Acute Pain Management

Macintyre, Pamela E.; Schug, Stephan A.

doi:10.1201/b17905

Cited by 21 publications

(20 citation statements)

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“…Previous studies have recognized that the nursing unit culture might influence the practice of pain management [1, 20]. However, the practices differed in each unit, according to the individual approaches of the nurses who responded to the patient's expressions of pain and discomfort.…”

Section: Findings and Discussionmentioning

confidence: 99%

“…For pain management, its documentation must comply with the national guidelines developed by the Royal College of Anesthesiologists of Thailand and the Thai Association for the Study of Pain [20] for the management of chronic pain and acute pain, and it has been ordered that these guidelines are implemented across all wards in Thailand. Despite this goal, our study shows that the implementation of the national guidelines has not been fully achieved.…”

Section: Findings and Discussionmentioning

confidence: 99%

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Treating without Seeing: Pain Management Practice in a Thai Context

Chatchumni

Namvongprom

Eriksson

et al. 2016

Pain Research and Management

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Pain management is a core nursing function, and it plays a key role in postoperative care. It is important to understand the cultural context of nursing practices and how this affects effective pain management. The aim of this study was to describe the professional and cultural framework within which pain management is practiced on a Thai surgical ward. Spradley's ethnographic methodology was used. Data were collected through 98.5 hours of field observations and interviews at a surgical ward in Thailand. Three themes were constructed that describe the way Thai nurses practiced pain management: (i) complex communications system to address pain and to respond to it, (ii) the essence of Thai-ness, and (iii) a passive approach to pain management. The results indicate that, in the response to discomfort and pain, better pain management will result if there is a shift from functional to patient-centered care. The nursing culture needs to be further researched and discussed, in order to set priorities in line with the goals of national and international organizations for improving postoperative care and promoting patient comfort.

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Section: Findings and Discussionmentioning

confidence: 99%

Section: Findings and Discussionmentioning

confidence: 99%

Treating without Seeing: Pain Management Practice in a Thai Context

Chatchumni

Namvongprom

Eriksson

et al. 2016

Pain Research and Management

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show abstract

“…The dose of every opioid received postoperatively was transcribed and converted into standardized parenteral morphine equivalents [47]. A total in milligrams was calculated for each day, and means were obtained and analyzed for both groups at each postoperative day (days 1 to 7).…”

Section: Methodsmentioning

confidence: 99%

Web-Based Nursing Intervention for Self-Management of Pain After Cardiac Surgery: Pilot Randomized Controlled Trial

Martorella¹,

Côté²,

Racine³

et al. 2012

J Med Internet Res

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BackgroundMost adults undergoing cardiac surgery suffer from moderate to severe pain for up to 6 days after surgery. Individual barriers and attitudes regarding pain and its relief make patients reluctant to report their pain and ask for analgesic medication, which results in inadequate pain management. More innovative educational interventions for postoperative pain relief are needed. We developed a Web-based nursing intervention to influence patient’s involvement in postoperative pain management. The intervention (SOULAGE-TAVIE) includes a preoperative 30-minute Web-based session and 2 brief face-to-face postoperative booster sessions. The Web application generates reflective activities and tailored educational messages according to patients’ beliefs and attitudes. The messages are transmitted through videos of a virtual nurse, animations, stories, and texts.ObjectiveThe aim of this single-blinded pilot randomized trial was to investigate the preliminary effects of a virtual nursing intervention (SOULAGE-TAVIE) to improve pain relief in patients undergoing cardiac surgery.MethodsParticipants (N = 60) were adults scheduled for their first cardiac surgery. They were randomly assigned to the experimental group using SOULAGE-TAVIE (n = 30) or the control group using usual care, including an educational pamphlet and postoperative follow-up (n = 30). Data were collected through questionnaires at the time of admission and from day 1 to day 7 after surgery with the help of a blinded research assistant. Outcomes were pain intensity, pain interference with daily activities, patients’ pain barriers, tendency to catastrophize in face of pain, and analgesic consumption.ResultsThe two groups were comparable at baseline across all demographic measures. Results revealed that patients in the experimental group did not experience less intense pain, but they reported significantly less pain interference when breathing/coughing (P = .04). A severe pain interference with breathing/coughing (pain ranked ≥ 7/10) was reported on day 3 after surgery by 15% of the patients in the experimental group (4/27), as compared to 44% (7/16) in the control group. On day 7 after surgery, participants in the experimental group also exhibited fewer pain-related barriers as measured by the Barriers Questionnaire-II (mean 10.6, SD 8.3) than patients in the control group (mean 15.8, SD 7.3, P = .02). No difference was found for pain catastrophizing. However, in both groups, means revealed a lower tendency to catastrophize pain before surgery as measured by the Pain Catastrophizing Scale (control group mean 1.04, SD 0.74; experimental group mean 1.10, SD 0.95) and after surgery (control group mean score 1.19, SD 0.94; experimental group mean score 1.08, SD 0.99). Finally, the experimental group consumed more opioid medication (mean 31.2 mg, SD 23.2) than the control group (mean 18.8 mg, SD 15.3, P = .001).ConclusionsThis pilot study provides promising results to support the benefits of this new Web-tailored approach that can increase accessibility to h...

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“…Level of sedation was scored on a 4-point scale from 0 to 3 (0 = wide awake, 1 = rouses easily and can stay awake; 2 = rouses easily but has difficulty staying awake, and 3 = somnolent, difficult to rouse) [5]. The degree of nausea and vomiting/retching was scored on a scale from 0 to 3 (0 = none, 1 = mild and does not need treatment, 2 = treatment was effective, 3 = persists despite treatment).…”

Section: Methodsmentioning

confidence: 99%

Pharmacokinetics of tramadol after subcutaneous administration in a critically ill population and in a healthy cohort

et al. 2014

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BackgroundTramadol is an atypical centrally acting analgesic agent available as both oral and parenteral preparations. For patients who are unable to take tramadol orally, the subcutaneous route of administration offers an easy alternative to intravenous or intramuscular routes. This study aimed to characterise the absorption pharmacokinetics of a single subcutaneous dose of tramadol in severely ill patients and in healthy subjects.Methods/designBlood samples (5 ml) taken at intervals from 2 minutes to 24 hours after a subcutaneous dose of tramadol (50 mg) in 15 patients (13 male, two female) and eight healthy male subjects were assayed using high performance liquid chromatography. Pharmacokinetic parameters were derived using a non-compartmental approach.ResultsThere were no statistically significant differences between the two groups in the following parameters (mean ± SD): maximum venous concentration 0.44 ± 0.18 (patients) vs. 0.47 ± 0.13 (healthy volunteers) mcg/ml (p = 0.67); area under the plasma concentration-time curve 177 ± 109 (patients) vs. 175 ± 75 (healthy volunteers) mcg/ml*min (p = 0.96); time to maximum venous concentration 23.3 ± 2 (patients) vs. 20.6 ± 18.8 (healthy volunteers) minutes (p = 0.73) and mean residence time 463 ± 233 (patients) vs. 466 ± 224 (healthy volunteers) minutes (p = 0.97).ConclusionsThe similar time to maximum venous concentration and mean residence time suggest similar absorption rates between the two groups. These results indicate that the same dosing regimens for subcutaneous tramadol administration may therefore be used in both healthy subjects and severely ill patients.Trial registrationACTRN12611001018909

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Acute Pain Management

Cited by 21 publications

References 0 publications

Treating without Seeing: Pain Management Practice in a Thai Context

Treating without Seeing: Pain Management Practice in a Thai Context

Web-Based Nursing Intervention for Self-Management of Pain After Cardiac Surgery: Pilot Randomized Controlled Trial

Pharmacokinetics of tramadol after subcutaneous administration in a critically ill population and in a healthy cohort

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