scholarly journals Non-Allopathic Interventions for the Management of Acute and Chronic Pain: A Brief Review

2020 ◽  
Vol 25 (2) ◽  
Author(s):  
Linda Cole
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Pain Control ◽  
Nursing Practice ◽  
Healthcare Providers ◽  
Allopathic Medicine ◽  
Management Approach ◽  
Historical Overview ◽  
Multimodal Approach ◽  
Effective Interventions

With increased regulation and scrutiny, healthcare providers may be reluctant to prescribe medications, especially opioids, for patients with pain, and particularly chronic pain. However, nurses, as the frontline resource for patients, must advocate for effective interventions to address pain. Sound knowledge of non-allopathic approaches (including non-conventional, complementary, alternative, and integrative strategies) for acute, chronic, and cancer-related pain control supports a holistic pain management approach for patient care. In this article I discuss the clinical relevance of pain management and provide an historical overview of non-allopathic medicine. The discussion considers the five domains of non-allopathic medicine along with negative aspects associated with these interventions and the need for a multimodal approach. The article conclusion offers implications for nursing practice that include resources for non-allopathic pain management for both providers and patients.

scholarly journals Patient Satisfaction with Spanish Pain Centers: Observational Study with More than 3,000 Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Juan Antonio García García ◽  
Patricia Hernández-Puiggròs ◽  
Javier Tesedo Nieto ◽  
María Pilar Acín Lázaro ◽  
Alfredo Carrera González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Pain Control ◽  
Short Form ◽  
Waiting Times ◽  
Brief Pain Inventory ◽  
Management Approach

Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p<0.001, and health status (VAS) from 40.6 to 61.9, p<0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement.

Craniotomy

2019 ◽  
pp. 221-245
Author(s):  
Roxana Grasu ◽  
Sally Raty
Keyword(s):  
Risk Factors ◽  
Pain Management ◽  
Side Effects ◽  
Respiratory Depression ◽  
Pain Control ◽  
Sensory Nerves ◽  
Current Evidence ◽  
Multimodal Approach ◽  
Perivascular Nerves ◽  
Persistent Headache

This chapter discusses postcraniotomy headache (PCH), a common yet frequently underdiagnosed and undertreated occurrence, with up to 30% of patients experiencing persistent headache after surgery. The chapter identifies risk factors for the development of acute and persistent PCH and describes mechanisms for its development, such as injury to the sensory nerves supplying the scalp and underlying tissues or to the perivascular nerves that supply sensation to the dura mater. Pain management following craniotomy is a balancing act of achieving adequate analgesia while avoiding oversedation, respiratory depression, hypercapnia, nausea, vomiting, and hypertension. Current evidence suggests that a balanced, multimodal approach to the treatment of acute PCH is often required to optimize pain control, minimize undesired side effects, and prevent the development of persistent PCH.

The Demise of Interdisciplinary Chronic Pain Management and Its Relationship to the Scourge of Prescription Opioid Diversion and Abuse

2018 ◽  
Author(s):  
Michael E. Schatman
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Healthcare Providers ◽  
Well Being ◽  
Insurance Companies ◽  
Prescription Opioid ◽  
Pain Medicine ◽  
Opioid Crisis ◽  
Opioid Medications ◽  
Opioid Diversion

Even though the efficacy of interdisciplinary pain management programs is supported, their numbers have decreased and the vast majority of Americans with chronic pain do not have access to them. Insurance companies do not want to pay for these services, hospitals believe they are financial losers, and the opioid crisis has placed a pall over the practice of pain medicine. The demise of these programs has left pain medicine in a fragmented state. Few healthcare providers who treat chronic pain patients have the time to coordinate care by multiple professionals The opioid crisis seen in certain areas, such as Appalachia, may be related to the lack of these interdisciplinary programs. There should be concerted efforts to increase access to and funding of these programs. Although they are not a panacea for all types of chronic pain, they can improve patients’ well-being and function and reduce their need for opioid medications.

scholarly journals American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain

2020 ◽  
Vol 4 (12) ◽  
pp. 2656-2701 ◽  
Author(s):  
Amanda M. Brandow ◽  
C. Patrick Carroll ◽  
Susan Creary ◽  
Ronisha Edwards-Elliott ◽  
Jeffrey Glassberg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Practice Research ◽  
Management Approach ◽  
Evidence Based ◽  
Cell Disease ◽  
Targeted Interventions ◽  
American Society

Background: The management of acute and chronic pain for individuals living with sickle cell disease (SCD) is a clinical challenge. This reflects the paucity of clinical SCD pain research and limited understanding of the complex biological differences between acute and chronic pain. These issues collectively create barriers to effective, targeted interventions. Optimal pain management requires interdisciplinary care. Objective: These evidence-based guidelines developed by the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in pain management decisions for children and adults with SCD. Methods: ASH formed a multidisciplinary panel, including 2 patient representatives, that was thoroughly vetted to minimize bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including updating or performing systematic reviews. Clinical questions and outcomes were prioritized according to importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment. Results: The panel reached consensus on 18 recommendations specific to acute and chronic pain. The recommendations reflect a broad pain management approach, encompassing pharmacological and nonpharmacological interventions and analgesic delivery. Conclusions: Because of low-certainty evidence and closely balanced benefits and harms, most recommendations are conditional. Patient preferences should drive clinical decisions. Policymaking, including that by payers, will require substantial debate and input from stakeholders. Randomized controlled trials and comparative-effectiveness studies are needed for chronic opioid therapy, nonopioid therapies, and nonpharmacological interventions.

scholarly journals Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids

Children ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 33 ◽  
Author(s):  
Anava Wren ◽  
Alexandra Ross ◽  
Genevieve D’Souza ◽  
Christina Almgren ◽  
Amanda Feinstein ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Psychological Functioning ◽  
Pediatric Patients ◽  
Multidisciplinary Treatment ◽  
Evidence Base ◽  
Opioid Therapy ◽  
Management Approach ◽  
Chronic Pain Conditions ◽  
Multidisciplinary Pain Management

Opioid therapy is the cornerstone of treatment for acute procedural and postoperative pain and is regularly prescribed for severe and debilitating chronic pain conditions. Although beneficial for many patients, opioid therapy may have side effects, limited efficacy, and potential negative outcomes. Multidisciplinary pain management treatments incorporating pharmacological and integrative non-pharmacological therapies have been shown to be effective in acute and chronic pain management for pediatric populations. A multidisciplinary approach can also benefit psychological functioning and quality of life, and may have the potential to reduce reliance on opioids. The aims of this paper are to: (1) provide a brief overview of a multidisciplinary pain management approach for pediatric patients with acute and chronic pain, (2) highlight the mechanisms of action and evidence base of commonly utilized integrative non-pharmacological therapies in pediatric multidisciplinary pain management, and (3) explore the opioid sparing effects of multidisciplinary treatment for pediatric pain.

Management of patients with pain and severe side effects while on intrathecal morphine therapy: A case study

2017 ◽  
Vol 17 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Kehua Zhou ◽  
Sen Sheng ◽  
Gary G. Wang
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Pain Control ◽  
Intrathecal Morphine ◽  
Management Approach ◽  
Intractable Pain ◽  
Pump Therapy ◽  
Pump Implantation ◽  
Morphine Therapy

AbstractBackground and aimsThe use of intrathecal morphine therapy has been increasing. Intrathecal morphine therapy is deemed the last resort for patients with intractable chronic non-cancer pain (CNCP) who failed other treatments including surgery and pharmaceutical interventions. However, effective treatments for patients with CNCP who “failed” this last resort because of severe side effects and lack of optimal pain control remain unclear.Methods and resultsHere we report two successfully managed patients (Ms. S and Mr. T) who had intractable pain and significant complications years after the start of intrathecal morphine therapy. The two patients had intrathecal morphine pump implantation due to chronic consistent pain and multiple failed surgical operations in the spine. Years after morphine pump implantation, both patients had significant chronic pain and compromised function for activities of daily living. Additionally, Ms. S also had four episodes of small bowel obstruction while Mr. T was diagnosed with end stage severe “dementia”. The successful management of these two patients included the simultaneous multidisciplinary approach for pain management, opioids tapering and discontinuation.ConclusionThe case study indicates that for patients who fail to respond to intrathecal morphine pump therapy due to side effects and lack of optimal pain control, the simultaneous multidisciplinary pain management approach and opioids tapering seem appropriate.

scholarly journals Patient Satisfaction With Chronic Pain Management: Patient Perspectives of Improvement

2021 ◽  
Vol 8 ◽  
pp. 237437352110078
Author(s):  
Yuelin (Cindy) Li ◽  
Eleni G Hapidou
Keyword(s):  
Chronic Pain ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Stages Of Change ◽  
Management Program ◽  
Management Approach ◽  
Chronic Pain Management ◽  
General Satisfaction ◽  
Pain Management Program ◽  
Treatment Measures

Integrating satisfaction measures with pain-related variables can highlight global change and improvement from the patients’ perspective. This study examined patient satisfaction in an interdisciplinary chronic pain management program. Nine hundred and twenty-seven (n = 927) participants completed pre- and post-treatment measures of pain, depression, catastrophizing, anxiety, stages of change, and pain acceptance. Multiple regression was used to examine these variables at admission and discharge as predictors of patient satisfaction. Pain-related variables explained 50.6% of the variance (R2 = .506, F 22,639 = 29.79, P < .001) for general satisfaction, and 38.9% of the variance (R2 = 0.389, F 22,639 = 18.49, P < .001) for goal accomplishment. Significant predictors of general satisfaction included depression (β = −0.188, P < .001) and the maintenance stage of change (β = 0.272, P < .001). The latter was also a significant predictor of goal accomplishment (β = 0.300, P < .001). Discharge pain-related measures are more influential than admission measures for predicting patient satisfaction. Patient satisfaction is significantly related to establishing a self-management approach to pain.

scholarly journals Post – operative analgesia in patients under thoracotomy

2019 ◽  
Vol 2 (1) ◽  
pp. 7
Author(s):  
Evangelos Giavasopoulos
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Pain Control ◽  
Postoperative Morbidity ◽  
Significant Risk ◽  
Pain Syndrome ◽  
Multimodal Approach ◽  
Postoperative Pain Control ◽  
Post Operative Pain ◽  
Respiratory Physiotherapy

The thoracotomy is one of the most painful surgery operations, and the final outcome is directly associated with the postoperative pain control, because it allows quick mobilization, intense respiratory physiotherapy and reduces postoperative morbidity. Unfortunately, patients under thoracotomy, incur a significant risk of chronic pain. Although there are guidelines for the management of post-operative pain relief in these patients, however there is no widespread surgical or anesthetic "gold standard."  In the present article it has been investigated the current literature related to the proposed therapies and other interventions that were recommended for  post-operative pain relief  after thoracotomy. The treatment of chronic pain after thoracotomy is difficult and includes physical rehabilitation techniques and multimodal approach. More and more researchers support that minimization of acute post-operative pain is the best method so as to avoid, prevent or reduce post- thoracotomy pain syndrome.

Postoperative Management and Radiography

2015 ◽  
Author(s):  
John Goodfellow ◽  
John O'Connor ◽  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Pain Control ◽  
Postoperative Management ◽  
Early Postoperative Period ◽  
Multimodal Approach ◽  
Invasive Approach ◽  
Opiate Use ◽  
Total Knee ◽  
Good Pain Control

In the early postoperative period, good pain control is essential. Regimes of pain management appropriate for total knee arthroplasty may not be suited to the very rapid mobilisation that is possible after UKA through a minimally invasive approach. A multimodal approach is best with minimal opiate use. Different regimes are used successfully in different institutions.

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