Introduction Abdominal surgeries requiring extended midline incisions are associated with severe postoperative pain (1). Postoperative pain was observed in 59 patients (40%) (95% CI =…
Leggi tutto The effect of ultrasound guided rectus sheath block on postoperative pain and opioid consumption. A review and implication for nursing clinical practiceCategoria: Review
Ultrasound-guided thoracic pectoral and serratus plane blocks: new approaches to reducing postoperative pain
ABSTRACT
Background: pectoralis nerve and serratus plane blocks (PECS) are newer ultrasound guided regional anesthesia techniques of the thorax. Aim: evaluate and consolidate scientific evidence of ultrasound-guided thoracic PECS or modified PECS block-serratus anterior plane block effect on postoperative pain in comparison with other comparison intervention. Methods: we searched 8 electronic databases: Medline, Cochrane, Scopus, Embase, Web of Science, CINAHL, ESCI and ILISI. Three of the authors independently selected trials, assessed the risk of bias, and extracted data. Results: final analysis included thirteen trials. When the PECS block is effective, an optimal duration of analgesia has been reported in the first 24 hours after surgery. PECS block (or its modifications) has a significant pain effect in the postoperative period. However, paravertebral block (PVB) has slightly better efficacy at 18 h and 24 h (p = 0.008 and <0.001 respectively) compared with PECS block. Conclusions: the PECS block produced excellent analgesia, often if combined with general anesthesia for breast surgery. PECS block could be recommended as an alternative to intravenous normal anesthesia in certain breast surgeries for pain postoperative management.
Key words: thoracic surgery, pectoral blocks, serratus plane block, postoperative pain, regional anesthesia, opioid.
Received: September 10, 2018
Accepted: October 10, 2018
DOI: 10.19190/PNM2018.1_ra10
Leggi tutto Ultrasound-guided thoracic pectoral and serratus plane blocks: new approaches to reducing postoperative painSimulated mindfulness meditation: a major breakthrough in the management of chronic pain
ABSTRACT
One of the most important challenges facing nursing today is providing proper pain management for patients suffering from chronic pain (1). According to recent surveys 100 million US adults suffer from chronic pain (2) and one in five people in Europe and developing countries are affected (3). As a result of the strong psychological component of pain perception, supplemental use of non-pharmacological analgesic techniques, such as mindfulness meditation, have proved highly effective (6). This literature review describes mindfulness meditation as an effective and affordable method to alter the pain experience and improve the quality of nursing care.
KEYWORDS: chronic pain, mindful meditation, nursing education, virtual reality
Received on January 11, 2016
Accepted on January 19, 2016
Pain Nursing Magazine 2016; 5: 38-43
DOI: 10.19190/PNM2016.1ra38
RIASSUNTO
Una delle più importanti sfide che oggi coinvolgono l’infermieristica è fornire un appropriato trattamento del dolore cronico (1). Secondo recenti indagini 100 milioni di adulti americani soffrono di dolore cronico (2) e ne è affetta una persona su cinque in Europa e nei Paesi in via di sviluppo (3). La percezione del dolore è legata a una forte componente psicologica; l’utilizzo di tecniche analgesiche non-farmacologiche, come la meditazione, ha dimostrato una elevata efficacia (6). Questa revisione della letteratura descrive la meditazione di consapevolezza quale efficace ed economico metodo per modificare l’esperienza dolore e migliorare la qualità della vita.
PAROLE CHIAVE: dolore cronico, meditazione di consapevolezza, formazione infermieristica, realtà virtuale
Cognitive behavioral therapy and nursing of chronic nonmalignant pain
ABSTRACT
The origin, course and subsequent maintenance of pain is influenced by psychosocial factors. Because of that, psychotherapy is also used in pain management. This article briefly describes the selected psychotherapeutical approaches. The use of the cognitive behavioral therapy (CBT) is dominant in multidisciplinary chronic nonmalignant pain management, that is why the article concentrates on it. The indication to CBT and profits are defined. This article further reviews briefly connection among some nursing theories and psychotherapeutical approaches and concentrates on CBT and the Roy Adaptation Model (RAM) for nursing practice. Describes similarities between CBT and RAM and their integration into nursing work.
KEYWORDS: chronic pain, cognitive behavioral therapy, nursing.
Received: november 30, 2015
Accepted after revision: december 3, 2015
Terapia cognitivo-comportamentale nel nursing del dolore non-oncologico
RIASSUNTO
L’origine, il decorso e la persistenza del dolore sono influenzati da fattori psicosociali. A causa di ciò, la psicoterapia è utilizzata anche nella gestione del dolore. In questo articolo si descrivono brevemente alcuni approcci psicoterapeutici selezionati. L’uso della terapia cognitivo-comportamentale (CBT) è predominante nella gestione multidisciplinare del dolore cronico non oncologico, e questo è il motivo per cui l’articolo vi si concentra. Vengono definiti l’indicazione per la CBT e i suoi vantaggi, per offrire una sintetica revisione di alcune teorie infermieristiche e gli approcci psicoterapeutici, con particolare attenzione sulla CBT e sul Roy Adaptation Model (RAM) per la pratica infermieristica. Vengono descritte le somiglianze tra CBT e RAM e la loro integrazione nel lavoro infermieristico.
PAROLE CHIAVE: dolore cronico, nursing, terapia cognitivo-comportamentale.