Jennifer A Elliot_ Howard S Smith-Handbook of acute pain management-Informa Healthcare (2011)

About the editors Pain is a pervasive symptom in medicine It is imperative that physicians not only evaluate and diagnose the source of pain, but that they also recognize how to manage the actual pain symptoms with effective treatment Addressing the latest developments in both pharmacologic and non-pharmacologic pain therapies, this text is a useful reference for all those administering to patients with acute pain JENNIFER A ELLIOTT, M.D., Associate Professor, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri Dr Elliott is a Physician at Saint Luke’s Hospital of Kansas City A certified Anesthesiologist and Pain Management specialist, Dr Elliott is the author of multiple publications concerning pharmacologic pain therapies She is a member of numerous medical organizations including the American Society of Anesthesiologists and the American Academy of Pain Medicine This easy to use handbook covers: • Important background on the anatomy and neurobiology of pain • The most up-to-date information on pharmacologic treatments including local anesthetics, NSAIDS, alpha-2 agonists, and opioids • Potential drug-drug and drug-disease interactions • The most up-to-date information on nonpharmacologic treatment like continuous catheter techniques and other injection-based therapies • Patient-controlled analgesia options • Anticoagulation guidelines during regional and neuraxial anesthetic techniques • Pain management issues in special populations – specifically pediatric, opioidtolerant, obstetric, trauma, and elderly patients HOWARD S SMITH, M.D., F.A.C.P., Associate Professor, Albany Medical College, Albany, New York Dr Smith is the Academic Director of Pain Management at the Albany Medical College‘s Department of Anesthesiology He is certified in Internal Medicine, Nuclear Medicine, Anesthesiology, Palliative Medicine, Addiction Medicine, and Pain Management Dr Smith is a widely published expert in the field of Pain Medicine A member of many medical organizations, Dr Smith is a fellow of the American College of Physicians and the American College of Nuclear Physicians Handbook of Acute Pain Management About the book Elliott • Smith Handbook of Acute Pain Management Handbook of Acute Pain Management Edited by Jennifer A Elliott Howard S Smith [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] Handbook of Acute Pain Management [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] Handbook of Acute Pain Management Edited by Jennifer A Elliott Department of Anesthesiology University of Missouri–Kansas City School of Medicine and Saint Luke’s Hospital of Kansas City Kansas City, Missouri, U.S.A Howard S Smith Department of Anesthesiology and Pain Management Albany Medical College Albany, New York, U.S.A [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] Published in 2011 by Informa Healthcare, Telephone House, 69-77 Paul Street, London EC2A 4LQ, UK Simultaneously published in the USA by Informa Healthcare, 52 Vanderbilt Avenue, 7th floor, New York, NY 10017, USA # 2011 Informa UK Ltd, except as otherwise indicated No claim to original U.S Government works Reprinted material is quoted with permission Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, unless with the prior written permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP, UK, or the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA (http://www.copyright.com/ or telephone 978-750-8400) Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe This book contains information from reputable sources and although reasonable efforts have been made to publish accurate information, the publisher makes no warranties (either express or implied) as to the accuracy or fitness for a particular purpose of the information or advice contained herein The publisher wishes to make it clear that any views or opinions expressed in this book by individual authors or contributors are their personal views and opinions and not necessarily reflect the views/opinions of the publisher Any information or guidance contained in this book is intended for use solely by medical professionals strictly as a supplement to the medical professional’s own judgement, knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines Because of the rapid advances in medical science, any information or advice on dosages, procedures, or diagnoses should be independently verified This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as appropriately to advise and treat patients Save for death or personal injury caused by the publisher’s negligence and to the fullest extent otherwise permitted by law, neither the publisher nor any person engaged or employed by the publisher shall be responsible or liable for any loss, injury or damage caused to any person or property arising in any way from the use of this book A CIP record for this book is available from the British Library ISBN-13: 978-0-7890-3168-6 Orders may be sent to: Informa Healthcare, Sheepen Place, Colchester, Essex CO3 3LP, UK Telephone: +44 (0)20 7017 5540 Email: CSDhealthcarebooks@informa.com Website: http://informahealthcarebooks.com/ For corporate sales please contact: CorporateBooksIHC@informa.com For foreign rights please contact: RightsIHC@informa.com For reprint permissions please contact: PermissionsIHC@informa.com Typeset by MPS Limited, a Macmillan Company Printed and bound in the United Kingdom [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] I would like to dedicate this book to my parents, David E and Christel M Elliott, and my husband, Michael J Bell, who have provided much guidance, unconditional love and support, and the inspiration to complete this book I would also like to give thanks to the many contributors for their time and effort, as well as Dean Shepard for his assistance with creating many of the figures and tables in this book J.A.E v [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] Preface Pain is a universal experience and is the most frequent reason people seek medical attention Medical students and residents receive comprehensive guidance in the evaluation and diagnosis of the source of pain complaints, yet formal education on the topic of pain symptom management has not traditionally been offered in medical training, leaving many clinicians uncomfortable with providing treatment for pain Pain can therefore become ‘‘painful’’ to the treating practitioner as well as the patient This book is intended to assist clinicians who are called upon to treat the patient in acute pain by enhancing their knowledge of and comfort with pain therapies The scope of providers who may be in a position to manage the acute pain patient is wide ranging, from medical students and residents to primary care providers, as well as anesthesiologists, neurologists, physiatrists, and other specialists This book will provide the reader with background information on the anatomy and neurobiology of pain to lay a foundation for the understanding of pain pathophysiology Pharmacologic approaches to acute pain management are thoroughly covered, including the use of local anesthetics, NSAIDS, opioids, and a2 agonists Patient-controlled analgesia options including patient-controlled epidural analgesia are also explored Nonpharmacologic and interventional anesthetic techniques are covered, including the use of continuous catheter techniques for postoperative pain management A chapter also reviews information about anticoagulation guidelines when considering the use of regional and neuraxial anesthetic techniques Finally, a discussion of pain management issues in special populations such as pediatric, obstetric, trauma, opioid-tolerant, and elderly patients is provided The material in this book is intended to provide an up-to-date look at the emerging treatment strategies in the continuously expanding field of pain management and is accompanied by numerous figures and tables to give an at-a-glance review of important concepts discussed in the text This text provides expanded information on topics such as opioids, including potential drug-drug and drug-disease interactions, which cannot readily be found in other similar texts currently on the market It also highlights the evolution of new technologies such as ‘‘smart’’ patient-controlled analgesia devices along with associated safety innovations Information on new developments in the field of regional anesthesia, especially the emergence of continuous catheter techniques, is included to bring the reader up to date on the latest available injection-based therapies My goal is that readers will find this book to be a user-friendly reference that addresses the most recent developments in the management of pain I hope this will assist readers in the approach to the patient suffering acute pain and will enhance their level of comfort as well as that of their patients Jennifer A Elliott vii [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] [Vinit][D:/informa_Publishing/Elliott_2400062/z_production/z_3B2_3D_files/978-07890-3168-6_CH0000_O.3d] [21/11/010/13:20:8] [1–12] Contents Preface vii Contributors xi The anatomy of postoperative pain Jun-Ming Zhang The neurobiology of acute pain 10 Eugene E Fibuch and John Q Wang Local anesthetics in the management of acute postoperative pain 19 Gary McCleane NSAIDs in the management of acute pain 28 Jennifer A Elliott, Eugene E Fibuch, and Laura Textor 73 Opioids in the management of acute pain Jennifer A Elliott Patient-controlled analgesia in the management of acute pain Jennifer A Elliott Authorized agent controlled analgesia Laura Textor 128 a2 Agonists in the management of acute pain Jennifer A Elliott and Howard S Smith 134 Nonpharmacological modalities for the treatment of acute pain 154 Laura Textor 10 Perioperative epidural analgesia and patient-controlled epidural analgesia Sonali Agarwal and Sudhir Diwan 173 11 Upper-extremity regional anesthetic techniques in the management of postoperative pain 184 James Rasinsky 12 Lower-extremity regional anesthetic techniques in the management of postoperative pain 198 J Mark Matthews ix 110 ... Department of Anesthesiology, University of Missouri–Kansas City School of Medicine, and Pain Management Services, Saint Luke? ?s Hospital, Kansas City, Missouri, U .S .A James Rasinsky Department of. .. Hospital of Kansas City, Kansas City, Missouri, U .S .A Eugene E Fibuch Department of Anesthesiology, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, U .S .A Jessica George... Missouri–Kansas City School of Medicine, Kansas City, Missouri, U .S .A Martin De Ruyter Department of Anesthesiology, University of Kansas School of Medicine, Kansas City, Kansas, U .S .A Sudhir Diwan Division