Presentation and management of chronic pain

Rajapakse, Dilini; Liossi, Christina; Howard, Richard

doi:10.1136/archdischild-2013-304207

Cited by 56 publications

(46 citation statements)

References 57 publications

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“…In addition, increasing age in children with SCD has been shown to be associated with a higher frequency of severe pain episodes as well as longer length of stay . For patients with SCD, pain syndromes are complex and multifactorial with biologic, psychological, and social factors, and a multidisciplinary approach is required to appropriately manage symptoms . Complementary and alternative strategies must be utilized in combination with medical therapy to help alleviate pain and suffering in pediatric patients with pain syndromes such as SCD; a holistic multidisciplinary approach such as utilized in palliative care has been suggested …”

Section: Introductionmentioning

confidence: 99%

Virtual reality as complementary pain therapy in hospitalized patients with sickle cell disease

Agrawal

Robertson²,

Litwin

et al. 2018

Pediatric Blood & Cancer

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Objective Due to incomplete management of vaso‐occlusive pain episodes (VOE) in patients with sickle cell disease (SCD), we sought to determine if immersive VR would be feasible for inpatients. Secondarily, we hypothesized that a single VR session would improve the VOE pain experience. Procedures Consecutive patients with SCD eight years and older admitted for VOE were offered one 15‐minute VR session, utilizing a relaxing underwater world specifically created for pediatric patients and to minimize potential simulator side effects. Safety and acceptability were evaluated with a brief survey before and after the session. Pain was evaluated utilizing the validated adolescent pediatric pain tool (APPT). Survey data and pain scores were analyzed using Wilcoxon signed‐rank test as the data were nonnormally distributed. Results Thirty patients, 21 female, with a median age of 16 years were enrolled, the majority having hemoglobin SS disease. The VR session had no reported side effects; all patients requested VR again in the future. Median pain intensity (pre‐VR 7.3 [interquartile range, IQR, 6.1, 8.8], post‐VR 5.8 [4.7, 7.9]), number of affected body areas (pre‐VR 3.0 [2.0, 7.8], post‐VR 2.0 [0, 4.8]), and qualitative measures including sensory, affective, evaluative, and temporal pain domains were all statistically reduced (i.e., P ≤0.01). Conclusions VR therapy was feasible in a cohort of patients with SCD admitted for VOE. In addition to standard therapies, VR may help reduce the pain experience with SCD VOE. Further study is required to determine the impact of VR therapy on opioid usage and length of stay in hospital.

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Section: Introductionmentioning

confidence: 99%

Virtual reality as complementary pain therapy in hospitalized patients with sickle cell disease

Agrawal

Robertson²,

Litwin

et al. 2018

Pediatric Blood & Cancer

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“…In the general population, the mainstay of chronic pain treatment has been pharmaceutical therapy. Recent work in this area has emphasized the biopsychosocial model that incorporates psychologic and complementary and alternative medicine interventions to pain management using a multidisciplinary approach . However, the complexity of pain in transplant patients may influence physicians to select opioids as a first‐line therapy.…”

Section: Discussionmentioning

confidence: 99%

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Drees

Tumin

Miller

et al. 2018

Clinical Respiratory J

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“…In other words, pain is perceived as such by each individual. Whatever its origin, it provides defense mechanisms and protective reactions, which modify the psychological trauma risk management (TRiM): mood alteration, anxiety, depression, fear, and rage, as well as the somatic TRiM: antalgic posture, facial expression alteration, activation of the autonomous nervous system, tachycardia, nausea, vomiting, and sweating (2). For these reasons, “total pain” is now recognized as a complex of physical and emotional suffering (fear, anxiety, depression, and rage), linked to cultural, spiritual, and social factors.…”

Section: Pediatric Pain In Oncologymentioning

confidence: 99%