Navigation Links
Mayo Clinic Proceedings: Review of pain management practices for cirrhosis patients
Date:5/26/2010

ROCHESTER, Minn. -- In the May issue of Mayo Clinic Proceedings, physician experts review current practices for pain management in cirrhotic patients. The physician experts reviewed all current literature available on PubMed and MEDLINE with no limits in the search to recommend a uniform and practical guide to approaching analgesia in the cirrhotic patients.

Cirrhosis is a substantial public health problem, accounting for approximately 770,000 deaths annually and, according to autopsy studies, affecting 4.5 percent to 9.5 percent of the global population. "Pain management in patients with cirrhosis is a difficult clinical challenge for health care professionals, and few prospective studies have offered an evidence-based approach," says Kymberly Watt, M.D., Department of Gastroenterology and Hepatology at Mayo Clinic.

No evidence-based guidelines exist on the use of analgesics in patients with liver disease and cirrhosis, says Dr. Watt. From her findings in the current literature, her recommendation for long-term acetaminophen use in cirrhotic patients (not actively drinking alcohol) is for reduced dosing at 2 to 3 grams per day. For short-term use or one-time dosing, patient should not exceed 4 grams total per day but the proposed new FDA guidelines (yet to be finalized) may recommend a maximum daily dosage of 2.6 grams per day for anyone.

In addition, the review article states that NSAIDs (nonsteroidal anti-inflammatory drugs) and opioids may be used in patients with chronic liver disease without cirrhosis. "NSAIDs should be avoided in those with both compensated and decompensated cirrhosis, primarily because of the risk of acute renal failure due to prostaglandin inhibition," says Dr. Watt.

"When appropriate, anticonvulsants and antidepressants are options worthy of exploration in chronic neuropathic pain management in patients with advanced liver disease. Diligent follow-up for toxicity, adverse effects and complications is necessary," adds Dr. Watt.

"In patients with end-stage liver disease, adverse events from analgesics are frequent, potentially fatal and often avoidable. This review underscores the scarcity of prospective studies that have assessed the safety of various analgesics in patients with advanced hepatic dysfunction," says Dr. Watt.


'/>"/>

Contact: Rebecca Finseth
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
Source:Eurekalert

Related medicine news :

1. Mobile Clinic Management EMR for Patient Health Information Launched by JAG Products and Canvas Partnership
2. Neuralstem updates clinical trial progress
3. Mayo Clinic researchers find gene they believe is key to kidney cancer
4. AeroClinic to Provide Free Blood Pressure Screenings at PHL Beginning May 20
5. Mayo Clinic researchers find genetic secrets to common kidney cancer
6. Taking the final step from the bench to the hospital or clinic bedside
7. Carefx to Collaborate with the Cleveland Clinic to Commercialize CCF Business Intelligence Solution
8. Renovations at Riley Hospital for Children will boost pediatric clinical research
9. Real-time, evidence-based information at clinicians fingertips to streamline mental health care
10. Tattoo Removal Laser Clinic Announces New PhotoAcoustic Laser Technology
11. Mass. Eye and Ear receives NEI grant renewal for growing clinical/scientists
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... 27, 2016 , ... TherapySites, the leading website ... Tennessee Counseling Association. This new relationship allows TherapySites to continue to ... adding exclusive benefits and promotional offers. , "TCA is extremely excited about this ...
(Date:6/27/2016)... ... June 27, 2016 , ... A revolution ... the emergency ambulance transport experience for the millions of people who require these ... disrupted the taxi industry through the use of technology. Now, SmartEMS has put ...
(Date:6/26/2016)... PLAINSBORO, N.J. (PRWEB) , ... June 27, 2016 , ... ... same sources, yet in many ways they remain in the eye of the beholder, ... Oncology (EBO), a publication of The American Journal of Managed Care. For the full ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a ... can give their videos a whole new perspective by using the title layers ... Film Studios. , ProSlice Levels contains over 30 Different presets to choose from. ...
(Date:6/26/2016)... NC (PRWEB) , ... June 26, 2016 , ... Brent Kasmer, a legally blind and ... to be personalized through a fitness app. The fitness app plans to fix the two ... currently only offer a one size fits all type program , They don’t ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Mass. , June 24, 2016   ... Spaulding Rehabilitation Network,s Dean Center for Tick ... Physical Medicine and Rehabilitation, MIT Hacking Medicine, University ... for Innovation, today announced the five finalists of ... for Lyme disease.  More than 100 scientists, clinicians, ...
(Date:6/24/2016)... and SAN CLEMENTE, Calif. , June ... -based mobile pulmonary function testing company, is now able to ... devices developed by ndd Medical Technologies , Inc. ... done in hospital-based labs.  Thanks to ndd,s EasyOne PRO ® , ... , can get any needed testing done in the comfort of ...
(Date:6/24/2016)... , June 24, 2016  Arkis BioSciences, ... less invasive and more durable cerebrospinal fluid treatments, ... funding.  The Series-A funding is led by Innova ... Fund, and other private investors.  Arkis, new financing ... instrumentation and the market release of its in-licensed ...
Breaking Medicine Technology: