Hospitalized Chronic Pain Patient

This practical guide provides the perspectives needed to treat acute and chronic pain in the hospital.

Authored by experts of diverse specialty backgrounds, chapters bring the available evidence together with modern strategies for caring for patients with complex pain. Basic considerations and multimodal and multidisciplinary approaches with the greatest impact on minimizing suffering and burden of care are covered in detail.

 The material in this text will assist the learner, the teacher, and the life-long learning practitioner by providing basic considerations for treating acute and chronic pain in the hospital. This book may also serve as a quick reference, review manual or teaching tool by teachers on rounds.

David A Edwards, MD PhD

Associate Professor

Chief, Division of Pain Medicine

Departments of Anesthesiology and Neurological Surgery

Vanderbilt University Medical Center

Nashville, TN

Padma Gulur MD

Professor of Anesthesiology

Executive Vice Chair

Department of Anesthesiology

Duke University

Durham NC

Christopher M. Sobey

Department of Anesthesiology

Vanderbilt University Medical Center

Nashville, TN

[External - Use Caution]

Preface.- Introduction to the Chronic Pain Patient.- Definitions.- Acute Pain.- Chronic Pain.- Opioid-induced Hyperalgesia.- History.- Physical Examination.- The SCRIPT History Template.- Patient Reported Outcomes.- Clinical and Experimental Tools for Measuring Pain.- Case 1: High Dose Opioids& Multiple Pain Medications.- Case 2: Buprenorphine.- Case 3: Methadone.- Case 4: Abdominal Pain.- Case 5: Unknown Pain Source.- Case 6: Sickle Cell Disease.- Case 7: A Cancer Pain Crisis.- Case 8: Spasticity& Pain.- Case 9: Renal& Hepatic Disease.- Case 11: Angry Patient.-  Case 12: Intrathecal Pain Pump.- Case 13: Spinal Cord Stimulation.- Case 14: Opioid Use Disorder.- Case 15: Comorbid Psychological Condition.- Case 16: Poor Prognosis in a Palliative Care Patient.- Case 17: Management of a Pain/Dyspnea in an Actively Dying Patient.- Opioids.- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).- Acetaminophen.- Local Anesthetics.- NMDA Antagonists.- Alpha-2 Agonists.- Gabapentin& Pregabalin.- Tricyclic Antidepressants& Serotonin-Norepinephrine Reuptake Inhibitors.- Steroids.- Cannabinoids.- Peripheral Regional Anesthesia Blocks.- Neuraxial Blocks.- Vertebroplasty& Kyphoplasty.- Surgical Interventions for Pain.- Opioid and Non-Opioid Therapies in Palliative Care.- Crisis Management and Refractory Pain.- Transition to Outpatient Care& Readmissions.- Opioid Tapering for Acute on Chronic Non-Cancer Pain.