5 técnicas simples para Pain Management
5 técnicas simples para Pain Management
Blog Article
Objectives. Provide a framework for comprehensive pain evaluation and individualized multimodal treatment. Improve quality of life and function in patients experiencing pain, while reducing the morbidity and mortality associated with pain treatments, particularly opioid analgesics.
Take sleeping pills strictly as prescribed by your health care provider. Some prescription sleeping pills are for short-term use only.
If you're taking sleeping pills for more than a few weeks, talk to your provider about an appropriate follow-up schedule to discuss your medicines.
For patients with cognitive and/or verbal disability, when analgesic plan involves a caregiver, caregivers should receive additional education on pain assessment. Providers should also carefully assess function and goals with both patient and caregiver.
Detoxification will likely be required in patients with continued uncontrolled pain on high doses of opioids. Often detoxification can be accomplished by conversion to buprenorphine.
Methadone. Do not use methadone as first-line treatment for chronic pain. Before a clinician prescribes methadone, the clinician should have gained experience monitoring and prescribing it, or should consult a pain specialist.
Pain intensity. A patient’s report of pain intensity provides a subjective gauge of the distraction and interference pain causes in their daily life.
Cognitive restructuring involves several steps that help to modify the way in which patients view pain and their ability to cope with pain.
Fentanyl testing. Fentanyl is a synthetic opioid and its metabolites are often missed in urine drug screens. GC/MS Acne & Skin Care or LCMS are relatively good at detecting it and are reasonable confirmatory tests.
Peripheral sensitization Injury, inflammation, or repetitive stimulation of the peripheral nociceptive neurons → local release of chemical mediators (e.g., cytokines, nerve growth factors, histamine)→ repeated or prolonged exposure to chemical mediators upregulates the ion channels in the nociceptors → increases sensitivity and/or reduces threshold to chemical mediators even further → increased action potentials → abnormal pain perception
The hallmark of acute pain is tissue inflammation. Acute pain can be nociceptive or neuropathic. Accordingly, measures to reduce inflammation are helpful when developing a treatment plan for acute pain conditions. Some treatments to consider for acute pain include those listed in the table below:
Organize office procedures to meet prescribing requirements. See patients who are on a stable Schedule II-III opioid regimen every 2-3 months. Send in prescriptions to last until the next scheduled appointment or beyond to permit pill counts. For example, on one date, electronically send two 4-week prescriptions and specify a future fill date on one of the prescriptions. For patients taking a Schedule II opioid who are seen every 3 months, utilize clinic personnel to monitor prescription dispensing.
“You’re the only person who can make yourself quit,” says Dr. Solanki. “You have control over what you put in your body.”
A successful regimen may combine low doses of different types of pain medications to treat different mechanisms of perceived pain simultaneously, increasing medication effectiveness while limiting the risk of toxicity.