MyMedR

Establishment of multidisciplinary pain management clinics and training programs in the developing world: experiences from Southeast Asia

Chaudakshetrin P, Cardosa MS, Goh CR, Javier FO, Musba AMT, Prateepavanich P, et al.

Pain, 2020 09;161 Suppl 1:S87-S94.

PMID: 33090741 DOI: 10.1097/j.pain.0000000000001871

Matched MeSH terms: Pain Management*

Educational initiatives and achievements of the International Association for the Study of Pain

Nicholas MK, Cardosa M, Turner J

Pain, 2023 Nov 01;164(11S):S6-S10.

PMID: 37831953 DOI: 10.1097/j.pain.0000000000003062

This article summarizes the many initiatives and achievements of the International Association for the Study of Pain (IASP) in pain education worldwide since 1973. These range from major events such as the World Congress on Pain that attracts thousands of attendees to the more intimate and focused Pain Schools and Pain Camps. The article describes how education has been a key focus of IASP since its inception and how IASP has responded to its members' desire for access to the latest knowledge about pain and evidence-based pain treatments. The unique contribution of IASP to the study of pain is reflected in its consistent focus on a biopsychosocial approach to pain, the promotion of interactions between basic scientists and clinicians, as well as multidisciplinary and interdisciplinary collaborations. Details of these rich offerings can be found on the IASP web site, and this article provides a guide for those seeking to access them.

Matched MeSH terms: Pain Management*

Medical cannabis for chronic pain: can it make a difference in pain management?

Maharajan MK, Yong YJ, Yip HY, Woon SS, Yeap KM, Yap KY, et al.

J Anesth, 2020 02;34(1):95-103.

PMID: 31535218 DOI: 10.1007/s00540-019-02680-y

Globally, chronic pain is a major therapeutic challenge and affects more than 15% of the population. As patients with painful terminal diseases may face unbearable pain, there is a need for more potent analgesics. Although opioid-based therapeutic agents received attention to manage severe pain, their adverse drug effects and mortality rate associated with opioids overdose are the major concerns. Evidences from clinical trials showed therapeutic benefits of cannabis, especially delta-9-tetrahydrocannabinol and cannabinoids reduced neuropathic pain intensity in various conditions. Also, there are reports on using combination cannabinoid therapies for chronic pain management. The association of cannabis dependence and addiction has been discussed much and the reports mentioned that it can be comparatively lower than other substances such as nicotine and alcohol. More countries have decided to legalise the medicinal use of cannabis and marijuana. Healthcare professionals should keep themselves updated with the changing state of medical cannabis and its applications. The pharmacokinetics and safety of medical cannabis need to be studied by conducting clinical research. The complex and variable chemically active contents of herbal cannabis and methodological limitations in the administration of cannabis to study participants, make the clinical research difficult.

Matched MeSH terms: Pain Management

Fulltext Comment on: Managing tooth pain in general practice

Ngeow WC, Chai WL

Singapore Med J, 2019 07;60(7):383.

PMID: 31378826 DOI: 10.11622/smedj.2019078

Matched MeSH terms: Pain Management*

Challenges faced by nurses in managing pain in a critical care setting

Subramanian P, Allcock N, James V, Lathlean J

J Clin Nurs, 2012 May;21(9-10):1254-62.

PMID: 21777315 DOI: 10.1111/j.1365-2702.2011.03789.x

To explore nurses' challenges in managing pain among ill patients in critical care.

Matched MeSH terms: Pain Management*

Fulltext Pain management: trends and challenges

Cardosa MS

Med J Malaysia, 2006 Jun;61(2):139-41.

PMID: 16898301

Pain remains as one of the most common reasons for visits to a doctor. The paper by Zalinawati et all published in this issue of the Journal confirmed this in two primary care settings, showing that a complaint of pain was recorded in almost a third of patients, similar to the prevalence reported in European studies.

Matched MeSH terms: Pain Management*

Perspectives in pancreatic pain

Salim AS

HPB Surg, 1997;10(5):269-77.

PMID: 9298380

This review describes some of the mechanisms which are thought to be important in the causation of pain in chronic pancreatitis. Both medical and surgical techniques for treating this pain are described.

Matched MeSH terms: Pain Management*

Fulltext Special consideration for pain management in the older person

Ong T, Thiam CN

Clin Med (Lond), 2022 Jul;22(4):295-297.

PMID: 35882494 DOI: 10.7861/clinmed.CM-2022-0273

Pain is common among older people. However, it remains underrecognised and under-treated. A comprehensive assessment of pain involves identifying its cause, establishing its severity, determining its impact on the person experiencing it and reviewing the person's response to treatment. Addressing their pain requires a different approach compared to a younger person because there is usually concomitant frailty, multimorbidity, polypharmacy, sensory deficits and cognitive impairment. This review will summarise a comprehensive approach to pain management in the older person.

Matched MeSH terms: Pain Management*

Fulltext Randomised controlled trial on the effectiveness of audible timed reminders for simulated serial pain score documentation in an emergency department

Ng, V.H., Ahmad Khaldun, I., Siti Sarah, M.Z., Ida Zarina, Z.

Medicine & Health, 2018;13(2):114-121.

MyJurnal

Pain is one of commonest presentations at Emergency Department (ED). Previous studies showed inadequate pain control in ED. However, few have addressed specific, practical methods of improving the timeliness and frequency of pain control in emergency setting. This study was a randomized controlled trial in a simulated environment of an actual functioning ED using a timer device to remind care personnel to assess pain and provide analgesia at set intervals versus a “standard therapy” group without visual/audio aids. The mean documentation performance scores between timer and control groups were 94.45% + 5.85 vs 72.22% + 17.57 (p

Matched MeSH terms: Pain Management

Fulltext Evaluation of two different doses of pre-emptive intravenous magnesium sulphate as post- operative adjunct analgesia after gynaecological surgery

Tan, H.Y., Cheah, S.K., Joanna, O.S.M., Azrin, M.A.

Medicine & Health, 2020;15(2):164-174.

MyJurnal

Kajian ini dilaksanakan untuk membandingkan keberkesanan analgesia pre-emptif intravena magnesium sulfat menggunakan dos yang berbeza terhadap kesan pengawalan kesakitan berikutan pembedahan ginekologi. Seramai 56 orang pesakit dengan Indeks Jisim Badan (BMI)

Matched MeSH terms: Pain Management

Fulltext Drought characterisation in Peninsular Malaysia using DrinC software

Md. Munir Hayet Khan, Nur Shazwani Muhammad, Ahmed El-Shafie

Pertanika Journal of Science & Technology, 2017;25(105):81-90.

MyJurnal

Prolonged drought conditions have adverse environmental and socio-economic impacts due to unmet water demands. Defining drought is difficult because of its onset and ending time. Therefore, characterisation of drought is essential for drought management operations. Thus, drought indices come in handy and are a practical approach to assimilate large amounts of data into quantitative information which can then be applied for drought forecasting, declaring drought levels, contingency planning and impact assessments. This study analyses drought events using indices, namely SPI and Deciles Index, computed with DrinC software program but are not popular in Malaysia. It is observed that both indices are identical and suitable for drought occurrences.

Matched MeSH terms: Pain Management

Malaysia's Pain Free programme

The Lancet

Lancet, 2019 05 11;393(10184):1912.

PMID: 31084952 DOI: 10.1016/S0140-6736(19)31005-0

Matched MeSH terms: Pain Management/economics; Pain Management/methods*; Pain Management/standards

Beyond the study of pain: the evolving role of the International Association for the Study of Pain in global advocacy

Arendt Nielsen L, Belton J, Cardosa M

Pain, 2023 Nov 01;164(11S):S22-S26.

PMID: 37831956 DOI: 10.1097/j.pain.0000000000003064

Although founded on the basis of the study of pain, the International Association for the Study of Pain (IASP) has actively advocated for improving pain relief and access to pain management in a variety of ways. The Global Year was launched in 2004 and has continued with a different theme each year, and "Pain Awareness Month" is held every September. The Declaration of Montreal (2010) emphasized that access to pain management is a fundamental human right as a result from the IASP-hosted International Pain Summit. The IASP has continued to publish timely statements related to pain and pain management. The work of IASP on the 11th version of the International Classification of Disease has ensured that chronic pain is recognized as a disease in its own right, and the establishment of the Global Alliance of Partners for Pain Advocacy Task Force recognizes the importance of engaging people with lived experience of pain in accomplishing IASP's mission. The Working Group on Global Advocacy now spearheads IASP's global efforts in capacity building to ensure that pain advocacy activities will continue to grow.

Matched MeSH terms: Pain Management

Fulltext Efficacy of Photobiomodulation in the Treatment of Cancer Chemotherapy-Induced Oral Mucositis: A Meta-Analysis with Trial Sequential Analysis

Al-Rudayni AHM, Gopinath D, Maharajan MK, Veettil SK, Menon RK

Int J Environ Res Public Health, 2021 Jul 12;18(14).

PMID: 34299869 DOI: 10.3390/ijerph18147418

Oral mucositis is a debilitating complication of chemotherapy, characterized by erythema, ulcers and oedema of the oral mucosa. This review aimed to evaluate the efficacy of Photobiomodulation in the treatment of oral mucositis using meta-analysis and trial sequential analysis, and also to assess the quality of the results by Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A comprehensive search of three databases, including Embase, Medline and Central, was performed to identify randomized controlled trials studying the efficacy of Photobiomodulation in the treatment of cancer chemotherapy-induced oral mucositis. The primary outcome was reduction in the severity of oral mucositis. Secondary outcomes were pain relief, duration of oral mucositis and adverse effects. The meta-analysis was performed using the random-effects model, and random errors of the meta-analyses were detected by trial sequential analysis. A total of 6 randomized controlled trials with 398 participants were included in our analysis. Photobiomodulation significantly reduced the severity of oral mucositis when compared to sham radiation (RR 0.43, 95% CI 0.20 to 0.93; p < 0.05). Sensitivity analysis by excluding trials with high risk of bias reiterated the robustness of our results (RR 0.28, 95% CI 0.16 to 0.48). Trial sequential analysis illustrated that the evidence from the meta-analysis was conclusive. The result of the meta-analyses with trial sequential analysis illustrated that Photobiomodulation is an effective therapeutic intervention for the treatment of oral mucositis, and the evidence gathered can be considered conclusive with a moderate level of certainty according to GRADE. Further trials are recommended to standardize the laser parameters required for the optimal effect.

Matched MeSH terms: Pain Management

Pain experience and satisfaction with postoperative pain control among surgical patients

Subramanian P, Ramasamy S, Ng KH, Chinna K, Rosli R

Int J Nurs Pract, 2016 Jun;22(3):232-8.

PMID: 25355297 DOI: 10.1111/ijn.12363

Alleviating acute pain and providing pain relief are central to caring for surgical patients as pain can lead to many adverse medical consequences. This study aimed to explore patients' experience of pain and satisfaction with postoperative pain control. A cross-sectional survey was carried out among 107 respondents who had undergone abdominal surgery in the surgical ward of an urban hospital using the Revised American Pain Society's Patient Outcome and Satisfaction Survey Questionnaires (APS-POQ-R). Data were analysed using descriptive statistics and chi-square test. Chi-square test showed significant association between race (P = 0.038), education level (P ≤ 0.001), previous operation status (P = 0.032) and operation status (P ≤ 0.001). Further analysis on nominal regression, association between dissatisfaction with factors of operation status (46.09 (95% CI 7.456, 284.947)) and previous operation status (13.38 (95% CI 1.39, 128.74)) was found to be significant. Moderate to high levels of pain intensity in the last 24 h after surgery, as well as moderate to high rates of pain-related interference with care activities were most reported. Pain still remains an issue among surgical patients, and effective pain management and health education are needed to manage pain more effectively after surgery.

Matched MeSH terms: Pain Management/methods*

A study of knowledge and attitudes of registered nurses towards pain management in an urban hospital

Ho SE, Ho CC, Pang Yuen H, Lexshimi R, Choy YC, Jaafar MZ, et al.

Clin Ter, 2013 May-Jun;164(3):215-9.

PMID: 23868622 DOI: 10.7417/CT.2013.1551

BACKGROUND AND AIMS: Nurses play a pivotal role in pain management. Unrelieved pain significantly interferes with patient's quality of life and is of great concern to nurses. The aim of this study was to determine the knowledge level and attitudes of nurses related to pain management.
MATERIALS AND METHODS: This descriptive study was conducted in an urban hospital. A total of 84 registered nurses were recruited using a modified version of questionnaire of Knowledge and Attitudes Survey Regarding Pain.
RESULTS: The findings showed that respondents possessed good knowledge (99.12±14.810) and attitude (66.00 ±10.415) towards pain management. Fifty five respondents (66%) responded as positive to cultural beliefs affecting their pain management and 65 respondents (77%) viewed that their personal experiences had influenced their practice in pain management. Another 45 respondents (54%) reported they have attended pain course. There was no significant difference in pain management between respondents' year of service, cultural belief and personal experiences (p=>0.05). In terms of knowledge towards to pain management, respondents' age groups of more than 40 years were noted to possess better knowledge (p=0.046), unmarried respondents (p=0.018), and attended pain course (p=0.001) were significant. Attitude towards to pain management was not significant (p≤0.05).
CONCLUSION: Nurses' knowledge and attitudes scores were impressive but there is room for further improvement to pain management. Continuing education organized by the hospital had significant impact on the nurses. However, this education course has to be reinforced from time to time in order to improve patients' pain experiences.

Matched MeSH terms: Pain Management*

Fulltext Audit of pain management in the emergency department

Fathil SM, Soong NS, Mustafa NM, Arith A, Ng WN, Bahrum NA, et al.

Med J Malaysia, 2011 Jun;66(2):89-91.

PMID: 22106683 MyJurnal

Pain management in Malaysian Emergency Departments has not been studied well. Convenience sampling was used to recruit 402 patients who presented with acute pain over a 2-week period. The 11-point Numerical Rating Scale was used to quantify pain. Pain relieving medications were prescribed to 178 patients (44.3%) in the Emergency Department. These patients had a median pain score of 7 on arrival. Nonsteroidal anti inflammatory drugs were the most commonly prescribed class of analgesic. Pain was found to be inadequately treated.

Matched MeSH terms: Pain Management*

[Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines]

Martínez-Nicolás I, Ángel-García D, Saturno PJ, López-Soriano F

Rev Calid Asist, 2016 Jan-Feb;31(1):55-63.

PMID: 26420516 DOI: 10.1016/j.cali.2015.06.009

OBJECTIVE: Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue.

MATERIALS AND METHODS: A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness.

RESULTS: Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one.

CONCLUSIONS: The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve.

Matched MeSH terms: Pain Management*

Paediatric pain management in low-income and middle-income countries

Tang SP, Yeo ASH, Cardosa MS

Lancet Child Adolesc Health, 2021 01;5(1):5-7.

PMID: 33064996 DOI: 10.1016/S2352-4642(20)30336-9

Matched MeSH terms: Pain Management*

Electric massage chairs reduce labor pain in nulliparous patients: a randomized crossover trial

Khairudin MN, Vallikkannu N, Gan F, Hamdan M, Tan PC

Am J Obstet Gynecol MFM, 2024 Apr;6(4):101324.

PMID: 38447674 DOI: 10.1016/j.ajogmf.2024.101324

BACKGROUND: Labor pain varies significantly among pregnant women, ranging from mild to extremely distressing. Nonpharmacologic pain relief methods during vaginal birth are increasingly popular, either as a complement to pharmacologic agents or, at times, as the primary method of pain relief. Multiple trials have reported that manual or by-hand massage reduces labor pain. The effectiveness of full-body mechanical massage using electric massage chairs on labor pain remains unexplored.

OBJECTIVE: This study aimed to evaluate mechanical massage using an electric massage chair on labor pain in nulliparous women.

STUDY DESIGN: A randomized counterbalanced crossover trial was conducted in a university hospital in Malaysia from August 2022 to February 2023. Eligible nulliparas in labor with a minimum labor pain score of 5 (0-10 numerical rating scale) were enrolled. Participants were randomized to 30 minutes on the massage chair with mechanical massage followed by 30 minutes on the massage chair without mechanical massage or the other way around in the massage sequence. The primary outcome was a change in pain score comparing pain with and without mechanical massage as a paired comparison for the entire trial participants. The secondary outcomes were across arms analyses of maternal and neonatal outcomes. The paired t test, t test, Mann-Whitney U test, chi-square test, and Fisher exact test were used as appropriate for the data.

RESULTS: Overall, 208 women were randomized: 104 to each intervention. Data were available from 204 participants (103 randomized to massage first and 101 to no massage first). The primary outcomes of change in labor pain scores (0-10 numerical rating scale) after massage and no massage (all participants included after crossover, paired t test analysis) were 4.51±2.30 and 5.38±2.10, respectively (mean difference, -0.87; 95% confidence interval, -1.14 to -0.59; Ppain score after electric chair mechanical massage compared with no massage. On the across randomized arms secondary analyses, labor pain scores after their first massage chair session were 4.35±2.52 (randomized to massage first, received massage as initial intervention) and 5.66±1.73 (randomized to no massage first, received no massage as initial intervention) (mean difference, -1.31; 95% confidence interval, -1.91 to -0.748; Ppain) and neonatal outcomes (Apgar scores at 1 and 5 minutes, cord artery blood pH and base excess, and neonatal admission) were not different across randomized arms.

CONCLUSION: Mechanical massage using an electric massage chair significantly reduced labor pain, offering a potential nonpharmacologic pain management option during labor.

Matched MeSH terms: Pain Management/methods

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