Pain Management

Oct 1, 2012 Issue
Opioid Abuse and Pain Management [Editorials]

Chronic nonmalignant pain affects a significant number of Americans. Concurrent with the increased need for pain management is a considerable increase in the use of prescription pain relievers for nonmedical purposes. Nonmedical use of prescription pain relievers is now the second most common form o...

Aug 1, 2012 Issue
Epidural Analgesia for Labor Pain [Cochrane for Clinicians]

Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. There were no statistically significant di...

Aug 1, 2012 Issue
Rational Use of Opioids for Management of Chronic Nonterminal Pain [Article]

Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Nonmedical use of prescription opioids, diversion, and overdose deaths have also increased sharply, sparking concern abo...

May 1, 2012 Issue
Tapentadol (Nucynta) for Treatment of Pain [STEPS]

Tapentadol is a DEA schedule II opioid medication with a safety profile, duration of action, frequency of dosing, and analgesic effect similar to those of other oral narcotics, although it is more expensive. At low doses, immediate-release tapentadol is better tolerated than oxycodone in terms of ga...

Aug 15, 2010 Issue
ICSI Releases Guideline on Chronic Pain Assessment and Management [Practice Guidelines]

The Institute for Clinical Systems Improvement (ICSI) released a guideline on the assessment and management of chronic pain in adults and physiologically mature adolescents 16 to 18 years of age.

Jul 1, 2010 Issue
Opioid Therapy for Chronic Noncancer Pain [Cochrane for Clinicians]

Weak evidence suggests that opioids reduce chronic noncancer pain in some highly selected patients, although the effects on quality of life and functional status are unclear.1 Many patients will discontinue opioids because of adverse effects or inadequate pain relief.

Dec 15, 2009 Issue
NSAID Prescribing Precautions [Article]

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding associated with NS...

Dec 1, 2009 Issue
Guidelines for the Use of Opioid Therapy in Patients with Chronic Noncancer Pain [Practice Guidelines]

The American Pain Society and American Academy of Pain Medicine recently released a guideline for the use of opioids in patients with chronic noncancer pain. Chronic opioid therapy is controversial because of the potential for adverse effects and abuse.

Sep 1, 2009 Issue
Acupuncture for Pain [Article]

Acupuncture is increasingly used as an alternative or complementary therapy for the treatment of pain. It is well tolerated, with a low risk of serious adverse effects. Traditional and modern acupuncture techniques may result in reported improvement in pain patterns. Research on acupuncture has had ...

Jul 1, 2009 Issue
When a Patient's Chronic Pain Gets Worse [Curbside Consultation]

This case encapsulates many of the significant challenges in providing care for patients with chronic noncancer pain.

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