martes, 8 de agosto de 2017

Dolor cronico / Chronic pain

Agosto 2, 2017. No. 2768


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Dolor y psicología- Una relación recíproca.
Pain and Psychology-A Reciprocal Relationship.
Ochsner J. 2017 Summer;17(2):173-180.
BACKGROUND: Depression typically affects 5% of the general population, but among patients with chronic pain, 30%-45% experience depression. Studies have shown that the relationship between depression and pain is bidirectional: depression is a positive predictor of the development of chronic pain, and chronic pain increases the risk of developing depression. METHODS: This literature review focuses on the relationship between psychology and pain, covering studies that have investigated the association between depression, pain sensitivity, opioid abuse, and gender differences in pain perception. We conducted a PubMed search pairing the word pain with depression, opioid use, and gender differences. RESULTS: The relationship between depression and pain is complex, as suggested by numerous studies that propose depression to be a moderator of the relationship between pain severity, physical functioning, and opioid use. Neuroimaging also suggests an anatomic overlap in the pathway of chronic pain and depression. Positive psychological factors, namely hope, pain acceptance, and optimism, affect the adjustment to persistent pain. CONCLUSION: The intricate relationship between pain and psychology is evidenced by the clinical overlap in their presentations and the overlap between the anatomic regions in the brain associated with the emotional and sensory features of pain and the areas affected by depression. Studies are beginning to improve our understanding of these two systems, but more studies are needed to elucidate the relationship.
KEYWORDS: Analgesics-opioid; chronic pain; depression; pain; pain perception; psychology
Dolor crónico postoperatorio: hallazgos recientes en la comprensión y el manejo.
Chronic postoperative pain: recent findings in understanding and management.
F1000Res. 2017 Jul 4;6:1054. doi: 10.12688/f1000research.11101.1. eCollection 2017.
Chronic postoperative pain is a poorly recognized potential outcome from surgery. It affects millions of patients every year, with pain lasting for months to years, resulting in patient suffering and ensuing economic consequences. The operations with the highest incidence of chronicpostoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery. Other risk factors include preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain. Attempts to prevent chronic postoperative pain have often led to debatable results. This article presents data from recently published studies examining the incidence, risk factors, mechanisms, treatment options, and preventive strategies for chronic postoperative pain in adults. In summary, many of the previously identified risk factors for chronic postoperative pain have been confirmed and some novel ones discovered, such as the importance of the trajectory of acute painand the fact that catastrophizing may not always be predictive. The incidence of chronic postoperative pain hasn't changed over time, and there is limited new information regarding an effective preventive therapy. For example, pregabalin may actually cause more harm in certain surgeries. Further research is needed to demonstrate whether multimodal analgesic techniques have the best chance of significantly reducing the incidence of chronic postoperative pain and to determine which combination of agents is best for given surgical types and different patient populations.
KEYWORDS: multimodal analgesia; persistent postoperative pain; surgery
El Comité Ejecutivo de la IASP insta a Venezuela a centrarse en el acceso a medicamentos para el dolor a la luz de escasez crítica
IASP Executive Committee Urges Venezuela to Focus on Access to Pain Medications in Light of Critical Shortages
As the leading global organization that brings together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain with the goal of improved pain relief worldwide, the International Association for the Study of Pain (IASP) has been made aware that difficult conditions in Venezuela have resulted in inadequate access to pain treatment.
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Anestesiología y Medicina del Dolor

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