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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The benefits, risks and resource implications of providing an Acute Pain Service were assessed during the first year of the service. Six hundred and sixty patients recovering from major surgery were treated with patient-controlled analgesia (510 patients) or extradural infusion analgesia (150 patients). The results of a prospective outcome study showed that pain control was good: more than 60% of patients scored their pain as mild during the first 24 h. Only 10% of patients complained of severe postoperative pain. Eight patients developed potentially serious complications including respiratory depression and hypotension; the diagnosis and management of these problems on general wards is discussed. Retrospective analysis of the incidence of postoperative chest infection in surgical patients showed a marked reduction during the first year of the service (1.3% in 1988, 0.4% in 1989-90 (P less than 0.01].
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PMID:The first year's experience of an acute pain service. 191 Oct 28

The problem of undertreatment of acute postoperative pain has been documented in many studies. This article reviews this evidence and defines the problem of undertreatment as a group of attitudes about pain treatment that originate with deficiencies in knowledge and skills and lead to the development of inappropriate behaviors on the part of health care professionals, patients, and health care system administrators. The correction of these attitudinal barriers to appropriate pain management will require education about opioid pharmacology, newer techniques of opioid administration, and the value of appropriate treatment to the individual patients and the health care system as a whole. Emerging Comprehensive Acute Pain Management Services will play a role in this education and in the standardization of postoperative pain treatment.
J Pain Symptom Manage 1990 Feb
PMID:Optimizing opioid treatment of postoperative pain. 196 90

Ketorolac tromethamine is the first injectable nonsteroidal anti-inflammatory drug approved for the management of acute pain. In analgesic potency and ability to relieve postoperative pain, it is comparable to morphine. The advantages of ketorolac over opiates are the absence of respiratory depression and lack of drug abuse potential. Ketorolac has a longer duration of action than morphine, but it has less effect on the central nervous system. Ketorolac should not be used for obstetric analgesia.
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PMID:Ketorolac: an injectable NSAID. 198 89

The long-term memory of acute postoperative pain intensity was evaluated in a population of patients who had undergone the removal of impacted third molar teeth. The results suggest a positive correlation between experienced and remembered intensities of postsurgical pain for up to 3 years after surgery. They also suggest that males and females do not differ significantly in their reports of postsurgical pain intensity, nor do they differ significantly in their memories of pain intensity. Pain recall using verbal pain descriptors was more reliable than recall with visual analog scales. Patient reports of intensity of past postsurgical acute pain, particularly those reports obtained with verbal descriptors, may be useful in the planning of treatment and in the selection and evaluation of analgesic regimens.
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PMID:Long-term memory of acute postsurgical pain. 200 92

Epidural analgesia is an important intervention for both acute and chronic pain management. It has been in use since the early 1900s, but the technique using local application of opiate analgesics has only been in use since the late 1970s (Moulin & Coyle, 1986). Today, many patients receive epidural analgesia for postoperative pain control, and its use for acute or chronic pain management in a hospital, pain clinic, or home setting also continues to increase. Epidural analgesia is also being utilized to manage acute pain in the pediatric client. Epidural analgesia requires meticulous techniques, beginning with placement of the epidural catheter and continuing with administration of medications and nursing management of the catheter. Nursing assessment and development of protocols along with preoperative and postoperative patient and family teaching are vital components of the total plan of care. The nurse practitioner (NP) or other health care provider must be cognizant of safety considerations, whether in the hospital environment, pain clinic, or home setting.
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PMID:Epidural analgesia: a viable option for pain control. 200 58

An acute pain service in a new district general hospital is described. We have reported incidence of severe pain, common postoperative anaesthetic problems and patient satisfaction in relation to the analgesic technique. Over half the patients were treated by intermittent intramuscular injection of opioid, but increase in the use of continuous intravenous therapy and in particular patient-controlled analgesia, was welcomed by both medical and nursing staff.
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PMID:Introducing an acute pain service. 201 94

Pain is one of the most original and oldest experiences of humans and is an example of the psychosomatic interconnection and unity of processes in the human organism. For man it is above all a subjective experience and condition. Pain can be divided into acute and chronic pain. In both it is possible to influence by psychological means in particular the intensity of pain, which is done by means which reduce anxiety, fear and tension. In case of acute pain this is achieved by the psychological approach of the doctor who should be empathic and be an authority for the patient. Muscular relaxation of the patient has also a favourable effect, similarly as the possibility to manifest pain freely and distracting attention from pain. Only in exceptional cases hypnosis and suggestion can be used. Chronic pain can be mitigated by psychotherapeutic programmes by means of which we alter the patient's incorrect idea on the origin of pain and help him to gain control over his pain and promote his activity and self-consciousness. It is advisable to engage in therapy also the family and support the formation of self-help groups. In the USA and FRG favourable and stable results are reported with influencing of pain and its therapy by psychological procedures.
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PMID:[Moderating pain by psychological means]. 202

A two-phase assay was developed in the rat to evaluate parenteral formulations intended for intramuscular administration for the induction of both acute pain-on-injection and delayed pain/discomfort at the injection site (secondary to muscle damage). Phase 1 of the assay assessed pain-on-injection using a modified version of the previously published rat paw-lick assay. Adult male CD rats (10/group) were given subplantar (footpad) injections of 0.1 ml and then observed for 15 min for paw-lick responses. To increase assay sensitivity, responses more subtle than paw licks (ie., paw lifts) were scored, and injection-site clinical signs were recorded 6, 24, and 48 hr after injection. Phase 2 of the assay assessed myotoxic potential, using the same rats after a 1-week recovery period. The rats were injected intramuscularly in the anterior thigh with 0.2 ml, bled from the orbital sinus at 2, 6, and 24 hr for analysis of serum creatine kinase (CK), and then necropsied at 24 hr to prepare tissue sections of the injection site for microscopic examination. A series of cephalosporin-type antibiotics produced pain-on-injection and muscle damage consistent with reported clinical experience (cefazolin less than cephalothin less than cefoxitin). Several nonantibiotic parenteral formulations (diazepam, digoxin, phenytoin, and lidocaine) tested in the paw-lick/muscle irritation model also produced responses that correlated with the clinic, i.e., virtually no acute pain but moderate to marked muscle damage. The results indicate that the two-phase rat paw-lick/muscle irritation model is effective in evaluating parenteral formulations for clinical acceptability, and that both phases of the assay are necessary to optimize predictability of the assay for human clinical experience.
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PMID:Rat paw-lick/muscle irritation model for evaluating parenteral formulations for pain-on-injection and muscle damage. 208 14

Pain syndromes of the lumbar spine are one of the main problems in orthopedic practice. The therapeutic effect of NSAIDs is not subject to doubt in this connection. But considering that the application of NSAIDs is frequently associated with side effects, a reduction of dosage would be to the patient's benefit. Clinical studies have shown that concomitant treatment with vitamins B1, B6, B12 and diclofenac leads to a more efficient pain relief than treatment using diclofenac alone and thus provides the possibility of saving NSAIDs. This clinical trial was carried out in order to determine whether these results can also be achieved when a reduced dosage of diclofenac (75 mg daily) is used. 123 patients with acute pain syndromes of the lumbar spine were treated with either B-vitamins and diclofenac or diclofenac alone for a maximum of 7 days. There was the option to terminate therapy in the trial after 3-4 days in the case of total pain relief. 45 patients could stop the treatment due to remission of symptoms. 30 patients belonged to the combination therapy group, the other 15 took diclofenac alone; this difference is statistically significant (p less than 0.05). All parameters concerning pain relief and movement of the vertebral column showed statistically significant differences in favour of the B-vitamin-diclofenac-combination, too. The results document the positive influence of B-vitamins on painful vertebral syndromes and indicate that B-vitamins contribute to saving of NSAIDs by shortening the treatment time and reducing daily NSAID-dosage.
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PMID:[Reduced diclofenac administration by B vitamins: results of a randomized double-blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes]. 213 83

Psychological strategies can facilitate management of acute pain. Methods of intervening that are reviewed include information provision, cognitive methods such as self-statements, distraction or attention control, relaxation, and hypnosis. Individual patient coping style and anxiety may moderate need for or ability to use these techniques. Increasing perceived control may be an underlying factor common to all psychological interventions for the management of pain.
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PMID:Psychological strategies in acute pain management. 218 11


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