Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review

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Web End = Can J Anesth/J Can Anesth (2016) 63:6985

DOI 10.1007/s12630-015-0506-9

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Web End = Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review

Traitements de mdecine complmentaire et alternative pertinents pour lanesthsiologiste et le clinicien de la douleur: un compte rendu narratif

Anna Woodbury, MD . Stephen Neal Soong, MD . David Fishman, MD . Paul S. Garca, MD, PhD

Received: 28 January 2015 / Revised: 23 August 2015 / Accepted: 2 October 2015 / Published online: 14 October 2015 Canadian Anesthesiologists Society 2015

AbstractPurpose This narrative review provides an overview of the complementary and alternative medicine (CAM) therapies that anesthesiologists and pain management practitioners commonly encounter along with recommendations for evaluation and implementation. Source A literature search of PubMed was performed using the comprehensive MeSH term, Complementary Therapies OR Dietary Supplements, and a search was conducted of the various licensing organizations and books published on the topics of CAM and integrative medicine. Principal ndings In North America, the most commonly encountered CAM therapies include 1) manipulation and procedural therapies; 2) herbs, nutritional supplements (nutraceuticals), and dietary therapies; and 3) mind-body and energy therapies. Controversy exists regarding many of these therapies, particularly those with a higher risk of harm, such as chiropractic manipulation, acupuncture, and nutraceutical use. Several well-conducted studies were analyzed to show how research in CAM can control for placebo responses. Practical considerations are provided

for patients and practitioners interested in pursuing or already employing CAM in perioperative and chronic pain management settings.

Conclusions Complementary and alternative medicine therapies in general may provide a useful adjunct in the management of chronic pain. Nevertheless, many patients are not aware of the risks and benets of individual therapies. In the perioperative setting, the most concerning CAM therapy is the use of herbs and other supplements that may produce physiologic and metabolic derangements and may interact with prescription medications. Resources exist to aid pain specialists, anesthesiologists, and patients in the evidence-based utilization of CAM therapies.

RsumObjectif Ce compte rendu narratif propose une...