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Patient-controlled subcutaneous analgesia with hydromorphone in cancer pain management.

BACKGROUND: Cancer pain is a significant public health concern worldwide, necessitating effective management strategies. This study aimed to explore the effects of patient-controlled subcutaneous analgesia (PCSA) with hydromorphone hydrochloride injection on refractory cancer pain. METHODS: We conducted a retrospective observational study involving patients who received PCSA with hydromorphone hydrochloride injection at our hospital from December 2022 to May 2023. All patients in this study were initially hospitalized to undergo dose titration and safety assessment for subcutaneous hydromorph

When Methadone Fails in Cancer Pain Management: A Retrospective Analysis.

BACKGROUND: Methadone is increasingly used. It is expected that some patients will lose the analgesic response or develop adverse effects. Opioid switching (OS) from methadone to other opioids has not been well described METHODS: The charts of patients with cancer pain receiving methadone, both intravenously and orally were reviewed for a period of two years (2023-2024). Patients who were switched from methadone, prescribed prior to or during admission to APCU were collected and analyzed. Epidemiological data were recorded. Opioid drugs, doses and route of administration prior to admission, at

Ayurvedic Management of Chronic Low Back Pain: A Case Report.

Low back pain (LBP) is one of the leading causes of disability globally. The prevalence of chronic LBP has increased dramatically, and there is a need for conservative therapeutic interventions to support patients with chronic LBP. A 66-year-old female patient presented with severe low back pain and associated disability of 2 years' duration. The patient received 8 weeks of Ayurvedic treatment. The Oswestry Disability Index score and self-rated pain on a scale from zero to ten were used to assess disability and pain over time. The patient reported a considerable reduction in LBP over the cours

Hyperbaric Oxygen Therapy for Management of Complex Regional Pain Syndrome.

OBJECTIVES: Complex regional pain syndrome remains a challenging condition characterized by severe, persistent pain and a variety of inflammatory and trophic symptoms. This study aimed to analyze the current literature to evaluate hyperbaric oxygen therapy (HBOT)'s efficacy in treating complex regional pain syndrome (CRPS), focusing on both sympathetically maintained pain (SMP) and sympathetically independent pain (SIP) subtypes. METHODS: A comprehensive literature search was conducted in PubMed Clinical Queries using the MeSH term "Complex Regional Pain Syndromes" OR the keyword "CRPS" AND "

Pain management in lacrimal lavage: insights from a comparative study.

PURPOSE: The lacrimal lavage test commonly assesses lacrimal obstruction but can cause discomfort. This study compares pain scores during la … xiety. Women reported greater pain than men, underscoring the need to address gender differences in pain management.

Clinical pain management: Current practice and recent innovations in research.

Chronic pain affects one in five adults. It is not only a major cause of disability for individual patients but also a driver of costs for entire healthcare systems. Treatment of pain remains a challenge, and the use of opioids has further led to a concurrent opioid epidemic. In this review, we discuss current standard treatment options for chronic pain, including pharmacological, behavioral, and interventional treatments. In addition, we review ongoing research in different areas that will potentially unlock new therapies.

Loco-Regional Anesthesia for Pain Management in Robotic Thoracic Surgery.

Robotic thoracic surgery is a prominent minimally invasive approach for the treatment of various thoracic diseases. While this technique offers numerous benefits including reduced blood loss, shorter hospital stays, and less postoperative pain, effective pain management remains crucial to enhance recovery and minimize complications. This review focuses on the application of various loco-regional anesthesia techniques in robotic thoracic surgery, particularly emphasizing their role in pain management. Techniques such as local infiltration anesthesia (LIA), thoracic epidural anesthesia (TEA), pa…

Peripheral Nerve Stimulation for Neuropathic Pain Management: A Narrative Review.

This narrative review examines the therapeutic efficacy of peripheral nerve stimulation (PNS) in the treatment of neuropathic pain (NP), a type of pain arising from lesions or diseases of the somatosensory system with a global prevalence ranging from 6.90% to 10.00%. Traditional pharmacological interventions often fall short for many persons, highlighting the need for alternative treatments such as PNS, which has demonstrated significant promise with minimal side effects. The review summarizes the effectiveness of PNS in various NP conditions, including trigeminal neuralgia and postherpetic ne

Perioperative Pain Management for Thoracic Surgery: A Multi-Layered Approach.

Cardiothoracic surgeries frequently pose unique challenges in the management of perioperative acute pain that require a multifaceted and per … imodal medications, while also utilizing the services of the Acute Pain Service can help to enhance pain management outcomes in cardiothoracic surgery.

Expert opinion on heat therapy for teenagers' musculoskeletal pain management.

BACKGROUND: Among children and adolescents, up to 40% will experience musculoskeletal pain (MP), which can significantly impair functional ability, reduce quality of life, cause emotional distress, and lead to sleeping disorders for both patients and their families. The first-line treatment often involves pharmacological interventions, even though there is a lack of evidence supporting the efficacy or the safety of this approach in this specific age group. Recent guidelines recommend the implementation of preventative strategies and physical tools as the first option to minimize the use of med

Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities.

BACKGROUND: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS: The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient set

Common Pain Disorders in Women: Diagnosis, Treatment, and Rehabilitation Management.

There is well-established epidemiologic evidence demonstrating variance in the pain disorders affecting women compared with men, although limited conclusive evidence exists regarding the pathophysiologic mechanisms to account for this difference. Six of the most common pain disorders affecting women include migraine headache, fibromyalgia, endometriosis, interstitial cystitis, temporomandibular disorders, and osteoarthritis. The sex-specific prevalence, risk factors, triggers, presentations, and treatments of these disorders are critical for physicians to appreciate and understand to provide t

Emergency department management of acute scrotal pain in pediatric patients.

Testicular torsion is a urologic emergency, accounting for up to 15% of cases of acute scrotal pain. Rapid recognition and management are essential to ensure viability of the testis. Doppler ultrasound can be used to confirm the diagnosis of testicular torsion; however, recent studies suggest that a more judicious use of ultrasound may be safe, decrease delays in surgical management, and avoid unnecessary utilization of resources. This issue reviews the epidemiology and historical and physical examination findings of testicular torsion and other common causes of acute scrotal pain. The existin

[Hypnotic pain management during ultrasound-guided infiltration of the hand].

Ultrasound-guided infiltration, performed to relieve pain, is a common and sometimes painful procedure, particularly on the hand. This potential pain, induced by the treatment, can cause apprehension in patients prior to such a procedure. The rheumatology team at the departmental hospital center (CHD) in Vendée hypothesized that a hypnosis session, by creating an imaginary glove on the patient's painful hand prior to the procedure, could help reduce the pain felt, as well as anxiety.

Multimodal locoregional procedures for cancer pain management: a literature review.

Pain is the most common and fearsome symptom in cancer patients, particularly in the advanced stage of disease. In cancer pain management, the first option is represented by analgesic drugs, whereas surgery is rarely used. Prior to considering surgical intervention, less invasive locoregional procedures are available from the wide pain management arsenal. In this review article, comprehensive information about the most commonly used locoregional options available for treating cancer pain focusing on interventional radiology (neurolysis, augmentation techniques, and embolization) and interventi…

Radial-sided wrist pain differentials: presentation, pathoanatomy, diagnosis, and management.

Patients with radial-sided wrist pain can be challenging to diagnose and treat. Various physicians, including emergency physicians, primary care physicians, and orthopedic or plastic surgeons can be involved in the initial and subsequent evaluation. We delve into the differential diagnosis of radial-sided wrist pain including osteoarticular, ligament, tendon, nerve, and other pathologies. We review the physical exam findings, diagnostic studies, and treatment options for each pathology based on recent and updated literature.

Pain Management Interventions in Lumbar Spinal Stenosis: A Literature Review.

Lumbar spinal stenosis (LSS) occurs due to the narrowing of the space within the vertebral canal and or intervertebral foramina. This results in the compression of the spinal cord and possibly the roots of the spinal nerves. Lower back pain and neurogenic claudication (NC) are major symptoms of spinal stenosis. This is a literature review that summarizes the important findings pertaining to pain management of spinal stenosis. Twenty-four original articles were assessed. Pain can be treated through non-invasive or surgical methods. Conservative techniques include physical exercises, epidural co…

Analgesic Alkaloids Derived From Traditional Chinese Medicine in Pain Management.

Chronic pain is one of the most prevalent health problems. The establishment of chronic pain is complex. Current medication for chronic pain mainly dependent on anticonvulsants, tricyclic antidepressants and opioidergic drugs. However, they have limited therapeutic efficacy, and some even with severe side effects. We turned our interest into alkaloids separated from traditional Chinese medicine (TCM), that usually act on multiple drug targets. In this article, we introduced the best-studied analgesic alkaloids derived from TCM, including tetrahydropalmatine, aloperine, oxysophocarpine, matrine

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… Anticonvulsants (such as gabapentin and pregabalin) are the first-line choice for chronic pain management. … Stopholidine was further shown to have promising potential for clinical use in pain management ( Chu et al., 2008 ). However, the clinical application of stopholidine is still rare and predominantly restricted to treat patients with schizophrenia. …

Evidence-Based Guidelines for Prehospital Pain Management: Literature and Methods.

INTRODUCTION: Emergency Medical Services (EMS) clinicians commonly encounter patients with acute pain. A new set of evidence-based guidelines (EBG) was developed to assist in the prehospital management of pain. Our objective was to describe the methods used to develop these evidence-based guidelines for prehospital pain management. METHODS: The EBG development process was supported by a previous systematic review conducted by the Agency for Healthcare Research and Quality (AHRQ) covering nine different population, intervention, comparison, and outcome (PICO) questions. A technical expert pane…