Acupuncture for Chronic Pain in a Chinese Out-Patient Clinic

During a student elective to China, the use of acupuncture in the treatment of chronic pain was investigated at a university teaching hospital. Sixteen patients in two groups: Osteoarthritis and others, answered questionnaires on their pain and its response to treatment. Acupuncture was found to provide effective pain relief and improved mobility in most patients for a period of 24 hours. This benefit was most marked in those who had had electroacupuncture.

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Administration of Nebulized Ketamine for Managing Acute Pain in the Emergency Department: A Case Series

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2019.10.44582 ◽

2020 ◽

Vol 4 (1) ◽

pp. 16-20 ◽

Cited By ~ 1

Author(s):

Jefferson Drapkin ◽

Aidin Masoudi ◽

Mahlaqa Butt ◽

Rukhsana Hossain ◽

Antonios Likourezos ◽

...

Keyword(s):

Emergency Department ◽

Chronic Pain ◽

Pain Relief ◽

Acute Pain ◽

Case Series ◽

Effective Pain Relief

Ketamine administration in sub-dissociative doses in the emergency department (ED) results in effective pain relief in patients with acute traumatic and non-traumatic pain, chronic pain, and opioid-tolerant pain. This case series describes five adult ED patients who received nebulized ketamine for predominantly acute traumatic pain. Three patients received nebulized ketamine at 1.5 milligrams per kilogram (mg /kg) dose, one patient at 0.75 mg/kg, and one patient at 1 mg/kg. All five patients experienced a decrease in pain from the baseline up to 120 minutes. The inhalation route of ketamine delivery via breath-actuated nebulizer may have utility for managing pain in the ED.

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Risk of infection within 4 weeks of corticosteroid injection (CSI) in the management of chronic pain during a pandemic: a cohort study in 216 patients

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0051 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Arul James ◽

Shruti Niraj ◽

Manish Mittal ◽

G. Niraj

Keyword(s):

Chronic Pain ◽

Pain Relief ◽

Corticosteroid Injection ◽

University Teaching ◽

Interventional Treatment ◽

Pain Medicine ◽

Improvement Project ◽

Hospital Patients ◽

Prospective Longitudinal

Abstract Objectives Targeted corticosteroid injections (CSI) are one of the treatments that can provide pain relief and thereby, enhance quality of life in patients with chronic pain. Corticosteroids (CS) are known to impair immune response. The objective was to evaluate the risk of developing post-procedural infection within 4 weeks of receiving depot CSI for chronic pain as part of on going quality improvement project. We hypothesised that interventional treatment with depot steroids will not cause a significant increase in clinical infection in the first 4 weeks. Methods Telephone follow-up was performed as a part of prospective longitudinal audit in a cohort of patients who received interventional treatment for chronic pain at a multidisciplinary pain medicine centre based at a university teaching hospital. Patients who received interventional treatment in the management of chronic pain under a single physician between October 2019 and December 2020 were followed up over telephone as part of on going longitudinal audits. Data was collected on any infection within 4 and 12 weeks of receiving the intervention. Outcomes collected included type of intervention, dose of depot steroids and pain relief obtained at 12 weeks following intervention. Results Over a 15 month period, 261 patients received pain interventions with depot CS. There was no loss to follow-up. Nine patients reported an infection within 4 weeks of receiving depot steroids (9/261, 3.4%). None of the patients tested positive for Covid-19. Eight patients (8/261, 3%) reported an infection between 5 and 12 weeks following the corticosteroid intervention. Although none of the patients tested positive for Covid-19, two patients presented with clinical and radiological features suggestive of Covid-19. Durable analgesia was reported by 51% (133/261) and clinically significant analgesia by 30% (78/261) at 12 weeks following the intervention. Failure rate was 19% (50/261). Conclusions Pain medicine interventions with depot steroids do not appear to overtly increase the risk for Covid-19 infection in the midst of a pandemic.

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The impact of relocation of chronic pain service from hospital setting to community centre on patient experience: a single-centre audit

British Journal of Pain ◽

10.1177/2049463718762975 ◽

2018 ◽

Vol 12 (4) ◽

pp. 220-229

Author(s):

Jonathan Jenkin Tsui ◽

Veronica Davey ◽

Lesley Colvin

Keyword(s):

Chronic Pain ◽

Patient Experience ◽

Teaching Hospital ◽

Community Treatment ◽

University Teaching ◽

Pain Clinic ◽

Patient Rating ◽

Patient Reported ◽

The Impact ◽

Community Centre

Background and aims: The Lothian Chronic Pain Service relocated from a university teaching hospital (Western General Hospital (WGH)) to a community centre (Leith Community Treatment Centre (LCTC)) in 2015. Transportation and geographical location were noted by staff to be potential challenges that could negatively impact on the patient experience. The objective of this study is to evaluate how relocating pain clinic from an urban-based hospital to a peripheral community centre on patient experience. Methods: An assessment and audit of the impact of the relocation on the Patient-Reported Experience Measure (PREM) of pain services was conducted. Using a nationally developed questionnaire, the patient-reported experience from LCTC was prospectively collected in 2016 and was compared to historical data obtained from WGH in 2014 by National Health Service (NHS) Scotland. All patients attending Lothian Chronic Pain Service clinics were deemed eligible for the audit. Patient demographics were compared between the two data sets. The impact of patient deprivation on patient experience was investigated using the Scottish Index of Multiple Deprivation (SIMD16). Results: Data from 111 patients from LCTC were compared to 206 patients from WGH. Percentage of patients rating care as ‘excellent’ was found to be significantly greater at LCTC than WGH (0.0049). However, overall patient rating of care from LCTC was not significantly different from WGH data and ratings were higher at LCTC. No correlation was found between patient deprivation and PREM. Conclusion: There is no clear evidence that PREM was negatively affected by the move from a university teaching hospital to a community setting. As this only reported experiences of patients who attended the service, further studies may be warranted to investigate the impact of patient nonattendance.

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