Pain control after tonsillectomy is imperative but often difficult. Current post-operative pain medication regimens include opioid analgesics and are often still inadequate. Though not standard of care, it is our practice to prescribe a single dose of oral steroid medication on the third day after surgery, when pain and swelling are at their peak, in order to assist with pain control and reduce opioid consumption. Though this practice has a rational theoretical basis, there is no prospective data supporting or discounting it. We aim to compare pain control, opioid consumption, and complication rates in children receiving post-operative steroids versus those who do not.
The purpose of this study is to gain knowledge from 10-15 minute key informant interviews (pre- and post-transplant recipients) in regards to their experience with pain and pain management. We will interview key informants on their attitudes and perceptions towards using mobile technology to track pain and pain management after surgery and providing educational resources for appropriate pain management.
Sickle cell disease (SCD) is a group of inherited blood disorders associated with recurrent pain, which may evolve into a chronic state over time. Acute and chronic pain approaches in SCD frequently involve the use of opioid medications. The purpose of this study is to understand opioid knowledge and perceptions of the benefits and risks of opioid medication in patients with SCD (all ages) and their caregivers (in the case of pediatric patients).
Chronic pain is a serious public health problem with estimates as high as nearly half of the adult population experiencing some form of pain that lasts for more than 6 months. This issue negatively impacts quality of life, is financially burdensome, and has contributed to the opioid crisis in the United States. Therefore, a non-pharmacologic, non-invasive approach for alleviating chronic pain like prefrontal repetitive transcranial magnetic stimulation (rTMS) is an appealing avenue for research into chronic pain management. While rTMS has already been approved for use in treating depression, it has shown promise in treating chronic pain as well. However, there is a debate about which coil designs are most effective and which regions of the brain respond best to rTMS therapy. This study will examine the use of two novel coil designs the H1 coil which is designed to increase activity of the dorsolateral prefrontal cortex and the H7 coil which is designed to decrease activity of the medial prefrontal cortex. To evaluate the efficacy of the two treatment strategies, patients will undergo thermal pain testing before and after the rTMS interventions. The relative efficacy of these two treatment strategies will be useful for establishing rTMS as an effective strategy for chronic pain management and determining the direction for future rTMS research.
The purpose of this study is to develop transcranial magnetic stimulation (TMS) as a novel, non-pharmacologic approach to decreasing pain in individuals with chronic pain. This study will test whether rTMS over the prefrontal cortex can produce a reduction in your perception of pain, your desire to use opiates, and your brain's response to opiate cues. The results of this study will be used to design and develop a large clinical trial of rTMS as an innovative, new treatment option for chronic lower back pain in individuals that have used chronic opiates.
The overall goal of this feasibility study is to test an individualized, nurse-led behavioral health program that leverages home telehealth technology to directly teach low and fixed income older adults residing in the community to reduce their pain and fatigue by improving mobility through strength and balance training in the context of a complementary mental health intervention to address motivation and social support. Specifically, the integrated intervention includes components to address (1) balance and fall prevention (Otago), (2) strengthening and mindfulness (Yoga), and importantly, (3) affective state and social support which are crucial to maintaining motivation (Behavioral Activation). Moreover, these 3 best practices interventions will be enhanced by integrating physical activity data tracking to complement self-report measures, the former of which will be available in real time for patient and provider review, with parameter violations (eg, non-activity during scheduled activity time; overall activity level lower for a set period of time) triggering brief telehealth sessions to address any problems. Finally, participant qualitative feedback will be captured through voice/video recorded diaries focusing on experienced pain, fatigue, sleep, personal reactions to the project and physical activity as well as technology issues they may encounter.
This study will be conducted in order to address the possible issue of opioid overprescription in extractions of third molars. Oral surgeons will be surveyed to determine their prescribing patterns. Patients will be surveyed 7 days after the procedure to evaluate their experience with the medication.
This study will compare 0.1mg and 0.05mg of spinal morphine for postoperative pain after scheduled, elective Cesarean delivery. All patients will receive a spinal anesthetic (single injection in the lower back to numb patients from the waist down) for operative anesthesia and will be
randomized into one of two groups: (group 1) 0.1mg spinal morphine and (group 2) 0.05mg spinal morphine. This will be a randomized, single blinded study.
The purpose of this study is to determine if giving the medicine "heparin" intravenously (through the veins) continuously for up to 14 days to subjects after a brain aneurysm has burst will help improve the chances of subjects having a good recovery after the bleed compared to subjects who get routine brain aneurysm care (standard of care). Patients who get routine care would also get heparin, but they would typically get an overall lower dose and the heparin would be injected under the skin (heparin shot) instead of in the veins.
Sickle cell disease (SCD) is a genetic blood disorder present at birth characterized by painful vaso-occlusive episodes. Pain episodes typically result in approximately one to two severe pain crises requiring hospitalization per year along with another ten pain episodes managed at home. Pain crises can emerge as early as six to twelve months and most children with the most common form of the disease (HbSS), experience a pain episode requiring hospital care by the age of five years. Promoting better coping with pain in preschool age children likely requires additional adaptation of methods and consideration of a developmental framework. Very young children have limited coping skills, a limited ability to communicate pain, and it is up to the primary caregiver to correctly interpret and treat the pain that a child may be experiencing. Despite the frequency of painful episodes early in life in SCD, there has been little work to-date addressing pain management in young children with SCD. Management of pain episodes early in life by parents may be an important developmental context for later child and family coping with pain, as well as coping with other aspects of this chronic health condition. Consequently, the current study will target parents of preschool age children with SCD through an online video-based platform in order to teach pain management skills to help to identify and manage SCD-related pain episodes.