Constant Pain ◽  
Half Dose ◽  
Perioperative Pain Management

<b><i>Introduction:</i></b> In animal research, obtaining efficient and constant pain control is regulatory but challenging. The gold standard pain management consists of opioid analgesic administration, such as buprenorphine or fentanyl extended-release patches. However, as in all drugs with a short half-life time, repeated buprenorphine administrations are needed, leading to multiple injections that affect the research protocol. On the other hand, fentanyl patch efficacy is discussed in some species. These elements highlight the need of an optimal formulation of analgesic drugs for laboratory animals. In this study, we investigated how Recuvyra®, a fentanyl transdermal solution (FTS), validated in dog perioperative pain management, could provide sustained analgesia after a single topical administration in pigs in a surgical context. <b><i>Methods:</i></b> A total of 11 minipigs were used in this study. As a preliminary experiment, two different doses were tested as a single application on five pigs: two pigs at full dose (2.6 mg/kg) and three pigs at half dose (1.3 mg/kg). Plasma fentanyl dosages were performed during 4 consecutive days, using liquid chromatography with tandem mass spectrometry detection. The efficacy of FTS was then evaluated in a perioperative period. Six minipigs benefited from a surgical intervention comprising a laparotomy. The FTS was blotted on the skin in a single application 20 min before the surgical incision and plasma fentanyl dosages, clinical examination (body weight, food intake, heart rate, and body temperature) and pain assessment were performed for 7 consecutive days. <b><i>Results:</i></b> During the preliminary experiment, all fentanyl concentrations reached the minimum effective concentration (MEC) extrapolated in pigs (fentanylemia ≥0.2 ng/mL) throughout the 4 days. The half dose was chosen for the next step of the study. After the surgical intervention, all plasma fentanyl concentrations remained above the MEC up to 7 days post administration. Pig clinical examinations and pain evaluations showed efficient and constant pain control at the half dose, and few adverse events were observed. <b><i>Discussion and Conclusion:</i></b> This study confirms the pharmacological and clinical efficacy of FTS at 1.3 mg/kg in pigs throughout at least 7 postoperative days following laparotomy. The clinical analgesic effect of FTS appears more efficient and well-tolerated than the one observed with repeated injections of buprenorphine. This analgesic drug formulation could be universally used in animal research to provide optimal perioperative pain management and long-term analgesia.

Positive Culture Change in Long-Term Care: A Procedure to Enhance Speech-Language Pathologist–Certified Nursing Assistant Collaboration

2019 ◽  
Vol 4 (5) ◽  
pp. 790-798
Author(s):  
Christen Page ◽  
Dana Howell ◽  
Natalie Douglas
Keyword(s):  
Culture Change ◽  
Long Term Care ◽  
Communication Strategies ◽  
Positive Culture ◽  
Professional Support ◽  
Evidence Based ◽  
Nursing Assistant ◽  
Term Care ◽  
Case Examples

Background The majority of residents in long-term care (LTC) facilities have cognitive communication impairments impacting their ability to communicate basic wants and needs to caregivers, particularly certified nursing assistants (CNAs). Speech-language pathologists (SLPs) are the most qualified individuals to educate CNAs about residents' communication behaviors; however, there is limited literature that outlines specific, evidence-based procedures for CNAs and residents in the LTC environment. The purpose of this article is to describe such a procedure, including 2 case examples, within a framework of positive culture change. Method This clinical focus article aims to describe the details and benefits of providing professional support for CNAs during a communication plan intervention. Then, the article will discuss the association between professional support and positive culture change in LTC. Professional support involves valuing the experience and time CNAs spend with residents, consistently requesting feedback regarding trained communication strategies, educating, demonstrating, and problem-solving with CNAs, as well as acknowledging CNAs' use of communication strategies during daily care with residents. Conclusions SLPs can serve as trendsetters in establishing a positive, functional organizational culture in LTC by providing professional support to CNAs. This article outlined an evidence-based procedure designed for SLPs working in the LTC environment to contribute to such positive culture change.

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