Pain management in palliative care: art or science

Publication date: Available online 6 September 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Brigid BassamAbstractPain management in palliative care is both an art and a science. Essential to good pain control is an understanding not only of the pathophysiology of the origin of the pain, but also the impact that the pain is having, as the palliative patient may have to live with the symptoms of disease for months or even years. Interventions can then be targeted and at various times, may include a range of pharmacological treatments, psychological or spiritual support and possibly the involvement of other specialties to alleviate a particular problem.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

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Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
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Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Authors: Wu J, Ku SC, Ko AL Abstract A 51-year-old man with metastatic renal cell carcinoma whose fentanyl requirement was 3000-4000 µg/h in inpatient hospice presented for a thoracic (T) vertebral 4-10 posterior spinal fusion for a lytic T7 compression fracture. He underwent total intravenous (IV) anesthesia with propofol, remifentanil, and ketamine; liposome bupivacaine was locally infiltrated at the end of the case. Following extubation on postoperative day (POD) 1, he had severe pain refractory to high-dose IV fentanyl patient control analgesia and ketamine infusion. His pain dramatically improved ...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
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Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Publication date: Available online 2 July 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Christopher JG. Green, Somnath BagchiAbstractOpiates remain the mainstay of the management of severe pain in acute, chronic and palliative settings across all population ages. Pharmacological advancement allows alternative routes of drug delivery best suited to individual patients and their conditions, with improved efficacy and safety. The different approaches to administration vary in their convenience, both to staff and patients, which can translate to differences in prescription compliance. Furthermore, the choice o...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM. Introduction Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
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This article is protected by copyright. All rights reserved. PMID: 30758119 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Do-not-resuscitate (DNR) orders are common among children receiving palliative care, who may nevertheless benefit from surgery and other procedures. Although anesthesia, surgery, and pediatric guidelines recommend systematic reconsideration of DNR orders in the perioperative period, data regarding how clinicians evaluate and manage DNR orders in the perioperative period is limited.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Do-not-resuscitate (DNR) orders are common among children receiving palliative care, who may nevertheless benefit from surgery and other procedures. Although anesthesia, surgery, and pediatric guidelines recommend systematic reconsideration of DNR orders in the perioperative period, data regarding how clinicians evaluate and manage DNR orders in the perioperative period are limited.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Brief Report Source Type: research
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