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Pain Treatment

Medical therapy must be maximized before a patient is a candidate for a pain procedure. Usually this requires escalating the dose of oral narcotic pain medications until the point that the pain is relieved or the side effects (usually somnolence or hallucinations) are intolerable (e.g. up to 300–400 mg/day of morphine sulfate-MS Contin may sometimes be necessary).

See Analgesics.

See Interventional pain management.

Non-pharmacologic interventions are often effective in reducing pain in the ED. However, most existing studies are small, warranting further investigation into their use for optimizing ED pain management 1).


Pain management following major intracranial surgery is often limited by a presumed lack of need and a concern that opioid analgesics will adversely affect postoperative outcome and interfere with the neurologic examination. Nevertheless, evidence in adults is accumulating that these patients suffer moderate to severe pain, and this pain is often under-treated.


The anterior cingulate cortex (ACC) is a structure involved in the affective component, and targeting it may relieve patients' pain.

1)
Sakamoto JT, Ward HB, Vissoci JRN, Eucker SA. Are non-pharmacologic pain interventions effective at reducing pain in adult patients visiting the Emergency Department? A Systematic Review and Meta-analysis. Acad Emerg Med. 2018 Mar 15. doi: 10.1111/acem.13411. [Epub ahead of print] PubMed PMID: 29543359.
pain_treatment.txt · Last modified: 2019/02/11 08:09 by administrador