Pain management最新文献

{"title":"Post-cesarean delivery pain management.","authors":"Maha Mostafa, Ahmed Hasanin, Mohamed Elsayad","doi":"10.1080/17581869.2025.2533104","DOIUrl":"10.1080/17581869.2025.2533104","url":null,"abstract":"<p><p>Cesarean delivery is one of the most common surgical procedures worldwide and is associated with moderate-to-severe postoperative pain. This review summarizes current evidence and guidelines for optimizing postoperative pain management while minimizing opioid-related side effects. Neuraxial long-acting opioids remain the gold standard but are limited by side effects such as pruritus, nausea, and urinary retention. Field blocks, including quadratus lumborum and erector spinae blocks, offer promising alternatives, though no single technique has demonstrated clear superiority over the other. Epidural analgesia provides effective pain control; however, its impact on early recovery limits its use in many settings. Routine administration of paracetamol and nonsteroidal anti-inflammatory drugs forms the foundation of multimodal analgesia and is universally recommended for being a simple intervention with minimal side effects. A single intraoperative dose of dexamethasone enhances analgesia and reduces opioid consumption without increasing risk of wound complications. Adjuvant analgesic techniques such as transcutaneous electrical nerve stimulation show potential benefits; however, more high-quality evidence is required before its implementation in routine practice. Finally, this review highlights gaps in current knowledge and emphasizes the need for standardized protocols and high-quality comparative studies to refine analgesic strategies for cesarean delivery.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"611-619"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619691","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":"Ultrasound-guided neuromodulation for neuropathic pain after radial forearm flap reconstruction: a case report.","authors":"Tomás Caroço, Bruno Paiva, Jorge Ribeiro, Daniela Teixeira, Ivone Rodrigues, Gisela Henriques Leandro","doi":"10.1080/17581869.2025.2530379","DOIUrl":"10.1080/17581869.2025.2530379","url":null,"abstract":"<p><p>Neuropathic pain is a common complication following radial forearm free flap (RFFF) reconstruction, often associated with damage to the superficial branch of the radial nerve (SBRN) and lateral antebrachial cutaneous nerve (LACN). Traditional treatment approaches, including pharmacologic and non-pharmacologic interventions, frequently provide incomplete pain relief. This case report describes the innovative use of ultrasound-guided musculocutaneous and SBRN blocks combined with pulsed radiofrequency (PRF) neuromodulation in a 70-year-old male with severe neuropathic pain following RFFF for tongue carcinoma reconstruction. The intervention provided immediate and complete pain relief, maintained for three days post-procedure. Partial symptom improvement persisted beyond the initial phase. Although complete pain relief was not sustained over the longer term, the significant initial response confirmed the targeted nerves as viable candidates for neuromodulation. This confirmation opens potential pathways for exploring longer-lasting neuromodulation techniques, such as cryoneurolysis or peripheral nerve stimulation, to achieve sustained pain relief. Further research into these modalities is recommended to optimize long-term outcomes for patients experiencing neuropathic pain post-RFFF reconstruction.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"549-553"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576102","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":"Approach to treating cancer-induced bone pain.","authors":"Rahul Chaturvedi, Amitabh Gulati","doi":"10.1080/17581869.2025.2531738","DOIUrl":"10.1080/17581869.2025.2531738","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"535-537"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601195","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":"Oral rimegepant as a preventive treatment of migraine: a plain language summary of a clinical study.","authors":"Robert Croop, Richard B Lipton, David Kudrow, Lisa Kamen, Charles M Conway, Peter J Goadsby","doi":"10.1080/17581869.2025.2522640","DOIUrl":"10.1080/17581869.2025.2522640","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"539-548"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626915","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":"The Johns Hopkins multidisciplinary pediatric pain management service: a concept paper.","authors":"M-Irfan Suleman, Ama Akoma Essuman, Maqbool Dada, Kayode Williams","doi":"10.1080/17581869.2025.2532356","DOIUrl":"10.1080/17581869.2025.2532356","url":null,"abstract":"<p><p>Chronic pain in children poses a significant and under-addressed public health burden. This concept paper outlines the proposed design and implementation of a Multidisciplinary Pediatric Pain Management Service (MPPMS) at Johns Hopkins Medicine, addressing four key objectives. First, it presents a novel care delivery model grounded in the biopsychosocial framework, led by a multidisciplinary team and structured to deliver patient-centered care across escalating levels of clinical intensity. Second, it details the operationalization of the clinic in three phases, starting with a lean model and scaling toward a transdisciplinary team structure through enhanced clinic efficiency, technology integration, and strategic resource allocation. Third, it examines the financial implications of the model, including cost-per-encounter estimates, phased improvements in resource utilization, and strategies for achieving long-term sustainability through alternative revenue streams and workflow optimization. Fourth, it proposes a comprehensive outcomes framework encompassing clinical, operational, and financial metrics to guide continuous improvement and facilitate national benchmarking. Collectively, this paper provides a scalable blueprint for managing pediatric chronic pain that integrates care, optimizes operations, ensures fiscal responsibility, and delivers measurable patient benefit, positioning the MPPMS as a model that can be replicated at other institutions to address this growing clinical need.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"587-593"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626916","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":"Virtual reality in chronic pain management: how do we galvanize a stagnant field?","authors":"Carly L A Wender, Zina Trost","doi":"10.1080/17581869.2025.2554561","DOIUrl":"https://doi.org/10.1080/17581869.2025.2554561","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964709","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":"Predictive factors of epidural rescue in combined spinal-epidural anesthesia for cesarean delivery.","authors":"Kaissar Sassi, Juliette Linval, Etienne Bechet, Nancy El Achkar, Elsa Tardif, Vincent Minville","doi":"10.1080/17581869.2025.2526318","DOIUrl":"10.1080/17581869.2025.2526318","url":null,"abstract":"<p><strong>Background: </strong>Combined spinal-epidural (CSE) is often recommended for cesarean deliveries expected to have prolonged duration. This study aimed to identify factors associated with the need for epidural rescue anesthesia during CSE for cesarean section, to better refine clinical indications for this technique.</p><p><strong>Methodology: </strong>This retrospective cohort study was conducted from 2020 to 2022 at the maternity of Toulouse University Hospital, France. Data were collected from 230 patients who underwent CSE for cesarean delivery. The mean age was 34.3 ± 5.6 years, 69.1% had previous cesarean sections, and 70% had a BMI > 24.9. Univariate analysis identified potential predictors, which were then included in multivariate logistic regression to determine independent factors associated with epidural rescue.</p><p><strong>Results: </strong>The overall rate of rescue epidural anesthesia was 16.5% (38/230). Multivariate analysis identified three independent predictors: gestational diabetes (adjusted odds ratio [aOR] 2.39, 95% CI: 1.07-5.29, <i>p</i> = 0.032), postpartum hemorrhage ≥ 500 mL (aOR 2.29, 95% CI: 1.35-3.90, <i>p</i> = 0.002), and surgical duration ≥ 62 minutes (aOR 4.36, 95% CI: 1.99-9.58, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Gestational diabetes, postpartum hemorrhage, and surgical duration exceeding 62 minutes significantly increase the likelihood of epidural rescue during CSE for cesarean delivery. These findings could guide more selective CSE use, potentially avoiding unnecessary epidural catheter placement in low-risk situations.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"501-508"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567688","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":"Effect of Citrus Aurantium L. on pain and blood pressure in patients undergoing hand reconstructive surgery.","authors":"Farideh Askari, Farzaneh Ghaffari, Nasrin Alaee, Mohsen Naseri, Akram Tayanloo-Beik","doi":"10.1080/17581869.2025.2515814","DOIUrl":"10.1080/17581869.2025.2515814","url":null,"abstract":"<p><strong>Background and purpose: </strong>Postoperative pain and blood pressure are common patient complaints. This study examined the effects of Citrus Aurantium (CA) on pain and blood pressure in patients undergoing hand reconstructive surgery.</p><p><strong>Methods: </strong>A double-blind, randomized clinical trial was conducted with 76 patients. The control group received a placebo, while the intervention group received CA essential oil. Blood pressure and pain levels were recorded before the intervention, and at 30 minutes and one-hour post-surgery. Data collection used blood pressure sheets, numerical visual pain scales, and demographic questionnaires.</p><p><strong>Result: </strong>The intervention group showed significantly greater pain reduction than the control group (<i>p</i> = 0.001), with CA increasing the likelihood of pain reduction by 1.73 times (Exp(B) = 1.73). Systolic and diastolic blood pressure significantly decreased post-intervention (<i>p</i> = 0.001, <i>p</i> = 0.005), but differences were not significant after 30 minutes and one hour after (<i>p</i> > 0.05). CA increased the likelihood of systolic blood pressure reduction by 16.87 times (Exp(B) = 16.78), with no effect on diastolic pressure.</p><p><strong>Conclusion: </strong>CA facilitates pain and blood pressure reduction in aromatherapy, suggesting its use as a simple, inexpensive, and noninvasive method for postoperative pain management.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"491-500"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576101","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":"The role of liposomal bupivacaine in pain management after the NOPAIN act.","authors":"Yash Shah, Anthony Barisano, Eric Ly, Vendhan Ramanujam","doi":"10.1080/17581869.2025.2525740","DOIUrl":"10.1080/17581869.2025.2525740","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"449-451"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507522","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":"Preoperative cryoneurolysis for peri- and postoperative pain in total knee arthroplasty: a systematic review and pooled analysis.","authors":"Brandon Goodwin, Hanna Brancaccio, Mitchell Kaplan, Valerie Rome, Sameer Shah, Sweta Mukhopadhyay, Seungkyu Park, Gilbert Siu","doi":"10.1080/17581869.2025.2522063","DOIUrl":"10.1080/17581869.2025.2522063","url":null,"abstract":"<p><strong>Background: </strong>Cryoneurolysis is seeing increased implementation in total knee arthroplasty (TKA), providing postoperative analgesia through preoperative cryoneurolysis of peripheral nerves. Thus, we are conducting this systematic review and meta-analysis to determine cryoneurolysis' efficacy in providing analgesia and improvements in recovery times for patients undergoing TKA.</p><p><strong>Methods: </strong>We conducted a comprehensive search using five databases including PubMed, Cochrane Library, Web of Science, Embase, and Scopus. The screened articles were assessed for inclusion of primary outcomes: pain scores before nerve cryoablation, peri- and post-operative pain scores in TKA, length of pain relief, patient demographics, and type of pain score employed. The Higgins I² test served to discern the degree of heterogeneity between included studies. Cohen's d was utilized to interpret the pooled effect size of the studies.</p><p><strong>Results: </strong>Our search yielded six articles that met our inclusion criteria. The overall effect size illustrated a d = 1.468 (95% CI: 1.084-1.851; <i>p</i> < 0.001) for the Visual Analog Score (VAS), Numerical Rating Score (NRS), and Patient-Reported Outcomes Measurement Information System (PROMIS) pain subscore. Each individual study possessed a large effect size.</p><p><strong>Conclusion: </strong>Our comprehensive review and meta-analysis indicated that cryoneurolysis provides effective pain management, providing TKA patients with significant pain reduction for 6-12 weeks post-surgery. Furthermore, improvements were observed in patient-centered outcomes: mobility, return to routine activities, and overall satisfaction. Future studies should be conducted to determine the long-term efficacy of cryoneurolysis and the appropriate timing and duration of cryoneurolysis to maximize its analgesic abilities.</p><p><strong>Protocolregistration: </strong>www.crd.york.ac.uk/prospero identifier is CRD42024542005.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"527-534"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560771","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}