Perioperative pain management for caesarean section in the mother with severe acute on chronic pain and opioid dependence

2013 ◽  
Vol 30 ◽  
pp. 178-178 ◽  
Author(s):  
D. Reddi ◽  
A. Mehta ◽  
N. Patel ◽  
B. Brandner
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Caesarean Section ◽  
Opioid Dependence ◽  
Perioperative Pain ◽  
Perioperative Pain Management

Major Surgeries are More Painful: Perioperative Pain Management and the Role of Preexisting Chronic Pain in Two Types of Spine Surgery

2016 ◽  
Vol 3 (3) ◽  
pp. 83-89
Author(s):  
Eva M Tiefenauer ◽  
Beate Poblete ◽  
Florian Marti ◽  
Christoph J Konrad ◽  
Karl F Kothbauer
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Spine Surgery ◽  
Perioperative Pain ◽  
Perioperative Pain Management

scholarly journals A retrospective audit of pain assessment and management post-caesarean section at New Somerset Hospital in Cape Town, South Africa

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Effraim F. Munsaka ◽  
Dominique Van Dyk ◽  
Romy Parker
Keyword(s):  
South Africa ◽  
Pain Management ◽  
Caesarean Section ◽  
Pain Assessment ◽  
Cape Town ◽  
Transversus Abdominis ◽  
Annual Number ◽  
Perioperative Pain ◽  
Retrospective Audit ◽  
Perioperative Pain Management

Background: The most common major surgical procedure performed worldwide is the caesarean section (CS). Effective pain management is a priority for women undergoing this procedure, to reduce the incidence of persistent pain (a risk factor for postpartum depression), as well as optimise maternal-neonatal bonding and the successful establishment of breastfeeding. Multimodal analgesia is the gold standard for post-CS analgesia. At present, no perioperative pain management protocols could be identified for the management of patients presenting for CS at regional hospitals in South Africa. This audit aimed to review the folders of patients who underwent CS, with particular reference to perioperative pain management guidelines for CS.Methods: A descriptive, retrospective, cross-sectional audit was conducted. Three hundred folders (10% of the annual number of caesarean procedures performed) from New Somerset Hospital, a regional hospital in Cape Town, South Africa were reviewed.Results: The women were a mean age of 30 years (standard deviation [s.d.]: 6.2). Median gravidity was 3 (interquartile range [IQR]: 2–3) and parity was 1 (IQR: 1–2); 52% had previously undergone a CS. In 93.3% cases, spinal anaesthesia was employed for CS. Pain assessment was poor, with only 55 (18%) patients having their pain assessed on the day of the operation. Analgesia was prescribed in over 98% of the patients, however, medication was only administered as prescribed in 32.6%. Non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed in 5% of cases. None of the patients received a patient-controlled analgesia (PCA), transversus abdominis plane (TAP) block, or wound infusion catheter as supplementary strategies.Conclusion: Pain management for post-CS patient at this hospital is lacking. There is the need for the implementation of a structured assessment tool to improve administration of analgesics in these patients. In addition, the reasons for the omission of NSAIDs from the analgesia regimen requires investigation. Hospital requires post-CS pain protocols to guide management especially in resource-limited settings.

scholarly journals Buprenorphine–Naloxone Therapy in Pain Management

2014 ◽  
Vol 120 (5) ◽  
pp. 1262-1274 ◽  
Author(s):  
Kelly Yan Chen ◽  
Lucy Chen ◽  
Jianren Mao
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Pain Relief ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Current Data ◽  
Provide Pain Relief ◽  
Opioid Induced Hyperalgesia ◽  
Perioperative Pain Management ◽  
Clinical Anesthesia

Abstract Buprenorphine–naloxone (bup/nal in 4:1 ratio; Suboxone®; Reckitt Benckiser Pharmaceuticals Incorporation, Richmond, VA) is approved by the Food and Drug Administration for outpatient office-based addiction treatment. In the past few years, bup/nal has been increasingly prescribed off-label for chronic pain management. The current data suggest that bup/nal may provide pain relief in patients with chronic pain with opioid dependence or addiction. However, the unique pharmacological profile of bup/nal confers it to be a weak analgesic that is unlikely to provide adequate pain relief for patients without opioid dependence or addiction. Possible mechanisms of pain relief by bup/nal therapy in opioid-dependent patients with chronic pain may include reversal of opioid-induced hyperalgesia and improvement in opioid tolerance and addiction. Additional studies are needed to assess the implication of bup/nal therapy in clinical anesthesia and perioperative pain management.

scholarly journals An Investigation into the Perceptions of Veterinarians towards Perioperative Pain Management in Calves

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1882
Author(s):  
Ria van Dyke ◽  
Melanie Connor ◽  
Amy Miele
Keyword(s):  
Pain Management ◽  
Bos Taurus ◽  
Current Work ◽  
Regulatory Regime ◽  
Perioperative Pain ◽  
Developmental Age ◽  
Perioperative Pain Management ◽  
Current Minimum ◽  
On Farm ◽  
Influence Perceptions

While veterinarians are instrumental to the welfare of calves (Bos taurus), limited knowledge exists concerning veterinary perceptions towards perioperative pain management in calves. As a part of a larger, nationwide study investigating the perceptions of veterinarians towards calf welfare, the current work sought to quantify veterinary perceptions towards perioperative pain management, including barriers to its use, and investigate demographic influences affecting those perceptions. An electronic mixed-methods survey was completed by 104 veterinarians registered with the Veterinary Council of New Zealand. The current work revealed that most veterinarians considered a multimodal approach as the most effective method for ameliorating perioperative pain in calves, rejected the practice of differential treatment based on developmental age, and perceived that postprocedural pain persists beyond 24 h for the majority of procedures included in the survey. Despite this, veterinarians identified certain barriers that may inhibit the provision of pain mitigation on-farm, including costs, inadequate recognition of pain, and ingrained farming practices. Certain demographic effects were found to influence perceptions towards perioperative pain management, including gender, the number of years since graduation, and species emphasis. Nevertheless, the current work demonstrated considerable support among veterinarians to improve pain management protocols during routine husbandry procedures. The asymmetries that exist between the current minimum provisions of perioperative pain management and veterinary perspectives suggest that substantive improvements are necessary in order to reconcile New Zealand’s existing regulatory regime with developments in scientific knowledge.

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