Pain Management

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By Michael A. Ashburn, M.D., M.P.H.

There are a number of clinical practice guidelines available to guide patient care for patients with pain. As seen elsewhere, pain-related clinical practice guidelines vary with regard to their quality and applicability to ongoing clinical practice.

In addition, clinical practice guidelines often do not have a specified process for periodic review and update. Therefore, it is critical for physicians to carefully understand the process used during guideline development and to make sure that the recommendations remain valid.

Acute Pain
Chronic Pain
Cancer-Related Pain and Palliative Care

Many organizations are involved in pain-related clinical practice guideline and policy statement development. Links to these organizations are provided below:

The following is a partial listing of pain-related clinical practice guidelines:

Acute Pain

Acute Pain Management: Scientific Evidence.
Second Edition December 2007 Update. Australian and New Zealand College of Anaesthetists.

Principles of Analgesic Use in the Treatment of Acute Pain, 6th edition.

Practice Guidelines for Acute Pain Management in the Perioperative Setting.
American Society of Anesthesiologists.

Guideline for the Management of Acute and Chronic Pain in Sickle-Cell Disease.
American Pain Society.

Diagnosis and Treatment of Low Back Pain.
American College of Physicians and the American Pain Society.

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Chronic Pain

Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain:
An Evidence-Based Clinical Practice Guideline
.
American Pain Society.

Clinical Practice Guidelines for the Use of Chronic Opioid Therapy in Chronic noncancer pain.
The American Pain Society.

Guideline for the Management of Fibromyalgia Syndrome Pain in Adults and Children.
The American Pain Society.

Guideline for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis and
juvenile Chronic Arthritis
.
The American Pain Society.

Practice Guideline for Chronic Pain Management. American Society of Anesthesiologists.

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Cancer-Related Pain and Palliative Care

Guideline for the Management of Cancer Pain in Adults.
American Pain Society. 

Practice Guideline for Cancer Pain Management.
American Society of Anesthesiologists. 

Clinical Practice Guidelines for Palliative Care.
National Consensus Project for Quality Palliative Care. 

Palliative Care for Advanced Disease Pathway: Unit Reference Manual.
Department of Pain Medicine and Palliative Care, Beth Israel Hospital.

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Anesthesiologists

Physicians Protecting Patients