Pain Management
Margaret O’Connor, Sanchia Aranda, Susie Wilkinson in Palliative Care Nursing, 2018
The temporal assessment involves a description of how the pain feels over time. This includes a description of the onset, duration, and frequency of the pain. These should be considered in association with an assessment of factors that exacerbate or relieve the pain. Nurses should pay particular attention to the following temporal factors (Portenoy & Hagen 1989). Incident pain: This is pain that occurs with movement or activity. Incident pain is usually predictable and can be prevented with doses of analgesics administered at an appropriate interval before the painful activity.Breakthrough pain: This is an unpredictable exacerbation of pain that occurs against a background of constant pain that is otherwise controlled.End-of-dose pain: This is pain that occurs just before the next dose of analgesic is due. This indicates a need to increase the dose or to decrease the interval of administration.
The Role of Nursing in Pain Management
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Tools for pain intensity rating are only as useful as patients’ ability to understand and use them. Nursing communication skills ensure that patients understand the use of chosen pain assessment instruments. Nurses use pain intensity rating scales appropriate to patients’ cognitive ability and language skills. Patients are asked to report pain intensity ratings without undue influence from others. The McGill Pain Questionnaire (MPQ) measures affective pain experience components in addition to pain intensity, supplementing data obtained during the nursing interview (Melzack, 1995). Using assessment tools, nurses determine pain intensity scores for the least and most intense pain levels. Patients identify whether there is breakthrough pain and, if so, what pain intensity scores occur.
Low-Dose Naltrexone
Sahar Swidan, Matthew Bennett in Advanced Therapeutics in Pain Medicine, 2020
The treatment for pain should be individualized for each patient depending on the pathology and symptoms. The goals of pain management therapy are to improve the patient’s level of functioning, decrease pain perception, reduce the use of medications when possible, and improve the quality of life. Traditional medication therapies for pain include the use of NSAIDs (e.g., ibuprofen, naproxen), non-opioid analgesics (e.g., acetaminophen), tricyclic antidepressants (e.g., amitriptyline, imipramine), and anticonvulsants (e.g., gabapentin). These treatment options focus on reducing the inflammatory response to pain stimuli as well as inhibiting afferent pain stimuli by acting as ligands of alpha-2-delta voltage-gated calcium channels in the CNS. Low-dose and ultra-low-dose naltrexone (ULDN) have been investigated for the management of pain, complex regional pain syndrome (CRPS), and painful diabetic neuropathy with encouraging results.
Clinical observation of regular intermittent epidural injection combined with different puncture points in suppressing breakthrough pain in labour analgesia
Published in Journal of Obstetrics and Gynaecology, 2019
Chunli Wu, Baolin Shi, Hong Jiang
The observation indexes were – (1) HR, BP, RR, SpO2 and FHR. (2) The VAS and a modified Bromage scores at different time points before analgesia (T0), 10 minutes (T1), 20 minutes (T2), 30 minutes (T3) and 60 minutes (T4) after the analgesia (timing was started immediately after the test dose was injected), 7–8 cm uterine orifice (T5), and whole was uterine open (T6), (0 point: the hip, knee and ankle can be fully flexed; one point: the knee and ankle can be flexed; two points: only the ankle can be flexed; three points: none of the above joints can be flexed); 60 minutes after analgesic, the scores were recorded once every one hour until the end of delivery. (3) After the sensation block plane was analgesic (with athalposis as the standard), the scores were recorded once every 10 minutes for the first 30 minutes, and then once every one hour until the end of delivery. (4) The occurrence of breakthrough pain. (5) Doses of ropivacaine and sufentanil. (6) The analgesic time (from the implementation of epidural analgesia to the medicine withdrawal due to a whole uterine opening), labour duration, and the delivery mode. (7) A maternal oxytocin dosage and a postpartum haemorrhage. (8) The prevalence of hypotension, itching, nausea, vomiting or other adverse reactions. (9) The neonatal weight and the Apgar scores at the 1st and 5th min after a birth recorded. (10) Maternal satisfaction score (0 point: dissatisfactory, 100 points: very satisfied).
Antinociceptive activity of doliroside B
Published in Pharmaceutical Biology, 2023
Xishan Bai, Yanhong Li, Yuxiao Li, Min Li, Ming Luo, Kai Tian, Mengyuan Jiang, Yong Xiong, Ya Lu, Yukui Li, Haibo Yu, Xiangzhong Huang
Pain causes a negative consequence on health status and influences the quality of life (Williams and Craig 2016). As pain is a complex medical concern, multiple pathways involved in the process from the transduction of noxious stimuli to cognitive and emotional processing in the brain (Ossipov et al. 2014). To date, many drugs are used in clinic management of pain symptoms, such as non-steroidal anti-inflammatory drugs (NSAIDs), opioid drugs, and anti-depressive drugs. Among these drugs, opioid analgesics are the most effective pharmacological agents for moderate to severe pain. Unfortunately, their therapeutic benefit is often limited by analgesic tolerance and hyperalgesia (Benyamin et al. 2008). Unwanted side effects also occur very often. In this sense, natural products could serve as a better choice for pain management drug discovery.
(E)-3-furan-2-yl-N-phenylacrylamide (PAM-4) decreases nociception and emotional manifestations of neuropathic pain in mice by α7 nicotinic acetylcholine receptor potentiation
Published in Neurological Research, 2021
Deniz Bagdas, Gulce Sevdar, Zulfiye Gul, Rabha Younis, Sinan Cavun, Han-Shen Tae, Marcelo O. Ortells, Hugo R. Arias, Mine Sibel Gurun
Pain has been described as a multi-dimensional state composed of sensory, affective, and cognitive components [1,2]. Furthermore, pain states that require clinical intervention are often accompanied by changes in affective behaviors [3,4]. At present, non-steroidal anti-inflammatory drugs and opioids remain the most common forms of pharmacological treatments for different types of pain. In general, these medications show low efficacy in several types of chronic pain, particularly associated with neuropathies, and opioids present high risk for addiction/abuse and death from overdose. Although chronic neuropathic pain is mainly treated with antidepressants (e.g. duloxetine and amitriptyline) and anticonvulsants (e.g. gabapentin and pregabalin), these medications also show limited efficacy and/or limited tolerability profiles across different patient populations. Hence, there is a critical need for more effective, non-opioid pharmacotherapies for pain management [5].
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