This practical guide provides the perspectives needed to treat acute and chronic pain in the hospital.
Authored by experts of diverse specialty backgrounds, chapters bring the available evidence together with modern strategies for caring for patients with complex pain. Basic considerations and multimodal and multidisciplinary approaches with the greatest impact on minimizing suffering and burden of care are covered in detail.
The material in this text will assist the learner, the teacher, and the life-long learning practitioner by providing basic considerations for treating acute and chronic pain in the hospital. This book may also serve as a quick reference, review manual or teaching tool by teachers on rounds.
Preface.- Introduction to the Chronic Pain Patient.- Definitions.- Acute
Pain.- Chronic Pain.- Opioid-induced Hyperalgesia.- History.- Physical
Examination.- The SCRIPT History Template.- Patient Reported
Outcomes.- Clinical and Experimental Tools for Measuring Pain.- Case 1: High
Dose Opioids & Multiple Pain Medications.- Case 2: Buprenorphine.- Case 3:
Methadone.- Case 4: Abdominal Pain.- Case 5: Unknown Pain Source.- Case 6:
Sickle Cell Disease.- Case 7: A Cancer Pain Crisis.- Case 8: Spasticity &
Pain.- Case 9: Renal & Hepatic Disease.- Case 11: Angry Patient.- Case 12:
Intrathecal Pain Pump.- Case 13: Spinal Cord Stimulation.- Case 14: Opioid
Use Disorder.- Case 15: Comorbid Psychological Condition.- Case 16: Poor
Prognosis in a Palliative Care Patient.- Case 17: Management of a
Pain/Dyspnea in an Actively Dying Patient.- Opioids.- Nonsteroidal
Anti-Inflammatory Drugs (NSAIDs).- Acetaminophen.- Local Anesthetics.- NMDA
Antagonists.- Alpha-2 Agonists.- Gabapentin & Pregabalin.- Tricyclic
Antidepressants & Serotonin-Norepinephrine Reuptake
Inhibitors.- Steroids.- Cannabinoids.- Peripheral Regional Anesthesia
Blocks.- Neuraxial Blocks.- Vertebroplasty & Kyphoplasty.- Surgical
Interventions for Pain.- Opioid and Non-Opioid Therapies in Palliative
Care.- Crisis Management and Refractory Pain.- Transition to Outpatient Care
& Readmissions.- Opioid Tapering for Acute on Chronic Non-Cancer Pain.
David A Edwards, MD PhD
Associate Professor
Chief, Division of Pain Medicine
Departments of Anesthesiology and Neurological Surgery
Vanderbilt University Medical Center
Nashville, TN
Padma Gulur MD
Professor of Anesthesiology
Executive Vice Chair
Department of Anesthesiology
Duke University
Durham NC
Christopher M. Sobey
Department of Anesthesiology
Vanderbilt University Medical Center
Nashville, TN
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