scholarly journals High Frequency, Low Background Rate Extrapleural Programmed Intermittent Bolus Ropivacaine Provides Superior Analgesia Compared with Continuous Infusion for Acute Pain Management Following Thoracic Surgery: A Retrospective Cohort Study

2019 ◽  
Vol 9 (5) ◽  
Author(s):  
Bridget Bishop ◽  
Brett Pearce ◽  
Luke Willshire ◽  
Matthew Kilpin ◽  
William Howard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pain Management ◽  
Thoracic Surgery ◽  
Acute Pain ◽  
Retrospective Cohort Study ◽  
High Frequency ◽  
Retrospective Cohort ◽  
Acute Pain Management ◽  
Background Rate ◽  
Intermittent Bolus

scholarly journals Assessment for acute pain management in post-total knee replacement (TKR): a prospective cohort study in two Saudi Arabian medical centers

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mariam Ahmad Alameri ◽  
Syed Azhar bin Syed Sulaiman ◽  
Abdullah Moh’d Talaat Ashour ◽  
Ma’ad Faisal Al-Saati
Keyword(s):  
Cohort Study ◽  
Pain Management ◽  
Total Knee Replacement ◽  
Acute Pain ◽  
Joint Replacement ◽  
Acute Pain Management ◽  
Analgesic Treatment ◽  
Pain Management Index ◽  
Medical Centers ◽  
Total Knee

Abstract Background Acute pain in post joint replacement surgeries is common, which makes the management of acute pain following joint replacement surgeries to be very important. Thus, this study was conducted to evaluate acute pain management of post TKR surgeries. Results Patients with negative pain management index (PMI) scores were classified as receiving inadequate analgesic treatment for their pain. Zero PMI was the most frequent score among the others with 195 (80.6%). The rest were − 1 (11 (4.5%)), 1 (27 (11.2%)), and 2 (9 (3.7%)), respectively. Only 4.5% (11/242) patients have negative PMI score, which could be considered as inadequate pain management in which these patients received inadequate analgesic treatment. Conclusion Acute pain management in post-TKR surgeries in both medical centers achieved an acceptable level, and majority of patients received an adequate analgesia in post-TKR surgeries.

Mexiletine Usage in a Chronic Pain Clinic: Indications, Tolerability, and Side Effects

2018 ◽  
Vol 1 (21;1) ◽  
pp. E573-E579 ◽  
Author(s):  
Adam Romman
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Cohort Study ◽  
Pain Management ◽  
Side Effects ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Diagnosis ◽  
Pain Clinic ◽  
Chronic Pain Management

Background: Background: Intravenous lidocaine has multiple applications in the management of acute and chronic pain. Mexiletine, an oral lidocaine analogue, has been used in a number of chronic pain conditions although its use is not well characterized. Objectives: To report our experience using mexiletine in a chronic pain population, specifically looking at tolerability, side effects, and EKG changes. Study Design: Retrospective, cohort study. Setting: Multiple pain clinic locations in an integrated multispecialty health system. Methods: All patients who had a mexiletine prescription between August 2015 and August 2016 were queried via the electronic medical record. Each chart was examined for demographics, QTc changes on EKG, length of use, and reasons for stoppage. Results:There were 74 total patients identified in the chronic pain management clinics as receiving at least 1 mexiletine prescription over the 1-year time period. Twice as many women as men received mexiletine prescriptions. Neuropathic pain was the most common primary diagnosis (64%) which included diabetic neuropathy, radiculopathy, and others. Fibromyalgia was the next most common primary diagnosis (28%). A QTc change on the EKG showed a mean decrease of 0.1 ms and median increase of 1.5 ms. At 6 months (180 days), approximately 30% of the patients remained on mexiletine therapy, and 28% remained on the therapy at 1 year (360 days). Median duration of use was 60 days and the mean was 288 days. Neurologic and gastrointestinal side effects were the most commons reason for stoppage. All side effects were mild and resolved with stoppage. After side effects, lack of response, or loss of efficacy, were the next most common reasons for stoppage. Limitations: Pain relief and outcomes were not specifically examined due to confounding factors including interventional treatments and multiple treatment modalities. This was a retrospective, cohort study limited to our specific clinic population with a relatively high loss to follow-up rate. Conclusion:Mexiletine is rarely a first line option for chronic pain management and is often used when multiple other modalities have failed. By reporting our experience, we hope other clinicians may have more familiarity with the drug’s use in a chronic pain practice. It appears reasonably tolerable, may not require frequent EKG monitoring, and can be an appropriate adjunct in the chronic pain population. More research is needed regarding efficacy and dose titration for mexiletine in chronic pain. Key Words: Chronic pain, mexiletine, IV lidocaine, pain, neuropathic pain, neuropathy, fibromyalgia, QTc, tolerability

Sign in / Sign up

Export Citation Format

Share Document