Journal of Dental Anesthesia and Pain Medicine最新文献

{"title":"Diastolic Ventricular Insufficiency and Use of Anesthetics","authors":"S. Castro, Nixon Martin Burbano Erazo, Luisa Rodriguez, Maria F Landinez, Cordero, Camilo Andrés Benavides Pai, S. A. Mora, Francisco Alberto Rodríguez Lee, Yudy, Andrea Chicaiza Guerrero","doi":"10.33140/japm.07.01.02","DOIUrl":"https://doi.org/10.33140/japm.07.01.02","url":null,"abstract":"Heart failure is a pathology that generates a progressive deterioration that little by little compromises the functional capacity of the individual who suffers from it, affecting the ability of the heart to pump blood to the body adequately. Regarding its prevalence in general, it can affect from 1% to 14% of the population in the United States and Europe. In Colombia, according to a study published in 2012, heart failure has a prevalence in the general population of 2.3%, with 67.5% being heart failure with preserved EF. This is classified according to the ejection fraction of the patients, which may be preserved or decreased. Diastolic ventricular dysfunction is of the type with normal ejection fraction. Its incidence varies in critically ill patients between 40 and 80%, the use of anesthetics in these patients has not been much studied, and however, some very important considerations can be taken into account when applying them. Methodology A narrative review was carried out, in which different databases were used such as Scielo, PubMed, Sciencedirect, academic google, among others. The selection of articles was made through indexed journals in English and Spanish languages from 2010 to 2021 that met the selection criteria. Results Diastolic dysfunction includes an alteration in diastolic ventricular compliance; that is, it affects cardiac filling, when the ventricle is relaxed. It is a condition in which, to sustain normal cardiac output, the filling pressure is increased. Patients with diastolic ventricular failure. Most anesthetics reduce sympathetic tone, which decreases venous return due to an increase in the compliance of the venous system, arterial vasodilation, and a decrease in blood pressure, thus generating a greater alteration in diastole, and consequently in preload. Conclusions The use of anesthetics in diastolic insufficiency should be further studied due to the implications it has at the cardiovascular level when inducing a patient. Being these more sensitive to hemodynamic changes, and cavitary pressures that generates a high risk of imminent decompensation during the procedures to which these patients undergo regardless of whether they are cardiac or not.","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90643833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of cannabis-based medications compared to placebo for the treatment of chronic neuropathic pain: a systematic review with meta-analysis.","authors":"Bradley Sainsbury,&nbsp;Jared Bloxham,&nbsp;Masoumeh Hassan Pour,&nbsp;Mariela Padilla,&nbsp;Reyes Enciso","doi":"10.17245/jdapm.2021.21.6.479","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.479","url":null,"abstract":"<p><strong>Background: </strong>Chronic neuropathic pain (NP) presents therapeutic challenges. Interest in the use of cannabis-based medications has outpaced the knowledge of its efficacy and safety in treating NP. The objective of this review was to evaluate the effectiveness of cannabis-based medications in individuals with chronic NP.</p><p><strong>Methods: </strong>Randomized placebo-controlled trials using tetrahydrocannabinol (THC), cannabidiol (CBD), cannabidivarin (CBDV), or synthetic cannabinoids for NP treatment were included. The MEDLINE, Cochrane Library, EMBASE, and Web of Science databases were examined. The primary outcome was the NP intensity. The risk of bias analysis was based on the Cochrane handbook.</p><p><strong>Results: </strong>The search of databases up to 2/1/2021 yielded 379 records with 17 RCTs included (861 patients with NP). Meta-analysis showed that there was a significant reduction in pain intensity for THC/CBD by -6.624 units (P < .001), THC by -8.681 units (P < .001), and dronabinol by -6.0 units (P = .008) compared to placebo on a 0-100 scale. CBD, CBDV, and CT-3 showed no significant differences. Patients taking THC/CBD were 1.756 times more likely to achieve a 30% reduction in pain (P = .008) and 1.422 times more likely to achieve a 50% reduction (P = .37) than placebo. Patients receiving THC had a 21% higher improvement in pain intensity (P = .005) and were 1.855 times more likely to achieve a 30% reduction in pain than placebo (P < .001).</p><p><strong>Conclusion: </strong>Although THC and THC/CBD interventions provided a significant improvement in pain intensity and were more likely to provide a 30% reduction in pain, the evidence was of moderate-to-low quality. Further research is needed for CBD, dronabinol, CT-3, and CBDV.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"479-506"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/21/jdapm-21-479.PMC8637910.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse effects following dental local anesthesia: a literature review.","authors":"Jean-Pierre T F Ho,&nbsp;Tom C T van Riet,&nbsp;Youssef Afrian,&nbsp;Kevin T H Chin Jen Sem,&nbsp;René Spijker,&nbsp;Jan de Lange,&nbsp;Jerome A Lindeboom","doi":"10.17245/jdapm.2021.21.6.507","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.507","url":null,"abstract":"<p><p>Local anesthesia is indispensable in dentistry. Worldwide, millions of local anesthetic injections are administered annually, and are generally considered safe invasive procedures. However, adverse effects are possible, of which dentists should be aware of. This scoping review aimed to provide an extensive overview of the reported literature on the adverse effects of dental local anesthesia. The types of papers, what is reported, and how they are reported were reviewed. Additionally, the incidence and duration of adverse effects and factors influencing their occurrence were also reviewed. An electronic search for relevant articles was performed in PubMed and Embase databases from inception to January 2, 2020. The titles and abstracts were independently screened by two reviewers. The analysis was narrative, and no meta-analysis was performed. This study included 78 articles. Ocular and neurological adverse effects, allergies, hematomas, needle breakage, tissue necrosis, blanching, jaw ankylosis, osteomyelitis, and isolated atrial fibrillation have been described. Multiple adverse effects of dental local anesthesia have been reported in the literature. The results were heterogeneous, and detailed descriptions of the related procedures were lacking. Vital information concerning adverse effects, such as the dosage or type of anesthetic solution, or the type of needle used, was frequently missing. Therefore, high-quality research on this topic is needed. Finally, the adverse effects that are rarely encountered in real-world general practice are overrepresented in the literature.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"507-525"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/2b/jdapm-21-507.PMC8637917.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis.","authors":"Marco Rossit,&nbsp;Victor Gil-Manich,&nbsp;José Manuel Ribera-Uribe","doi":"10.17245/jdapm.2021.21.6.527","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.527","url":null,"abstract":"<p><p>The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"527-545"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/c2/jdapm-21-527.PMC8637914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effects of articaine and bupivacaine in impacted mandibular third molar tooth surgery: a randomized, controlled trial.","authors":"Berkay Tokuç,&nbsp;Fatih Mehmet Coşkunses","doi":"10.17245/jdapm.2021.21.6.575","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.575","url":null,"abstract":"<p><strong>Background: </strong>The aim of this randomized, triple-blind trial was to determine the anesthetic, analgesic, and hemodynamic effects of articaine and bupivacaine in the extraction of impacted mandibular third molar teeth.</p><p><strong>Methods: </strong>Twenty-six patients who underwent removal of bilaterally symmetric mandibular third molars were randomly assigned to articaine and bupivacaine groups in a split-mouth design. The onset of anesthetic action, intraoperative comfort, total amount of solution used, duration of postoperative anesthesia and analgesia, rescue analgesic use, postoperative pain, intraoperative bleeding, and hemodynamic parameters were evaluated.</p><p><strong>Results: </strong>In the articaine group, the onset of anesthetic activity was faster, intraoperative comfort was greater, and effective anesthesia required less local anesthetic solution. The bupivacaine group showed a significantly longer duration of postoperative anesthesia and analgesia, in addition to lower visual analog scale values at 6 and 48 hours postoperatively. There were no significant differences between the two solutions regarding rescue analgesic medication use, intraoperative bleeding, or hemodynamics.</p><p><strong>Conclusion: </strong>Articaine showed greater clinical efficacy than bupivacaine in intraoperative anesthesia, achieving faster onset of anesthetic action and greater patient comfort while also requiring less reinforcement during surgery. However, bupivacaine was superior in terms of postoperative anesthesia, reducing postoperative pain due to its residual anesthetic and analgesic effects. Both anesthetic solutions led to similar hemodynamics at low doses in mandibular third molar surgery.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"575-582"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/1f/jdapm-21-575.PMC8637915.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39839525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania.","authors":"Nicco Sales,&nbsp;Karpal Singh Sohal,&nbsp;Jeremiah Robert Moshy,&nbsp;Sira Stanslaus Owibingire,&nbsp;David K Deoglas,&nbsp;Paulo J Laizer","doi":"10.17245/jdapm.2021.21.6.557","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.557","url":null,"abstract":"<p><strong>Background: </strong>Conscious sedation is a useful adjunct in the treatment of patients in dentistry; however, a lack of knowledge among the dental profession regarding sedation is a restricting factor in the practice of dental sedation. Therefore, this study was conducted to assess the knowledge and practice of sedation in dentistry among dental professionals in Tanzania.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted for five months targeting all practicing dental professionals in Tanzania. A modified questionnaire contained 14 questions regarding knowledge about sedative agents and a section on the practice of sedation. The data obtained from this study were coded and entered into a computer program and analyzed using SPSS software version 23.0. The data are presented as frequencies and percentages in tables and charts. Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>The age range of participants was between 24 and 63 years (mean 36.6 ± 7.7 years). There were 107 men (78.1%), and the male-to-female ratio was 3.6:1. The majority (76.6%) of participants only had an undergraduate dental degree. Thirty-one percent of participants only worked in publicly owned health facilities. Slightly more than half (59.9%) of participants had satisfactory knowledge regarding sedation in dentistry. There was no statistically significant association between the level of sedation-related knowledge and the demographic characteristics of the participants. Only 21.9% reported using sedation in their practice, and the most commonly used sedative drug was diazepam. The reasons for not using dental sedation in clinical practice included a perceived lack of knowledge on sedation, lack of equipment, and cost.</p><p><strong>Conclusion: </strong>Most dental professionals in Tanzania have basic knowledge of sedation in dentistry, although knowledge regarding sedative agents is generally low. The practice of sedation in dentistry in Tanzania is very low compared to that in middle- and high-income countries. Inadequate knowledge, lack of equipment, and the cost of practicing sedation are the main reasons for not practicing sedation.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"557-564"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/51/jdapm-21-557.PMC8637913.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of transcutaneous electrical nerve stimulation as an adjunct therapy in trigeminal neuralgia - a randomized double-blind placebo-controlled clinical study.","authors":"Suman Bisla, Ambika Gupta, Shalini Agarwal, Harneet Singh, Ankita Sehrawat, Aarti Singh","doi":"10.17245/jdapm.2021.21.6.565","DOIUrl":"10.17245/jdapm.2021.21.6.565","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is a severe form of pain that affects the daily activities of a patient. Transcutaneous electrical nerve stimulation (TENS) therapy is an emerging option for the treatment of acute and chronic pain. The aim of this study was to evaluate the effect of TENS therapy as an adjunct to drug therapy for the treatment of TN.</p><p><strong>Methods: </strong>A total of 52 patients diagnosed with TN according to the International Classification of Headache Disorders (version 3) were included. Each patient was randomized to either the TENS or placebo TENS groups. Intervention was given in continuous mode and 100-Hz frequency for 20 mins biweekly for 6 weeks. Parameters were measured at baseline, TENS completion and 3 months, 6 months, and 1 year of follow up. The parameters observed were mean carbamazepine dose, mean visual analog scale (VAS) score, mean present pain intensity (PPI) score, and functional outcome. Non-parametric analyses, one-way ANOVA and the Kruskal-Wallis test were applied for intragroup comparisons, while the Mann-Whitney U test and independent t-test were used for intergroup comparisons of variables. The chi-square test was applied to analyze categorical data.</p><p><strong>Results: </strong>Compared to the placebo TENS group, the mean dose of carbamazepine in the TENS group was significantly reduced at TENS completion, as well as at 6 months and 1 year follow up. Changes in mean VAS score, mean PPI score, and functional outcome did not show significant differences between the groups (P>0.05).</p><p><strong>Conclusion: </strong>TENS therapy does not lead to any changes in pain levels but it may reduce the mean dose of carbamazepine when used as an adjunct treatment in patients with TN.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"565-574"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/20/jdapm-21-565.PMC8637911.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39839524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of efficacy of Physics Forceps versus conventional forceps in pediatric dental extractions: a prospective randomized study.","authors":"Sainath Reddy Elicherla,&nbsp;Sujatha Bandi,&nbsp;Mahesh Nunna,&nbsp;Kanamarlapudi Venkata Saikiran,&nbsp;Varada Sahithi,&nbsp;Sivakumar Nuvvula","doi":"10.17245/jdapm.2021.21.6.547","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.547","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions.</p><p><strong>Methods: </strong>This was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale).</p><p><strong>Results: </strong>A significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group.</p><p><strong>Conclusion: </strong>Physics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":"21 6","pages":"547-556"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/9c/jdapm-21-547.PMC8637916.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9302161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of patients with allergy to local anesthetics: two case reports.","authors":"Varun Arya,&nbsp;Geetanjali Arora,&nbsp;Sanjeev Kumar,&nbsp;Amrita Kaur,&nbsp;Santosh Mishra","doi":"10.17245/jdapm.2021.21.6.583","DOIUrl":"https://doi.org/10.17245/jdapm.2021.21.6.583","url":null,"abstract":"<p><p>Lidocaine is the most commonly used local anesthetic (LA) agent in various dental as well as oral and maxillofacial procedures. Although rare, adverse effects and allergic reactions to lidocaine have been reported. In patients with suspected allergy to LA or a history of such reaction, careful history-taking and allergy testing should be performed to choose an alternative LA agent to avoid any adverse effects. Here, we present two cases of delayed hypersensitivity reaction to lidocaine, wherein the patients presented with erythema, edema, and itching. Intradermal testing confirmed allergic reaction to lidocaine, and the patients underwent successful dental treatment using an alternative LA agent. This report highlights the importance of allergy testing prior to LA use considering the serious consequences of allergy to these agents and describes the management of such patients using an alternative LA agent.</p>","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":" ","pages":"583-587"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/e1/jdapm-21-583.PMC8637912.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39839526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Opioid Use on Results of Interventional Back-Pain Management on Patients with Chronic Back Pain","authors":"","doi":"10.33140/japm.06.02.06","DOIUrl":"https://doi.org/10.33140/japm.06.02.06","url":null,"abstract":"Objectives Preoperative exposure to opiates has recently shown to be associated with poor outcomes after elective major surgery, but little is known as to how pretreatment opioid use affects results of interventional back-pain management. We investigated the impact of preoperative opioid use on outcomes after interventional pain management procedures on patients with chronic back pain. Methods A high-volume, single-center quality register analysis was performed on patients who underwent interventional pain management for chronic back pain as a part of multidisciplinary pain management program. Chronic opioid use was defined as having an opioid prescription concurrent with 90 days. Results: A total of 797 patients underwent intervention during the study period 2019-2020. Pretreatment opioid use was present in 262 patients (33%). Patients with chronic back-pain using opiates reported significantly more pain and discomfort before treatment as well as lowered working ability. Facet-joint medial branch blocks resulted for significant improvement for both groups directly after the treatment as well as at 2-hours follow-up. However, non-opiate group reported significantly more improvement at 2-days follow up as well as at one- month follow-up compared to opiate users. Opiate users reported nearly the same pain level at one-month follow-up as before treatment. Conclusions: Pretreatment opioid use is associated with greater pain discomfort, impairment and reduced functional ability, as well as poorer long-term effect of interventional back pain treatment at 1-month follow-up. In our study opiate users reported same positive effects of facet-joint nerve blocks immediately after the treatment and 2 hours after the treatment but significantly smaller effect at one-month follow-up. This could indicate that opiate use may diminish effects of pain treatments by affecting relearning, behavioral changes and central pain modulation. These findings may help to understand the impact of pretreatment opioid use on patient care, and its implications on hospital and societal cost.","PeriodicalId":15634,"journal":{"name":"Journal of Dental Anesthesia and Pain Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85965116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}