Pain physician最新文献

{"title":"Efficacy Analysis of Temporary Spinal Cord Stimulation in the Treatment of Refractory Postherpetic Neuralgia.","authors":"Xin Li, Yaping Wang, Kai Chen, Dingquan Zou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord stimulation can be considered in PHN patients if conservative treatment is not effective. However, the long-term pain outcomes of temporary (7-14 days) spinal cord stimulation (tSCS) in refractory PHN patients with a course of more than 3 months have not been  documented.</p><p><strong>Objectives: </strong>To investigate the efficacy of tSCS as a treatment for refractory PHN.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Pain Department in a university hospital.</p><p><strong>Methods: </strong>A total of 52 patients with refractory PHN were treated with tSCS between March 2018 and February 2021. Their medical records were collected, and the patients were divided into 3 groups according to the course of their disease into the medium-term group, long-term group and ultra-long-term group. The changes in the numeric rating scale (NRS) scores, Pittsburgh sleep quality index (PSQI) responses, pain relief rate, postoperative efficiency and patients' use of analgesics were recorded before the operation, 3 days, 10 days, one month, 3 months, 6 months and 12 months after the operation.</p><p><strong>Results: </strong>The average NRS scores, the maximum NRS scores and the PSQI scores at 3 days, 10 days, one month, 3 months, 6 months and 12 months after the operation were significantly lower than those before the operation (P < 0.05). The average NRS scores and the maximum NRS scores of all groups increased significantly from one month to 6 months compared to those at 10 days after the tSCS treatment, and they decreased significantly at 12 months compared with 6 months post-operation. The average NRS scores of the medium-term and long-term group were significantly lower than that of the ultra-long-term group at 1-3 months after the operation, and the maximum NRS scores at one month, 3 months and 12 months after the operation were also significantly lower in the medium-term and long-term group compared to the ultra-long-term group. The average PSQI scores at 1-12 months after the operation were not significantly higher than that at 10 days after the operation, but it decreased significantly at 12 months compared with 6 months after the operation. Among the 3 groups, the PSQI scores of the medium-term and long-term group were significantly lower than those of the ultra-long-term group at 6 months after the operation. The postoperative pain relief rate ranged from 41.51%-59.81%, and the total effective rate was 42.31%-69.23%, and there was no significant difference among the 3 groups. Some patients still needed analgesics at 12 months after the operation, but the number of patients who were taking medications post-operation was significantly lower than that before the operation.</p><p><strong>Limitations: </strong>This is a single-center retrospective study with the inability to completely control for variables. Additionally, the number of cases is small and the follow-up du","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of Radiofrequency Ablation Among Facet Joint-Related Chronic Low Back Pain Patients in Thailand.","authors":"Manit Sittimart, Dimple Butani, Chittawan Poonsiri, Manta Korakot, Manilung Nalongsack, Pornpan Chalermkitpanit, Pramote Euasobhon, Koravee Pasutharnchat, Sasikaan Nimmaanrat, Napatpaphan Kanjanapanang, Yot Teerawattananon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) is a common secondary treatment recommended for facet joint-related chronic low back pain (CLBP). However, Thailand still lacks sufficient evidence of RFA's cost-effectiveness to support the decision to fund it.</p><p><strong>Objective: </strong>To conduct a comparative economic evaluation of RFA and conservative treatment for CLBP patients over 16-month and 28-month time horizons in Thailand.</p><p><strong>Study design: </strong>A full economic evaluation encompassing measurements of both health utilities and health costs.</p><p><strong>Setting: </strong>Data were collected from 3 university hospitals in Bangkok, Thailand: King Chulalongkorn Memorial Hospital, Siriraj Hospital, and Ramathibodi Hospital.</p><p><strong>Methods: </strong>The cost-utility analysis, which used the Markov model, was developed according to the Thai health technology assessment guidelines and compared RFA and the best supportive care from the societal perspective. In the study, the population consisted of patients who had endured low back pain for more than 3 months despite receiving conservative treatment. The results were presented as an incremental cost-effective ratio (ICER) in Thai Baht (THB)/quality-adjusted life year (QALY). Scenario and sensitivity analyses were conducted.</p><p><strong>Results: </strong>RFA was not cost-effective in Thailand when compared to conservative treatment, with a cost-effectiveness (CE) ratio of I$13,652 at all time horizons. The ICER of RFA was I$99,267 and I$52,380/QALY for the 16- and 28-month time horizons, respectively. In a scenario analysis in which RFA was repeated at 28 months and followed up to 52 months, the ICER was reduced to I$43,451. One-way sensitivity analysis showed that the ICER was most sensitive to the changes in utility parameters, the cost of RFA, and opportunity cost in the no-pain state.</p><p><strong>Limitations: </strong>The study uses primary data to derive the utility value and determine the costs. However, the limitation includes a relatively small sample size and a short follow-up time for parameter inputs.</p><p><strong>Conclusion: </strong>This study, the first economic evaluation of RFA for CLBP in Asia, showed that RFA was not cost-effective in Thailand. Price negotiation is recommended to make the intervention more cost-effective before it is included in the benefit package.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Short-Term Supraorbital Nerve Stimulation and Pain Relief for Acute and Subacute Ophthalmic Herpetic Neuralgia: A Randomized Controlled Crossover Trial\".","authors":"Hui Li, Hao Zhou, Ling Ye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended vs. Traditional Operating Table in C-Arm-Guided Percutaneous Balloon Compression of the Gasserian Ganglion for Trigeminal Neuralgia: A Prospective Study.","authors":"Fengyun You, Ri Chen, Meirong Chen, Xueru Xu, Ruohan You, Xiu Jiang, Huake Zeng","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The degree of cervical extension required during percutaneous balloon compression (PBC) of the Gasserian ganglion for trigeminal neuralgia (TN) varies among patients, but the traditional operating tables often fail to fulfil each patient's individual requirements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to compare the clinical efficacy of an extended operating table to that of a traditional operating table in C-arm-guided PBC of the Gasserian ganglion for TN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This is a consecutively prospective comparative study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Fujian Provincial Hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study consecutively enrolled patients with TN who were scheduled for PBC of the Gasserian ganglion between February 2020 and February 2023. Some patients who underwent the procedure were placed on an extended operating table, whereas others were placed on a traditional operating table. The primary outcome was the duration of the cervical extension. The secondary outcomes included the duration of patient positioning, operation duration, C-arm radiation exposure, and pressure pain threshold of the bilateral trapezius, levator scapulae, and upper trapezius muscles, as well as the occurrence rate of postoperative complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 76 patients (mean age of 53.18 ± 2.74 years old, 44 men) were enrolled, with 38 patients using the extended operating table. The baseline characteristics between the extended and traditional operating table groups were comparable (P &gt; 0.05). The duration of the cervical extension was significantly shorter in patients who used an extended operating table than in those who used a traditional operating table (58.77 ± 2.11 vs. 76.49 ± 2.16, P &lt; 0.001). Patients who used an extended operating table exhibited significantly shorter positioning time (3.40 ± 0.45 vs. 10.32 ± 0.66, P &lt; 0.001), operation duration (50.88 ± 2.95 vs. 76.49 ± 2.16, P = 0.020), and C-arm radiation exposure (8.71 ± 1.06 vs. 10.87 ± 1.26, P &lt; 0.001) and significantly higher postoperative 24-hour pressure pain thresholds of the bilateral trapezius muscle (left: 274.39 ± 10.42 vs. 187.05 ± 6.19, P &lt; 0.001; right: 272.89 ± 11.62 vs. 185.42 ± 6.88, P &lt; 0.001), bilateral levator scapulae (left: 357.71 ± 11.37 vs. 245.34 ± 12.87, P &lt; 0.001; right: 353.71 ± 14.14 vs. 245.05 ± 13.20, P &lt; 0.001), and bilateral upper trapezius (left: 253.63 ± 10.91 vs. 163.95 ± 8.44, P &lt; 0.001; right: 255.66 ± 11.99 vs. 165.32 ± 7.93, P &lt; 0.001) compared to those who used a traditional operating table. The occurrence of postoperative adverse events, such as headache, neck pain, back pain, and limb numbness, was significantly lower in the extended operating table group (2.63% vs. 13.79%, P = 0.047) than in the traditional operating table group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;This is a single-center study with a small, homogeneous sample, limiting the generali","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older and Better: A Narrative Review of Successful Aging and Adaptation to Pain in Late Life.","authors":"Emanuel Narcis Husu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;\"Invariably, the self-assessed QoL was far better than I, as a physician, would have anticipated from the diseases and disabilities that you reported.\" -Ben Eiseman, MD, based on a survey of his octogenarian Yale University classmates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic pain control is a high priority for the elderly; it is one of the most frequently encountered medical problems in this group. Chronic pain affects 60%-75% of people aged 65 years and older. Chronic pain's prevalence is even higher in those living in assisted living or nursing homes. Based on epidemiological data, the prevalence of chronic pain is directly proportional to age and is especially so in women. At least one in 3 patients over age 65 report significant ongoing pain that is often inadequately treated. Despite this high prevalence of chronic pain in older persons, aging research sheds light on how this suffering may be reduced. Healthy aging is not an oxymoron. Successful aging and adaptation to chronic pain involve similar medical, temperamental, behavioral, and cultural factors. Older patients with chronic pain face well-documented cultural bias, fear, and clinical pessimism; but adaptive coping is a realistic expectation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This narrative review aims to summarize the available literature on strategies used by older persons to optimize adaptation to late-life pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This is a narrative review of a PubMed literature search 1947 to March 4, 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A PubMed literature search covering years 1947 to March 4, 2024 was performed using permutations of the search terms pain, chronic pain, persistent pain, aging, elderly, and coping. Relevant articles were also obtained from careful review of the references in articles identified in the search.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;I summarized the available literature on strategies used by older persons to optimize adaptation to late-life pain. There are distinct differences between older persons and younger persons in the strategies they use to cope with chronic pain. Furthermore, I identified significant overlap between strategies and actions used by older persons to cope with pain and those strategies and actions used to successfully adapt to the aging process; these commonalities demonstrate a linkage of these adjustment processes and have clinical utility. Also presented are 2 cases that demonstrate the relevance of these factors for treating elderly patients with chronic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The literature search was limited to PubMed, which excluded psychology databases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Chronic pain is common in the elderly and is not adequately treated. Data indicate that older persons can benefit from guidance toward distinct attitudes and actions they can employ to cope with persistent pain. Epidemiologic and aging literature describe attitudes and behaviors that facilitate","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Effectiveness of Intraarticular Hyaluronate and Corticosteroid injections in Adhesive Capsulitis: A Systematic Review and Meta-analysis.","authors":"Kyeong Eun Uhm, Min Cheol Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Adhesive capsulitis of the shoulder causes inflammation and adhesions in the shoulder joint capsule, leading to pain and limited range of motion (ROM). Intraarticular corticosteroid (CS) and hyaluronic acid (HA) injections are common therapeutic options for adhesive capsulitis, but their comparative effectiveness remains unclear.</p><p><strong>Objectives: </strong>To provide a robust comparison of the outcomes of HA and CS, we conducted a meta-analysis of relevant previous studies that examined the therapeutic effects of intraarticular HA and CS injections in patients with adhesive capsulitis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>This meta-analysis of randomized controlled trials compared the effectiveness of intraarticular HA and CS injections. Of the 10,205 articles, 7 met our predetermined criteria and were included in the analysis.</p><p><strong>Results: </strong>Patients who received CS injections demonstrated superior pain reduction and functional improvement at 2-4 weeks after injection to those who received HA injections. Nevertheless, comparable outcomes were observed between the 2 groups at 6 and 12 weeks. The active or passive range of motion of the shoulder joint was not significantly different between patients who received HA injections and those who received CS injections.</p><p><strong>Limitations: </strong>The meta-analysis included only a small number of studies, and the number of HA injections examined in those studies varied from one to 3 at a time, whereas an CS injection was performed only once in most of the included studies.</p><p><strong>Conclusions: </strong>The administration of intraarticular HA injection emerges as a commendable therapeutic option for patients with adhesive capsulitis, particularly for those requiring repetitive injections or at risk of developing side effects from injections of CS. Although intraarticular CS injections offer accelerated short-term (2-4 weeks) pain relief and functional improvement, comparable effects were observed within 6 and 12 weeks after intraarticular HA and CS injections.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iliotibial-Band and Gluteus Medius Percutaneous Ultrasound Tenotomy for Refractory Trochanteric Pain Syndrome: A Longitudinal Observational Study with One-Year Durability Results.","authors":"Sandeep Yerra, Tahereh Naeimi, Alan D Kaye, Ferdinand J Chan, David Gonzalez, Ugur Yener, Sayed Emal Wahezi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain that affects patients' quality of life and functioning. The condition is often associated with tightness of the iliotibial band (ITB) and tendinopathy of the gluteus medius (GMed) tendon, which are subjected to excessive stress and inflammation. A traditional treatment for GTPS is conservative medical management (CMM), which includes but is not limited to physiotherapy, oral anti-inflammatory medication, and/or local steroid injections. Surgery is performed when these treatments fail. The failure of these techniques indicates that some treatments classified as CMM may not be feasible for some patients.</p><p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of combined GMed and ITB injections for a cohort of CMM-refractory GTPS patients.</p><p><strong>Study design: </strong>A retrospective chart review.</p><p><strong>Setting: </strong>Single-center, academic hospital.</p><p><strong>Methods: </strong>Between 01/01/2022 and 12/31/2022, a retrospective analysis of 68 hips that underwent combination GMed-ITB percutaneous ultrasound tenotomy (PUT) was performed. The primary outcome measure was a numeric rating scale (NRS) for hip pain, and the secondary outcome measures were VISA-G (Victorian Institute of Sports Assessment-Gluteal Tendinopathy) scores, sitting-to-standing and walking tolerance, and side-lying tolerance.</p><p><strong>Results: </strong>The patients' NRS scores decreased, and the VISA-G scores and all functional measures increased one year after the procedure, indicating significant improvement in pain and functioning (P < 0.001). Treatment success, defined as 50% reduction in pain and side-lying tolerance, was achieved by 83% of the patients. No major complications were reported.</p><p><strong>Limitations: </strong>The lack of a comparable cohort reduces the data's interpretative significance. Having a control arm would have enabled a statistical comparison between treated and untreated patients to provide a valid assessment of the procedure's benefit.</p><p><strong>Conclusions: </strong>This study demonstrated the feasibility and efficacy of combined GMed-ITB PUT as a novel treatment for GTPS in patients who failed CMM. The results showed significant and durable improvement in pain, function, and quality of life at the one-year follow-up. Our study suggests that both ITB and GMed tendons are involved in the pathogenesis of GTPS. The present study compared favorably with previous studies that reported outcomes of either ITB PUT or GMed PUT alone, implying that combining the approaches may offer superior benefits. Furthermore, the study had several strengths, such as the use of a validated outcome measure (VISA-G), the elimination of bias by independent practitioners, and the inclusion of a difficult population with severe pain.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Institutional Cross-Sectional Phone Survey Study: Evaluation of Causes for Loss to Follow-up After Spinal Cord Stimulator Implantation.","authors":"Kyle Kang, Michael Glicksman, Johnson Ho, Kevin Hoang, Anh Phung, Sravya Madabhushi, Jamal Hasoon, Cyrus Yazdi, Alexandra Cg Fonseca, Alan D Kaye, Michael E Schatman, Jatinder Gill, Thomas Simopoulos, Christopher L Robinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord stimulation (SCS) is often an option of last resort for patients with post-laminectomy syndrome or an alternative option for patients with complex regional pain syndrome, chronic nonsurgical low back pain, or painful diabetic peripheral neuropathy when conservative management has failed. Although SCS is a helpful option, it is not without complications that can frequently lead to explantation of the SCS device and dissatisfaction with the treatment. Furthermore, as with any technology, SCS has potential issues that may lead to patient frustration and ultimately result in patient noncompliance and lack of follow-up visits.</p><p><strong>Objectives: </strong>The goals of this study are to explore the magnitude of and reasons for patient loss to follow-up after SCS device implantation.</p><p><strong>Study design: </strong>A cross-sectional phone survey.</p><p><strong>Setting: </strong>A tertiary-care academic hospital.</p><p><strong>Methods: </strong>A cross-sectional phone survey was performed on 49 patients who were deemed lost to follow-up when they did not return to the clinic one month after being implanted with permanent SCS devices at Beth Israel Deaconess Medical Center. Patients were administered an institutional review board-approved questionnaire exploring their reasons for not returning to the clinic.</p><p><strong>Results: </strong>Over a 5-year period, 257 patients underwent full implantation of an SCS device. Of the 49 patients lost to follow-up, 24 were able to be contacted, and they completed the questionnaire. Twenty of the patients continued to use the SCS device but were lost to follow-up for the following reasons: 58% (14/24) due to improvement of pain, 13% (3/24) due to minimal improvement in pain control, 4% (1/24) due to other urgent health conditions, and 8% (2/24) due to patient noncompliance and missing follow-up appointments (4/24). Four patients discontinued using the SCS device after an average of 1.5 years +/- one year, 12% (3/24) due to inadequate pain control and 4% (1/24) due to inability to recharge the device (1/24). Of these patients, 2 of the 4 contacted their SCS representatives for help with troubleshooting prior to discontinuation. None of the patients was explanted.</p><p><strong>Limitations: </strong>The main limitation of this study was the incompletion rate, which was 51.0% (25 out of 49 patients).</p><p><strong>Conclusions: </strong>This paper, the first cross-sectional study of loss to follow-up among patients who are implanted with SCS devices, identifies that up to 19% of patients are quickly lost to follow-up after implantation. Only half of the patients in this study could be reached, with most successfully using their device for meaningful pain control, but a substantial number of patients likely required additional device optimization for pain relief.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Safety of the Rhomboid Intercostal Block for Postoperative Analgesia in Chest Surgery and Breast Surgery: A Systemic Review and Meta-Analysis.","authors":"Qi Hong Shen, Yue-Zhong Lv, Ya-Fen Shi, Lan Lai, Yan-Jun Chen, Qing-He Zhou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Prior research has suggested that the rhomboid intercostal block (RIB) may contribute to postoperative analgesia after surgeries of the chest and breast.</p><p><strong>Objective: </strong>To explore the effectiveness and safety of RIB for postoperative analgesia, as well as whether RIB is superior to other types of nerve blocks.</p><p><strong>Study design: </strong>A systematic review and meta-analysis.</p><p><strong>Setting: </strong>Querying electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, was part of the process in searching for eligible clinical trials for this meta-analysis and systematic review.</p><p><strong>Methods: </strong>The Cochrane Collaboration's tool for quality evaluation was utilized in assessing the bias risk in the selected randomized controlled trials (RCTs). meta-analysis was facilitated through the utilization of Review Manager 5.3. The determination of the evidence's quality adhered to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>After the inclusion and exclusion criteria were established, the incorporation of 8 RCTs, encompassing 714 patients, took place. During the first 24 hours after the operation, patients in the RIB group exhibited lower pain scores and less opioid consumption than did those in the no-block group. Furthermore, a decrease in the incidence of postoperative vomiting and nausea was noted in the RIB group. Nevertheless, when comparing outcomes, it was revealed that the RIB group and the other nerve block group did not differ significantly.</p><p><strong>Limitations: </strong>No subgroup analysis to investigate the sources of heterogeneity was performed. The number of studies in this meta-analysis of RIB compared to those that focus on other types of nerve block is relatively small. The optimal concentrations and volumes of local anesthetics were not evaluated.</p><p><strong>Conclusions: </strong>RIB may be a new option for pain relief after chest and breast surgery.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to Comment on \"Effectiveness of Radiofrequency Ablation of the Genicular Nerves of the Knee for the Management of Intractable Pain from Knee Osteoarthritis\".","authors":"Min Cheol Chang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}