Regional Anesthesia and Pain Medicine最新文献

{"title":"Comments on \"Fatal arachnoiditis following accidental intradural injection of chlorhexidine: a case report and literature review\".","authors":"Julien Raft, Anne-Sophie Lamotte, Dan Benhamou, Claude Ecoffey, Hervé Bouaziz","doi":"10.1136/rapm-2026-107928","DOIUrl":"https://doi.org/10.1136/rapm-2026-107928","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845717","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":"Chronic postsurgical pain after cesarean section and the importance of anticipation.","authors":"Carles Espinós Ramírez, David Martínez-Rodríguez, Gisela Roca, Pere Castellví Obiols","doi":"10.1136/rapm-2026-107783","DOIUrl":"https://doi.org/10.1136/rapm-2026-107783","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846208","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":"Novel use of ultrasound-guided high-intensity focused ultrasound (HIFU) may enable the neuroablation of the sacroiliac joint in a swine model: a feasibility study.","authors":"Evgeny Bulat, Rahul Chaturvedi, Jason Crowther, Sebastien Monette, Amitabh Gulati","doi":"10.1136/rapm-2024-105809","DOIUrl":"10.1136/rapm-2024-105809","url":null,"abstract":"<p><strong>Background: </strong>Sacroiliac joint (SIJ) dysfunction accounts for the etiology of pain in 15%-30% of low back pain cases. Some patients with conservative treatment-refractory SIJ dysfunction undergo radiofrequency (RF) ablation of the SIJ for prolonged pain relief. This procedure involves placing up to 12 RF probes in what is an invasive, resource-intensive, and time-consuming process. High-intensity focused ultrasound is an alternative neuroablative technique that is non-invasive and potentially less cumbersome. MRI-guided high-intensity focused ultrasound (MRgHIFU) had previously been successfully applied to SIJ ablation in a swine model, and more recently had been trialed in humans. However, ultrasound-guided high-intensity focused ultrasound (USgHIFU) of the SIJ may be a more practical and rapid alternative to MRIgHIFU.</p><p><strong>Methods: </strong>This was a prospective technology efficacy and safety study in a swine model. Three Yorkshire pigs underwent bilateral SIJ ablation using a proprietary USgHIFU prototype. Post procedure, treatment efficacy was assessed using clinical evaluation of pain and changes in ambulation, gross inspection of lumbosacral necropsy and pathology sections, and histology.</p><p><strong>Results: </strong>Post anesthetic monitoring for 72 hours showed no signs of gait abnormalities or perceived pain in the swine models. Of the primary sacral spine targets, histological specimen review suggested successful lesioning of 37/54 sites (68.5%), specifically in the targeted areas that were visualized under ultrasound. Of the successful lesion zones, 22/37 (59.5%) included nerve lesions, 34/37 (91.9%) included muscle lesions, 34/37 (91.9%) included periosteum lesions, and 20/21 (95.2%) included bony lesions.</p><p><strong>Conclusions: </strong>The preliminary study thus demonstrates that USgHIFU can create targeted contiguous strip lesions along the SIJ and lead to thermal necrosis of the posterior sacral network without causing additional neurological damage or damage to adjacent muscle tissue or bone outside of target areas.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"533-538"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016644","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":"Comments on: \"insights into possible mechanisms for nerve block success\".","authors":"Kai Henrik Wiborg Lange, Christoffer Calov Jørgensen, Christian Rothe","doi":"10.1136/rapm-2024-106256","DOIUrl":"10.1136/rapm-2024-106256","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"601"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822830","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":"Abdominal field blocks in minimally invasive surgery and the cutaneous sensory block area.","authors":"Christopher Blom Salmonsen, Kai Henrik Wiborg Lange, Jakob Kleif, Claus Anders Bertelsen","doi":"10.1136/rapm-2024-106278","DOIUrl":"10.1136/rapm-2024-106278","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"602"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856723","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":"From spin wizardry to regenerative alchemy: a philosophical inquiry into healing and standardization.","authors":"Guilherme Ferreira-Dos-Santos","doi":"10.1136/rapm-2025-106689","DOIUrl":"10.1136/rapm-2025-106689","url":null,"abstract":"<p><p>In Regenerative Medicine, the quest to harness the body's own healing potential is as much a philosophical journey as it is a clinical challenge. Promising interventions-from platelet-rich plasma injections to stem cell therapies-often differ in subtle yet critical ways, leading to variable outcomes. One method might modestly enrich bioactive components, while another yields a preparation bursting with regenerative signals. This variability compels us to ask: should we focus on merely categorizing these diverse approaches, or instead strive to define the fundamental nature of the therapeutic agents we deploy?This Daring Discourse explores the tension between the intricate diversity of human biology and our need for consistency and reproducibility in treatment. Drawing on the parable of the blind men and the elephant, it illustrates how isolated perspectives reveal only fragments of the truth; only by integrating these views can we grasp the full regenerative potential. It further cautions against the rise of \"spin wizards\"-clinicians who, relying solely on centrifugation without understanding underlying biological determinants, claim a universal cure for degenerative conditions.This narrative advocates for a unified framework that marries innovative techniques with rigorous standardization. Such an approach promises to transform Regenerative Medicine from a field of hopeful experiments into one where treatments are reliably safe and effective, ultimately fulfilling its transformative potential.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"596-597"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063290","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":"Indications for percutaneous and paddle leads for patients with chronic spinal pain: a systematic review.","authors":"Maarten Moens, Abdulhamid Ciçek, Jiya Anand, Julie G Pilitsis, Michaël Bruneau, Maxime Billot, Manuel Roulaud, Philippe Rigoard, Jan Willem Kallewaard, Lisa Goudman","doi":"10.1136/rapm-2025-106686","DOIUrl":"10.1136/rapm-2025-106686","url":null,"abstract":"<p><strong>Background/importance: </strong>Both percutaneous and paddle leads are utilized when implanting spinal cord stimulation (SCS). Both leads appear to be safe and effective, yet, there is a scarcity of guidelines for deciding which type of lead a physician should use.</p><p><strong>Objective: </strong>The main goal is to provide an overview of clinical indications for percutaneous and paddle leads for SCS in patients with chronic spinal pain.</p><p><strong>Evidence review: </strong>Databases consulted for this systematic review were PubMed, Web of Science, Scopus and Embase. Only studies evaluating SCS in chronic spinal pain patients, with or without previous spine surgery, were eligible. The study protocol was prospectively registered (PROSPERO, CRD42022347329).</p><p><strong>Findings: </strong>Of the 102 included studies, 66.67% studies (n=68) implanted percutaneous leads, 30.4% (n=31) paddle leads and 2.9% (n=3) paddle leads with a percutaneous approach. Percutaneous leads are implanted when patients have no anatomic abnormalities, including no previous spinal interventions at the target location or thoracolumbar junction, and no previous experience with SCS or intrathecal drug delivery. Percutaneous leads may be considered for patients without a history of spinal surgery. Paddle leads are preferred when percutaneous lead placement is technically too difficult, including patients with a history of previous spine surgeries, or as a rescue therapy for failed percutaneous trials.</p><p><strong>Conclusions: </strong>Lead-specific indications were revealed for patients with chronic spinal pain, yet, the experience of the physician or affiliated department is suggested to have an important role. A clinical flowchart is proposed to help physicians in the decision-making process in daily clinical practice.</p><p><strong>Prospero registration number: </strong>CRD42022347329.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"504-511"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334458","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":"A response to Rashomon perspectives in PENG block.","authors":"Angela Lucia Balocco, Admir Hadzic, Philippe Emmanuel Gautier","doi":"10.1136/rapm-2024-106212","DOIUrl":"10.1136/rapm-2024-106212","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"598-599"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the utility of large language models in generating search strings for systematic reviews in anesthesiology: a comparative analysis of top-ranked journals.","authors":"Alessandro De Cassai, Burhan Dost, Yunus Emre Karapinar, Müzeyyen Beldagli, Mirac Selcen Ozkal Yalin, Esra Turunc, Engin Ihsan Turan, Nicolò Sella","doi":"10.1136/rapm-2024-106231","DOIUrl":"10.1136/rapm-2024-106231","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the effectiveness of large language models (LLMs), specifically ChatGPT 4o and a custom-designed model, Meta-Analysis Librarian, in generating accurate search strings for systematic reviews (SRs) in the field of anesthesiology.</p><p><strong>Methods: </strong>We selected 85 SRs from the top 10 anesthesiology journals, according to Web of Science rankings, and extracted reference lists as benchmarks. Using study titles as input, we generated four search strings per SR: three with ChatGPT 4o using general prompts and one with the Meta-Analysis Librarian model, which follows a structured, Population, Intervention, Comparator, Outcome-based approach aligned with Cochrane Handbook standards. Each search string was used to query PubMed, and the retrieved results were compared with the PubMed retrieved studies from the original search string in each SR to assess retrieval accuracy. Statistical analysis compared the performance of each model.</p><p><strong>Results: </strong>Original search strings demonstrated superior performance with a 65% (IQR: 43%-81%) retrieval rate, which was statistically different from both LLM groups in PubMed retrieved studies (p=0.001). The Meta-Analysis Librarian achieved a superior median retrieval rate to ChatGPT 4o (median, (IQR); 24% (13%-38%) vs 6% (0%-14%), respectively).</p><p><strong>Conclusion: </strong>The findings of this study highlight the significant advantage of using original search strings over LLM-generated search strings in PubMed retrieval studies. The Meta-Analysis Librarian demonstrated notable superiority in retrieval performance compared with ChatGPT 4o. Further research is needed to assess the broader applicability of LLM-generated search strings, especially across multiple databases.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"554-557"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016637","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":"Anterior quadratus lumborum block in total hip arthroplasty: a two-center, randomized, placebo-controlled trial showing no additional benefit over multimodal analgesia.","authors":"Romain Rozier, Anouk Loiseleur, Charlotte Ciais, Ophélie Moulin, Baptiste Alais, Kewan Marguerite, Emmanuelle Badia, Laurie Tran, Juliette Balbo, Axel Maurice-Szamburski","doi":"10.1136/rapm-2024-106247","DOIUrl":"10.1136/rapm-2024-106247","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) frequently causes postoperative pain, hindering recovery and prolonging hospital stays. While multimodal analgesia aims to minimize opioid use and enhance outcomes, the optimal regional anesthesia technique is unclear due to the hip's complex innervation.</p><p><strong>Objective: </strong>This multicenter randomized placebo-controlled trial evaluated whether adding an anterior quadratus lumborum block (QLB) to multimodal analgesia with non-steroidal anti-inflammatory drugs (NSAIDs) reduces opioid consumption in THA patients.</p><p><strong>Methods: </strong>60 adults undergoing primary unilateral THA were randomized to receive either anterior QLB with 20 mL of 0.2% ropivacaine (n = 30) or a placebo saline injection (n = 30). All participants received multimodal analgesia including NSAIDs. The primary outcome was cumulative opioid consumption in oral morphine equivalents (OMEs) within the first 24 postoperative hours. Secondary outcomes included patient experience assessed by the EVAN scale on postoperative day 1, elevated pain and opioid consumption on days 1 and 2, time to first standing, walking distance and quadriceps strength on day 1, as well as walking progression, return to sport activity and analgesic use at 3 months.</p><p><strong>Results: </strong>No significant difference was found in 24-hour cumulative OME consumption between groups (median 40 mg (IQR 20-50 mg) vs 31 mg (IQR 20-45 mg); p = 0.6). Patient experience, pain scores and opioid consumption were similar. Rehabilitation outcomes at 3 months also did not differ.</p><p><strong>Conclusion: </strong>Adding anterior QLB to multimodal analgesia did not reduce opioid consumption or enhance postoperative pain control and functional recovery in THA patients. Anterior QLB may not provide additional benefits when combined with multimodal analgesia with NSAID for THA.</p><p><strong>Trial registration number: </strong>NCT04555291.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"491-497"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392427","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}