Pain physician最新文献

{"title":"Chronic Tendinopathy Driven by Neoinnervation: The Role of the Paratenon, Upregulated Neural Biomarkers, and Evolving Evidence - A Scoping Review.","authors":"Suwannika Palee, Atthakorn Jarusriwanna, Danielle Lee, Ugur Yener, Alan D Kaye, Naum Shaparin, Sayed E Wahezi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This scoping review systematically evaluates and synthesizes evidence on the presence of neoinnervation in chronic tendon pain. By analyzing the frequency and progression of neural biomarker upregulation, the present investigation seeks to illuminate existing knowledge gaps, contextualize shifts in research focus over time, and propose potential therapeutic approaches for the more precise and effective management of tendinopathy.</p><p><strong>Objectives: </strong>To identify major neural biomarkers associated with nerve ingrowth, detailing historical development, current understanding, and implications in tendinopathy.</p><p><strong>Study design: </strong>A scoping review.</p><p><strong>Setting: </strong>An academic medical center.</p><p><strong>Methods: </strong>Searches were conducted up to June 2024 using PubMed, Embase, Web of Science, and Scopus, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The selected studies included clinical human case-control studies and in vivo experimental animal models that examined neoinnervation in tendinopathy. Data extraction included study design, animal induction models, biomarker detection methods, neural biomarker upregulation, and supporting evidence to evaluate the involvement of neoinnervation and the role of the paratenon in tendinopathy.</p><p><strong>Results: </strong>Of the 26 studies reviewed, 19 (73%) identified neoinnervation in chronic tendinopathy, and 20 (76.9%) highlighted the role of the paratenon, suggesting its potential as a key target for therapeutic interventions. Notably, 14 studies (53.8%) examined both neoinnervation and the paratenon's role, indicating significant interplay. Analyses of neural biomarkers revealed possible upregulation of protein gene product 9.5 (PGP 9.5) in 15 studies (57.6%) and substance P in 13 studies (50%), emphasizing the crucial roles of those biomarkers in the neurobiological mechanisms of tendinopathy pain. Other biomarkers, including calcitonin gene-related peptide (CGRP), tyrosine hydroxylase, growth-associated protein-43 (GAP-43), NMDA receptor (NMDAR), glutamate, neurokinin 1 receptor (NK1R), neuropeptide Y, adrenoreceptor, nerve sprouting markers, specific chemokines, and various immune-related markers, were also identified as potentially upregulated. Our review of temporal trends indicates that recent research has expanded to encompass a broader range of biomarkers, thereby enhancing our understanding of the complexity and multisystem involvement in the pathology of tendinopathy.</p><p><strong>Limitations: </strong>This review is limited by the predominance of case-control and experimental studies, which inherently offer lower levels of evidence due to methodological constraints like lack of randomization and potential biases. Additionally, the present review may not fully address how biomarker expression or neoinnervation change","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"287-297"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799799","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":"Using Artificial Intelligence to Predict Residual Distal Lumbosacral Pain Post Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures.","authors":"Yuye Zhang, Yingzi Zhang, Xingyu You, Xueli Qiu, Wenxiang Tang, Yufei Zhang, Fanguo Lin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous kyphoplasty (PKP) can restore spinal stability and relieve pain in patients with osteoporotic vertebral compression fractures (OVCF). However, in some cases, distal lumbosacral pain (DLP) persists postoperatively, affecting patients' expectations of the surgery and their recovery to activities of daily life.</p><p><strong>Objective: </strong>To use artificial intelligence to predict DLP post-PKP for OVCF, thereby providing personalized treatment plans for patients with OVCF.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Setting: </strong>The study was carried out at a university hospital.</p><p><strong>Methods: </strong>A univariate analysis was performed to identify the risk factors for DLP post-PKP. A heatmap analysis was conducted to examine the relationships between variables in the dataset. A random forest model was established, and its performance was evaluated using a confusion matrix. After validating and tuning the model, features were ranked based on their contribution to prediction accuracy.</p><p><strong>Results: </strong>A total of 179 patients completed this study. Patients were divided into 2 groups (Group 0 without DLP; Group 1 with DLP). The univariate analysis indicated statistically significant differences in terms of bone density, intravertebral vacuum cleft, sarcopenia, bone cement distribution, interspinous ligament degeneration, and Hounsfield unit (P < 0.05). The heatmap analysis revealed a moderate correlation between DLP and both sarcopenia and interspinous ligament degeneration. A random forest model was built. The confusion matrix showed that the model exhibited strong performance across all metrics. The random forest model showed that the preoperative Cobb angle and sarcopenia were the most critical features.</p><p><strong>Limitations: </strong>This was a retrospective study, which may be prone to selection and recall bias. Single-center noncontrolled studies may also introduce bias.</p><p><strong>Conclusion: </strong>Our random forest model can effectively predict DLP post-PKP for OVCF, assisting in the selection of treatment plans.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E337-E346"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799811","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":"Feasibility of Epidural Localization Using the EpiFaith® Syringe: A Cadaveric Study.","authors":"Alaa Abd-Elsayed, Amol Soin, Jeremy Zbili","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Achieving accurate epidural access during surgery is challenging, with failure rates reported as high as 40%. The loss of resistance (LOR) technique remains the standard but relies heavily on the clinician's tactile sense, which can lead to inaccuracies. The EpiFaith® (Flat Medical) syringe, designed with a visual LOR cue, aims to enhance the accuracy of physicians' attempts to achieve epidural access.</p><p><strong>Objective: </strong>This study aimed to evaluate the usability and accuracy of the EpiFaith® syringe for epidural access at the cervical, thoracic, and lumbar levels. The syringe was tested by 2 physicians-one with prior clinical experience using the device and one who would use it for the first time-on cadaver models.</p><p><strong>Study design: </strong>A cadaveric study was conducted by 2 providers who tested the EpiFaith® syringe across multiple spinal levels.</p><p><strong>Setting: </strong>The study was carried out in medical facilities equipped with cadaveric simulation and fluoroscopic imaging.</p><p><strong>Methods: </strong>Five fresh adult cadavers were used, with both providers performing epidural access procedures at spinal levels from C7 to S1. One provider had prior experience using the EpiFaith® syringe, while the other had none. Each procedure used 1 mL of normal saline for LOR detection, and successful epidural access was confirmed using contrast and fluoroscopy. Variables recorded included injection site, number of attempts, first-attempt success rates, device usage, and instances of false LOR.</p><p><strong>Results: </strong>The experienced provider (Provider 1) performed procedures on 16 spinal levels across 4 cadavers, achieving a 100% first-attempt success rate with no false LOR events. The inexperienced provider (Provider 2) performed procedures on 7 spinal levels, achieving a 57.1% (4/7) first-attempt success rate, with 3 false LOR events (30%). Provider 2 accessed the epidural space successfully after adjusting the technique in response to false LOR signals.</p><p><strong>Limitations: </strong>Cadaveric models lack normal physiological conditions, and the small sample size limits generalizability. Further studies in live settings are needed to validate the EpiFaith® syringe's clinical utility and learning curve.</p><p><strong>Conclusion: </strong>The EpiFaith® syringe is an effective tool for achieving epidural access, particularly for experienced clinicians. Even inexperienced users can adapt to the device's feedback to access the epidural space successfully. Further clinical validation is necessary to confirm the syringe's potential to improve procedural accuracy and reduce false LOR events in real-world settings.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E431-E435"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799872","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":"Effects of Dexamethasone Administration in Sphenopalatine Ganglion Block for Allergic Rhinitis: A Prospective, Randomized, Single-blind Controlled Trial.","authors":"Qinyue Luo, Junyang Fang, Yunqian Zhang, Ran Wang, Biyun Xu, Lei Cheng, Lijuan Lu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Allergic rhinitis (AR) is a common chronic condition that significantly affects quality of life. Ultrasound-guided sphenopalatine ganglion block (SPGB) is a minimally invasive, safe, and effective treatment gaining clinical attention for symptom relief. Dexamethasone is often used in an SPGB, but its effect on autonomic nerve modulation remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to assess the therapeutic effect of ultrasound-guided SPGB for treating AR and to compare the clinical efficacy and adverse reactions of dexamethasone used in conjunction with an SPGB.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A prospective, randomized, single-blind controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, People's Republic of China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This randomized clinical trial, involving 84 patients with AR, was conducted at Nanjing Drum Tower Hospital from February 2024 through May 2024. Patients were randomly assigned to either the experimental group (42 patients) or the control group (42 patients), with blinding applied. A total of 78 patients completed the study (40 in the experimental group, 38 in the control group). Both groups received an ultrasound-guided SPGB once a week for 4 weeks, alternating sides. The experimental group was treated with a combination of bupivacaine and dexamethasone, while the control group received only bupivacaine. Changes in efficacies, Total Nasal Symptom Score (TNSS), nasal symptom Visual Analog Scale (VAS), Rhino-conjunctivitis Quality of Life Questionnaire (RQLQ) scores, Total Nasal Respiratory Volume (TNRV), Total Nasal Volume (TNV), and Total Nasal Resistance (TNR) were measured at pretreatment and at one week, one month, 3 months, and 6 months posttreatment. Additionally, effective rate was calculated as the percentage of patients achieving a clinically meaningful response, defined as a reduction in TNSS of 30% or greater from baseline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both groups had significant reductions in TNSS, nasal symptom VAS, and RQLQ scores compared to pretreatment levels at all follow-up points (P &lt; 0.001). At one week, one month, and 3 months posttreatment, the experimental group had higher efficacies, lower TNSS, lower VAS, and lower RQLQ scores than the control group (P &lt; 0.05). At 6 months posttreatment, there were no significant differences between the groups for efficacy rates, VAS, or RQLQ scores (P &gt; 0.05) while the experimental group had lower TNSS scores (P &lt; 0.05). Both groups had significant improvement in nasal ventilation, with increases in TNRV and TNV and reductions in TNR (P &lt; 0.001). At each follow-up, the experimental group had higher TNRV and TNV and lower TNR compared to the control group, with statistical significance observed at most time points (P &lt; 0.05), except for TNRV at 6 months and TNV at 3 and 6 months posttreatment. Safety indicators sho","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"307-320"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799808","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 Relief at All Spinal Regions and Lower Lumbar VAS: Endoscopic Rhizotomy vs. Radiofrequency Ablation: A Retrospective Cohort Study.","authors":"Ramy Gadalla, Mani Nathan Nair, Christopher Spevak, Georgia Wang, Debraj Mukherjee, Guillermo Ernesto Corredor Alonso, Hasan Syed, Ehsan Dowlati, Benjamin Ramsey, Mark Habib, Baher Yanni","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Facet joint syndrome accounts for many patients' chronic neck and low back pain. Current interventional treatment options for these conditions include radiofrequency ablation (RFA) and endoscopic rhizotomy (ER), which target the medial branch of the dorsal ramus innervating the facet joint capsule. RFA is a percutaneous procedure in which radiofrequency waves ablate the medial branch. ER, a newer and more invasive procedure, is typically reserved for patients who have not responded to RFA. This retrospective cohort study aims to compare the postoperative pain level (VAS score), duration of pain relief, and opioid intake among patients who have received ER to those of patients who have received RFA. The results of these operations at all 3 spinal levels will be examined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the longevity and quality of pain relief status post RFA versus ER for facet joint syndrome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A retrospective cohort study that includes patients treated with sequentially with RFA and then ER. The study analyzed the endpoint after each procedure for each spinal region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Three urban neuro-spine centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study utilized the Strengthening the Reporting of Observational Studies in Epidemiology Analysis (STROBE) initiative. Patients with positive diagnostic medial branch blocks (80% pain relief) obtained RFA and ER, in sequence. The region of procedure (cervical, thoracic, or lumbar), morphine milligram equivalent (MME) requirements, VAS pain scores before and after the procedure, and duration of relief were collected from the electronic medical records. Patient follow-ups were conducted at 3 months, 6 months, 9 months, 12 months, and after 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 234 patients who underwent 511 RFAs and 386 ERs, ER was associated with significantly better efficacy than RFA in VAS scores (P = 0.001), opioid consumption (P = 0.0442), and duration of pain relief (P &lt; 0.0001), with all spinal levels analyzed aggregately. However, with each spinal region analyzed separately, ER was associated with significantly lower VAS scores only in the lumbar spine (P &lt; 0.0001) while the longer duration of relief persisted across all regions (P &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The study design was retrospective and nonrandomized. The study also did not utilize functional scales, e.g., the Oswestry Disability Index. Finally, ER is not available to the public.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both procedures decrease pain levels and opioid consumption significantly. ER is associated with lower pain levels, lower opioid consumption, and a longer duration of pain relief than RFA in the aggregate data. However, when each spinal region is re-analyzed separately, ER results in significantly lower pain levels only in the lumbar spine. Nonetheless, ER continues to provide a longer relief dur","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E445-E456"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799871","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":"Non-Partisan Proposal for Reforming Physician Payment System and Preserving Telehealth Services.","authors":"Laxmaiah Manchikanti, Paul J Hubbell Iii, Ramarao Pasupuleti, Ann Conn, Mahendra Sanapati","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Physician payments have declined significantly due to budget neutrality rules and reimbursement cuts. Since 2001, Medicare payments to physicians have dropped by 33% when adjusted for inflation. These reductions have been compounded by 2% annual sequestration cuts introduced after the Affordable Care Act (ACA), which continues through 2032. Despite their long-term impact, sequestration cuts receive little public attention.Congress has historically delayed or softened these cuts. However, in 2025, a bill that would have adjusted payment rates was removed from the continuing resolution, resulting in continued reductions. Meanwhile, insurance premiums have risen nearly 400%, highlighting the disparity between healthcare costs and physician compensation.Ironically, while physicians face significant payment cuts, the Centers for Medicare & Medicaid Services (CMS) proposed on January 10, 2025, a 4.3% payment increase for Medicare Advantage plans-totaling $21 billion in 2026 and an estimated $210 billion over the following decade starting in calendar year 2026. This proposal comes amid ongoing concerns about Medicare Advantage overpayments, estimated at nearly $100 billion annually, and additional funding through annual premiums of $198 from all Medicare beneficiaries, amounting to roughly $13 billion per year.In response, the American Society of Interventional Pain Physicians (ASIPP) submitted a nonpartisan reform proposal advocating for telehealth protections and elimination of sequester cuts-measures that have received strong bipartisan support in Congress.</p><p><strong>Current status: </strong>Both the House of Representatives and the Senate voted to pass a reconciliation bill-nicknamed the \"Big Beautiful Bill\", which has been signed into law by the President recently. It proposes an $8.9 billion investment in the Medicare Physician Fee Schedule, with a 2.25% update in 2026. The proposal does not address the budget neutrality provision, growing practice costs, inflationary pressures, or ongoing sequestration and pay-as-you-go (PAYGO) cuts. It also fails to resolve issues with the Medicare Access and CHIP Reauthorization Act (MACRA), particularly within the Merit-Based Incentive Payment System (MIPS).</p><p><strong>Conclusion: </strong>On November 1, 2024, CMS finalized a 2.8% cut to physician payments-an estimated $20 billion-while also eliminating telehealth services. These cuts continue to threaten physician sustainability and patient access to care.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E329-E335"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799874","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":"Evaluating Associations and Contributing Factors of Descending Pain Modulation and Autonomic Nervous System Activity in Chronic and Nonchronic Knee Pain.","authors":"Hironobu Uzawa, Kenichiro Takeshima, Toshiro Otani, Yusuke Nishida","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Central sensitization in individuals with knee pain is associated with altered autonomic nervous system activity and descending pain modulation; however, the exact nature of these relationships remains unclear. We have hypothesized that chronic knee pain (CKP) disrupts the relationship between autonomic nervous system activity and conditioned pain modulation, whereas nonchronic knee pain (nCKP) does not.</p><p><strong>Objectives: </strong>This study aimed to examine the association between autonomic nervous system activity and descending pain modulation as well as to identify factors contributing to dysfunction in the descending pain modulation system.</p><p><strong>Study design: </strong>Observational study.</p><p><strong>Setting: </strong>An institutional hospital.</p><p><strong>Methods: </strong>Female patients with knee pain were recruited via advertisements and orthopedic referrals. Patients were categorized as having either CKP or nCKP, based on whether their pain persisted for 3 months or longer. Conditioned pain modulation was assessed using cold-water immersion (8-12°C for 3 minutes) as a measure of descending pain modulation. Autonomic nervous system activity, represented by low- and high-frequency normalized units (LFnorm and HFnorm), was assessed via heart rate variability. Changes in autonomic nervous system activity were calculated as post-immersion values minus pre-immersion values. Associations between conditioned pain modulation and changes in LFnorm and HFnorm units were analyzed using linear regression and Cohen's kappa. Path analysis was performed to explore factors affecting autonomic nervous system activity and conditioned pain modulation in patients with CKP.</p><p><strong>Results: </strong>Of 96 patients, 90 (71 with CKP and 19 with nCKP) were analyzed. Changes in LFnorm were significantly associated with conditioned pain modulation only in patients with nCKP (P = 0.012). Among those with CKP, the baseline LFnorm was associated with pain catastrophizing and the number of pain sites.</p><p><strong>Limitations: </strong>The study included only female patients, and the nCKP-pain group was relatively small.</p><p><strong>Conclusions: </strong>Patients with nCKP exhibited significant relationships between conditioned pain modulation and sympathetic nervous system activity, suggesting that the phenomenon of descending pain modulation was intact. Conversely, in patients with CKP, those associations were absent, and sympathetic activity was rather influenced by pain catastrophizing and the number of pain sites. These findings suggest that chronic pain may impair descending pain modulation through altered autonomic nervous system function.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E437-E444"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799809","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":"Comparing the Effects of Fentanyl, Sufentanil, and Butorphanol Combined With Flurbiprofen Axetil on Postoperative Intravenous Patient-controlled Analgesia Post Cesarean Delivery.","authors":"Changjian Liao, Guangyan Li, Xiaojing Chen, Yingmei Liu, Zhongbo Lu, Jinglei Gao, Xiaofeng Huang, Xinping Yang, Zhiheng Liu, Xiongjuan Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The analgesic effects between fentanyl, sufentanil, and butorphanol combined with flurbiprofen axetil on postoperative patient-controlled intravenous analgesia (PCIA) after cesarean delivery has never been evaluated.</p><p><strong>Objectives: </strong>To evaluate the postoperative analgesic efficacy of selected PCIA formulae.</p><p><strong>Study design: </strong>This is a retrospective study.</p><p><strong>Setting: </strong>Department of Anesthesiology, Shenzhen Second People's Hospital, a medical center in Shenzhen City, Guangdong Province, People's Republic of China.</p><p><strong>Methods: </strong>From January 2022 through October 2023, the records of 463 patients who underwent a cesarean delivery were reviewed at Shenzhen Second People's hospital. All used a postoperative PCIA formula combined with flurbiprofen axetil and an antiemetic (ondansetron or tropisetron). The patients were placed into one of 3 groups: the Fentanyl Group (fentanyl plus flurbiprofen axetil plus ondansetron or tropisetron, 178 patients); the Sufentanil Group (sufentanil plus flurbiprofen axetil plus ondansetron or tropisetron, 159 patients); or the Butorphanol Group (butorphanol plus flurbiprofen axetil plus ondansetron or tropisetron, 126 patients). The primary data collected were the perioperative use of analgesics, postoperative Visual Analog Scale score, and no differences in adverse reactions were observed, except for the incidence of nausea and vomiting.</p><p><strong>Results: </strong>A significant difference was found between using epidural analgesics (such as morphine) and intravenous analgesics (such as butorphanol, flurbiprofen axetil, tramadol, parecoxib, and dexmedetomidine). There was no difference among the groups in postoperative Visual Analog Scale scores at 24 hours and 48 hours post cesarean delivery. There also was no difference in adverse reactions.</p><p><strong>Limitations: </strong>Our study was limited by a small sample size and did not differentiate the Visual Analog Scale scores between states of rest and movement.</p><p><strong>Conclusion: </strong>The analgesic effect in patients who underwent cesarean delivery is similar when using different postoperative PCIA formulae. Although butorphanol displayed no analgesic advantage over fentanyl and sufentanil postoperatively, it caused fewer postoperative nausea and vomiting incidences than fentanyl and sufentanil.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"329-336"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799804","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 \"Ultrasound-Guided Radiofrequency Ablation for Chronic Osteoarthritis Knee Pain in the Elderly: A Randomized Controlled Trial\".","authors":"Xuan Hu, Min Yang, Shi-Yu Zhu, Yun-Qing Zhu, Xiao-Kai Zhou","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E457-E458"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799803","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 \"Could the hanging drop technique be an alternative technique to loss of resistance in cervical epidural injections?\"","authors":"Ling Ye, Bangyi Xiang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 4","pages":"E462-E463"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799801","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}