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Current concepts in
Current concepts in
Current concepts in
Current concepts in
Current concepts in
Current concepts in
Current concepts in
Current concepts in
Current concepts in
Current concepts in
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Current concepts in

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This is brief presentation about current concepts in pain management. …

This is brief presentation about current concepts in pain management.
For further details contact Dr Harshe at dr.harshe@gmail.com

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  • 1. Dr Rajeev Harshe MDConsultant pain managementApollo Hospitals, Ahmadabad.(Hon. Pain consultant to H.E. Governor of Gujarat)
  • 2. Why pain management ?Current practices in IndiaHow best can be done ?Acute pain management-brief overviewChronic pain management-brief overview.
  • 3.  Human issue Recovery issue Hypersensitivity issue Legal aspect NABH/JCI issue Economic issue (faster turnover)
  • 4.  I/M shots periodically I/V shots periodically Rectal suppositories I/V infusions ( 5% centers) Random use of patches
  • 5.  Possibility of Inadequate analgesia Lack of dedicated person to look after pain relief Patients even if suffer.. feel it is a part ofexperience.
  • 6.  Multimodal analgesia Infusion better Bolus for breakthrough pain more gratifying Topical and regional analgesia better used Pain Team including pain nurse. Consider status of liver/kidney/brain
  • 7.  Portable infusion pump ( Elastomeric) PCA PCEA Diclofenac/ketorolac/buprenorphine patches Lollypops / Lozenzes Nasal sprays
  • 8.  NSAIDS Opioids: Morphine,Fentanyl,buprenorphine,Tramadol Other: Paracetamol IV 1 gm qds Dexmedetomidine Clonidine/ketamine/neostigmine
  • 9.  Tapentadol (dual action) Methadone (prolonged single shot preop.) Oxycodone Opioid antagonists Gabapentine in acute pain ( neuropathy) Opiorphine ( prevents degradation ofendogenous Opioids) ibudilast
  • 10.  Diagnostic cum therapeutic nerve blocks- (somatic and sympathetic) Radiofrequency ablation of sensory nerves Epidural/ intrathecal infusions byimplantable pumps Peripheral plexus infusions by portablepumps Percutaneous epiduroscopy and adhesiolysis Spinal stimulation by implanted stimulators Various disc procedures for IDDs
  • 11.  Pain due to spondylitis Pain due to propalsed disc Listhesis induced pain Vertebral pain Myofascial pain Neuralgias –trigeminal / post herpetic Malignancy pain Pain of vascular origin Persistent pain after spine surgery
  • 12.  Platelet rich plasma injections. Stem cell treatment Nasal sprays for any kind of pain
  • 13. Can we have Aroma Therapy used foranalgesia?
  • 14. Dr Rajeev Harshe MDConsultant pain managementApollo Hospitals, Ahmadabad.(Hon. Pain consultant to H.E. Governor of Gujarat)

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