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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.
CD-ROM includes illustrated case studies and approx. 300 self assessment questions.
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.
Gives a thorough and analytical review of the treatment options for post-operative pain using acupuncture.
This new edition reflects the evolution of the field including new topics for historical relevance regarding the changing attitudes towards opioid prescription and use. The book points out that the realization of liberalizing use is almost uncontrollably linked to unnecessary patient death. Similarly, the evidence is increasingly confirming that interventional pain procedures work. New evidence presents, for example, that Percutaneous Lysis of Adhesions is an effective therapeutic modality that has advantages over other options due to its cost effective nature and long term outcomes reducing the need for additional procedures including surgeries and more and more expensive medications. Awareness about the consequences of bad outcomes leads to medicolegal complications. The inevitable trigger is bad outcome which is often related to knowledge, training, experience, as well as equipment design. Some of the examples and lessons learned from the medicolegal arena may soon prevent such occurrences.
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
This text covers the fundamentals of pain, the pharmacology of drugs used, and summarises the current evidence base for the management of acute pain. It provides practical direct clinical applications and strategies for the management of specific medical conditions in patient groups such as the elderly
Postoperative pain is a common problem in clinical practice that becomes chronic in approximately 10% to 30% of adults who undergo surgery, being severe in 5 to 10% of them. It is one of the main causes of chronic pain, which makes it a major public health problem. It generates in patients who suffer it a worsening of their quality of life, their psychological well-being, and disability with the consequent incapacity for work. Given that both its etiology and its consequences are complex and multifactorial, postoperative pain must be approached from a multimodal perspective: preventive, pharmacological, nutritional, rehabilitative, nursing intervention, psychological and, in those refractory cases, through surgical approaches or nerve block techniques. This book aims at first to analyze the pathophysiological and psychological bases that underlie its etiology. Next, it aims to carry out an updated review of the multidisciplinary programs for the treatment of postoperative pain that have been carried out and what their results have been. Moreover, the contribution of each of these disciplines in the ambulatory management of postoperative pain will be reviewed. Finally, we want to study the peculiarities of the management of this type of pain in the oncological patient, as well as the personal and socioeconomic consequences and the increase in other comorbidities of this important reason for consultation.