The vast array of causes, mechanisms, and interventional strategies for pain has created an extensive field of research spanning a variety of disciplines. This thesis aims to describe the multidimensional factors leading to pain, how pain can be assessed, and how we can best target these pain pathways to improve acute pain management. Although opioids have been used for centuries in many analgesic therapies, new research and public concern are increasingly deterring clinicians from prescribing them. This thesis will discuss opioid's mechanism of action, risk of adverse effects, and limitations. Furthermore, the 'opioid crisis' will be examined from its beginning to where we are now. Alternative pharmacological and nonpharmacological therapeutic options are presented in the hope of exposing opioid-sparing improvements to analgesia; their mechanism of action, efficacy, and limitations are described where applicable.
Beyond individual analysis and evaluations of reputable, highly cited studies for each therapeutic option, this thesis also examines multimodal analgesia and how it is changing acute pain management. Multimodal analgesia allows multiple dimensions of the pain pathway to be targeted by using multiple drugs, leading to greater pain relief, decreased doses of medications, and reduced side effects. Multidisciplinary advantages are also discussed, including dynamic clinician involvement, individualization, organizational procedures, and patient education interventions. The complexities of pain management therapy and suggestions for future directions presented in this thesis are intended to expose additional options or techniques to ultimately improve surgical outcomes, increase patient satisfaction, and decrease public health risks.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/31158 |
| Date | 11 July 2018 |
| Creators | Cacace, Hanna |
| Contributors | Otis, James, Offner, Gwynneth |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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