1,721,125 research outputs found
Analgesia - Methods and Protocols
Full text linkEven if pain is the one of the most common human experience, it is still difficult to describe it accurately and this fact represents a major challenge for researchers and clinicians. The IASP (International Association for the Study of Pain) defines pain as “unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”, emphasizing at the same time its emotional aspect and the fact that in many case it is difficult to demonstrate a reliable damage. Nevertheless, as prof. Szallasi underlined in his introduction, pain, and especially chronic pain, still remains undertreated even though it is affecting even more people than that entailed by pain’s description: this fact has important social and economical implications......
Continuous peripheral nerve blocks: state of the art
No full textPurpose of review: This review was performed through a Medline research to evaluate articles published between January 2004 and April 2005. Technical procedures, indications, drugs, infusion regimens, and complications of continuous peripheral nerve blocks were considered. Recent findings: A total of 27 articles were reviewed. With respect to technical procedures, the authors focused on advantages of stimulating catheters or ultrasound guidance. With the help of these techniques, a correct catheter placement as close to the targeted nerve as possible was obtained. The total amount of local anesthetic administered was thereby reduced. Using ultrasound needle guidance, the spread of local anesthetic around the nerve could be visualized. Articles dealing with the choice of local anesthetic showed equianalgesia and equipotency of continuous perineural infusion of levobupivacaine 0.125% and ropivacaine 0.2%. The best infusion regimen for postoperative analgesia appears to be a combination of a preset basal rate administered together with small bolus doses in almost all continuous peripheral nerve blocks. Overall, complications such as infections, local anesthetic toxic plasma levels, hematoma formation, or nerve injury seem to be rare in continuous peripheral nerve blockade. Summary: Continuous peripheral nerve blockade is an effective and safe technique for postoperative analgesia, even when administered at home. To optimize this technique, further studies are needed to help minimize the risk of side effects, improve techniques to locate the targeted nerve (stimulating catheters or ultrasound imaging) and choose less toxic drugs (levobupivacaine and ropivacaine) with more effective infusion regimens
Management of postoperative pain: how accurate and successful is our acute pain management?
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Analysis of a population of patients who referred to a second level pain center. Clinical and demographic characteristics
No full textAbstract: Pain is the symptom that leads most patients to ask for medical intervention; if not controlled, pain may become a very costly item in the Italian Health Care system. Proper referral to a second level specialist pain center can extensively decrease the duration of a painful condition, prevent the onset of more pain and of the so-called pain syndromes, and also reduce the improper use of analgesic drugs or pain surgery. Patients should be referred to a specialist pain center when their pain is uncontrolled.
In this observational study we analyzed the clinical and demographic data of a population referred for the first time to a specialist pain center (Fondazione Salvatore Maugeri, Pavia) in the year 2008 to define patient characteristics and to understand who makes referrals and after which kind of pharmacological and interventional treatment.
Our results indicate that in Italy patients are referred to a pain center very late, which increases the duration of pain syndromes and the cost of pain management
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