Manage perioperative pain in morbidly obese patients by taking an all-round multimodal approach

AbstractMorbidly obese individuals often require surgery, including bariatric (weight management) surgery. Acute pain management in the morbidly obese must consider the risk of chronic post-surgical pain, opioid dependence, and comorbidities (e.g. sleep-disordered breathing). A stepped, multimodal, opioid-sparing approach titrated to the type and severity of pain type should be taken, with co-administration of systemic and local anaesthetic agents when appropriate.
Source: Drugs and Therapy Perspectives - Category: Drugs & Pharmacology Source Type: research

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ConclusionsThere is a relation between excess abdominal fat and CA. Abdominal obesity might contribute to the development of central sensitization in migraineurs, leading to migraine chronification.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
Comorbidity is the presence of one or more additional conditions co-occurring with a primary condition. In this episode, host schizophrenic Rachel Star Withers with her cohost Gabe Howard will be discussing comorbidity with schizophrenia. Comorbidity is associated with worse health outcomes, more complex clinical management and increased health care costs. Occupational therapist and host of the podcast Occupied, Brock Cook, will be joining us to discuss ways that he works with people with schizophrenia to manage multiple health issues.  Highlights from “Comorbidity with Schizophrenia” Episode [01:28] What ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Antipsychotic Inside Schizophrenia Mental Health and Wellness Psychiatry Psychology Psychotherapy Bipolar disorder and schizophrenia comorbid comorbid psychiatric conditions Comorbidities Comorbidity Diagnosis Of Schizophrenia Livi Source Type: blogs
We present the case of a 59-year-old woman with third-grade obesity and severe comorbidities including osteoporosis, dyslipidemia, diabetes mellitus, hypertension, night eating following bariatric biliary-intestinal bypass surgery, severe fibromyalgia, poly-arthrosis, lumbar disc herniation in L5S1, sleep disorders and sleep apnea syndrome, and emotional disorders with anxiety and depression, who suffered from chronic pain unresponsive to a combination of multiple analgesics. After a period of metabolic and nutritional rehabilitation, analgesic treatment with tapentadol prolonged release (PR) was started and gradually incr...
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
ConclusionsA history of MST is common among older women veterans and associated with a range of medical and mental health diagnoses. These findings call attention to the need for additional research in this understudied population, and the importance of trauma-informed care approaches for women across the lifespan.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Authors: Hawker GA Abstract Osteoarthritis (OA) is the most common form of arthritis, affecting 1 in 3 people over age 65 and women more so than men. The prevalence of OA is rising due, in part, to the increasing prevalence of OA risk factors, including obesity, physical inactivity, and joint injury. OA-related joint pain causes functional limitations, poor sleep, fatigue, depressed mood and loss of independence. Compared to age and sex-matched peers, OA patients incur higher out of pocket health-related expenditures and substantial costs due to lost productivity. Most people with OA (59-87%) have at least one othe...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Conclusions Health care could be substantially improved if all medical specialties would be familiar with BPD, its pathology, medical and psychiatric comorbidities, complications, and treatment. In mental health care, several empirically validated treatments that are applicable in a wide range of clinical settings are available.
Source: Psychosomatic Medicine - Category: Psychiatry & Psychology Tags: CLINICAL APPLICATIONS Source Type: research
A 57-year-old man with a history of coronary artery disease, diastolic heart failure, obstructive sleep apnea, chronic kidney disease, morbid obesity, 60 pack-year smoking history, and gastric bypass (performed 20 years ago) presented to an outside institution with severe chest pain, sepsis, and pneumopericardium. He had no other history of abdominal or thoracic surgery. He was readmitted for heart failure exacerbation and was subsequently transferred to our institution for a higher level of care and possible surgical management.
Source: Surgery - Category: Surgery Authors: Source Type: research
ConclusionsA substantial part of the population reports pain over a long period of their life course and long ‐term trajectories of pain may reflect phenotypes that may be relevant to take into account in pain management. Several risk factors, such as short‐sleep duration, smoking, obesity and poor perceived or mental health may be relevant in recognizing those with pain, and tackling these may contribu te to the prevention of pain over the life course.SignificanceAsking adults about pain every 5  years over a 15‐year period shows that almost one‐third never reported pain and one‐fifth persistent pain. &ldqu...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsA substantial part of the population reports pain over a long period of their life course and long ‐term trajectories of pain may reflect phenotypes that may be relevant to take into account in pain management. Several risk factors, such as short sleep duration, smoking, obesity and poor perceived or mental health may be relevant in recognizing those with pain, and tackling these may contribute to the prevention of pain over the life course.SignificanceAsking adults about pain every 5 years over a 15 ‐year period shows that almost one‐third never reported pain and one‐fifth persistent pain. ‘Persis...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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