Latest & greatest articles for pain

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Top results for pain

21. Clinical Practice Guidelines and Consensus Statements About Pain Management in Critically Ill End-of-Life Patients: A Systematic Review

Clinical Practice Guidelines and Consensus Statements About Pain Management in Critically Ill End-of-Life Patients: A Systematic Review To identify and synthesize available recommendations from scientific societies and experts on pain management at the end-of-life in the ICU.We conducted a systematic review of PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and Biblioteca Virtual en Salud from their inception until March 28, 2019.We included all clinical practice guidelines (...) , especially in the applicability and rigor of development. Most documents were in agreement on five topics: 1) using a quantitative tool for pain assessment; 2) administering narcotics for pain relief and benzodiazepines for anxiety relief; 3) against prescribing neuromuscular blockers during withdrawal of life support to assess pain; 4) endorsing the use of high doses of opioids and sedatives for pain control, regardless of the risk that they will hasten death; and 5) using quality indicators to improve

2019 EvidenceUpdates

22. The Efficacy, Tolerability, and Joint Safety of Fasinumab in Osteoarthritis Pain: A Phase IIb/III Double-Blind, Placebo-Controlled, Randomized Clinical Trial

The Efficacy, Tolerability, and Joint Safety of Fasinumab in Osteoarthritis Pain: A Phase IIb/III Double-Blind, Placebo-Controlled, Randomized Clinical Trial To prospectively assess the efficacy, general safety, and joint safety of fasinumab, an anti-nerve growth factor monoclonal antibody, in osteoarthritis (OA) hip and/or knee pain.Patients with moderate-to-severe OA pain (knee or hip) and history of inadequate response or intolerance to analgesics were randomized to receive fasinumab (at 1 (...) mg, 3 mg, 6 mg, or 9 mg) or placebo every 4 weeks over 16 weeks and were followed up to week 36. Efficacy end points were the change from baseline to week 16 in the pain and physical function subscale scores of the Western Ontario and McMaster Universities OA Index (WOMAC), and patient global assessment (PGA) of OA. Joints were monitored at scheduled assessments (by plain film radiography and magnetic resonance imaging) during treatment and follow-up, and if prompted, at the time of active joint

2019 EvidenceUpdates

23. 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

24. Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis (Full text)

Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis Corticosteroid injection is frequently used for plantar heel pain (plantar fasciitis), although there is limited high-quality evidence to support this treatment. Therefore, this study reviewed randomised trials to estimate the effectiveness of corticosteroid injection for plantar heel pain.A systematic review and meta-analysis of randomised trials that compared corticosteroid injection to any comparator (...) . Primary outcomes were pain and function, categorised as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks).A total of 47 trials (2989 participants) were included. For reducing pain in the short term, corticosteroid injection was more effective than autologous blood injection (SMD -0.56; 95% CI, - 0.86 to - 0.26) and foot orthoses (SMD -0.91; 95% CI, - 1.69 to - 0.13). There were no significant findings in the medium term. In the longer term, corticosteroid injection was less

2019 EvidenceUpdates PubMed

25. Timing of Pain Reassessment Post-Pharmacological Treatment Administration in Hospitals: Guidelines

Timing of Pain Reassessment Post-Pharmacological Treatment Administration in Hospitals: Guidelines Timing of Pain Reassessment Post-Pharmacological Treatment Administration in Hospitals: Guidelines | CADTH.ca Find the information you need Timing of Pain Reassessment Post-Pharmacological Treatment Administration in Hospitals: Guidelines Timing of Pain Reassessment Post-Pharmacological Treatment Administration in Hospitals: Guidelines Last updated: August 2, 2019 Project Number: RA1051-000 (...) Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What are the evidence-based guidelines regarding frequency and timing of pain reassessment following medication administration in hospital? Key Message Three evidence-based guidelines were identified regarding frequency and timing of pain reassessment following medication administration in hospital. Files Rapid Response Reference List Published : August 2, 2019 Related Content Follow us: © 2019

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

26. Impact of different intraoperative CO2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2 : a prospective randomised controlled clinical trial

Impact of different intraoperative CO2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2 : a prospective randomised controlled clinical trial To compare the effects of two different intraoperative CO2 pressures (8 and 15 mmHg) during laparoscopic hysterectomy for benign uterine pathologies in terms of postoperative abdominal and shoulder pain, laparoscopy-mediated vegetative alterations, pain (...) medication requirement, arterial CO2 pressure (pCO2 ), surgical parameters, and safety.Prospective randomised controlled study.German university hospital.Female patients undergoing laparoscopic hysterectomy for benign uterine pathologies.Patients were randomised to a standard pressure (SP; 15 mmHg, control) or low-pressure (LP; 8 mmHg, experimental) group.Primary outcomes were postoperative abdominal and shoulder pain intensities, measured via numeric rating scale (NRS) and vegetative parameters (fatigue

2019 EvidenceUpdates

27. Are beta blockers safe to use in cocaine-related chest pain?

Are beta blockers safe to use in cocaine-related chest pain? Chiefs’ Inquiry Corner – 8/26/19 – Clinical Correlations Search Chiefs’ Inquiry Corner – 8/26/19 August 26, 2019 2 min read The classic teaching that beta blockers should be avoided in patients who actively use cocaine is a subject of debate. There is the theoretical risk of “unopposed alpha effect” which is based on very small human studies, case reports, and some small animal studies. For example, there are only two prospective

2019 Clinical Correlations

28. Statement on Environmental Sustainability in Anaesthesia and Pain Medicine Practice

Statement on Environmental Sustainability in Anaesthesia and Pain Medicine Practice PS64 2019 Page 1 PS64 2019 Australian and New Zealand College of Anaesthetists (ANZCA) Faculty of Pain Medicine Statement on Environmental Sustainability in Anaesthesia and Pain Medicine Practice 1. PURPOSE The purpose of this statement is: 1.1 to affirm ANZCA’s commitment to minimising the health impact of climate change and promoting environmental sustainability. 1.2 to serve as a resource for clinicians (...) to promote environmentally sustainable practices in their workplace. 1.3 to assist healthcare facilities in embedding sustainable practices in the delivery of safe patient care. 2. SCOPE This document is intended to apply to all clinicians practising anaesthesia, perioperative medicine and pain medicine, and all healthcare facilities in which anaesthesia, perioperative and pain medicine services are provided. 3. BACKGROUND The healthcare sector is highly interconnected with activities that emit pollution

2019 Australian and New Zealand College of Anaesthetists

29. 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)

30. Oral morphine analgesia for preventing pain during invasive procedures in non-ventilated premature infants in hospital: the Poppi RCT

Oral morphine analgesia for preventing pain during invasive procedures in non-ventilated premature infants in hospital: the Poppi RCT Oral morphine analgesia for preventing pain during invasive procedures in non-ventilated premature infants in hospital: the Poppi RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try (...) a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} The trial was stopped early because of profound respiratory adverse effects, without evidence of analgesic benefit for procedural pain, from the administration of oral morphine to non-ventilated premature infants. {{author}} {{($index , , , , , , , , , , , & . Vaneesha Monk 1, *, † , Fiona Moultrie 1, † , Caroline Hartley 1 , Amy Hoskin 1

2019 NIHR HTA programme

31. WITHDRAWN: Peripheral nerve blocks for postoperative pain after major knee surgery. (PubMed)

WITHDRAWN: Peripheral nerve blocks for postoperative pain after major knee surgery. Major knee surgery is a common operative procedure to help people with end-stage knee disease or trauma to regain mobility and have improved quality of life. Poorly controlled pain immediately after surgery is still a key issue for this procedure. Peripheral nerve blocks are localized and site-specific analgesic options for major knee surgery. The increasing use of peripheral nerve blocks following major knee (...) surgery requires the synthesis of evidence to evaluate its effectiveness and safety, when compared with systemic, local infiltration, epidural and spinal analgesia.To examine the efficacy and safety of peripheral nerve blocks for postoperative pain control following major knee surgery using methods that permit comparison with systemic, local infiltration, epidural and spinal analgesia.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 1, 2014), MEDLINE and EMBASE, from

2019 Cochrane

32. Evidence Brief - Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain

Evidence Brief - Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Health Services Research & Development Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction (...) or Discontinuation in Patients with Chronic Pain 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: Mackey K, Anderson J, Bourne D, Chen E, Peterson K. Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office

2019 Veterans Affairs Evidence-based Synthesis Program Reports

33. 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

34. Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients Undergoing Modified Radical Mastectomy

Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients Undergoing Modified Radical Mastectomy Simultaneous application of pectoral nerve block and serratus-intercostal plane block (SPB) is one of the most desirable multimodal analgesic strategies, with wide implementation of the enhanced recovery after surgery pathway for modified radical mastectomy (MRM).The aim of the present study was to investigate the efficacy and safety (...) , the duration at the postanesthesia care unit, and the incidence of adverse events were lower in group PS, compared with that of the group C. Moreover, PECS I together with SPB contributed to better sleep quality and higher patient satisfaction of pain relief.This study was limited by its sample size.These results suggest that the combination of PECS I and SPB provide superior perioperative pain relief in breast cancer surgery.Pectoral nerve block, serratus-intercostal plane block, postoperative analgesia

2019 EvidenceUpdates

35. Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis (Full text)

Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualize an individual's understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate (...) the clinical effectiveness, and patients' experience of, PNE for people with CMP. Electronic databases were searched for studies published between January 1, 2002, and June 14, 2018. Twelve randomized, controlled trials (n = 755 participants) that reported pain, disability, and psychosocial outcomes and 4 qualitative studies (n = 50 participants) that explored patients experience of PNE were included. The meta-analyzed pooled treatment effects for PNE versus control had low clinical relevance in the short

2019 EvidenceUpdates PubMed

36. Pharmacological interventions for chronic pain in children: an overview of systematic reviews

Pharmacological interventions for chronic pain in children: an overview of systematic reviews

2019 EvidenceUpdates

37. Unstable shoes for the treatment of lower back pain: a meta-analysis of randomized controlled trials

Unstable shoes for the treatment of lower back pain: a meta-analysis of randomized controlled trials We aimed to perform a systematic review and meta-analysis to compare the treatment effects of unstable shoes and flat shoes on lower back pain patients.Literature databases, including PubMed, Web of Science, and EMBASE (up to June 2019), were searched systematically.Two authors independently screened the retrieved records and identified the randomized controlled trials where patients with lower (...) back pain who wore unstable shoes as intervention and wore flat shoes as a control. Relevant data were extracted for meta-analysis using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the pooled outcome evidence levels.Five randomized controlled trials and 251 patients were included in the analysis. The meta-analysis results showed that there was a tendency toward a reduction in the Roland-Morris disability

2019 EvidenceUpdates

38. Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial

Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial Preterm neonates hospitalized in the neonatal intensive care unit undergo frequent painful procedures daily, often without pain treatment, with associated long-term adverse effects. Maternal-infant skin-to-skin contact, or kangaroo care (KC), and sweet-tasting solutions such as sucrose are effective strategies to reduce pain during (...) a single procedure; however, evidence of sustained efficacy over repeated procedures is limited. We aimed to determine the relative sustained efficacy of maternal KC, administered alone or in combination with 24% sucrose, to reduce behavioral pain intensity associated with routine neonatal procedures, compared with 24% sucrose alone. Stable preterm infants (n = 242) were randomized to receive KC and water, KC and 24% sucrose, or 24% sucrose before all routine painful procedures throughout

2019 EvidenceUpdates

39. Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial

Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain (...) and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8

2019 EvidenceUpdates

40. Intranasal sufentanil versus intravenous morphine for acute severe trauma pain: A double-blind randomized non-inferiority study (Full text)

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

2019 EvidenceUpdates PubMed