Role of pain management programmes in chronic pain

The coronavirus disease 2019 (COVID-19) can be responsible for severe acute respiratory syndrome and death. To limit the infection spread, non-urgent surgical procedures, day procedures, including interventional pain management, and patient visits, have been postponed or interrupted during the COVID-19 pandemic. Pain management is defined as a fundamental human right, but the rapidly changing nature of the COVID-19 outbreak requires revisions in clinical practice for chronic pain. This article describes the role of home healthcare services in managing cancer pain based on clinical practice during the COVID-19 pandemic and emphasizes the triple triage concept and the use of telemedicine. Key words: Coronavirus; COVID-19; Telemedicine; Home care; Cancer Pain Citation: Ergönenç T, Ergönenç JS, Altınpulluk EY. The role of home healthcare in managing cancer-related pain during COVID-19 pandemic: ‘The Triple Triage Protocol’. Snaesth. Pain intensive care 2021;25(1):1-4. DOI: 10.35975/apic.v25i1.1430 Received: 4 January 2021, Reviewed & Accepted: 8 January 2021

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Is Neuraxial Clonidine a Safer Alternative to Opioids for Chronic Pain? An Alternative Worth Exploring

Neurology and Neurobiology ◽

10.31487/j.nnb.2020.03.09 ◽

2020 ◽

pp. 1-7

Author(s):

Nagy Mekhail ◽

Shrif Costandi ◽

Alaa Abd-Elsayed ◽

Gregory Fiore ◽

...

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Potential Role ◽

Common Side Effect ◽

Chronic Pain Management ◽

Inclusion Criteria ◽

Opioid Use ◽

Levels Of Evidence ◽

The Past

Objective: Exploring the potential role of clonidine as an alternative to the currently available neuraxial medication options for the management of chronic pain. Methods: A comprehensive literature search was conducted investigating the treatment of chronic pain using clonidine over the past 73 years. A stepwise filtering approach was used to obtain articles addressing neuraxial treatment of chronic pain in adults. Selected articles were assessed for their levels of evidence followed by a discussion of their contribution to the understanding of the role of clonidine in chronic pain management. Results: Out of 1,035 articles that described the administration of clonidine for chronic pain management, seven articles met all of the inclusion criteria. Their levels of evidence ranged from 1a to 4 (Oxford Centre CEBM). Neuraxial administration of clonidine was found to be effective in the treatment of chronic pain, often exhibiting a synergistic effect with other analgesics to provide pain reduction with reduced opioid use. The most common side effect was hypotension, in some cases reported to have been serious. Conclusion: The use of neuraxial clonidine, in either a primary or adjunctive role, appears promising as an effective treatment for chronic pain.

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