Preoperative Anesthesia, Pharmacotherapy And Mirror Therapy

Joint pain, particularly in the knees and shoulders as well as back pain constitute the large majority of patients who present to their doctor's office with a complaint of pain. Many of these patients proceed to have surgery, all too often with less than optimal outcomes. Many of these patients still have the same pain

The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver

Also, many drugs have been used post surgery in treating PLP with success, particularly oral morphine. An inexpensive and easy drug-free therapy to follow, which its’ success in reducing PLP has been replicated in many studies, is mirror therapy. Mirror therapy also has the added benefit of being able to be done at home by the patient at his or her own pace. Finally, there are many novel therapies that have been very promising in treating PLP including cryoablation therapy of the affected nerve and/or neuroma, and EMDR therapy, which can simultaneously treat PTSD and similar

The following analysis will observe various methods of CAM pain reduction, highlighting two major CAM therapies of interest: music therapy, animal therapy. In addition, the following analysis will discuss how different demographics react to such therapies, with gender, age, ethnicity, and education level playing a role in relation to a patient’s willingness to be open to CAM. Lastly this analysis will discuss the drawbacks of CAM therapies in the medical community today, emphasising a lack of discussion between provider and patient, and the general lack of clinical education surrounding CAM therapies within the medical community.

Mirror therapy is when patients use a mirror to view a superimposed reflection of their normal limb on their phantom limb. The patient would then exercise their normal limb. In a study conducted by Sumatani et al. (2008), 22 patients with PLP took part in a single session of mirror therapy. The results showed a significant alleviation of pre versus post treatment PLP visual analogue scale (VAS). The researchers found that patients described greater than 50% relief of deep-pain descriptors. Regular sessions of mirror therapy are required to maintain treatment effects (Timms, Carus, 2015). In a study performed by Gover-Chamlou (2015) two patients underwent mirror therapy. The first participant came back after four weeks and stated a huge decline in PLP after performing the mirror therapy. After an additional four weeks of therapy the participant stated the PLP was completely gone. Patient two did the same therapy and reported complete loss of PLP only four weeks after starting the

The strength of this recommendation is inconclusive. As practitioners, we should have minimum restraint in following this recommendation and should be on the lookout for new evidence in addition to strongly listening to patient preference. This recommendation is based upon three RCT’s. Two of these studies were of high strength and one was of moderate strength with regard to quality. All three of these studies had moderate applicability. In these studies, pain improvement was not consistently statistical significant (MD = .81, 95% CI -1.76, .14; MD = 2.26, p<.001; MD = -.82, 95% CI -1.247, -.39), and neither was function (MD = 3, 95% CI -1.05, 7.05; MD = 6.54, p=.001). In addition, the authors concluded the clinical significance of these findings were

when pain scores were greater than 5 on a 0-10 pain scale scoring system. In addition to

After 27 physical therapy visits post surgeries in a period of 6 months the patient reported no perceived disability with work after 52 weeks. Although, some functional disability was experienced when it came to general activities and sports between 4 to 13 percent based on the QuickDASH. Pain levels reported by the VAS remained considerable low. The subject reported pain level between 0-4 on a 10 scale; pain decreased to zero by week 10.

Outcome: Consistent pain monitoring and reevaluating. Pain management through opioid medication and non-medication methods. We attempted to use ice packs as pain relief. Patient was unreceptive to the use of pain medication because it did not help his pain. Opioid medication relieved pain for this patient, however pain was consistently rated as 8.

Although low back pain is prevalent and is having a very high chance of chronicity and recurrence, there is lack of evidence on effective treatment in acute phase patients.

Fransen had reported statistically significant evidence that showed the benefit of exercise on pain, physical function and quality of life immediately following post-treatment. Results for 2-6 months after treatment were also reported and showed statistically significant evidence. Different exercise methods were tested to see if report of pain and physical function would vary, depending on what exercise was used. The results showed that there was no statistical difference between different exercises. (Fransen, 2015)

Pain is one of the most common challenging complains by patients. Pain in general is a very uncomfortable feeling. Studies have shown that pain can affect the quality of life of individuals (Ferrel, 1995). Over 100 million Americans suffer from chronic pain. This is the kind of pain that lasts for more then 6 months. It can be mild or excruciating pain (Ratini, 2014). Nurse researchers have spent the last 30 years trying to study pain management using both pain measurements and outcomes of pain. Some studies have even shown that pain is not completely controlled even with pharmacological agents (Wells, Pasero, & McCaffery, 2008). Pain that is not managed adequately can lead to adverse physical and psychological patient outcomes, for patients and their families (Wells, Pasero, & McCaffery, 2008).

The results suggested that there was a lack of consensus about the ideal treatment for chronic pain, but acupuncture is gaining popularity in the Western medicine. Acupuncture is worthwhile for the hospital to implement as an alternative to relieve pain since it has no side effects. The sample size, intervention length, and method of sham acupuncture might contribute to the contradiction of the results. All studies were randomized controlled trials, but most studies had small sample sizes and short study times. Most studies use sham acupuncture to cut placebo effect; however, each study had different standards and technique for sham acupuncture. The sham acupuncture might possibly produce a therapeutic effect and interfere with the result interpretation. For the chronic spinal pain studies, there might be some bias since both studies were conducted by the same researchers and same setting in different years. The results would be stronger if the studies were conducted in different settings and with a different population.

Even though chronic pain is usually permanent there are some treatments and possible solutions, sometimes requiring the combination of several approaches.

Assessing and treating pain is a complex puzzle. McCaffery a researcher from the UCLA Center for Health Science says the standard definition of pain is, “whatever the experiencing person says it is” (Bernhofer 1). However, a practitioner’s personal opinions about a patient’s pain might interfere with this definition when performing a pain assessment. Treatment of pain is different than working with a patient who has hypertension and requires increased dosages of medications to reduce blood pressure. Practitioners are not likely to judge a hypertensive patient’s character because of their medication needs. However, it is harder to have an unbiased opinion of a patient complaining of chronic pain who does not respond to the standard pain medications.