Recent advances in acute pain management

Birmingham, Patrick K.

doi:10.1016/s0045-9380(06)80004-6

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…Other variables including the patient’s other relatives and belief structure, provide additional considerations. 5 – 8 Various modalities have been used to address pediatric cancer pain. Although pharmacological options have been used to decrease pediatric pain, barriers to successful implementation include parents’ reluctance to their child receiving pain medication, inadequate information/education pertaining to physician medication orders, subjective pain perception and severity scores, and fear of addiction or tolerance to pain medication among others.…”

Section: Introductionmentioning

confidence: 99%

“…Although pharmacological options have been used to decrease pediatric pain, barriers to successful implementation include parents’ reluctance to their child receiving pain medication, inadequate information/education pertaining to physician medication orders, subjective pain perception and severity scores, and fear of addiction or tolerance to pain medication among others. 8 – 10 Insurers are eager to adopt interventions for controlling cancer pain (pediatric and adult), since this would facilitate considerable cost saving to the health care industry as a means to increase patient compliance to therapy and disease management as well as to decrease other morbidities. 11 – 14 …”

Section: Introductionmentioning

confidence: 99%

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Martial arts intervention decreases pain scores in children with malignancy

Bluth

Thomas

Cohen³

et al. 2016

PHMT

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BackgroundMartial arts intervention in disease has been mostly limited to adult inflammatory, musculoskeletal, or motor diseases, where a mechanical intervention effects positive change. However, the application and benefit to pain management in childhood malignancy are not well described. Here, we assess the effects of defined martial arts intervention in children with cancer with respect to their pain perception and management.MethodsSixty-four children with childhood malignancies were enrolled in a martial arts program, which encompassed both meditation and movement modalities. Pain scores (0–10) were recorded pre- and post- 1-hour session intervention. Pain scores were crossed by total visits and tabulated by whether participant pain reduced at least 1 unit, stayed the same, or increased in intensity immediately after (post) participation session. Differences in pain scores were further compared by age and sex.ResultsPrepain and postpain scale data were measured for 64 participants, 43 males (67.2%) and 21 females (32.8%), ranging from 3 years to 19 years. Preintervention and postintervention data were obtained for 223 individual session visits. Mean number of patient participation visits was 1.8±1.6 (range one to nine visits). Of 116 individual measured sessions where the participants began with a pain score of at least 1, pain intensity reduced ≥1 unit in 85.3% (99/116) of visits, remained the same in 7.8% (9/116), and increased in 6.9% (8/116). For the majority (96.3%; 77/80) of sessions, participants began with a prepain intensity score of at least 5–10 with reduction in pain intensity following the session. The overall mean pain score presession visit was reduced bŷ40% (pre: 5.95±2.64 and post: 3.03±2.45 [95% CI: 2.34–3.50]; P≤0.001). Median pain intensity scores had greater reductions with increased age of participants (3–6 years [–1], 7–10 years [–2], 11–14 years [–3], and 15–19 years [–4]).ConclusionMartial arts intervention can provide a useful modality to decrease pain in childhood cancer, with greater effect achieved with higher baseline pain scores and patient age. Martial arts intervention may improve patient compliance with respect to medical and surgical management, thus reducing disease morbidity and health care costs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Martial arts intervention decreases pain scores in children with malignancy

Bluth

Thomas

Cohen³

et al. 2016

PHMT

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“…Much progress has been made in refining pharmacological strategies for pain management, both in knowledge of effective medications and routes of administration. Several overviews that outline the most effective medications, criteria for selection, titration of dosages and indications for choice of routes are available (12,21,80,(83)(84)(85)(86)(87)(88)(89)(90)(91)(92). Combined therapy, using more than one medication and/or route, is often recommended to maximize the beneficial effects of each medication and/or route (92,93).…”

Section: Strategies and Technologies For Postoperative Painmentioning

confidence: 99%

Children’s Pain: A Mandate for Change

Brennan-Hunter

2001

Pain Research and Management

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There have been tremendous research advances in the past 15 years in knowledge about children's pain, and strategies for recognizing and managing that pain. However, the clinical care of children in pain remains a challenge. Children's pain continues to be frequently unrecognized, dismissed or ineffectively managed. A loud call for change is being voiced by physicians, nurses, children and their families. A review of the literature was conducted to document this issue. Starting with a Medline search of the key word 'child* + pain' and continuing with a snowball technique, articles and resources addressing children's pain were collected. Resources presented or published after 1990 were particularly sought because they theoretically reflect both current knowledge about children's pain and the implementation of this knowledge in practice. Unfortunately, although information on pain is available to help children, in many instances, it is not being used. The purpose of the present paper is twofold - to present an overview of current knowledge of children's pain, and factors that hinder its effective assessment and management; and to present a mandate for change. Children's postoperative pain is highlighted in this paper as an example of the gap between pain knowledge and clinical practice. Although treatment strategies differ across different types of pain, children's conditions and ages, the principles and mandate for change discussed in this paper are directly relevant to all categories of children's pain.

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“…Other variables including the patient's other relatives and belief structure, provide additional considerations. [5][6][7][8] Various modalities have been used to address pediatric cancer pain. Although pharmacological options have been used to decrease pediatric pain, barriers to successful implementation include parents' reluctance to their child receiving pain medication, inadequate information/ education pertaining to physician medication orders, subjective pain perception and severity scores, and fear of addiction or tolerance to pain medication among others.…”

Section: Introductionmentioning

confidence: 99%

“…Although pharmacological options have been used to decrease pediatric pain, barriers to successful implementation include parents' reluctance to their child receiving pain medication, inadequate information/ education pertaining to physician medication orders, subjective pain perception and severity scores, and fear of addiction or tolerance to pain medication among others. [8][9][10] Insurers are eager to adopt interventions for controlling cancer pain (pediatric and adult), since this would facilitate considerable cost saving to the health care industry as a means to increase patient compliance to therapy and disease management as well as to decrease other morbidities. [11][12][13][14] The application of martial arts in health maintenance has been well documented.…”

Section: Introductionmentioning

confidence: 99%

Martial Arts Intervention Decreases Pain Scores In Children With Malignancy

Cohen

McCrae

O’Malley

et al. 2013

Blood

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Background Martial arts intervention in disease has been mostly limited to inflammatory, musculoskeletal or motor diseases (rheumatoid / osteoarthritis, fibromyalgia, Parkinson’s disease) where a mechanical intervention effects positive change. However, the application and benefit to malignancy is not well described. Methods Ninety four children with childhood malignancies enrolled in a martial arts program which encompassed both “soft” (meditation, chi gung) and “hard” (karate) martial arts platforms over the course of 12 months. Pain scores were recorded pre and post intervention. Data are reported as percent change from baseline pre intervention values compared with post using Wilcoxen Signed Ranks test comparing pain score means for all cases; with significance p< 0.05) Results The majority of participants were African American (>95%) with a M:F ratio of 3:1. Further, most participant scored improvement in pain after 1-3 encounters. Pain scores prior to intervention were recorded on a scale of 0-10. Patients who partook in the martial arts program demonstrated a reduction in pain scores of 14-30.2% (p<0.05) based on mean comparisons as a group or when corrected for number of visits. Differences in pain scores trended as more pronounced in older vs. younger children, but were not significant (p>0.05). Differences in gender were not significant (p>0.05). Conclusion Martial arts can provide a useful modality to decrease pain in childhood cancer. This can improve patient compliance with respect to medical and surgical management thus reducing disease morbidity and healthcare costs. Disclosures: No relevant conflicts of interest to declare.

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Recent advances in acute pain management

Cited by 6 publications

References 36 publications

Martial arts intervention decreases pain scores in children with malignancy

Martial arts intervention decreases pain scores in children with malignancy

Children’s Pain: A Mandate for Change

Martial Arts Intervention Decreases Pain Scores In Children With Malignancy

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