Latest & greatest articles for acute pain

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Top results for acute pain

1. Chest Pain – Possible Acute Coronary Syndrome

Chest Pain – Possible Acute Coronary Syndrome American College of Radiology End User License Agreement ACR Appropriateness Criteria is a registered trademark of the American College of Radiology. By accessing the ACR Appropriateness Criteria®, you expressly agree and consent to the terms and conditions as described at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/TermsandConditions.pdf Personal use of material is permitted for research, scientific and/or information purposes only. You (...) Criteria ® Clinical Condition: Chest Pain Suggestive of Acute Coronary Syndrome Radiologic Procedure Rating Comments RRL* Tc-99m SPECT MPI rest and stress 8 This procedure is appropriate for intermediate-to-high likelihood for coronary artery disease. There is abundant literature available on clinical utility. ???? Arteriography coronary 8 This procedure is the gold standard and is invasive. ??? Tc-99m SPECT MPI rest only 7 In the setting of ongoing chest pain, this procedure has a high negative

2019 American College of Radiology

2. Multidisciplinary Treatment Programs for Patients with Acute or Subacute Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Multidisciplinary Treatment Programs for Patients with Acute or Subacute Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Multidisciplinary Treatment Programs for Patients with Acute or Subacute Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Multidisciplinary Treatment Programs for Patients with Acute or Subacute Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines (...) Multidisciplinary Treatment Programs for Patients with Acute or Subacute Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: May 7, 2019 Project Number: RC1109-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of multidisciplinary treatment programs for patients with acute or subacute pain in outpatient settings? What is the cost-effectiveness

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

3. Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines

Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines Last updated: June 14, 2019 Project Number: RA1039-000 Product Line: Research Type: Drug Report (...) Type: Reference List Result type: Report Question What is the clinical effectiveness of prescribing opioids in smaller quantities for patients with acute pain? What are the evidence-based guidelines associated with opioid prescribing for patients with acute pain? Key Message One systematic review of guidelines, two non-randomized studies, and four evidence-based guidelines were identified regarding smaller quantity opioid prescribing for acute pain. Files Rapid Response Reference List Published

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

4. Multidisciplinary Pain Consult Teams for Acute Care in Hospitals: Clinical Utility and Cost-Effectiveness

Multidisciplinary Pain Consult Teams for Acute Care in Hospitals: Clinical Utility and Cost-Effectiveness Multidisciplinary Pain Consult Teams for Acute Care in Hospitals: Clinical Utility and Cost-Effectiveness | CADTH.ca Find the information you need Multidisciplinary Pain Consult Teams for Acute Care in Hospitals: Clinical Utility and Cost-Effectiveness Multidisciplinary Pain Consult Teams for Acute Care in Hospitals: Clinical Utility and Cost-Effectiveness Last updated: August 16, 2019 (...) Project Number: RB1357-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical utility of acute pain assessment by multidisciplinary pain consult teams in an inpatient setting? What is the cost-effectiveness of acute pain assessment by multidisciplinary pain consult teams in an inpatient setting? Key Message No relevant health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

5. Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial

Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial Nonsteroidal anti-inflammatory drugs (NSAIDs) are used extensively for the management of acute pain, with ibuprofen being one of the most frequently used oral analgesics in the emergency department (ED). We compare the analgesic efficacy of oral ibuprofen at 3 different doses for adult ED patients with acute pain.This was a randomized, double-blind trial (...) comparing analgesic efficacy of 3 doses of oral ibuprofen (400, 600, and 800 mg) in adult ED patients with acute painful conditions. Primary outcome included difference in pain scores between the 3 groups at 60 minutes.We enrolled 225 subjects (75 per group). The difference in mean pain scores at 60 minutes between the 400- and 600-mg groups was -0.14 (95% confidence interval [CI] -0.67 to 0.39); between the 400- and 800-mg groups, 0.14 (95% CI -0.65 to 0.37); and between the 600- and 800-mg groups

2019 EvidenceUpdates

6. Comparative Effectiveness of Analgesics To Reduce Acute Pain in the Prehospital Setting

Comparative Effectiveness of Analgesics To Reduce Acute Pain in the Prehospital Setting Comparative Effectiveness of Analgesics To Reduce Acute Pain in the Prehospital Setting Comparative Effectiveness Review Number 220 R Comparative Effectiveness Review Number 220 Comparative Effectiveness of Analgesics To Reduce Acute Pain in the Prehospital Setting Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 (...) analgesics as treatment of moderate to severe acute pain in the prehospital setting. Key Messages • As initial therapy in the prehospital setting: o Nonsteroidal anti-inflammatory drugs provide similar pain relief to opioids and may cause fewer overall side effects and less drowsiness. o Acetaminophen may provide similar pain relief to opioids, and may cause fewer side effects overall and less dizziness. o Ketamine may provide similar pain relief to opioids. Ketamine may cause more dizziness or overall

2019 Effective Health Care Program (AHRQ)

7. Evidence Brief - Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment

Evidence Brief - Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment Health Services Research & Development Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted (...) Treatment to the ESP Report RSS feed Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Recommended Citation: Veazie S, Mackey K, Bourne D, Peterson K. Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-Assisted Treatment. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans

2019 Veterans Affairs Evidence-based Synthesis Program Reports

8. Intranasal sufentanil versus intravenous morphine for acute severe trauma pain: A double-blind randomized non-inferiority study

Intranasal sufentanil versus intravenous morphine for acute severe trauma pain: A double-blind randomized non-inferiority study Intravenous morphine (IVM) is the most common strong analgesic used in trauma, but is associated with a clear time limitation related to the need to obtain an access route. The intranasal (IN) route provides easy administration with a fast peak action time due to high vascularization and the absence of first-pass metabolism. We aimed to determine whether IN sufentanil (...) (INS) for patients presenting to an emergency department with acute severe traumatic pain results in a reduction in pain intensity non-inferior to IVM.In a prospective, randomized, multicenter non-inferiority trial conducted in the emergency departments of 6 hospitals across France, patients were randomized 1:1 to INS titration (0.3 μg/kg and additional doses of 0.15 μg/kg at 10 minutes and 20 minutes if numerical pain rating scale [NRS] > 3) and intravenous placebo, or to IVM (0.1 mg/kg

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2019 EvidenceUpdates

9. Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention

Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention Video-assisted thoracoscopic surgery (VATS) is considered as one of the minimally invasive surgeries. Early postoperative pain alleviation is very important to avoid complications, at the same time, proper early pain control is an established fact to decrease the incidence of chronic pain.To evaluate the efficacy of thoracic paravertebral block (PVB) by a bupivacaine/ dexmedetomidine mixture (...) on acute and chronic post-thoracoscopic surgery pain in patients undergoing VATS.A randomized prospective double-blinded trial.Assiut University Hospitals, Orman Cardiology Hospital.Sixty adult patients underwent elective VATS surgery under general anesthesia randomly allocated into 2 groups; Group I received thoracic PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and Group II received PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and dexmedetomidine (1 mcg/kg). Postoperative pain (at rest, with cough

2019 EvidenceUpdates

10. Efficacy and safety of loxoprofen sodium topical patch for the treatment of pain in patients with minor acute traumatic limb injuries in Brazil: a randomized, double-blind, noninferiority trial

Efficacy and safety of loxoprofen sodium topical patch for the treatment of pain in patients with minor acute traumatic limb injuries in Brazil: a randomized, double-blind, noninferiority trial Posttraumatic injury pain is commonly treated with oral nonsteroidal anti-inflammatory drugs. However, oral nonsteroidal anti-inflammatory drugs cause several adverse events, with topical formulations arising as an important alternative. Therefore, we aimed at evaluating the efficacy and safety (...) of loxoprofen patch (LX-P) in the treatment of patients with posttraumatic pain. This phase III, randomized, double-blind, noninferiority study enrolled Brazilian patients aged 18 to 65 years diagnosed with lower and upper limb posttraumatic injury who were experiencing moderate or severe pain. Patients were assigned to active LX-P or to loxoprofen tablet (LX-T), and pain intensity was measured based on a visual analog scale score variation after 7 days of treatment. Data on clinical symptoms, rescue

2019 EvidenceUpdates

11. Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain?

Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages e47–e49 Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? x Jonathan M. Kirschner , MD (EBEM Commentator) , x Benton R. Hunter , MD (EBEM Commentator) Department (...) of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN DOI: | Publication History Published online: December 11, 2018 Expand all Collapse all Article Outline Take-Home Message In adult emergency department (ED) patients with acute pain, low-dose intravenous ketamine (0.3 to 0.5 mg/kg) may provide pain relief within 10 minutes that is similar to that of single-dose intravenous morphine (0.1 mg/kg). Methods Data Sources A medical librarian searched MEDLINE, EMBASE, Scopus, Cochrane

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2019 Annals of Emergency Medicine Systematic Review Snapshots

12. Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain

Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain Acute appendicitis (AA) is one of the most frequent surgical pathologies in pediatrics.To investigate the utility of proadrenomedullin (pro-ADM) for the diagnosis of AA.Prospective, analytical, observational, and multicenter study conducted in 6 pediatric emergency departments. Children up to 18 years of age with suspected AA were included. Clinical, epidemiological (...) , and analytical data were collected.We studied 285 children with an average age of 9.5 years (95% confidence interval [CI], 9.1-9.9). AA was diagnosed in 103 children (36.1%), with complications in 10 of them (9.7%). The mean concentration of pro-ADM (nmol/L) was higher in children with AA (0.51 nmol/L, SD 0.16) than in children with acute abdominal pain (AAP) of another etiology (0.44 nmol/L, SD 0.14; p < 0.001). This difference was greater in complicated cases compared with uncomplicated AA (0.64 nmol/L, SD

2019 EvidenceUpdates

13. Chronic use of tramadol after acute pain episode: cohort study. (PubMed)

Chronic use of tramadol after acute pain episode: cohort study. To determine the risk of prolonged opioid use in patients receiving tramadol compared with other short acting opioids.Observational study of administrative claims data.United States commercial and Medicare Advantage insurance claims (OptumLabs Data Warehouse) January 1, 2009 through June 30, 2018.Opioid-naive patients undergoing elective surgery.Risk of persistent opioid use after discharge for patients treated with tramadol alone (...) =0.013).People receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http

2019 BMJ

14. Subdissociative-dose Ketamine Is Effective for Treating Acute Exacerbations of Chronic Pain

Subdissociative-dose Ketamine Is Effective for Treating Acute Exacerbations of Chronic Pain Subdissociative-dose ketamine (SDDK) is used to treat acute pain. We sought to determine if SDDK is effective in relieving acute exacerbations of chronic pain.This study was a randomized double-blind placebo-controlled trial conducted May 2017 to June 2018 at a public teaching hospital (ClinicalTrials.gov #NCT02920528). The primary endpoint was a 20-mm decrease on a 100-mm visual analog scale (VAS) at 60 (...) minutes. Power analysis using three groups (0.5 mg/kg ketamine, 0.25 mg/kg ketamine, or placebo infused over 20 minutes) estimated that 96 subjects were needed for 90% power. Inclusion criteria included age > 18 years, chronic pain > 3 months, and acute exacerbation (VAS ≥ 70 mm). Pain, agitation, and sedation were assessed by VAS at baseline and 20, 40, and 60 minutes after initiation of study drug. Telephone follow-up at 24 to 48 hours used a 10-point numeric rating scale for pain.A total of 106

2019 EvidenceUpdates

15. Transition from acute to chronic pain after surgery. (PubMed)

Transition from acute to chronic pain after surgery. Over the past decade there has been an increasing reliance on strong opioids to treat acute and chronic pain, which has been associated with a rising epidemic of prescription opioid misuse, abuse, and overdose-related deaths. Deaths from prescription opioids have more than quadrupled in the USA since 1999, and this pattern is now occurring globally. Inappropriate opioid prescribing after surgery, particularly after discharge, is a major cause (...) of this problem. Chronic postsurgical pain, occurring in approximately 10% of patients who have surgery, typically begins as acute postoperative pain that is difficult to control, but soon transitions into a persistent pain condition with neuropathic features that are unresponsive to opioids. Research into how and why this transition occurs has led to a stronger appreciation of opioid-induced hyperalgesia, use of more effective and safer opioid-sparing analgesic regimens, and non-pharmacological interventions

2019 Lancet

16. Randomized Trial of Intravenous Lidocaine Versus Hydromorphone for Acute Abdominal Pain in the Emergency Department

Randomized Trial of Intravenous Lidocaine Versus Hydromorphone for Acute Abdominal Pain in the Emergency Department We compare the efficacy and safety of intravenous lidocaine with that of hydromorphone for the treatment of acute abdominal pain in the emergency department (ED).This was a randomized, double-blind, clinical trial conducted in 2 EDs in the Bronx, NY. Adults weighing 60 to 120 kg were randomized to receive 120 mg of intravenous lidocaine or 1 mg of intravenous hydromorphone. Thirty (...) minutes after administration of the first dose of the study drug, participants were asked whether they needed a second dose of the investigational medication to which they were randomized. Patients were also stratified according to clinical suspicion of nephrolithiasis. The primary outcome was improvement in pain scores of 0 to 10 between baseline and 90 minutes. An important secondary outcome was need for "off-protocol" parenteral analgesics, including opioids and nonsteroidal anti-inflammatory

2019 EvidenceUpdates

17. Feasibility of a Hybrid Web-Based and In-Person Self-management Intervention Aimed at Preventing Acute to Chronic Pain Transition After Major Lower Extremity Trauma (iPACT-E-Trauma): A Pilot Randomized Controlled Trial

Feasibility of a Hybrid Web-Based and In-Person Self-management Intervention Aimed at Preventing Acute to Chronic Pain Transition After Major Lower Extremity Trauma (iPACT-E-Trauma): A Pilot Randomized Controlled Trial 1) To assess the feasibility of research methods to test a self-management intervention aimed at preventing acute to chronic pain transition in patients with major lower extremity trauma (iPACT-E-Trauma) and 2) to evaluate its potential effects at three and six months postinjury (...) . Design. A pilot randomized controlled trial (RCT) with two parallel groups.A supraregional level 1 trauma center.Fifty-six adult patients were randomized. Participants received the intervention or an educational pamphlet. Several parameters were evaluated to determine the feasibility of the research methods. The potential efficacy of iPACT-E-Trauma was evaluated with measures of pain intensity and pain interference with activities.More than 80% of eligible patients agreed to participate

2019 EvidenceUpdates

18. APOLLO-1: a randomized placebo and active-controlled phase III study investigating oliceridine (TRV130), a G protein-biased ligand at the micro-opioid receptor, for management of moderate-to-severe acute pain following bunionectomy

APOLLO-1: a randomized placebo and active-controlled phase III study investigating oliceridine (TRV130), a G protein-biased ligand at the micro-opioid receptor, for management of moderate-to-severe acute pain following bunionectomy Oliceridine is a novel G protein-biased µ-opioid receptor agonist designed to provide intravenous (IV) analgesia with a lower risk of opioid-related adverse events (ORAEs) than conventional opioids.APOLLO-1 (NCT02815709) was a phase III, double-blind, randomized (...) trial in patients with moderate-to-severe pain following bunionectomy. Patients received a loading dose of either placebo, oliceridine (1.5 mg), or morphine (4 mg), followed by demand doses via patient-controlled analgesia (0.1, 0.35, or 0.5 mg oliceridine, 1 mg morphine, or placebo). The primary endpoint compared the proportion of treatment responders through 48 hours for oliceridine regimens and placebo. Secondary outcomes included a composite measure of respiratory safety burden (RSB

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2019 EvidenceUpdates

19. Neuroleptanalgesia for acute abdominal pain: a systematic review

Neuroleptanalgesia for acute abdominal pain: a systematic review Acute abdominal pain (AAP) comprises up to 10% of all emergency department (ED) visits. Current pain management practice is moving toward multi-modal analgesia regimens that decrease opioid use.This project sought to determine whether, in patients with AAP (population), does administration of butyrophenone antipsychotics (intervention) compared to placebo, usual care, or opiates alone (comparisons) improve analgesia or decrease (...) Trials Registry), relevant bibliographies, and conference proceedings were also searched. Searches were not limited by date, language, or publication status. Studies eligible for inclusion were prospective randomized clinical trials enrolling patients (age ≥18 years) with AAP treated in acute care environments (ED, intensive care unit, postoperative). The butyrophenone must have been administered either intravenously or intra-muscularly. Comparison groups included placebo, opiate only

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2019 EvidenceUpdates

20. Treatment for Acute Pain: An Evidence Map (Draft)

Treatment for Acute Pain: An Evidence Map (Draft) Draft Comparative Effectiveness Review Number XX Treatment for Acute Pain: An Evidence Map Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. xxx-xx-xxxx Prepared by: Evidence-based Practice Center Investigators: First and Last Names, X.X. First and Last Names, X.X. AHRQ Publication No. xx-EHCxxx This information is distributed (...) Messages Purpose of review The purpose of this evidence map is to provide a high-level overview of the current guidelines and systematic reviews on pharmacologic and nonpharmacologic treatments for acute pain. We map the evidence for several acute pain conditions including postoperative pain, dental pain, neck pain, back pain, renal colic, acute migraine, and sickle cell crisis. Improved understanding of the interventions studied for each of these acute pain conditions will provide insight on which

2019 Effective Health Care Program (AHRQ)