Current Pain and Headache Reports最新文献

{"title":"Lumbar Radiofrequency Ablation (LRFA)- Myths and Facts: A Narrative Review of the Literature.","authors":"Vinicius Tieppo Francio, Logan Leavitt, Christopher Radlicz, Benjamin Gill, Dawood Sayed","doi":"10.1007/s11916-025-01413-z","DOIUrl":"https://doi.org/10.1007/s11916-025-01413-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Lumbar radiofrequency ablation (LRFA) is an interventional procedure that utilizes thermal energy to selectively ablate the lumbar medial branch nerves (LMBN) to provide relief from facet-mediated chronic axial low back pain. While LRFA is widely performed, considerable variability exists in its technical execution. This review aims to synthesize the current literature on key device- and procedure-related factors that influence radiofrequency lesioning and to clarify common misconceptions regarding LRFA.</p><p><strong>Recent findings: </strong>Emerging evidence suggests that several device-related parameters-including cannula and needle size, active tip length, temperature settings, lesioning duration, and needle angulation-affect lesion size and clinical outcomes. However, the impact of adjunctive steroid administration on lesion characteristics and therapeutic efficacy remains inconclusive. Furthermore, while some concerns have been raised regarding the potential for LRFA to accelerate spinal degeneration, definitive evidence is lacking. There is, however, a plausible association between LRFA and multifidus atrophy. The use of motor testing prior to ablation is warranted. Current data support the safety of LRFA in patients with posterior spinal instrumentation and implantable devices. Device- and procedure-specific variables may significantly influence LRFA lesion characteristics and clinical outcomes. While the safety profile of LRFA is generally favorable, potential complications exist, underscoring the need for a nuanced understanding of optimal procedural techniques. Despite its widespread adoption, misconceptions persist regarding optimal approaches, safety considerations, and determinants of efficacy. This review critically evaluates the existing literature to address these controversies and provide an evidence-based perspective on LRFA.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"98"},"PeriodicalIF":3.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486819","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":"Emerging Clinical Roles of Gabapentin and Adverse Effects, Including Weight Gain, Obesity, Depression, Suicidal Thoughts and Increased Risk of Opioid-Related Overdose and Respiratory Depression: A Narrative Review.","authors":"Alan D Kaye, Gabrielle Cassagne, Brennan M Abbott, Alexandra M Dubuisson, Jasmine J Fagan, Isabella Indovina, Deniz Gungor, Anusha Kallurkar, Adam M Kaye, Sahar Shekoohi","doi":"10.1007/s11916-025-01410-2","DOIUrl":"10.1007/s11916-025-01410-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Gabapentin, introduced in the 1990s as an anticonvulsant and anti-epileptic drug, has become a cornerstone treatment for various neurological and pain-related conditions. Its approved uses include seizure disorders, postherpetic neuralgia, and restless leg syndrome, while off-label applications commonly include diabetic neuropathy, fibromyalgia, post-traumatic stress disorder, and insomnia. The efficacy of gabapentin stems from its ability to modulate voltage-gated calcium channels, reducing excitatory neurotransmitter release in the central nervous system. However, its pharmacological versatility is accompanied by significant risks, including weight gain and combination additive and/or synergistic opioid-related respiratory depression.</p><p><strong>Recent findings: </strong>Weight gain, affecting up to 25% of patients, is primarily attributed to secondary effects such as altered gastrointestinal function and peripheral edema. This adverse effect can negatively impact treatment adherence, especially in patients with chronic conditions requiring long-term therapy. Patients with preexisting metabolic disorders face heightened risks, necessitating strategies like dietary counseling and tailored treatment adjustments to mitigate weight gain. In multimodal pain management, gabapentin mediated additive and/or synergistic effects with opioids enable reduced opioid doses but increase the risk of respiratory depression and overdose. These dose-dependent interactions amplify sedative effects, particularly in vulnerable populations such as the elderly. To optimize therapeutic benefits while minimizing risks, healthcare providers must adopt individualized treatment plans, carefully adjust dosages, and educate patients. Further research is essential to better understand mechanisms of action, improve safety profiles, and develop prescribing practices that balance efficacy with reduced adverse outcomes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"95"},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334361","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":"Low Dose Naltrexone In The Management Of Chronic Pain Syndrome: A Meta-Analysis Of Randomized Controlled Clinical Trials.","authors":"Naveen Chandrashekar Hegde, Archana Mishra, Divya V, Rituparna Maiti, Debasish Hota, Anand Srinivasan","doi":"10.1007/s11916-025-01411-1","DOIUrl":"10.1007/s11916-025-01411-1","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pain conditions are among the leading causes of years lost to disability. Low Dose Naltrexone (LDN) has anti-inflammatory and immunomodulatory properties. LDN, by blocking Toll-Like Receptors (TLR), prevents central sensitization and conversion of acute pain state to a state of chronic pain. This meta-analysis compared LDN's effectiveness in chronic pain syndromes based on published randomized trials.</p><p><strong>Method: </strong>Seven studies were included after a systematic search and screening from PubMed, Embase, Scopus, Cochrane, and clinical trial registries. The efficacy outcome analyzed was the standardized mean difference (SMD), the Cohen's d, of change in pain scores between LDN and the comparator drugs using the random-effect model. Subgroup analyses by condition type and comparator were performed to analyze the effect of LDN. Adverse events were evaluated using incidence rate ratio(IRR), publication bias by funnel plot, risk of bias by Cochrane Risk of Bias tool version 2.0, and certainty of evidence by GRADE evaluation.</p><p><strong>Results: </strong>LDN did not show a significant difference in pain response compared to control groups [d = -0.11 (95%CI -0.96 to 0.74); P = 0.31]. In fibromyalgia, LDN had improvement compared to placebo [d = -0.34 (95%CI -0.62 to -0.06); P = 0.0186]. Against active comparators, LDN had no difference [d = 0.67 (95% CI -4.69 to 6.02); P = 0.35]. Adverse events were increased with LDN compared to placebo [IRR = 1.4 (95% CI 1.12 to 1.75); P = 0.0026] but comparable to active comparators [IRR = 0.55 (95% CI 0.04 to 7.31); P = 0.65].</p><p><strong>Conclusion: </strong>LDN is better than placebo in fibromyalgia pain management, and LDN is similar to active controls in chronic pain management.</p><p><strong>Prospero registration number: </strong>CRD42024511451.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"96"},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334362","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":"Adverse Effects Associated With High-Dose Ketamine Infusions For Refractory Pain And Psychiatric Conditions.","authors":"Elika D Javaheri, Christopher Wie, Stephen Covington, Lopa Misra, Scott Pew, Omar Viswanath, John Freeman, Jillian Maloney","doi":"10.1007/s11916-025-01408-w","DOIUrl":"https://doi.org/10.1007/s11916-025-01408-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>As higher doses of ketamine are being used in numerous medical conditions such as Complex Regional Pain Syndrome (CRPS), it is critical to examine common adverse effects (AEs) explicitly associated with high doses of ketamine (HDK).</p><p><strong>Recent findings: </strong>HDK is often associated with psychiatric symptoms such as agitation, anxiety, and sleep disturbances. Psychiatric effects have been documented in various methods of administration of HDK, including oral, intravenous, and intranasal formulations. Emesis is a common AE of HDK and is more prevalent at higher ketamine doses. Hepatotoxicity is common after HDK, is dose-dependent, and is usually transient. HDK-induced uropathy is another potential AE. When monitored appropriately, HDK administered in a hospital setting appears safe; practitioners should be mindful that certain AEs of HDK are likely dose-dependent.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"93"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327650","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":"Trialing Strategies Prior to Intrathecal Drug Delivery in Cancer-Related Pain: A Narrative Review.","authors":"Elizabeth Roux, Alan D Kaye, Shivam S Shah, Sahar Shekoohi, David Hao","doi":"10.1007/s11916-025-01409-9","DOIUrl":"10.1007/s11916-025-01409-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cancer-related pain poses a significant clinical challenge, especially in advanced stages where systemic analgesic therapies become insufficient or intolerable. Intrathecal drug delivery systems (IDDS) offer targeted pain control while minimizing systemic exposure. However, the optimal trialing approach before permanent IDDS implantation remains contentious. This narrative review examines literature on IDDS trialing strategies in cancer pain management. A comprehensive search was conducted of PubMed, MEDLINE, and Embase databases and identified studies published up to January 2025. The review included prospective and retrospective studies, randomized controlled trials, cohort studies, and case series on trialing techniques, clinical outcomes, safety, tolerability, and efficacy. Key strateghies assessed include single-shot intrathecal bolus, multiple intrathecal boluses, continuous epidural infusion, and continuous intrathecal infusion. The review found significant variability in trialing practices, with limited high-quality comparative data to support standardized protocols. Trial success criteria varied widely, encompassing pain reduction, side effects, and patient-reported outcomes.</p><p><strong>Recent findings: </strong>The studies described a range of trialing strategies with varying durations, opioid dosages, and criteria for success. However, due to the lack of direct comparisons between these approaches, it is difficult to draw clear conclusions about the relative effectiveness of continuous intrathecal, continuous epidural, and bolus-based trials. Some institutions bypassed trialing, prioritizing symptom relief over procedural risks.</p><p><strong>Conclusion: </strong>This review highlights the need for individualized trialing strategies based on patient status, institutional preferences, and clinician expertise. Given the variability in current practices, further research is needed to establish evidence-based guidelines and optimize clinical decision-making.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"94"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334363","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":"Persistent Opioid Use Following Major Orthopedic Surgery.","authors":"Rahib K Islam, Brynne E Tynes, Victoria T Tong, Anton Pelto, Matthew Bratton, Kazi N Islam, Richard D Urman, Shahab Ahmadzadeh, Harish Siddaiah, Ross Rieger, Jeffrey Sterritt, Sahar Shekoohi, Alan D Kaye","doi":"10.1007/s11916-025-01404-0","DOIUrl":"https://doi.org/10.1007/s11916-025-01404-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>This narrative review addresses the growing public health concern of persistent opioid use following major orthopedic surgery. It aims to identify and analyze the critical factors that contribute to the transition from acute to persistent opioid consumption in this context.</p><p><strong>Recent findings: </strong>Patient-related characteristics, including pre-existing conditions and prior substance use, are critical predictors of prolonged opioid use. Additionally, surgery-related factors such as the type and duration of procedures complicate postoperative pain management. The prevalence of persistent opioid use after surgery remains high despite the emergence of effective Enhanced Recovery After Surgery protocols and patient education initiatives. Multimodal analgesia is highlighted as a vital strategy for reducing the risk of long-term opioid dependency. Persistent opioid use after orthopedic surgery poses significant challenges, including increased risks of physical and mental health complications, the development of opioid use disorder, and a substantial economic burden on healthcare systems. Targeted interventions and continuous research are essential to mitigate these risks, reduce long-term opioid dependency, and improve overall patient outcomes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"92"},"PeriodicalIF":3.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175757","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":"Cluster Headache in Children: Current Status, Diagnostic and Treatment Challenges and Future.","authors":"Hong Yang, WeiHong Liu, QiuYang Zou, DeJiang Li","doi":"10.1007/s11916-025-01403-1","DOIUrl":"10.1007/s11916-025-01403-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to summarize the current understanding of cluster headaches (CH) in children, focusing on epidemiology, pathophysiology, clinical characteristics, diagnostic challenges, treatment strategies, and future research directions.</p><p><strong>Recent findings: </strong>Cluster headaches in children are infrequent, with an incidence that appears to be significantly lower than that observed in adults, highlighting the need for more comprehensive studies. Pediatric patients often present with atypical symptoms, such as shorter pain duration and less pronounced autonomic features, leading to frequent misdiagnosis or delayed diagnosis. The hypothalamus plays a central role in the pathophysiology of CH, involving circadian rhythm disturbances, trigeminal nerve-vascular activation, and autonomic dysfunction. High-flow oxygen and triptan medications are effective for acute treatment in adults, but their safety and efficacy in children require further validation. Preventive treatments, such as verapamil, are used cautiously in pediatric patients, with close monitoring for side effects. Non-pharmacological interventions, including lifestyle adjustments and psychological support, are critical for long-term management. Cluster headaches in children are a rare but debilitating condition that poses significant diagnostic and therapeutic challenges. Current diagnostic criteria, primarily based on adult data, may not fully capture the unique clinical features of pediatric patients, leading to misdiagnosis or missed diagnosis. Treatment strategies are largely extrapolated from adult studies, with limited evidence-based data for children. Future research should focus on improving diagnostic criteria, exploring pediatric-specific pathophysiological mechanisms, and validating safe and effective treatment options. Early identification and intervention are essential to improving the quality of life and long-term outcomes for pediatric patients.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"91"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152793","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":"Prognostic Value of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Profiles in Predicting Outcomes of Occipital Nerve Stimulation for Refractory Chronic Migraine: A Retrospective Bias-Corrected Multivariable Analysis.","authors":"Marco Mercieri, Matteo Luigi Giuseppe Leoni, Alessia Naccarato, Omar Viswanath, Samah Said Al Sarmi, Giustino Varrassi, Marco Cascella, Roberto Arcioni","doi":"10.1007/s11916-025-01401-3","DOIUrl":"10.1007/s11916-025-01401-3","url":null,"abstract":"<p><strong>Background: </strong>Refractory chronic migraine (rCM) is characterized by debilitating headaches that do not respond adequately to conventional medical treatments, leaving patients severely disabled. In these rare cases, central cervical spinal cord stimulation or occipital nerve stimulation (ONS) may offer a potential therapeutic option. However, these techniques are not without risks, lack clear scientific evidence, and impose a significant economic burden. Therefore, it is crucial to identify parameters that can assist physicians in selecting appropriate candidates for implantation. This study aimed to investigate the role of psychological profiles in predicting outcomes for ONS in rCM patients.</p><p><strong>Methods: </strong>We conducted a retrospective analysis on rCM patients treated with ONS at a second-level neuromodulation university facility. These patients were refractory to conventional medical treatments, including onabotulinumtoxin-A injections (monoclonal antibodies targeting CGRP were not yet available). The NRS for migraine intensity, the number of monthly migraine attacks, and drug consumption were assessed at 6-month and 12-month follow-ups post-implant. Psychological profiles were evaluated prior to OCN using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). A multivariable logistic regression model was developed to predict ONS outcomes, incorporating MMPI-2 as a covariate. The model's accuracy and performance were assessed through non-parametric bootstrap, calibration, and discrimination analyses.</p><p><strong>Results: </strong>Twenty-three rCM patients were analysed. ONS was able to significantly reduce the pain intensity, the number of headache attacks per month, and drug consumption compared to pre-treatment levels at both 6- and 12-month follow-ups. The final multivariable logistic model at 12 months showed that the MMPI-2 Depression score was independently and negatively associated with favourable outcomes following ONS (optimism-adjusted OR 0.52, 95% CI 0.21-0.77, p = 0.03). The ROC curve indicated high model sensitivity (AUC: 0.96, 95% CI: 0.88-0.98), and the calibration plot revealed a good fit, with some improvement needed in mid-range predicted probabilities.</p><p><strong>Conclusion: </strong>ONS significantly reduced pain intensity, headache frequency, and drug use at the 12-month follow-up compared to pre-treatment levels. The MMPI-2 Depression score was an independent predictor of ONS failure, highlighting the importance of comprehensive psychological assessments in patient selection for ONS.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"90"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Guidelines for Implantable Peripheral Nerve Stimulation (PNS) in the Management of Chronic Pain.","authors":"Laxmaiah Manchikanti, Alaa Abd-Elsayed, Alan D Kaye, Mahendra R Sanapati, Nebojsa Nick Knezevic, Vivekanand Manocha, Joshua A Hirsch","doi":"10.1007/s11916-025-01397-w","DOIUrl":"https://doi.org/10.1007/s11916-025-01397-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This article assesses the current evidence and guidelines on peripheral nerve stimulation (PNS) and provides recommendations for its use in managing moderate to severe chronic pain.</p><p><strong>Recent findings: </strong>PNS has been utilized for over 50 years in the treatment of chronic pain. However, since 2015, the Food and Drug Administration (FDA) has approved percutaneously implanted PNS leads and neurostimulators, providing a minimally invasive, non-opioid alternative for managing persistent and refractory chronic pain. The American Society of Interventional Pain Physicians (ASIPP) has established evidence-based consensus guidelines for the clinical use of PNS systems in addressing chronic pain. ASIPP guidelines performed extensive evidence synthesis, including systematic reviews, randomized controlled trials (RCTs), and observational studies using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria or certainty of evidence, and qualitative synthesis based on the best available evidence. The evidence level and recommendations showed fair evidence with moderate strength of recommendation for implantable PNS systems following a trial or selective lumbar medial branch stimulation without a trial and for temporary PNS for 60 days. This review offers a comprehensive analysis of peripheral neuropathic pain as a cause of chronic, intractable, function-limiting, and high-impact pain. It discusses the diagnosis of peripheral nerve and neuropathic pain, evidence evaluation and synthesis, medical necessity criteria, patient education, and clinical recommendations. The goal is to enhance patient outcomes by integrating PNS technology into clinical practice.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"89"},"PeriodicalIF":3.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133327","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 of Magnesium Sulfate in Perioperative Multimodal Analgesia.","authors":"Andrea A Lopez-Ruiz, Lindsey P Trinchet, Steven Morozowich, Lopa Misra","doi":"10.1007/s11916-025-01395-y","DOIUrl":"10.1007/s11916-025-01395-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Patients frequently report inadequate pain management following surgical procedures. Physicians must often prescribe analgesics, notably opioids, as a means of providing pain relief. Due to the addictive nature of this class of medications, improper post-surgical pain management propagates the United States opioid crisis. The administration of multimodal analgesia is a strategy implemented to decrease long-term outpatient prescription opioid use. Magnesium sulfate has recently attracted interest for its potential use as an adjunct in multimodal analgesia in addition to its other diverse uses in medicine. This review aims to highlight the most recent data validating the use of magnesium sulfate in perioperative multimodal analgesia.</p><p><strong>Recent findings: </strong>A narrative review was conducted using PubMed and Ovid MEDLINE(R) Epub Ahead of Print, In-Process & Other Non-Indexed Citations. Articles that examined the effects of intravenous magnesium sulfate on perioperative pain and/or recovery from 1946 to present were considered. 15 articles met the inclusion criteria and discussed the use of magnesium sulfate as an adjunct in multimodal analgesia across the following surgical specialties: cardiac surgery, general surgery, gynecologic surgery, orthopedic surgery, urologic surgery, neurosurgery, and otolaryngology surgery. The results of the cited studies indicate that magnesium sulfate is a well-tolerated multimodal analgesic agent that reduces postoperative pain, reduces opioid consumption, and increases patient satisfaction.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"88"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111770","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}