Navigation Links
Mayo Clinic Proceedings: Review of pain management practices for cirrhosis patients

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
Mayo Clinic

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:
(Date:11/25/2015)... ... November 25, 2015 , ... As ... Water For Empowerment ™ attracts volunteers together who want to combine talents and ... as key stakeholders in the process. The non-profit launched its first major fundraiser ...
(Date:11/25/2015)... ... November 25, 2015 , ... Dr. John Pierce, Medical Director at the Ageless ... treatment with the Capillus272™ Pro laser therapy cap. FDA cleared for safety and efficacy, ... without the need for surgery, prescription pills, or topical foams. , “Capillus272™ Pro ...
(Date:11/25/2015)... ... November 25, 2015 , ... Lakeview Health, a Jacksonville-based drug ... their sobriety and show through pictures what a positive difference it makes. The ... with the hashtag #FacesOfGratitude on their Facebook, Twitter, and Instagram accounts. Short ...
(Date:11/25/2015)... ... ... On November 23rd 2015 Cozy Products, a division of Bird-X ... Products explains what this means for business moving forward. , The Tri Lite heater ... model: to sell personal heaters that reduce energy consumption, are economical and keep people ...
(Date:11/25/2015)... ... 2015 , ... In an ongoing Clinical Study conducted by an independent physician, ... Angel is evaluating the efficacy of its product and its disinfection protocol. This study ... from May 2014 through October 2015 at a 360-bed, acute-care, academic medical center located ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015  Today AVACEN Medical announced the issue of United ... Energy Including Blood Viscosity Adjustment ". This patent shields the company,s AVACEN 100 dry heat therapy ... Method. Photo - ... ... ...
(Date:11/25/2015)... Endo International plc (NASDAQ: ENDP ) (TSX: ENL) today ... will discuss corporate updates at the 27 th Annual ... on Wednesday, December 2, 2015 at 1 p.m. ET. ... then the link to the event. Participants should allow approximately ... the site and download any streaming media software needed to ...
(Date:11/25/2015)... NEW YORK , November 25, 2015 ... global market of self-monitoring blood glucose devices was valued ... to grow with a CAGR of 5.7% during 2015 ... increasing geriatric population and increasing prevalence of diabetes. In ... about diabetes care is also contributing to the growth ...
Breaking Medicine Technology: