No abstract available.
Pain Management

No abstract available.
Pain Management

There is a growing awareness and acceptance of the benefits for cancer pain patients derived from psychiatric contributions to pain control. Unfortunately, cancer patients with pain are more vulnerable to psychiatric complications of cancer such as depression, anxiety and delirium. Knowledge of the indications and usefulness of the psychotropic drugs in the cancer pain population will be the most rewarding, particularly because these drugs are useful not only in the treatment of psychiatric complications of cancer, but also as adjuvant analgesic agents in the management of cancer pain.
PAIN MANAGEMENT

Patient’s belief towards pain management may affect pain management outcomes and quality of life. The main aim of the present study was to determine the impact of a pre-operative pain education package towards pain belief among patients undergoing orthopaedic surgery in a tertiary hospital. A one-group pre-test post-test design study was conducted on orthopaedic surgery patients. Thirty respondents were recruited and pre-operative pain education was administered individually before surgery. Pre-operative and post-operative pain belief, management scores and side effects were measured using the Barrier Questionnaire (BQ-13). The results reported significant differences between pre-test scores (Mean = 41.87, Standard Deviation = 11.467) and post-test scores (Mean=34.80, Standard Deviation=13.026) of pain belief (t = 2.84, p = 0.004). There were also significant differences between pre-test scores (Mean = 37.10, Standard Deviation = 10.610) and post-test scores (Mean=30.80, Standard Deviation = 11.424) of pain management (t = 3.856, p = 0.0005). Respondent’s gender (t = -2.403, p = 0.023) and ethnicity (F = 5.038, p=0.014) reported significant differences with p value < 0.05, respectively. However, there were no significant differences between educational level, ethnicity, prior surgical history with pain belief (p> 0.05). There was positive impact of the pain education package towards pain belief and painmanagement among respondents who underwent orthopaedics surgery in a tertiary hospital. Reinforcement of pain educational program is pivotal in order to achieve optimal post-operative pain management.
Pain management

Pain is an unpleasant sensation that can cause physical and psychological problems for the patient. Despite the pharmacological intervention for reducing pain, it remains as an issue after surgery. Music therapy as non-pharmacological intervention can effect post-operative pain and patients’ requirement of analgesics. The purpose of this study was to determine effect of music therapy on pain after elective total knee replacement (TKR) surgery. This study compared analgesics consumption by patients post-operatively for five days. A Quasi-experimental design with convenience sample of patient with a mean of 64.35 (49-76) who underwent TKR in UKM Medical Centre from May to December 2012 was used. Forty patients were randomly assigned in one of the two groups using a sealed-envelope technique. The experimental group listened to music for five days post-operatively and were on analgesics and control group were treated with pharmacological intervention only. Pain was measured by McGill Pain Questionnaire-Short Form (MPQ-SF) for patient on bed rest on day one, day three and day five post-operatively. Statistical (Mann- Whitney) findings between groups showed the experimental group significantly had less pain on day one and day five rather than the control group at 0.05 level using Pain Rating Intensity (PRI), Visual Analogue Scale (VAS) and Present Pain Intensity (PPI). Statistical (Friedman) tests within group showed that the patient had significantly decreased pain over time at level 0.05 using PRI, VAS and PPI. Statistical (Mann- Whitney) tests revealed that there was no significant difference when using analgesics between the two groups in five days post-operatively at milligram but comparing median showed experimental group used less analgesic than control group. Music therapy is simple, available, save and cheap effective intervention for pain management post-operatively. Pain management is one of the key roles of nursing and nurses can use music therapy as a simple intervention to reduce pain.
Pain Management

BACKGROUND: Postoperative Pain control in Open Nephrectomy is one of the leading concerns of patients who underwent the procedure. Many efforts were made to determine the most efficient concoction for pain control, and studies have shown that opioids were the most efficient in reducing pain; however, it was observed that these opioids would produce side effects which hinders the goals of Enhanced Recovery after Surgery (ERAS). Lidocaine Intravenous infusion on the other hand, has been introduced as an adjunct as an opioid sparing alternative. It has been reported that it is effective in managing pain in different types of surgeries with promising results. OBJECTIVE: To determine the effectiveness of perioperative intravenous lidocaine infusion as an adjunct in postoperative analgesia in patients undergoing open nephrectomy. METHODOLOGY: This is a randomized, double-blind, placebo-controlled study among patients admitted at The Institution, who underwent Elective open nephrectomy. Randomization into two treatment groups was done via draw lots. Both groups received treatment 30mins prior to cutting time wherein induction of anesthesia using Midazolam 1 mg IV, Fentanyl 50mcg/dose IV, Propofol 1 % 1 mg/kg IV, with sevoflurane were used and adjusted accordingly. Rocuronium 0.6mg/kg IV was used as muscle relaxant. During induction, Group A received Lidocaine 2% (200mg) diluted to D5W in a 50ml syringe and infused intravenously via Target controlled infusion (TCI) with a maintenance rate of 40mcg/kg/min infusion intra-operatively at the start of cutting time. On the other hand, Group B will receive PNSS in a 50ml syringe. Postoperative outcome measured for this study includes numeric pain scores at 1, 2, 1 2, and 24 hours post operatively, number of morphine rescue doses and presence of adverse drug reactions. RESULTS Patients who received lidocaine had significantly lower mean pain scores across all time periods (7.6±1.2 at 1 hr, 3.4±1.3 at 2 hrs, 2.5±0.8 at 12 hrs, and 1.5±2.0 at 24 hrs) compared to those who received placebo (5.4± 1.6 at 1 hr, 5.4± 1.6 at 2 hrs, 4.9±1.1 at 12 hrs, and 3.5±1.5 at 24 hrs) (pvalue= 0.0021 ). The mean pain scores of both groups significantly decreased starting from 1 hour to 24 hours after surgery (p-value=0.0000). Patients who received lidocaine had significantly lower mean number of rescue morphine (1 .9±2.1) compared to those who received placebo (5.6±2. 9) (p-value=0.0001 ). No patients had significant adverse reactions from the lidocaine group, while 6 patients (33.3%) had nausea from the placebo group (p-value=0.019). Conclusion: Peri-operative intravenous Lidocaine Infusion (IVLI) is effective in reducing postoperative pain during the first, second, twelfth and twenty-fourth hours after nephrectomy. Also, the administration of perioperative IVLI significantly lowered the number of needed rescue morphine.
Pain Management

No abstract available.
Pain Clinics* ; Pain Management*

No abstract available.
Pain Clinics* ; Pain Management*

The author investigated pain experiences of 90 cancer patients and adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of "worst pain" during the 24 hour period, 70% of the patients reported they had "severe" pain. As for ratings on "pain now" 43% of the cancer patients reported "moderate to severe" pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes, systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.
Humans ; Pain Management* ; Pain Measurement

No abstract available.
Compliance* ; Pain Management*