In this chapter, we provide an overview of the most current techniques in the evaluation, diagnosis, and treatment of pain in the outpatient setting. We performed a targeted literature review by searching for the terms such as “chronic pain” and “pain management.” Relevant articles were cited, and findings were described in the chapter text. Additionally, we supplemented our review with images from the Spine and Pain Associates’ offices at St. Luke’s University Health Network (SLUHN) in Bethlehem, PA, as well as medical illustrations by our authors. We begin the review with a description of pain—its definition, components, complexity, and classifications and then provide a stepwise outline of the pharmacologic approach beyond nonsteroidal anti-inflammatory drugs before delving into newer interventional pain management procedures. Subsequently, this chapter is not comprehensive as it does not provide extensive discussion on older, more established procedures such as epidural steroid injections as well as practices falling out of favor such as discograms and neurolysis. Instead, we focus on newer subacute to chronic nonmalignant pain interventions. Finally, we attempt to highlight future directions of the growing field. Overall, we provide an overview of the management of chronic by providing insights into updates to chronic pain management.
As the prevalence of mental health illnesses rises worldwide, the use of psychotropic medications follows. Undoubtedly, many patients using psychotropic medications will undergo procedures requiring anesthesia both in the operating room and outside of it. This chapter focuses on psychotropic medications that may complicate the surgical and postoperative course of patients undergoing anesthesia. Toward this aim, we performed a literature review using targeted key terms. Relevant articles were cited, and findings are summarized in this narrative review. We begin with discussing psychotropic medication pharmacology, drug-drug interactions, and side effects, emphasizing their interaction with anesthetic agents. We summarize the current recommendations for managing these medications in the perioperative period. In the discussion section, we focus on highlighting future directions for the intersection between psychotropic medications and anesthesia. Overall, we provide insight into the perioperative management of patients taking psychotropic medications, the point of intersection between the fields of psychiatry and anesthesia.
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