Pain physician最新文献

{"title":"Rhomboid Intercostal versus Serratus Anterior Plane Block for Analgesia After Thoracodorsal Artery Perforator Flap Following Partial Mastectomy: A Randomized Controlled Trial.","authors":"Shereen E Abd Ellatif, Emad Salah Ibrahim, Heba M Fathi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The thoracodorsal artery perforator (TDAP) flap has been developed to improve the postoperative aesthetic and psychological states of patients who receive breast-conserving surgery (BCS); nonetheless, the TDAP flap exacerbates the pain that occurs at 2 surgical sites.</p><p><strong>Objectives: </strong>This trial aimed to compare the efficacy of the rhomboid intercostal block (RIB) and the serratus anterior plane block (SAB) as postoperative analgesics for BCS.</p><p><strong>Study design: </strong>Prospective randomized controlled clinical trial.</p><p><strong>Setting: </strong>This clinical trial was conducted at Zagazig University Hospitals.</p><p><strong>Methods: </strong>Eighty-four patients scheduled for BCS followed by a TDAP flap were randomly divided into 3 groups (of 28 patients each). Group C received general anesthesia, and groups SAB and RIB received SAB and RIB blocks, respectively, followed by general anesthesia. The cumulative tramadol consumption within 24 hours after the operation was the primary outcome. The postoperative pain score, first-rescue analgesic time, and sensory block coverage were the secondary outcomes.</p><p><strong>Results: </strong>The 24-hour cumulative tramadol consumption and duration of the first rescue analgesic were significantly lower and longer, respectively, in the RIB group, than in the SAB group or the control group. The VAS score was lower in the RIB group than in the SAB or control group at all measurement times, except at 24 hours postoperatively, and the values among the groups were not significantly different. Dermatomal coverage of the anterior and posterior hemithorax extended from T2-T9 in the RIB group and from T2-T10 in the anterior hemithorax only in the SAB group.</p><p><strong>Limitations: </strong>Both block procedures were applied as single shots, and their impact on chronic postoperative pain was not assessed; the observation may therefore be drawn that a continuous local anesthetic (LA) infusion catheter could be used to extend the period of analgesia.</p><p><strong>Conclusion: </strong>Because of its ability to block both the anterior and posterior hemithorax, the RIB, is more efficient than the SAB at controlling acute pain and reducing opioid consumption in patients undergoing BCS followed by TDAP flaps; thus, the RIB can be employed as a potential alternative in these surgeries.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E1-E12"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190172","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 Long-term Outcome of Usual and Unusual Indications for Spinal Cord Stimulation: A Prospective Study.","authors":"Niruji Saengsomsuan, Pramote Euasobhon, Bunpot Sitthinamsuwan, Nattha Saisavoey, Caixia Li, Nantthasorn Zinboonyahgoon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Evidence of the efficacy of spinal cord stimulation (SCS) has been well demonstrated as a method of pain control for patients who exhibit failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), and inoperable peripheral vascular diseases (PVD) (\"usual indications\"). However, a long-term study comparing the usual indications for which SCS is employed with those of other intractable painful conditions is still lacking.</p><p><strong>Objectives: </strong>To assess the long-term effectiveness of SCS treatment for both usual and unusual indications.</p><p><strong>Study design: </strong>Observational study and original research.</p><p><strong>Setting: </strong>This work was conducted at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.</p><p><strong>Methods: </strong>We recruited patients undergoing SCS treatment for chronic refractory pain caused by various conditions and followed up on those patients for up to 36 months. The patients were divided into usual indications for SCS, including FBSS, CRPS, and PVD; and unusual indications for SCS, including chronic refractory neuropathic pain of various etiologies. Pain intensity, pain-related interference, and health-related quality of life (HRQOL) were collected at the baseline, 6 months, and one, 2, and 3 years after SCS implantation, and the values seen at each time point were compared to the baseline values.</p><p><strong>Results: </strong>Forty-six patients were recruited, 30 of whom underwent successful SCS implantation (24 usual and 6 unusual indications). The overall pain intensity was significantly lower than it was at the baseline, decreasing from 6 to 3, 5, 4, 4 out of 10 at 6, 12, 24 and 36 months after implantation, respectively (P < 0.01). Pain-related interference and HRQOL tended to improve over time after implantation. Patients with usual indications had a significantly higher rate of trial-per-implant ratio than those with unusual indications, with an odd ratio of 5.14 (95% CI 1.36-19.50). Furthermore, patients with usual indications tended to see greater improvement and more constancy in pain intensity, pain-related interference, and HRQOL than those with unusual indications.</p><p><strong>Limitations: </strong>This analysis was a single-center prospective study with a nonrandomized design and a relatively small sample size.</p><p><strong>Conclusions: </strong>Overall, SCS is an effective long-term treatment for chronic refractory pain. However, patients with usual indications for SCS have a higher success rate in SCS trials and a trend toward better outcomes after SCS implantation than do patients with unusual indications.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E61-E71"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190164","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 \"Efficacy Analysis of Temporary Spinal Cord Stimulation in the Treatment of Refractory Postherpetic Neuralgia\".","authors":"Dingping Zhou, Huolin Zeng, Ling Ye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E95-E96"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190110","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 \"Older and Better: A Narrative Review of Successful Aging and Adaptation to Pain in Late Life\".","authors":"Theodore D Cosco","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E109"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190116","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 Errata.","authors":"Asipp","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"69"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190131","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":"Lipocalin-2 in the Anterior Cingulate Cortex Contributes to Remifentanil-Induced Postoperative Hyperalgesia.","authors":"Jing Shen, Yilong Wang, Weijie Xie, Qing Luo, Fanhua Meng, Henry Liu, Zeyong Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Opioids, which are widely used during surgery in perioperative settings, may cause hyperalgesia, especially when the opioid employed is remifentanil. Opioid-induced hyperalgesia may increase the length of a patient's hospital stay and negatively affect enhanced recovery after surgery and the patient's prognosis. Currently, there is no consensus on treatment strategies for remifentanil-induced postoperative hyperalgesia (RIPH).</p><p><strong>Objectives: </strong>This study aimed to test the hypothesis that upregulation of lipocalin-2 (LCN2) in the anterior cingulate cortex (ACC) contributes to RIPH.</p><p><strong>Study design: </strong>A controlled animal study.</p><p><strong>Setting: </strong>A university laboratory.</p><p><strong>Methods: </strong>The RIPH mouse model was established through the subcutaneous infusion of remifentanil in mice undergoing plantar incision surgery. The von Frey test and the Hargreaves test were used to measure the pain threshold. By combining RNA sequencing, Western blotting, in vivo pharmacology, and the construction of adeno-associated virus vectors that modulated the expression level of LCN2 specifically, the role of LCN2 in the occurrence of RIPH in mice was explored.</p><p><strong>Results: </strong>Compared to the mice that were subjected to the combination of incisions and saline (inci + saline), mice subjected to incisions and remifentanil (inci + remi) did not experience a significant reduction in the mechanical pain threshold of their ipsilateral hind paws. The mechanical pain threshold of the contralateral hind paws of the inci + remi mice was significantly reduced compared to those of the inci + saline mice. According to transcriptome analysis, LCN2 expression was significantly upregulated in RIPH-model mice. Furthermore, the Western blotting analysis also showed a significant increase in the level of LCN2 in the ipsilateral ACC of RIPH-model mice. An intra-anterior cingulate cortex injection of LCN2 mAb could attenuate hyperalgesia in mice. Knockdown of LCN2 expression in the ACC significantly alleviated mechanical hyperalgesia in mice. Additionally, the overexpression of LCN2 in the ACC could directly induce mechanical hyperalgesia without affecting thermal nociception.</p><p><strong>Limitations: </strong>Future research needs to explore more potential mechanisms of affecting pain sensitivity through LCN2 upregulation.</p><p><strong>Conclusions: </strong>Our results demonstrated that the upregulation of LCN2 in the ACC plays a crucial role in the occurrence of RIPH, suggesting that LCN2 potentially be a therapeutic target for alleviating RIPH.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E49-E59"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190145","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":"Pregabalin Combined With Opioids for Managing Neuropathic Pain in Patients With Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Chuanbing Wen, Maoying Wang, Maotong Liu, Chenyu Zhu, Jinlong Zhao, Qing Jiang, RuRong Wang, Jun Li, Li Song","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cancer-related neuropathic pain significantly affects patients' quality of life. Despite existing treatments, pain control remains inadequate for many of these patients. There is a lack of strong evidence for the efficacy of the combination of pregabalin, which is often used to treat neuropathic pain, and opioids for treating cancer-related neuropathic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the analgesic effects and safety of pregabalin combined with opioids for managing cancer-related neuropathic pain through high-quality evidence analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A systematic review and meta-analysis of pregabalin combined with opioids for cancer-related neuropathic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically searched the PubMed, Web of Science, Embase, Cochrane Library and Cochrane Central Register of Controlled Trials databases from their inception through October 5, 2023. Two reviewers independently selected studies and extracted articles that met the inclusion and exclusion criteria. Quality assessments of the included studies were performed using the modified Cochrane Collaboration tool; data analysis was performed using RevMan 5.4 (The Nordic Cochrane Centre for The Cochrane Collaboration).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 8 studies were included in our qualitative synthesis, and 6 studies were included in the meta-analysis (6 studies with 757 patients, including 342 in the experimental group and 415 in the control group). The results showed a significant difference between the pregabalin combined with opioids group and the opioids alone group in terms of Numeric Rating Scale (NRS-11) pain scores (weighted mean difference [WMD] = -1.00; 95% CI, -1.29 to -0.70; P &lt; 0.001). However, no significant difference in the NRS-11 score was observed between the pregabalin combined with opioids group and active comparator combined with opioids group (WMD = -0.47; 95% CI, -1.05 to 0.11; P = 0.11). There was a significant difference between the pregabalin combined with opioids group and the active comparator combined with opioids group in terms of extra morphine milligram equivalents (relative risk [RR] = 0.37; 95% CI, 0.20 to 0.70; P = 0.002). No significant difference was observed in quality of life (WMD = -2.01; 95% CI, -5.29 to 1.27; P = 0.23). In general, the frequency of adverse events in the pregabalin combined with opioids group was greater than that in the opioids alone group, but the frequency of adverse events between the pregabalin combined with opioids group and the active comparator combined with opioids group was unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The limited number of articles and sample size are the limitations of this meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Pregabalin combined with opioids reduces cancer-related neuropathic pain but increases dizziness, somnolence, and peripheral edema, thus supporting its use in the c","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190156","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 \"Comparative Study Between the Analgesic Effect of Prednisolone and Pregabalin in Managing Post Dural Puncture Headache after Lower-limb Surgeries\".","authors":"Qiang Wang, Jiang Zhu, Ling Ye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E107-E108"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189999","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 \"Computed-Tomography-guided Percutaneous Bilateral Neurolytic Celiac Plexus Block with Alcohol for Upper Abdominal Visceral Cancer Pain\".","authors":"Jie Zhang, Ling Ye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E93-E94"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190033","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 \"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":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 1","pages":"E110"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190137","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}