Essentials of Pain Management by Nalini Vadivelu Richard D. Urman & Roberta L. Hines

Author:Nalini Vadivelu, Richard D. Urman & Roberta L. Hines
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

Traumatic brain injury

1.5 million per year in US

MVC, firearms, falls

Intracranial bleed, spinal cord injury, cerebral edema, and hypoxia

Short term: analgesic care plan that minimizes effects on cerebral hemodynamics; long term: it may include prophylactic and/or abortive therapy for headaches, nerve blocks for neck pain, and cervicogenic headaches

Chronic headaches, neck pain, back pain, cognitive impairment, psychological disorders

Traumatic amputation

Trauma accounts for >16% of the >133,000 amputations per year in US. The last sentence should be Most involve digits in the upper extremities

MVC, power tools, lawn mowers, crush injuries, knives, and saws

Blood loss, limb preservation, which can significantly improve long-term function

Mixed evidence for preemptive effect of epidural analgesia to prevent postamputation pain in planned amputations. Treatment of stump pain should focus on underlying cause (e.g., neuroma, heterotopic ossification, adhesive scar tissue, ill-fitting prosthesis). Strongest evidence for short-term benefit for phantom pain is for opioids

Traumatic lower limb amputees have increased morbidity and mortality from cardiovascular disease. High prevalence rates of back pain (>50%), hip pain, bursitis, and other musculoskeletal conditions in lower extremity amputees. Heterotopic ossification is much more common (>50%) in major limb traumatic amputations

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