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Primum non nocere... The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic... It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela? This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.
This book provides a comprehensive review of the challenges, risk stratification, approaches and techniques needed to improve pain control in ambulatory surgery centers (ASCs). It addresses not only the management of acute perioperative pain but also describes modalities that could potentially reduce the risk of evolution of acute pain into chronic pain, in addition to weaning protocols and follow ups with primary surgical specialties and pain physicians as needed. Organized into five sections, the book begins with the foundations of managing ASCs, with specific attention paid to the current opioid epidemic and U.S. policies relating to prescribing opioids to patients. Section two and three then explore facets of multimodal analgesia and non-operating room locations, including the use of ultrasounds, sedation in specific procedures, regional anesthesia, ketamine infusions, and the management of perioperative nausea and intractable pain in outpatient surgery. Section four examines the unique challenges physicians face with certain patient demographics, such as the pediatric population, those suffering from sleep apnea, and those with a history of substance abuse. The book closes with information on discharge considerations, ambulatory surgery protocols, recovery room protocols, and mandatory pain management services. An invaluable reference for all health personnel and allied specialties, Pain Control in Ambulatory Surgery Centers (ASCs) meets the unmet need for a resource that covers optimum pain control in patients undergoing outpatient surgery as well as the urgent ASCs challenges that are presented on an immense scale with national and international impact.
Some people suffer from chronic, debilitating disorders for which no conventional treatment brings relief. Can marijuana ease their symptoms? Would it be breaking the law to turn to marijuana as a medication? There are few sources of objective, scientifically sound advice for people in this situation. Most books about marijuana and medicine attempt to promote the views of advocates or opponents. To fill the gap between these extremes, authors Alison Mack and Janet Joy have extracted critical findings from a recent Institute of Medicine study on this important issue, interpreting them for a general audience. Marijuana As Medicine? provides patientsâ€"as well as the people who care for themâ€"with a foundation for making decisions about their own health care. This empowering volume examines several key points, including: Whether marijuana can relieve a variety of symptoms, including pain, muscle spasticity, nausea, and appetite loss. The dangers of smoking marijuana, as well as the effects of its active chemical components on the immune system and on psychological health. The potential use of marijuana-based medications on symptoms of AIDS, cancer, multiple sclerosis, and several other specific disorders, in comparison with existing treatments. Marijuana As Medicine? introduces readers to the active compounds in marijuana. These include the principal ingredient in Marinol, a legal medication. The authors also discuss the prospects for developing other drugs derived from marijuana's active ingredients. In addition to providing an up-to-date review of the science behind the medical marijuana debate, Mack and Joy also answer common questions about the legal status of marijuana, explaining the conflict between state and federal law regarding its medical use. Intended primarily as an aid to patients and caregivers, this book objectively presents critical information so that it can be used to make responsible health care decisions. Marijuana As Medicine? will also be a valuable resource for policymakers, health care providers, patient counselors, medical faculty and studentsâ€"in short, anyone who wants to learn more about this important issue.
This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.
Primary knee arthroplasty (PKA) has a long history and modern mobile bearing knee implants are successfully implanted worldwide since 1977. Primary Knee Arthroplasty focuses on basic science, personal surgical experiences, clinical, functional and radiographic outcomes of PKA, with special focus on challenging knees such as severe varus and valgus deformities with associated bone defects, fixed flexion deformities, soft tissue contractures, and arthrodesed knees. Patella treatment with or without resurfacing is addressed in great detail. Early criterion-based rehabilitation and the patient’s return to participating in sports are discussed as is the management of prosthetic or surgery related complications. Lavishly illustrated to complement the text, Primary Knee Arthroplasty is a ‘must-have’ for all practicing knee replacement surgeons, orthopedic surgeons in training, orthopedic nurses, and physiotherapists with a special interest in knee arthroplasty. Tips and tricks provided by experienced knee surgeons are indispensable for daily clinical practice.
Chronic pain is a common medical problem shared by roughly 100 million Americans-close to one third of the U.S. population. In the past few decades there has been an alarming trend of using prescription opioids to treat chronic pain. But these opioids-the main prescribed analgesic-come with hidden costs, and this book reveals the ramifications of their use and provides a low or no-risk alternative. Armed with the right information, you can make informed decisions about your pain care. By appreciating the risks and limitations of prescription opioids, and by learning to reduce your own pain and suffering, you will gain control over your health and well-being. Each copy includes Beth Darnall's new binaural relaxation CD, Enhanced Pain Management.
This book presents current evidence in an Enhanced Recovery Programme context, and provides a common sense approach to using the array of available analgesia techniques appropriately in major abdominal surgery. Current pain relief options are discussed, many of which have been described only in the last ten years. Topics covered range from the now widespread use of portable ultrasound machines to an appreciation of the value of some older drugs in a new context. Analgesia for Major Abdominal Surgery is aimed at anesthetists, acute pain teams, and acute pain nurses, as well as colorectal, hepatobiliary, urological and gynecological surgeons.