Latest & greatest articles for pain

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Top results for pain

61. Treatment for Acute Pain: An Evidence Map

Treatment for Acute Pain: An Evidence Map Treatment for Acute Pain: An Evidence Map Technical Brief Number 33 RTechnical Brief Number 33 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. 290-2015-0000-81 Prepared by: Minnesota Evidence-based Practice Center Minneapolis, MN Investigators: Michelle Brasure, Ph.D., M.S.P.H., M.L.I.S. Victoria (...) A. Nelson, M.Sc. Shellina Scheiner, PharmD, B.C.G.P. Mary L. Forte, Ph.D., D.C. Mary Butler, Ph.D., M.B.A. Sanket Nagarkar, D.D.S., M.P.H. Jayati Saha, Ph.D. Timothy J. Wilt, M.D., M.P.H. AHRQ Publication No. 19(20)-EHC022-EF Oct ober 2019 ii Key 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

2019 Effective Health Care Program (AHRQ)

62. Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain Full Text available with Trip Pro

Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain Within the SCOT-HEART (Scottish COmputed Tomography of the HEART Trial) trial of patients with stable chest pain, the use of coronary computed tomography angiography (CTA) reduced the rate of death from coronary heart disease or nonfatal myocardial infarction (primary endpoint).This study sought to assess the consistency and mechanisms of the 5-year reduction in this endpoint.In this open-label trial

2019 EvidenceUpdates

63. Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis (Abstract)

Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.For (...) this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also

2019 EvidenceUpdates

64. Oral COX-2 inhibitors for pain

Oral COX-2 inhibitors for pain '); } else { document.write(' '); } ACE | Oral COX-2 inhibitors for treating pain Search > > Oral COX-2 inhibitors for treating pain - Oral COX-2 inhibitors for treating pain Published on 2 September 2019 Guidance Recommendations The Ministry of Health's Drug Advisory Committee has recommended: celecoxib 200 mg capsule; and etoricoxib 60 mg, 90 mg and 120 mg tablets for treating pain in line with their registered indications in Singapore. For patients with renal

2019 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

65. Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety Full Text available with Trip Pro

Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reducing pain and anxiety in pediatric patients undergoing medical procedures.On April 25, 2018 (...) , we searched EMBASE, MEDLINE, CENTRAL, PubMed, Web of Science, and PsycINFO with the keywords "VR," "children," and "adolescents." Studies that applied VR in a somatic setting with participants ≤21 years of age were included. VR was defined as a fully immersive 3-dimensional environment displayed in surround stereoscopic vision on a head-mounted display (HMD). We evaluated pain and anxiety outcomes during medical procedures in VR and standard care conditions.We identified 2889 citations, of which

2019 EvidenceUpdates

66. Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial (Abstract)

Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial Pain after total knee arthroplasty (TKA) affects postoperative recovery and patient satisfaction. The analgesic benefits of corticosteroids have not been well studied. We, therefore, investigated the analgesic effects of intravenous (IV) dexamethasone (DEX) in patients undergoing a TKA.This was a randomized, double-blind, placebo-controlled (...) trial of 0.15 mg/kg of IV DEX vs saline placebo in unilateral TKA. Fifty patients/arm were recruited. Primary outcomes were pain level, determined by a visual analog scale, and the amount of morphine consumption (mg) ≤48 hours post-TKA. Secondary outcomes were rates of nausea and vomiting, C-reactive protein concentrations, and functional outcomes.The DEX group had a significantly lower mean visual analog scale score both at rest and during motion at 12, 15, 18, and 21 hours (P < .05). At 21 hours

2019 EvidenceUpdates

67. The Effect of Dexmedetomidine Added to Preemptive Ropivacaine Infiltration on Postoperative Pain After Lumbar Fusion Surgery: A Randomized Controlled Trial (Abstract)

The Effect of Dexmedetomidine Added to Preemptive Ropivacaine Infiltration on Postoperative Pain After Lumbar Fusion Surgery: A Randomized Controlled Trial A prospective and controlled study of dexmedetomidine added to preemptive ropivacaine infiltration in lumbar fusion surgery.Assessment of dexmedetomidine added to preemptive ropivacaine infiltration for the relief of postoperative pain after lumbar fusion surgery.Single local anesthetic preemptive wound infiltration for the relief (...) of postoperative pain does not translate into major or consistent clinical benefits after lumbar fusion surgery. Dexmedetomidine added to local anesthetics prolonged the duration of blockade and enhanced the analgesic in peripheral nerve block. The effect of dexmedetomidine added to preemptive ropivacaine infiltration in lumbar fusion surgery for the relief of postoperative pain has yet not been studied.Fifty-seven patients with elective posterior lumbar fusion were randomly divided into two groups. Five

2019 EvidenceUpdates

68. Efficacy of Systemic Steroid Use Given One Day After Total Knee Arthroplasty for Pain and Nausea: A Randomized Controlled Study Full Text available with Trip Pro

Efficacy of Systemic Steroid Use Given One Day After Total Knee Arthroplasty for Pain and Nausea: A Randomized Controlled Study Systemic steroid has been used to control pain and nausea in total knee arthroplasty (TKA), but most studies recommend a single dose administration prior to, or during, surgery. This study aimed to determine the efficacy of administration on 1 day postoperatively.Patients who were scheduled to undergo TKA were randomly assigned to the following groups: control group (...) , receiving normal saline injection; group 1, receiving 10 mg dexamethasone intravenously (IV) 1 hour before surgery; group 2, receiving 0.1 mg/kg dexamethasone (IV) 24 hours after surgery; or group 3, receiving 0.2 mg/kg dexamethasone (IV) 24 hours after surgery (n = 44-46 per group). Primary outcomes were pain and nausea visual analogue scale (VAS). Secondary outcomes were analgesic administration, rescue antiemetic administration, C-reactive protein, range of motion, and complications.Postoperative

2019 EvidenceUpdates

69. Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial (Abstract)

Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP).Randomized controlled trial.Outpatient care units.Sixty-four non-specific (...) CNP patients were randomly allocated to MET (n = 32) or UC (n = 32) groups.Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy.The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment

2019 EvidenceUpdates

70. Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder

Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Management Briefs eBrief-no160 -- Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no160 -- Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Health Services Research & Development Management eBrief (...) no. 160 » Issue 160 October 2019 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Brief: Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Acute pain management in patients with opioid use disorder (OUD) can be challenging due to several factors including increased pain sensitivity and higher opioid tolerance. Use of medications for OUD (MOUD) including methadone, buprenorphine/naloxone, or naltrexone adds to the complexity of acute pain management

2019 Veterans Affairs - R&D

71. Pentosan polysulfate sodium (Elmiron) - bladder pain syndrome characterised by either glomerulations or Hunner’s lesions

Pentosan polysulfate sodium (Elmiron) - bladder pain syndrome characterised by either glomerulations or Hunner’s lesions 1 Published 11 November 2019 1 SMC2194 pentosan polysulfate sodium 100mg hard capsules (Elmiron®) Consilient Health Ltd 04 October 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE (...) : following a full submission considered under the orphan equivalent process pentosan polysulfate sodium (Elmiron ® ) is accepted for use within NHSScotland. Indication under review: for the treatment of bladder pain syndrome characterised by either glomerulations or Hunner’s lesions in adults with moderate to severe pain, urgency and frequency of micturition. In patients with bladder pain syndrome and glomerulations or Hunner’s lesions, pentosan polysulfate sodium was associated with significantly more

2019 Scottish Medicines Consortium

72. Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures

Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures Common medical procedures to assess and treat patients can cause significant pain and distress. Clinicians should have a basic approach for minimizing pain and distress in children, particularly for frequently used diagnostic and therapeutic procedures. This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical (...) procedures. Simple, evidence-based strategies for managing pain and distress are reviewed, with guidance for integrating them into clinical practice as an essential part of health care. Health professionals are encouraged to use minimally invasive approaches and, when painful procedures are unavoidable, to combine simple pain and distress-minimizing strategies to improve the patient, parent, and health care provider experience. Health administrators are encouraged to create institutional policies

2019 Canadian Paediatric Society

73. Patellofemoral Pain

Patellofemoral Pain Clinical Practice Guidelines RICHARD W. WILLY, PT , PhD • LISA T . HOGLUND, PT , PhD • CHRISTIAN J. BARTON, PT , PhD LORI A. BOLGLA, PT , PhD • DAVID A. SCALZITTI, PT , PhD • DAVID S. LOGERSTEDT , PT , PhD ANDREW D. LYNCH, PT , PhD • LYNN SNYDER-MACKLER, PT , ScD, FAPTA • CHRISTINE M. MCDONOUGH, PT , PhD Patellofemoral Pain Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical (...) © 2019 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.cpg2 | september 2019 | volume 49 | number 9 | journal of orthopaedic & sports physical therapy Patellofemoral Pain: Clinical Practice Guidelines DIAGNOSIS A Clinicians should use reproduction of retropatellar or peri- patellar pain during squatting as a diagnostic test for patellofemoral pain (PFP). Clinicians should also use perfor- mance of other functional activities that load the patellofemoral joint (PF J

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

74. Pentosan polysulfate sodium for treating bladder pain syndrome

Pentosan polysulfate sodium for treating bladder pain syndrome Pentosan polysulfate sodium for treating bladder pain syndrome T echnology appraisal guidance Published: 13 November 2019 www.nice.org.uk/guidance/ta610 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration (...) to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Pentosan polysulfate sodium for treating bladder pain syndrome (TA610) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 25Contents Contents 1 Recommendations 4 2 Information about pentosan polysulfate sodium 6 3 Committee discussion 7

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

75. Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration

Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration 1 Public Summary Document Application No. 1466 – Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration Applicant: The Interventional Radiology Society of Australasia (IRSA) Date of MSAC consideration: MSAC 75 th Meeting, 28-29 March 2019 MSAC 74 th Meeting, 22-23 November 2018 Context for decision: MSAC makes its advice in accordance with its Terms (...) , MSAC deferred its advice regarding public funding of vertebroplasty for severely painful osteoporotic vertebral fractures of less than either 3 or 6 weeks duration. MSAC considered that a stakeholder meeting, to provide a broader clinical perspective and patient input, could inform the uncertainties in the application. MSAC also considered that an independent meta-analysis of the individual patient data (IPD) from all relevant randomised trials would be informative to further address uncertainties

2019 Medical Services Advisory Committee

76. Gliptins: joint pain and exposure to NSAIDs

Gliptins: joint pain and exposure to NSAIDs Prescrire IN ENGLISH - Spotlight ''Gliptins: joint pain and exposure to NSAIDs'', 1 November 2019 {1} {1} {1} | | > > > Gliptins: joint pain and exposure to NSAIDs Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight In the November issue of Prescrire International - Gliptins: joint pain and exposure (...) to NSAIDs FREE DOWNLOAD In the Adverse Effects section of the November issue, the results of a study by the independent French medical journal Prescrire, based on data from France's national health insurance system. Full text available for free download. Summary Joint and muscle pain are part of the adverse effect profile of gliptins. In France, Prescrire carried out a study, using data from the mandatory national health insurance system, showing that patients taking gliptins are more frequently exposed

2019 Prescrire

77. Stressed out about stress testing? The utility of stress testing after non-ACS chest pain Full Text available with Trip Pro

Stressed out about stress testing? The utility of stress testing after non-ACS chest pain Stressed out about stress testing? The utility of stress testing after non-ACS chest pain - CanadiEM Stressed out about stress testing? The utility of stress testing after non-ACS chest pain In by Vivian Tam October 15, 2019 The Case Your next patient in the acute zone of the ED is Mr. Liu, a 53-year old man presenting with one hour of acute onset atypical chest pain. He has several risk factors (...) ​ A review of the evidence on stress testing A recent disputed the commonly cited 2% ACS miss rate after ED discharge. ​4​ In the Pope et al . study, of the 10,689 patients presenting with undifferentiated chest pain, 889 patients had acute MI. ​5​ Nineteen of the confirmed MI patients were mistakenly discharged. Therefore, of all patients presenting to the ED with undifferentiated chest pain, less than 0.2% were missed (whereas the 2% figure is derived from the 19 missed MIs of the 889 patients

2019 CandiEM

78. Inhaled nitric oxide for treating pain crises in people with sickle cell disease. (Abstract)

Inhaled nitric oxide for treating pain crises in people with sickle cell disease. In people with sickle cell disease, sickled red blood cells cause the occlusion of small blood vessels which presents as episodes of severe pain known as pain crises or vaso-occlusive crises. The pain can occur in the bones, chest, or other parts of the body, and may last several hours to days. Pain relief during crises includes both pharmacologic and non-pharmacologic treatments. The efficacy of inhaled nitric (...) oxide in pain crises has been a controversial issue and hypotheses have been made suggesting a beneficial response due to its vasodilator properties. Yet no conclusive evidence has been presented.This review aims to evaluate the available randomised controlled studies which address this topic.To capture the available body of evidence evaluating the efficacy and safety of the use of inhaled nitric oxide in treating pain crises in people with sickle cell disease; and to assess the treatment's

2019 Cochrane

79. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. (Abstract)

Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder in which the two main clinical features are pelvic pain and lower urinary tract symptoms. There are currently many approaches for its management, using both pharmacological and non-pharmacological interventions. The National Institute of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) score is a validated measure (...) commonly used to measure CP/CPPS symptoms. We considered a 25% decrease of NIH-CPSI baseline score or a six-point reduction as MCID.To assess the effects of pharmacological therapies for chronic prostatitis/chronic pelvic pain syndrome.We performed a comprehensive search using CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, trial registries, grey literature and conference proceedings, with no restrictions on the language of publication or publication status. The date of the latest search of all databases

2019 Cochrane

80. 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 (...) may not modify or create derivative works based on American College of Radiology material. No part of any material posted on the American College of Radiology Web site may be copied, downloaded, stored in a retrieval system, or redistributed for any other purpose without the expressed written permission of American College of Radiology. Date of origin: 1995 Last review date: 2014 ACR Appropriateness Criteria ® 1 Chest Pain Suggestive of ACS American College of Radiology ACR Appropriateness

2019 American College of Radiology