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- Scope of the Problem
-
1. Cancer pain
- Prof. Judith Paice
- Current Therapies
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3. Spinal analgesia for cancer pain
- Prof. Jon Raphael
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4. Celiac plexus block
- Prof. David Brown
- Future Directions
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6. Symptom control: using technology pragmatically
- Dr. Steven Richeimer
- From Palliative Care to Chronic Pain
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7. Insight and responsibility: ethics in pain medicine and palliative care
- Prof. Rollin Gallagher
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8. The patient with pain: a palliative care approach
- Dr. Janet Abrahm
- Archived Lectures *These may not cover the latest advances in the field
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9. Cancer pain and related symptoms: an overview
- Prof. Judith Paice
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10. Cancer pain control: an evidence-based approach
- Prof. Daniel Carr
- Dr. Baraa Tayeb
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11. Optimal treatment of chronic pain
- Prof. Gordon Irving
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12. Chronic cancer pain: the price of success?
- Prof. Allen Burton
Printable Handouts
Navigable Slide Index
- Introduction
- Multifactorial nature of pain
- Episodic vs. persistent pain
- PCA vs. IM/IV boluses (1)
- PCA vs. IM/IV boluses (2)
- PCA guidelines for healthy patients
- Blocks in cancer pain
- Epidural analgesia
- Epidural hematoma risk factors
- Infraclavicular approach to the brachial plexus
- Nerve blocks with catheters
- Neuroablation/neurolysis
- Lumbar sympathetic block technique
- Hypogastric plexus blockade
- Neurolysis: celiac and superior hypogastric plexus
- Radiofrequency lesioning
- Intrathecal drug delivery systems
- Spinal pump
- Criteria for implantable pain management
- Invasive treatment for cancer pain management
- Side effects of pain medications
- Clinical experience with intrathecal therapy
- Cancer pain trial, 2002
- Reduction in 15 toxicities
- Survival
- Cancer pain trial results: summary
- Spinal cord
- Intrathecal pump infusions
- IT bupivacaine
- Feeding sequence of predatory cone snail
- IT ziconotide for refractory pain
- IV infusion for intractable pain
- Other palliative issues
- Drugs suitable for subcutaneous infusion
- The pain cycle
- Conclusion
Topics Covered
- Use of PCA for acute or episodic pain
- Blocks in cancer pain
- Targeted analgesia
- Use of continuous infusions
- Neuroablative blocks
- Spinal pumps: indications and benefits
- Options for spinal pump medications
- New option: Ziconotide
- Managing the distressed patient best with a multidisciplinary team
- Update interview: Update regarding opioids
- Update interview: Ketamine and other NMDA antagonists
- Update interview: Increased interest in interventional techniques and implants
- Update interview: The importance of multidisciplinary teams in pain medicine
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Richeimer, S. (2020, August 14). Symptom control: using technology pragmatically [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved September 1, 2024, from https://doi.org/10.69645/GJNG6913.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Steven Richeimer has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Update Available
The speaker addresses developments since the publication of the original talk. We recommend listening to the associated update as well as the lecture.
- Full lecture Duration: 36:01 min
- Update Interview Duration: 12:37 min
A selection of talks on Cancer
Transcript
Please wait while the transcript is being prepared...
0:00
Hello I am Steven Richeimer,
Chief of the Division of Pain Medicine
at the Keck School of Medicine at
the University of
Southern California in Los Angeles.
Today we're gonna discuss how technology
provides some solutions in assistance for
treating difficult to control pain and
other symptoms of discomfort.
0:22
However, it is important for
us to understand the pain is not
occurring as a simple manifestation
of a physiological problem.
Pain in fact,
is not exactly the same thing as suffering
as we see in the middle of this slide.
Pain and suffering overlap,
but they are not identical and
there are many factors that contribute to
the degree of suffering of the patient.
These includes psychological factors,
spiritual factors,
social and family factors.
Therefore, it is very important
that when we turn to technological
solutions that we are not providing
them in a sterile environment
that ignores the entire context of
the patient's pain and their suffering.
1:12
When we examine the patient with pain,
it's important for
us to understand the pattern of
the pain that they suffer with.
So for instance, providing long-acting
opioids provides an excellent
steady baseline of pain control for
the patient who has persistent pain.
But it is not an effective approach for
the patient who has spikes of episodic or
breakthrough pain.
For such an approach we need to be able
to rapidly deliver additional medication.