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xvi Foreword The authors of the book are aware of all these problems and try to make allowances for varying attitudes about evidence, as well as varying quality of the evidence. Upon reading many of the chapters concerning the difficult pain areas, I was often struck by the absence of a superior management, but overall, was left with a sense of comfort that, by drawing upon clinical experience, I would not be harming the patient. In many chapters, one finds recommendations for how to avoid problems that the reader might otherwise not have considered, such as systemic absorption of ocular medications – therefore NSAID drops should not be used in pregnant patients. Most readers would probably know that the NSAIDs can prematurely close a ductus that needs to be patent in the fetus, but would they think of it in relationship to an ophthalmic drop? <strong>This</strong> book is very useful for a wide group of readers with varying experience. Many students and residents will be commencing their clinical practice and attempting to learn appropriate dosages as well as which medications are preferable. For them, this book will provide an indispensable reference. It is probably best read in conjunction with caring for a given patient rather than trying to absorb the material by reading the book from cover to cover, which could be confusing and would certainly represent an unretainable amount of information. The more experienced physician will also profit from the material in the book. There is always room to discover what your own individual style of practice is based upon, alter it where there is new information that you did not previously possess, or continue with your old style as you supplement the book evidence with your own clinical experience. While the book is oriented towards the emergency physician and acute care provider, the material is broad enough that it would certainly also be useful for any office practice, as well as for many inpatient physicians in a variety of specialties. The book has been very carefully edited to try to make the language, and the recommendations, uniform. In this respect, the book’s broad subject matter and international scope render drug names a challenge. One thing I found particularly helpful is the tabulated lexicon of brand and generic names. While I understand the reason for using generic names, that is not
Foreword xvii the way most new agents are learned, and I am frequently lost as to what drug is being talked about when only the generic name is used. While we have earned some of the opprobrium that is connected with pain management, it is quite clear that reading this book will alter the way one thinks about pain management and remind one to be more empathetic and generous. It will give the emergency physician good sound evidence upon which to base practice. I am sure that our patients will be grateful for this guidance to their improved care. Peter Rosen MD Boston
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Page 5 and 6: Emergency Department Analgesia An E
Page 7 and 8: Contents List of contributors page
Page 9 and 10: Tension-type headache 384 Trigemina
Page 11 and 12: Michel Galinski, MD Attending Physi
Page 13: Benjamin A. White, MD Resident, Har
Page 16 and 17: xiv Foreword code to light up the p
Page 21 and 22: Preface A typical shift in the Emer
Page 23 and 24: Acknowledgments Many thanks to this
Page 25: General considerations
Page 28 and 29: 4 Introduction and general approach
Page 34 and 35: 10 Assessment of pain CATHERINE A.
Page 36 and 37: 12 Assessment of pain n Pain assess
Page 38 and 39: 14 Assessment of pain The Face, Leg
Page 40 and 41: 16 Assessment of pain 3. Silka P, R
Page 42 and 43: 18 Assessment of pain 33. Melzack R
Page 44 and 45: 20 Prehospital analgesia and protoc
Page 46 and 47: 22 Prehospital analgesia prehospita
Page 48 and 49: 24 Prehospital analgesia care provi
Page 50 and 51: 26 Prehospital analgesia EMS settin
Page 52 and 53: 28 Prehospital analgesia 18. Kurtz
Page 54 and 55: 30 Prehospital analgesia 48. Helm M
Page 56 and 57: 32 Epidemiologic overview of ED pai
Page 66 and 67: 42 Geriatric analgesia ULA HWANG AN
Page 68 and 69:
44 Geriatric analgesia physiologic
Page 70 and 71:
46 Geriatric analgesia Analgesic ap
Page 72 and 73:
48 Geriatric analgesia The common e
Page 74 and 75:
50 Geriatric analgesia 12. Hohl C,
Page 76 and 77:
52 Chronic pain DAVID CLINE AND STE
Page 78 and 79:
54 Chronic pain care providers, it
Page 80 and 81:
56 Chronic pain the agent’s monoa
Page 82 and 83:
58 Chronic pain be in the ED record
Page 84 and 85:
60 Chronic pain 7. Freynhagen R, Bu
Page 86 and 87:
62 NSAIDs and opioids applicable sa
Page 88 and 89:
64 NSAIDs and opioids We believe th
Page 90 and 91:
66 NSAIDs and opioids well-demonstr
Page 92 and 93:
68 NSAIDs and opioids 5. Navascues
Page 94 and 95:
70 Nonstandard medication delivery
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
78 Reflections on ED analgesia of u
Page 104 and 105:
80 Reflections on ED analgesia para
Page 106 and 107:
82 Reflections on ED analgesia chem
Page 109:
Chief complaints and diagnoses
Page 112 and 113:
88 Abdominal aortic aneurysm occurs
Page 114 and 115:
90 Abdominal aortic aneurysm 19. Le
Page 116 and 117:
92 Aortic dissection Citing sedativ
Page 118 and 119:
94 Arthritis TODD M. LISTWA AND STE
Page 120 and 121:
96 Arthritis NSAIDs may be safer th
Page 122 and 123:
98 Arthritis for patients with high
Page 124 and 125:
100 Arthritis rofecoxib, ordiclofen
Page 126 and 127:
102 Arthritis For breakthrough pain
Page 128 and 129:
104 Arthritis Pediatric: NSAID (e.g
Page 130 and 131:
106 Arthritis 13. Hur C, Chan AT, T
Page 132 and 133:
108 Arthritis 38. Curtis SP, Ko AT,
Page 134 and 135:
110 Arthritis 63. Bliddal H, Tersle
Page 136 and 137:
112 Biliary tract pain A retrospect
Page 138 and 139:
114 Biliary tract pain n Summary an
Page 140 and 141:
116 Biliary tract pain 20. Malesci
Page 142 and 143:
118 Bites and stings - marine enven
Page 144 and 145:
120 Bites and stings - marine jelly
Page 146 and 147:
122 Bites and stings - marine 11. C
Page 148 and 149:
124 Bites and stings - terrestrial
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
134 Breast pain COX-2 selective NSA
Page 160 and 161:
136 Breast pain Pregnancy: acetamin
Page 162 and 163:
138 Burns JEREMY ACKERMAN AND ADAM
Page 164 and 165:
140 Burns for moderate-to-severe bu
Page 166 and 167:
142 Burns References 1. Singer AJM,
Page 168 and 169:
144 Burns 30. Patterson DR, Ptacek
Page 170 and 171:
146 Bursitis and periarticular infl
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
152 Cancer and tumor pain bony (or
Page 178 and 179:
154 Cancer and tumor pain (20 mg ev
Page 180 and 181:
156 Cancer and tumor pain existing
Page 182 and 183:
158 Cancer and tumor pain n Summary
Page 184 and 185:
160 Cancer and tumor pain 21. Carac
Page 186 and 187:
162 Cardiac chest pain KALANI OLMST
Page 188 and 189:
164 Cardiac chest pain has traditio
Page 190 and 191:
166 Cardiac chest pain Practice Gui
Page 192 and 193:
168 Chest wall trauma MICHEL GALINS
Page 194 and 195:
170 Chest wall trauma NSAIDs. As is
Page 196 and 197:
172 Chest wall trauma n Summary and
Page 198 and 199:
174 Chest wall trauma 21. Seltzer J
Page 200 and 201:
176 Chronic low-back pain limited t
Page 202 and 203:
178 Chronic low-back pain n Summary
Page 204 and 205:
180 Cluster headache SOHAN PAREKH A
Page 206 and 207:
182 Cluster headache n Summary and
Page 208 and 209:
184 Corneal abrasion LISA CALDER n
Page 210 and 211:
186 Corneal abrasion 6. Patrone G,
Page 212 and 213:
188 Cystitis, urethritis, and prost
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
194 Dysmenorrhea to that achieved w
Page 220 and 221:
196 Dysmenorrhea 12. Fine PG. The r
Page 222 and 223:
198 Endometriosis by 50-74% compare
Page 224 and 225:
200 Esophageal spasm KALANI OLMSTED
Page 226 and 227:
202 Esophageal spasm via central mo
Page 228 and 229:
204 Fibromyalgia MICHAEL WALTA AND
Page 230 and 231:
206 Fibromyalgia A multicenter plac
Page 232 and 233:
208 Fibromyalgia n Summary and reco
Page 234 and 235:
210 Fibromyalgia 15. Sayar K, Aksu
Page 236 and 237:
212 Fibromyalgia 41. Russell IJ, Mi
Page 238 and 239:
214 Gastritis and peptic ulcer dise
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
226 Gastroesophageal reflux disease
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
232 Hemorrhoids and perianal pain B
Page 258 and 259:
234 Hemorrhoids and perianal pain a
Page 260 and 261:
236 Hemorrhoids and perianal pain t
Page 262 and 263:
238 Hemorrhoids and perianal pain C
Page 264 and 265:
240 Hemorrhoids and perianal pain 9
Page 266 and 267:
242 Hemorrhoids and perianal pain 3
Page 268 and 269:
244 Migraine and undifferentiated h
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
254 Mucositis and stomatitis KELLY
Page 280 and 281:
256 Mucositis and stomatitis eviden
Page 282 and 283:
258 Mucositis and stomatitis above)
Page 284 and 285:
260 Mucositis and stomatitis 5. Dem
Page 286 and 287:
262 Mucositis and stomatitis 30. Mu
Page 288 and 289:
264 Neck and back pain - mechanical
Page 290 and 291:
266 Neck and back pain - mechanical
Page 292 and 293:
268 Neck and back pain - radicular
Page 294 and 295:
Page 296 and 297:
Page 298 and 299:
274 Neck and back pain - spinal spo
Page 300 and 301:
276 Neck and back pain - spinal spo
Page 302 and 303:
278 Neuropathy - complex regional p
Page 304 and 305:
280 Neuropathy - diabetic DAVID CLI
Page 306 and 307:
282 Neuropathy - diabetic n Summary
Page 308 and 309:
284 Neuropathy - diabetic 16. Lesse
Page 310 and 311:
286 Neuropathy - HIV related 3600 m
Page 312 and 313:
288 Neuropathy - HIV related 12. Le
Page 314 and 315:
290 Neuropathy - overview OVER-THE-
Page 316 and 317:
292 Neuropathy - overview The TCAs,
Page 318 and 319:
294 Neuropathy - overview Gabapenti
Page 320 and 321:
296 Neuropathy - overview However,
Page 322 and 323:
298 Neuropathy - overview Reference
Page 324 and 325:
300 Neuropathy - overview 27. Wiffe
Page 326 and 327:
302 Neuropathy - phantom limb pain
Page 328 and 329:
304 Neuropathy - phantom limb pain
Page 330 and 331:
306 Ocular inflammation STEPHEN H.
Page 332 and 333:
308 Ocular inflammation Other RCT d
Page 334 and 335:
310 Ocular inflammation Pregnancy:
Page 336 and 337:
312 Ocular inflammation 20. Frucht-
Page 338 and 339:
314 Odontalgia MICHAEL T. SCHULTZ A
Page 340 and 341:
316 Odontalgia 100 mg caffeine and
Page 342 and 343:
318 Odontalgia TOPICAL THERAPY Topi
Page 344 and 345:
320 Odontalgia 4. Cooper SA, Engel
Page 346 and 347:
322 Odontalgia 32. Sveen OB, Yaekel
Page 348 and 349:
324 Orthopedic extremity trauma inf
Page 350 and 351:
326 Orthopedic extremity trauma The
Page 352 and 353:
328 Orthopedic extremity trauma fem
Page 354 and 355:
330 Orthopedic extremity trauma 35.
Page 356 and 357:
332 Osteoporotic vertebral compress
Page 358 and 359:
334 Osteoporotic vertebral compress
Page 360 and 361:
336 Otitis media and externa benefi
Page 362 and 363:
338 Otitis media and externa 5. Var
Page 364 and 365:
340 Pancreatitis (which lacks effec
Page 366 and 367:
342 Pancreatitis 5. Hubbard GP, Wol
Page 368 and 369:
344 Pharyngitis KELLY YOUNG n Agent
Page 370 and 371:
346 Pharyngitis complete pain relie
Page 372 and 373:
348 Pharyngitis 7. Blagden M, Chris
Page 374 and 375:
350 Pharyngitis 31. Shi Y, Gu R, Li
Page 376 and 377:
352 Postdural puncture headache Cas
Page 378 and 379:
354 Post-herpetic neuralgia JEREMY
Page 380 and 381:
356 Post-herpetic neuralgia virtual
Page 382 and 383:
358 Post-herpetic neuralgia 11. Raj
Page 384 and 385:
360 Renal colic scores. 3 The Cochr
Page 386 and 387:
362 Renal colic References 1. O’C
Page 388 and 389:
364 Sialolithiasis n Summary and re
Page 390 and 391:
366 Sickle cell crisis concluded th
Page 392 and 393:
368 Sickle cell crisis One potentia
Page 394 and 395:
370 Sickle cell crisis titrated in
Page 396 and 397:
372 Sickle cell crisis but acute ca
Page 398 and 399:
374 Sickle cell crisis treatment ti
Page 400 and 401:
376 Sickle cell crisis 3. Dunlop RJ
Page 402 and 403:
378 Sickle cell crisis Disease-rela
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380 Temporomandibular disorders NAT
Page 406 and 407:
382 Temporomandibular disorders n S
Page 408 and 409:
384 Tension-type headache SOHAN PAR
Page 410 and 411:
386 Tension-type headache for TH, b
Page 412 and 413:
388 Tension-type headache 18. Lance
Page 414 and 415:
390 Trigeminal neuralgia as the ini
Page 416 and 417:
392 Undifferentiated abdominal pain
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Page 420 and 421:
Page 422 and 423:
Tables
Page 424 and 425:
Selected nonsteroidal anti-inflamma
Page 426 and 427:
Selected opioids Maintenance pediat
Page 428 and 429:
Other analgesic drugs Lactation Dos
Page 430 and 431:
Other analgesic drugs (cont.) Lacta
Page 432:
Other analgesic drugs (cont.) Lacta
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