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Pain Management

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Abstract

Continuing in neurology, this chapter will address P&S monitoring in pain management. Here we take data from both chronic care and critical care. The majority of the critical care applications will be presented later in that section. Pain is a stressor. The sympathetic nervous system responds to stress. Therefore, sympathetic responses may be used as an objective measure of pain responses, assuming BP is well managed. Given this premise, P&S monitoring in general helps in pain management in four ways: (1) objectively quantifying pain level, (2) differentiating the types of pain, (3) titrating therapy, and (4) documenting rehabilitation. The comorbidities associated with chronic pain are due to the effects of sympathetic excess. Quantitatively assessing sympathetic activity periodically helps to reduce the risk of high BP and hypertension, GI and sleep disorders, urogenital dysfunction, cardiovascular disease, MI, and sudden cardiac death. The last few risks are a main reason for cardiology referral from pain management. While the pain management physician is not ordering an autonomic assessment for the purposes of documenting risk of cardiovascular disease, MI, and sudden cardiac death, it is a natural outcome of the assessment as described elsewhere in this compendium. It is not the intent of the pain management physician to usurp the cardiologist, only to provide the cardiologist with the opportunity to test further and care for their patient. Recently, the field of pain management medicine has welcomed anesthesiologists.

Keywords

  • Chronic Fatigue Syndrome
  • Sympathetic Activity
  • Chronic Migraine
  • Migraine Patient
  • Complex Regional Pain Syndrome

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Pain Management. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_24

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  • DOI: https://doi.org/10.1007/978-3-319-07371-2_24

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