A Natisha Nabbijohn, Ian R Newby-Clark, David Mack, Alain Stintzi, C Meghan McMurtry
{"title":"Pain Trajectories in Pediatric Inflammatory Bowel Disease: Disease Severity, Optimism, and Pain Self-efficacy.","authors":"A Natisha Nabbijohn, Ian R Newby-Clark, David Mack, Alain Stintzi, C Meghan McMurtry","doi":"10.1097/AJP.0000000000001279","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001279","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to characterize pain intensity (average, worst) and disease severity in youth with inflammatory bowel disease in the 12-months post-diagnosis, and to examine the relation between pain and risk (disease severity) and resilience (optimism, pain self-efficacy) factors over time.</p><p><strong>Methods: </strong>Data collection ran from February 2019 to March 2022. Newly diagnosed youth aged 8-17 with IBD completed numerical rating scales for average and worst pain intensity, Youth Life Orientation Test for optimism, and Pain Self-Efficacy Scale for pain self-efficacy via REDCap; weighted Pediatric Crohn's Disease Activity Index and the Pediatric Ulcerative Colitis Activity Index were used as indicators of disease severity. Descriptive statistics characterized pain and disease severity. Multilevel modeling explored relations between variables over time, including moderation effects of optimism and pain self-efficacy.</p><p><strong>Results: </strong>At baseline, 83 youth (Mage=13.9, SD=2.6; 60.2% Crohn's disease; 39.8% female) were included. Attrition rates at 4 and 12 months were 6.0% and 9.6%, respectively. Across time, at least 52% of participants reported pain. Participants in disease remission increased from 4% to 70% over 12-months. Higher disease severity predicted higher worst pain, regardless of time since diagnosis. Higher pain self-efficacy: (a) predicted lower average and worst pain, especially at later time points; and (b) attenuated the association between disease severity and worst pain when included as a moderator. Higher optimism predicted lower worst pain.</p><p><strong>Discussion: </strong>Pain is prevalent in pediatric inflammatory bowel disease and impacted by disease severity, pain self-efficacy, and optimism. Findings highlight modifiable intervention targets.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul W Hodges, Raimundo Sanchez, Shane Pritchard, Adam Turnbull, Andrew Hahne, Jon Ford
{"title":"Towards Validation of Clinical Measures to Discriminate Between Nociceptive, Neuropathic and Nociplastic Pain: Cluster Analysis of a Cohort with Chronic Musculoskeletal Pain.","authors":"Paul W Hodges, Raimundo Sanchez, Shane Pritchard, Adam Turnbull, Andrew Hahne, Jon Ford","doi":"10.1097/AJP.0000000000001281","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001281","url":null,"abstract":"<p><strong>Objectives: </strong>The International Association for the Study of Pain defines three pain types presumed to involve different mechanisms - nociceptive, neuropathic and nociplastic. Based on the hypothesis that pain types should guide matching of patients with treatments, work has been undertaken to identify features to discriminate between them for clinical use. This study aimed to evaluate the validity of features to discriminate between pain types.</p><p><strong>Methods: </strong>Subjective and physical features were evaluated in a cohort of 350 individuals with chronic musculoskeletal pain attending a chronic pain management program. Analysis tested the hypothesis that, if features nominated for each pain type represent 3 different groups, then (i) cluster analysis should identify 3 main clusters of patients, (ii) these clusters should align with the pain type allocated by an experienced clinician, (iii) patients within a cluster should have high expression of the candidate features proposed to assist identification of that pain type. Supervised machine learning interrogated features with the greatest and least importance for discrimination; and probabilistic analysis probed the potential for coexistence of multiple pain types.</p><p><strong>Results: </strong>Results confirmed that data could be best explained by 3 clusters, clusters were characterized by a priori specified features, and agreed with the designation of the experienced clinician with 82% accuracy. Supervised analysis highlighted features that contributed most and least to the classification of pain type and probabilistic analysis reinforced the presence of mixed pain types.</p><p><strong>Discussion: </strong>These findings support the foundation for further refinement of a clinical tool to discriminate between pain types.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Casey León, Minhee L Sung, Joel I Reisman, Weisong Liu, Robert D Kerns, Kirsha S Gordon, Avijit Mitra, Sunjae Kwon, Hong Yu, William C Becker, Wenjun Li
{"title":"Occurrence of Opioid-Related Neurocognitive Symptoms Associated With Long-term Opioid Therapy.","authors":"Casey León, Minhee L Sung, Joel I Reisman, Weisong Liu, Robert D Kerns, Kirsha S Gordon, Avijit Mitra, Sunjae Kwon, Hong Yu, William C Becker, Wenjun Li","doi":"10.1097/AJP.0000000000001266","DOIUrl":"10.1097/AJP.0000000000001266","url":null,"abstract":"<p><strong>Objective: </strong>Neurocognitive symptoms (NCSs) may be early indicators of opioid-related harm. We aimed to evaluate the incidence and potential attribution of opioid-related NCS among patients on long-term opioid therapy (LOT) by using natural language processing to extract data from the electronic health records within the Veterans Health Administration.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients prescribed LOT in 2018. NCS were identified from clinical notes across 3 periods: 6 months before LOT initiation, during LOT, and 1-year post-LOT discontinuation. Opioid-related NCS included cognitive impairment, sedation, light-headedness, altered mental status, and intoxication. We calculated incidence rates, incidence rate ratios, and hazard ratios to evaluate the occurrence and potential opioid attribution of NCS across these periods.</p><p><strong>Results: </strong>Among 55,652 patients, 3.1% experienced opioid-related NCS, with the highest incidence observed during LOT. Prevalence of NCS was greater in patients who were: between 55 and 64 (3.6%) or 65 and 74 years old (3.2%), Asian (4.8%, P = 0.02), and had received treatment for substance use disorders (7.1%, P = 0.01). In adjusted proportional hazards models, identified Asian race (hazard ratio: 2.20 [95% CI: 1.09-4.44], P = 0.03), and cooccurring conditions dementia (1.50 [1.12-2.00], 0.01), depression (1.31 [1.14-1.49], <0.01), posttraumatic stress disorder (1.18 [1.02-1.37], 0.02), substance use disorder (1.62 [1.36-1.92], 0.01), cardiovascular disease (1.18 [1.01-1.37], 0.04), chronic obstructive pulmonary disease (1.16 [1.01-1.33], 0.03), cirrhosis (1.73 [1.34-2.24], 0.01), chronic kidney disease (1.41 [1.19, 1.66]; 0.01) and traumatic brain injury (1.42 [1.06-1.91], 0.02) were associated with increased likelihood of NCS. Likelihood of NCS increased with LOT dose and decreased with LOT duration.</p><p><strong>Conclusion: </strong>This study suggests that opioid-related NCS are most likely to occur during LOT, indicating a potential temporal association with opioid use. These findings highlight the importance of monitoring NCS in patients on LOT as part of a broader strategy to mitigate opioid-related harms.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Safety and Efficacy of Opioid-sparing Anesthesia Compared With Traditional Opioid Anesthesia: A Scoping Review.","authors":"Maria P Lauretta, Luca Marino, Federico Bilotta","doi":"10.1097/AJP.0000000000001261","DOIUrl":"10.1097/AJP.0000000000001261","url":null,"abstract":"<p><strong>Objectives: </strong>The rationale of adoption opioid-sparing anesthesia (OSA) is to achieve perioperative analgesia with a minimal amount of opioids combined with nonopioid adjuvants during and after surgery, namely multimodal anesthesia. The OSA approach was originally developed to overcome the known complications of opioid-based anesthesia (OA), and the present scoping review (ScR) aims at providing clinical evidence of the safety and efficacy of OSA with respect to OA.</p><p><strong>Methods: </strong>This ScR is mainly focused on studies presenting evidence on the safety and efficacy of OSA versus OA. PubMed and EMBASE databases were utilized to find relevant studies. The search strategy included the following keywords: \"opioid sparing anesthesia complications, opioid sparing anesthesia efficacy, opioid sparing anesthesia safety.\" The findings from the 25 included studies were categorized into the following subsections: article characteristics, goals of the studies, OSA protocols, and surgical settings analyzed.</p><p><strong>Results: </strong>In the 25 reviewed studies, evidence related to the impact of OSA versus OA was considered. Intraoperative safety and efficacy end points include hemodynamic stability and anesthetic/analgesic requirements. Postoperative end points include early cognitive dysfunction, opioid-induced bowel disorder, the physical status of mothers and newborns after labor and emergency cesarean, systemic immune and inflammation modifications, postoperative recovery, in-hospital and long-term opioid requirement, early postoperative pain, and chronic postsurgical pain. The studies reported lower intraoperative mean arterial pressure and heart rate fluctuations when α 2 agonists were adopted, while no differences were recorded for other complication rates. Analysis of OSA approaches for the postoperative conditions includes α 2 agonists, NMDA receptor blocking agents, gabapentinoids, nefopam hydrochloride, and locoregional anesthesia techniques with a positive impact on most of the end points considered.</p><p><strong>Discussion: </strong>The clinical implementation of OSA encompasses the perioperative use of nonopioid drugs and locoregional anesthesia techniques. The reviewed studies reported OSA as a feasible approach to reduce opioid-related complications with no impact on patient safety.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joaquin E Moreno, Bridget A Nestor, Morgan Mitcheson, Sarah Nelson
{"title":"The Moderating Role of Ethnicity on Depressive and Anxiety Symptoms and Pain Catastrophizing in Hispanic/Latinx and Non-Hispanic/Latinx White Youth with Chronic Pain.","authors":"Joaquin E Moreno, Bridget A Nestor, Morgan Mitcheson, Sarah Nelson","doi":"10.1097/AJP.0000000000001272","DOIUrl":"10.1097/AJP.0000000000001272","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain (CP) significantly impacts emotional and physical well-being and overall quality of life across diverse populations in the United States (U.S.). Notably, underrepresented minoritized (URM) groups, such as Hispanic/Latinx youth, may experience disproportionate effects due to health disparities and lack of access to quality healthcare. However, this remains understudied. This study aims to examine the association between CP and its related psychosocial factors- depressive and anxiety symptoms, and pain catastrophizing- in Hispanic/Latinx youth, as compared to Non-Hispanic White (NHW) youth.</p><p><strong>Methods: </strong>The current study sample included 58 self-identifying Hispanic/Latinx and 58 NHW youth seeking CP treatment at a large northeastern tertiary pain clinic, ages 12-18 y.o., M=15.49, SD=1.71), of which 88% identified as biologically female. Participant samples for each group were age-and-sex matched.</p><p><strong>Results: </strong>Significant associations were found between anxiety and depressive symptoms and pain catastrophizing for youth in both groups. Ethnicity significantly moderated the associations between pain catastrophizing and depressive symptoms and between anxiety and depressive symptoms, with NHW youth with pain exhibiting stronger relations between these constructs when compared to Hispanic/Latinx youth with pain.</p><p><strong>Discussion: </strong>Our results suggested that for NHW youth with CP, greater tendencies toward catastrophizing and experiences of anxiety may more strongly contribute to depressive symptoms, when compared to their Hispanic/Latinx youth counterparts. Further investigation of pain-coping mechanisms among Hispanic/Latinx youth and other youth from historically marginalized populations (e.g., racial/ethnic minoritized groups) will help advance clinical understanding of sociocultural variability in links between pain-related psychosocial outcomes in the CP experience.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultrasound-Guided Double-Point Versus Single-Point Serratus Anterior Plane Block for Modified Radical Mastectomy: A Randomized Controlled Trial.","authors":"Jianghui Xu, Dandan Ling, Qianyun Xu, Pengfei Sun, Shiyou Wei, Lingling Gao, Feifei Lou, Jun Zhang","doi":"10.1097/AJP.0000000000001256","DOIUrl":"10.1097/AJP.0000000000001256","url":null,"abstract":"<p><strong>Objectives: </strong>The double-point serratus anterior plane block (SAPB) covers more area, including the axilla, than the single-point approach, potentially offering better pain relief after modified radical mastectomy (MRM). The objective of this study were to evaluate the clinical outcomes of these 2 procedures for patients treated with MRMs.</p><p><strong>Methods: </strong>Sixty women were randomly assigned to double- or single-point groups. Double-point received SAPB at the third and fifth ribs, single-point at the fifth rib. The primary outcome includes pain numeric rating scale (NRS) at rest and movement 24 hours postsurgery. The secondary outcomes are axilla comfort NRS, recovery quality, and adverse events.</p><p><strong>Results: </strong>At 24 hours postsurgery, the double-point group compared with the single-point group showed movement pain NRS of 3 (2 to 3) versus 3 (3 to 4) ( P =0.011) and rest pain NRS of 1 (1 to 1) versus 2 (1 to 3) ( P =0.037). The difference between them did not exceed the minimum clindically important difference (MCID). The axillary comfort NRS in the double-point group was lower than the single-point group at 6 and 12 hours postsurgery, at 1 (1 to 2) versus 2 (2 to 4) ( P =0.001) and 1 (1 to 2) versus 2 (2 to 4) ( P =0.01), respectively, but there were no statistically significant differences at 24 and 48 hours postsurgery. At 48 hours postsurgery, pain scores and opioid use were similar in both groups. Recovery scores, rescue analgesia timing, adverse events, and hospital stay length were similar in both groups.</p><p><strong>Discussion: </strong>Double-point SAPB offers wider anesthetic spread but shows no significant clinical advantage in pain or axillary comfort over single-point SAPB after MRM.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa R Miller-Matero, Celeste Pappas, Samah Altairi, Monica Sehgal, Timothy Chrusciel, Joanne Salas, Scott Secrest, Lauren Wilson, Ryan W Carpenter, Mark D Sullivan, Brian K Ahmedani, Patrick J Lustman, Jeffrey F Scherrer
{"title":"Alcohol, Tobacco, and Marijuana Use Among Individuals Receiving Prescription Opioids for Pain Management.","authors":"Lisa R Miller-Matero, Celeste Pappas, Samah Altairi, Monica Sehgal, Timothy Chrusciel, Joanne Salas, Scott Secrest, Lauren Wilson, Ryan W Carpenter, Mark D Sullivan, Brian K Ahmedani, Patrick J Lustman, Jeffrey F Scherrer","doi":"10.1097/AJP.0000000000001257","DOIUrl":"10.1097/AJP.0000000000001257","url":null,"abstract":"<p><strong>Objective: </strong>Substance use among individuals receiving prescription opioids for pain may be associated with poorer functioning. The purpose of this study was to examine whether the use of substances (ie, alcohol, marijuana, or tobacco) among individuals prescribed opioids for pain management was associated with pain, psychiatric disorders, and opioid misuse.</p><p><strong>Methods: </strong>Patients with non-cancer pain and a new opioid prescription were recruited from 2 health systems. Participants (N = 827) completed measures regarding pain severity, pain interference, psychiatric symptoms, and substance use.</p><p><strong>Results: </strong>Substance use was common with 58.0%, 26.2%, and 28.9% reporting alcohol, tobacco, and marijuana use, respectively. The use of tobacco or marijuana was associated with poorer functioning. Those with tobacco use had greater pain severity, interference, number of pain sites, and concern for opioid misuse, and were more likely to have probable depression, anxiety, and posttraumatic stress disorders. Participants reporting marijuana use were more likely to have higher concerns for opioid misuse scores and probable depression, anxiety, and posttraumatic stress disorders. Use of alcohol was associated with lower pain severity and interference and fewer number of pain sites.</p><p><strong>Conclusion: </strong>Substance use is common among individuals receiving prescription opioids. Some types of substance use may be related to poorer opioid, pain, and psychiatric functioning. Clinicians prescribing opioids for pain management should assess for substance use, including tobacco, and be aware of the association with poorer functioning. Interventions could target pain, psychiatric symptoms, and substance use simultaneously to optimize outcomes for individuals with pain and substance use.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandro Heredia Ciuró, Javier Martín Núñez, Andrés Calvache Mateo, Laura López López, Maria Dels Angels Cebriá I Iranzo, Irene Cabrera Martos, Marie Carmen Valenza
{"title":"Percutaneous Electrical Stimulation Improves Chronic Knee Pain and Function: A Systematic Review and Meta-analyses.","authors":"Alejandro Heredia Ciuró, Javier Martín Núñez, Andrés Calvache Mateo, Laura López López, Maria Dels Angels Cebriá I Iranzo, Irene Cabrera Martos, Marie Carmen Valenza","doi":"10.1097/AJP.0000000000001254","DOIUrl":"10.1097/AJP.0000000000001254","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this systematic review and meta-analysis was to evaluate the effectiveness of percutaneous electrical stimulation in the modulation of pain and its implication in the function of patients with a painful knee condition.</p><p><strong>Materials and methods: </strong>A search was conducted from database inception to September 2023 across PubMed, Web of Science, and Scopus databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies. Study quality was assessed using the physiotherapy evidence database Scale and the risk of bias was evaluated with the Cochrane Assessment tool.</p><p><strong>Results: </strong>Eight studies were included. A significant statistical effect was found ( P < 0.001) for reducing pain and improving function after treatment. In addition, a significant statistical effects were identified for reducing pain ( P = 0.009) and improving function ( P < 0.001) after follow-up. The risk of bias was low.</p><p><strong>Conclusion: </strong>This review showed a positive effect of applying the percutaneous electrical stimulation for reducing pain and improving function in adults with a painful knee.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuyang Zhu, Yi Yang, Qinyu Zhang, Xuan Li, Wenqiang Xue, Yuan Liu, Yufei Zhao, Wenxia Xu, Peng Yan, Shuang Li, Yu Fang, Jie Huang
{"title":"Comparison of Ultrasound-guided Single-injection Erector Spinae Plane Block, Retrolaminar Block, and Paravertebral Block for Postoperative Analgesia in Single-incision Video-assisted Thoracoscopic Surgery: A 3-arm, Double-blind, Randomized Controlled Noninferiority Trial.","authors":"Yuyang Zhu, Yi Yang, Qinyu Zhang, Xuan Li, Wenqiang Xue, Yuan Liu, Yufei Zhao, Wenxia Xu, Peng Yan, Shuang Li, Yu Fang, Jie Huang","doi":"10.1097/AJP.0000000000001259","DOIUrl":"10.1097/AJP.0000000000001259","url":null,"abstract":"<p><strong>Objective: </strong>Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS).</p><p><strong>Methods: </strong>Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures.</p><p><strong>Results: </strong>The AUC for NRS was 107.8±10.53 in the ESPB group, 104.8±8.05 in the RLB group, and 103.6±10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2±3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2±2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events.</p><p><strong>Discussion: </strong>ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Increase in Early Menarche is Associated With the Increase in Chronic Back Pain in Female Adolescents: The Health Behavior in School-aged Children Study 2002-2014.","authors":"Josep Roman-Juan, Mark P Jensen, Jordi Miró","doi":"10.1097/AJP.0000000000001247","DOIUrl":"10.1097/AJP.0000000000001247","url":null,"abstract":"<p><strong>Objective: </strong>Research has shown that there has been an increase in the prevalence of chronic back pain (CBP) in adolescents, especially in female adolescents. The purpose of the current study was to test the hypothesis that the observed increase in the prevalence of early menarche in female adolescents is contributing to the increase in the prevalence of CBP over time in this population.</p><p><strong>Methods: </strong>Cross-sectional data from 251,390 female adolescents from 27 countries/regions were drawn from the Health Behaviour in School-aged Children questionnaire-based surveys conducted in 2002, 2006, 2010, and 2014. The Karlson-Holm-Breen method was used to examine the explanatory role of the increase in the prevalence of early menarche on the increase in the prevalence of CBP while controlling for socioeconomic status, physical activity, body mass index, and psychological symptoms.</p><p><strong>Results: </strong>The increase in the prevalence of early menarche between 2002 and 2014 was associated with the increase in the prevalence of CBP ( P < 0.001). The percent of CBP prevalence increase accounted for by the increase in early menarche was 2.2%.</p><p><strong>Conclusions: </strong>The increase in the prevalence of CBP in female adolescents observed over the last decade may be explained, in part, by the decrease in the age of menarche. This finding, coupled with research showing a decline in early menarche worldwide, highlights the need to delve deeper into the underlying mechanisms of the association between early menarche and pain-particularly CBP-in female adolescents.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"684-689"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}