Pub Date : 2019-10-02DOI: 10.5772/intechopen.85864
M. Cascella
The symptom pain is a perception affected by complex interconnections of biological, psychological, and social factors. Analgesic monotherapy can often provide pain relief in clinical conditions featuring non-severe pain. In other circumstances, such as those characterized by intractable cancer pain, or concerning acute/ chronic non-cancer neuropathic pain, the intensity and quality of the pain require individualized multidrug approaches, with different analgesics and adjuvants used in combination according to clinical practice guidelines published by international and regional professional associations [1]. Moreover, because pharmacological strategies may not be able to successfully treat all patients with acute or chronic pain, nonpharmacological strategies should be included in the analgesic program, supporting and strengthening drug therapy [2]. Again, especially, chronic pain represents a dynamic experience, profoundly changeable in a spatial-temporal manner; thus, standardized and fixed protocols are not universally applicable for pain therapy. From these premises, the individualized, dynamic, and multicomponent pathway is summarized by the concept of the multimodal approach to pain management and represents a real revolution in this field of medicine. This optimization strategy can allow managing the pain by treating this symptom in its variegated clinical expressions through multiple interventions. According to the concept of multimodal therapy, the objective of pain relief is possible by targeting different sites of the nociceptive pathway [3] and by managing the galaxy of pain-related conditions through pharmacologic and nonpharmacologic modalities [4]. However, several considerations should be addressed in order to better understand its rational application for both acute (e.g., postoperative) and chronic pain management.
{"title":"Introductory Chapter: The Rationale for a Multimodal Approach to Pain Treatment","authors":"M. Cascella","doi":"10.5772/intechopen.85864","DOIUrl":"https://doi.org/10.5772/intechopen.85864","url":null,"abstract":"The symptom pain is a perception affected by complex interconnections of biological, psychological, and social factors. Analgesic monotherapy can often provide pain relief in clinical conditions featuring non-severe pain. In other circumstances, such as those characterized by intractable cancer pain, or concerning acute/ chronic non-cancer neuropathic pain, the intensity and quality of the pain require individualized multidrug approaches, with different analgesics and adjuvants used in combination according to clinical practice guidelines published by international and regional professional associations [1]. Moreover, because pharmacological strategies may not be able to successfully treat all patients with acute or chronic pain, nonpharmacological strategies should be included in the analgesic program, supporting and strengthening drug therapy [2]. Again, especially, chronic pain represents a dynamic experience, profoundly changeable in a spatial-temporal manner; thus, standardized and fixed protocols are not universally applicable for pain therapy. From these premises, the individualized, dynamic, and multicomponent pathway is summarized by the concept of the multimodal approach to pain management and represents a real revolution in this field of medicine. This optimization strategy can allow managing the pain by treating this symptom in its variegated clinical expressions through multiple interventions. According to the concept of multimodal therapy, the objective of pain relief is possible by targeting different sites of the nociceptive pathway [3] and by managing the galaxy of pain-related conditions through pharmacologic and nonpharmacologic modalities [4]. However, several considerations should be addressed in order to better understand its rational application for both acute (e.g., postoperative) and chronic pain management.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114202314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-18DOI: 10.5772/INTECHOPEN.85501
L. Perryman
Spinal cord stimulation (SCS), as a neuromodulation therapy, has rapidly evolved over the past few decades to become the treatment of choice for many chronic pain syndromes. However, many equipment-related limitations such as the bulk of the equipment, an implantable pulse generator (IPG), the limited therapeutic stimulation frequency utilized, and the potential adverse events have restricted SCS applications. Recently, advanced nanotechnology and minimally invasive surgical techniques have shown promising options to expand the indications due to reduced surgical trauma/hospital time/costs. We describe the basis for nanotechnology neuromodulation and the preliminary experience with wireless SCS in the treatment of chronic pain conditions. The equipment utilizes a miniature stimulator with microelectronics, percutaneously placed at the appropriate stimulation target, with wireless control to provide the desired stimulation, and then moderated by the clinician and the patient. The wireless device reduces the bulk of the SCS equipment to a single electrode (with embedded sensors), using the new improved neuralelectric interface. This wireless neuromodulation (WNM) has been clinically used in several chronic pain conditions, including failed back surgery syndrome, facial pain, chronic regional pain syndrome, and postherpetic neuralgia, with encouraging outcome, without the complications of a traditional SCS resulting from the IPG or its accessories.
{"title":"Wireless Neuromodulation: From Bench to Bedside","authors":"L. Perryman","doi":"10.5772/INTECHOPEN.85501","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85501","url":null,"abstract":"Spinal cord stimulation (SCS), as a neuromodulation therapy, has rapidly evolved over the past few decades to become the treatment of choice for many chronic pain syndromes. However, many equipment-related limitations such as the bulk of the equipment, an implantable pulse generator (IPG), the limited therapeutic stimulation frequency utilized, and the potential adverse events have restricted SCS applications. Recently, advanced nanotechnology and minimally invasive surgical techniques have shown promising options to expand the indications due to reduced surgical trauma/hospital time/costs. We describe the basis for nanotechnology neuromodulation and the preliminary experience with wireless SCS in the treatment of chronic pain conditions. The equipment utilizes a miniature stimulator with microelectronics, percutaneously placed at the appropriate stimulation target, with wireless control to provide the desired stimulation, and then moderated by the clinician and the patient. The wireless device reduces the bulk of the SCS equipment to a single electrode (with embedded sensors), using the new improved neuralelectric interface. This wireless neuromodulation (WNM) has been clinically used in several chronic pain conditions, including failed back surgery syndrome, facial pain, chronic regional pain syndrome, and postherpetic neuralgia, with encouraging outcome, without the complications of a traditional SCS resulting from the IPG or its accessories.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126489341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-03DOI: 10.5772/INTECHOPEN.84580
İ. Solmaz, Aydan Örsçelik
Pain is a symptom caused by a disease process and/or tissue injury. With the prolongation of life expectancy in humans, the incidence of degenerative joint diseases and as a result pain has increased. Unfortunately, a method of treatment that stops or reverses progression by affecting the pathogenesis in these diseases has not been developed. Physical therapeutics such as medicine and physical rehabilitation often are prescribed for patients suffering with pain. Recently, in addition to these routine therapies used in pain treatment, many regenerative injection-based therapies, including prolotherapy (PrT) or platelet-rich plasma (PRP) have been widely used. PrT is using for damaged or degenerated connective tissue healing, such as ligaments, tendons, and cartilage. The combination of local inflammatory effect, stimulation of local growth factor release, and down regulation of neuropathic inflammation can be defined as the mechanism. As a result of these, joint instability and ligament laxity reduce and pain decrease. PRP is the cellular component of the plasma. Although PRP is used for the same reasons as PrT, it can be used in acute cases unlike PrT. This chapter is intended to understand the use of regenerative injection therapies (PrT and PRP) better in the treatment of pain.
{"title":"Features and Clinical Effectiveness of the Regenerative Injection Treatments: Prolotherapy and Platelet-Rich Plasma for Musculoskeletal Pain Management","authors":"İ. Solmaz, Aydan Örsçelik","doi":"10.5772/INTECHOPEN.84580","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84580","url":null,"abstract":"Pain is a symptom caused by a disease process and/or tissue injury. With the prolongation of life expectancy in humans, the incidence of degenerative joint diseases and as a result pain has increased. Unfortunately, a method of treatment that stops or reverses progression by affecting the pathogenesis in these diseases has not been developed. Physical therapeutics such as medicine and physical rehabilitation often are prescribed for patients suffering with pain. Recently, in addition to these routine therapies used in pain treatment, many regenerative injection-based therapies, including prolotherapy (PrT) or platelet-rich plasma (PRP) have been widely used. PrT is using for damaged or degenerated connective tissue healing, such as ligaments, tendons, and cartilage. The combination of local inflammatory effect, stimulation of local growth factor release, and down regulation of neuropathic inflammation can be defined as the mechanism. As a result of these, joint instability and ligament laxity reduce and pain decrease. PRP is the cellular component of the plasma. Although PRP is used for the same reasons as PrT, it can be used in acute cases unlike PrT. This chapter is intended to understand the use of regenerative injection therapies (PrT and PRP) better in the treatment of pain.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122088919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-25DOI: 10.5772/INTECHOPEN.84195
Sevda Arısoy, Işık Çoban, Özlem Üstün‐Aytekin
Traditional opioids have been used for the people who suffer from cancer, burns, surgery, HIV/AIDS, and other serious illness pains for years. However, numerous side effects like dizziness, apnea, physical dependence, tolerance, addiction, nau-sea, and vomiting push the researchers to look forward to the new opioid options. The opioid peptides which derived from foods provide significant advantages as the safe and natural alternative. The researchers reported that it is also promising a new functional food and nutraceutical. In this chapter, the type of food-derived opioids, their origins, possible receptors, their amino acid sequences, opioid effects, production techniques, and health benefits are reviewed.
{"title":"Food-Derived Opioids: Production and the Effects of Opioids on Human Health","authors":"Sevda Arısoy, Işık Çoban, Özlem Üstün‐Aytekin","doi":"10.5772/INTECHOPEN.84195","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84195","url":null,"abstract":"Traditional opioids have been used for the people who suffer from cancer, burns, surgery, HIV/AIDS, and other serious illness pains for years. However, numerous side effects like dizziness, apnea, physical dependence, tolerance, addiction, nau-sea, and vomiting push the researchers to look forward to the new opioid options. The opioid peptides which derived from foods provide significant advantages as the safe and natural alternative. The researchers reported that it is also promising a new functional food and nutraceutical. In this chapter, the type of food-derived opioids, their origins, possible receptors, their amino acid sequences, opioid effects, production techniques, and health benefits are reviewed.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132177702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-11DOI: 10.5772/INTECHOPEN.84581
Xuehai Yan
Breakthrough cancer pain has attracted more and more attentions recently because it has become the biggest obstacle to control cancer pain. Pain can occur at any stage of cancer. Despite the aggressive treatment, some patients still experience high-intensity pain in the short term, which is commonly referred to as breakthrough pain. Typical breakthrough pain has clinical features such as rapid onset and short duration, and it has uncontrollable and unpredictable characteristics, which impact the overall life quality of patients and the therapeutic effect of cancer pain. It has always been a puzzle and difficult in clinical treatment of breakthrough cancer pain. This paper aims to provide a more detailed review of the definition, assessment tools, classification and characteristics, epidemiology, and mechanism and treatment of breakthrough cancer pain, in order to facilitate the future development of this work in clinical treatment.
{"title":"Breakthrough Cancer Pain","authors":"Xuehai Yan","doi":"10.5772/INTECHOPEN.84581","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84581","url":null,"abstract":"Breakthrough cancer pain has attracted more and more attentions recently because it has become the biggest obstacle to control cancer pain. Pain can occur at any stage of cancer. Despite the aggressive treatment, some patients still experience high-intensity pain in the short term, which is commonly referred to as breakthrough pain. Typical breakthrough pain has clinical features such as rapid onset and short duration, and it has uncontrollable and unpredictable characteristics, which impact the overall life quality of patients and the therapeutic effect of cancer pain. It has always been a puzzle and difficult in clinical treatment of breakthrough cancer pain. This paper aims to provide a more detailed review of the definition, assessment tools, classification and characteristics, epidemiology, and mechanism and treatment of breakthrough cancer pain, in order to facilitate the future development of this work in clinical treatment.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131836460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.5772/INTECHOPEN.83837
Sameer Shaikh
Pain in the orofacial region is by far the commonest reason for patients to seek treatment. Tooth and intraoral structures are often the main sources of orofacial pain. Odontogenic pain, also commonly known as tooth pain, originates from dental structures, pulpal or periodontal. Nonodontogenic oral pain can originate from intraoral structures such as gingiva and buccal mucosa. Arriving at a correct and definitive diagnosis is of paramount importance to institute an appropriate treatment. Obtaining a detailed history from the patient including the location, duration, frequency, periodicity, character, and quality of pain assists in differentiating odontogenic from nonodontogenic causes. Wide varieties of pharmacological agents, along with invasive and noninvasive procedures, are available to manage odontogenic and nonodontogenic pain. While managing orofacial pain, clinical and pharmacological judgment should encompass a systematic and objective assessment in compliance with the strongest evidence available. In this chapter, there will be a discussion of various choices and options available to manage a few of the orofacial pain complaints.
{"title":"Management of Odontogenic and Nonodontogenic Oral Pain","authors":"Sameer Shaikh","doi":"10.5772/INTECHOPEN.83837","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83837","url":null,"abstract":"Pain in the orofacial region is by far the commonest reason for patients to seek treatment. Tooth and intraoral structures are often the main sources of orofacial pain. Odontogenic pain, also commonly known as tooth pain, originates from dental structures, pulpal or periodontal. Nonodontogenic oral pain can originate from intraoral structures such as gingiva and buccal mucosa. Arriving at a correct and definitive diagnosis is of paramount importance to institute an appropriate treatment. Obtaining a detailed history from the patient including the location, duration, frequency, periodicity, character, and quality of pain assists in differentiating odontogenic from nonodontogenic causes. Wide varieties of pharmacological agents, along with invasive and noninvasive procedures, are available to manage odontogenic and nonodontogenic pain. While managing orofacial pain, clinical and pharmacological judgment should encompass a systematic and objective assessment in compliance with the strongest evidence available. In this chapter, there will be a discussion of various choices and options available to manage a few of the orofacial pain complaints.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133119443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-25DOI: 10.5772/INTECHOPEN.84377
G. Lauder, N. West, Greg Siren
Chronic pain is a significant burden in all societies. The myofascial origins of chronic pain are often unrecognized but play a major role in chronic pain generation. Myofascial release has been shown to be effective and can augment the limited number of therapeutic tools available to manage chronic pain. However, there is no standardized approach that allows for comparative analysis of this technique. myoActivation ® is a unique therapeutic system, which targets active myofascial trigger points, fascia in tension, and scars in patients with chronic pain. Targets for intervention are determined through obtaining a history of lifetime trauma and a structured, reproducible posture, and movement assessment. Catenated cycles of movement tests, palpation, and needling are used to achieve the goal of pain resolution through restoration of soft tissue integrity. This chapter describes the distinctive features of myoActivation from the important key elements of the patient’s clinical history, through to the aftercare instructions. Relevant evidence for each component will be presented. Case studies will be used to illustrate some important concepts and the effectiveness of myoActivation . This chapter is relevant to all clinicians that manage people living with chronic pain.
{"title":"myoActivation: A Structured Process for Chronic Pain Resolution","authors":"G. Lauder, N. West, Greg Siren","doi":"10.5772/INTECHOPEN.84377","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84377","url":null,"abstract":"Chronic pain is a significant burden in all societies. The myofascial origins of chronic pain are often unrecognized but play a major role in chronic pain generation. Myofascial release has been shown to be effective and can augment the limited number of therapeutic tools available to manage chronic pain. However, there is no standardized approach that allows for comparative analysis of this technique. myoActivation ® is a unique therapeutic system, which targets active myofascial trigger points, fascia in tension, and scars in patients with chronic pain. Targets for intervention are determined through obtaining a history of lifetime trauma and a structured, reproducible posture, and movement assessment. Catenated cycles of movement tests, palpation, and needling are used to achieve the goal of pain resolution through restoration of soft tissue integrity. This chapter describes the distinctive features of myoActivation from the important key elements of the patient’s clinical history, through to the aftercare instructions. Relevant evidence for each component will be presented. Case studies will be used to illustrate some important concepts and the effectiveness of myoActivation . This chapter is relevant to all clinicians that manage people living with chronic pain.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125824907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.5772/INTECHOPEN.84593
H. Krug
Osteoarthritis is a significant public health problem and is rapidly increasing in prevalence with the aging population. Pain is the most disabling consequence of osteoarthritis. Treatment for pain is inadequate and needs to be addressed with new therapeutic modalities. Chronic pain is often the result of peripheral and central pain sensitization which reduces the pain threshold and increases the perceived pain response to noxious and even non-noxious stimuli. Neurotoxins can reduce this sensitization by various mechanisms and are a fertile area of research for the treatment of chronic pain. Botulinum toxins, vanilloids, and conotoxin have all been studied for the treatment of chronic pain. Botulinum toxins and vanilloids have the greatest potential as analgesics for chronic joint pain thus far. Monoclonal antibodies directed against nerve growth factor have also been developed for the treatment of chronic joint pain due to osteoarthritis. These antibodies are not technically neurotoxins but have significant analgesic potential. However, they may have undesirable side effects and are still being evaluated as possible therapies for chronic osteoarthritis pain.
{"title":"The Use of Neurotoxins for Palliative Treatment of Chronic Joint Pain","authors":"H. Krug","doi":"10.5772/INTECHOPEN.84593","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84593","url":null,"abstract":"Osteoarthritis is a significant public health problem and is rapidly increasing in prevalence with the aging population. Pain is the most disabling consequence of osteoarthritis. Treatment for pain is inadequate and needs to be addressed with new therapeutic modalities. Chronic pain is often the result of peripheral and central pain sensitization which reduces the pain threshold and increases the perceived pain response to noxious and even non-noxious stimuli. Neurotoxins can reduce this sensitization by various mechanisms and are a fertile area of research for the treatment of chronic pain. Botulinum toxins, vanilloids, and conotoxin have all been studied for the treatment of chronic pain. Botulinum toxins and vanilloids have the greatest potential as analgesics for chronic joint pain thus far. Monoclonal antibodies directed against nerve growth factor have also been developed for the treatment of chronic joint pain due to osteoarthritis. These antibodies are not technically neurotoxins but have significant analgesic potential. However, they may have undesirable side effects and are still being evaluated as possible therapies for chronic osteoarthritis pain.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"32 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132027283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-11DOI: 10.5772/INTECHOPEN.83427
M. Bender, L. Papa
There is a growing expectation of physicians to treat acute pain more aggressively in the emergency department (ED). This has contributed to an increase in opiate prescribing practices that has resulted in a crisis of medication abuse and misuse. The resultant backlash against physicians has created a void within the realm of acute pain management, as physicians search for a means to treat their patients in a way that is both empathetic and responsible. In an effort to combat this growing epidemic, alternative means of pain control are being explored. Patient-controlled analgesia devices (PCADs) have been used extensively in multiple fields of medicine and have demonstrated significant clinical utility for treating pain postoperatively; however there is a dearth of evidence to support their use within the acute care setting. Due to this lack of evidence, PCADs have not been widely implemented in the ED. Recent studies have shown that the use of PCADs may improve objective pain scores and increase both patient and nurse satisfaction while reducing the likelihood of developing chronic pain. The economic feasibility of this undertaking remains unclear; however there is strong evidence for the clinical utility of this modality to treat acute pain in this population.
{"title":"The Utility of Patient-Controlled Analgesia for Managing Acute Pain in the Emergency Department","authors":"M. Bender, L. Papa","doi":"10.5772/INTECHOPEN.83427","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83427","url":null,"abstract":"There is a growing expectation of physicians to treat acute pain more aggressively in the emergency department (ED). This has contributed to an increase in opiate prescribing practices that has resulted in a crisis of medication abuse and misuse. The resultant backlash against physicians has created a void within the realm of acute pain management, as physicians search for a means to treat their patients in a way that is both empathetic and responsible. In an effort to combat this growing epidemic, alternative means of pain control are being explored. Patient-controlled analgesia devices (PCADs) have been used extensively in multiple fields of medicine and have demonstrated significant clinical utility for treating pain postoperatively; however there is a dearth of evidence to support their use within the acute care setting. Due to this lack of evidence, PCADs have not been widely implemented in the ED. Recent studies have shown that the use of PCADs may improve objective pain scores and increase both patient and nurse satisfaction while reducing the likelihood of developing chronic pain. The economic feasibility of this undertaking remains unclear; however there is strong evidence for the clinical utility of this modality to treat acute pain in this population.","PeriodicalId":423392,"journal":{"name":"From Conventional to Innovative Approaches for Pain Treatment","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129504073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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