Regional Anesthesia and Pain Medicine最新文献

{"title":"Midclavicle block: more than a change of name.","authors":"Hipolito Labandeyra, Ryan S D'Souza, Luis Fernando Valdés-Vilches","doi":"10.1136/rapm-2025-107180","DOIUrl":"https://doi.org/10.1136/rapm-2025-107180","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126561","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":"Midclavicle block and clavipectoral fascia block: should we change the block or just the name?","authors":"Juan Carlos de la Cuadra-Fontaine, Ximena Figueroa, Pierangela Pietrantoni, Natalia P Molina","doi":"10.1136/rapm-2025-107057","DOIUrl":"https://doi.org/10.1136/rapm-2025-107057","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126616","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":"Postoperative follow-up by automated text messaging versus telephone call in outpatient care with continuous regional analgesia: a randomized controlled feasibility trial.","authors":"Erick Strange, Fernando R Altermatt, Luis Cáceres, Christopher Morrison, Luis Cortés, Nicolás Sumonte, Andrés Neyem","doi":"10.1136/rapm-2025-106818","DOIUrl":"https://doi.org/10.1136/rapm-2025-106818","url":null,"abstract":"<p><strong>Background: </strong>Patients with continuous nerve blocks need structured follow-up, but daily phone calls are resource-intensive. Automated text messaging may offer a scalable alternative.</p><p><strong>Methods: </strong>In this randomized feasibility trial, 100 outpatients with continuous peripheral nerve catheters were assigned to either automated WhatsApp-based follow-up (mobile app group) or daily telephone calls (phone group) for 3 days. The primary outcome was usability, measured by the System Usability Scale (SUS, 0-100 scale; scores ≥68 indicate acceptable usability, ≥85 excellent usability). Secondary outcomes included satisfaction, response rates, reconsultations, and catheter-related events.</p><p><strong>Results: </strong>Out of 100 randomized patients, 91 were analyzed (46 mobile app group; 45 phone call group). The mobile app achieved a mean SUS score of 87.8, reflecting excellent usability. Satisfaction and response rates were high and similar between groups. Reconsultations were more frequent with the app (28.3% vs 6.7%), mainly non-urgent patient calls. Reports of minor catheter-related events were also more common in the app group (60.9% vs 37.8%).</p><p><strong>Conclusions: </strong>Automated messaging is feasible, demonstrates excellent usability, and preserves patient satisfaction. The higher rates of minor symptom reporting and reconsultations highlight areas for refinement in future research.</p><p><strong>Trial registration number: </strong>NCT06313294.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092960","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":"Brief pain reprocessing therapy for fibromyalgia: a feasibility, acceptability, and preliminary efficacy pilot.","authors":"John Sturgeon, Zina Trost, Yoni K Ashar, Mark A Lumley, Howard Schubiner, Daniel Clauw, Afton L Hassett","doi":"10.1136/rapm-2025-107076","DOIUrl":"10.1136/rapm-2025-107076","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia (FM) is a common, disabling, and costly nociplastic pain condition. Most frontline treatments show modest effects in reducing pain in FM, which may be due to a mismatch between the mechanisms of existing interventions and mechanisms underlying nociplastic pain. The current study was a single-arm, open-label trial examining the feasibility, acceptability, and preliminary efficacy of a novel, three-session telehealth behavioral intervention (Brief Pain Reprocessing Therapy (BPRT)). BPRT incorporates psychological techniques specifically targeting the putative mechanisms of nociplastic pain in a brief, telehealth format.</p><p><strong>Methods: </strong>35 adults with FM initiated treatment. Participants were asked to complete three one-on-one intervention sessions via telehealth and online questionnaires at four time points (pre-intervention and at 1, 2, and 3 months post-intervention) assessing average pain intensity, pain interference, and pain-related fear.</p><p><strong>Results: </strong>33 participants (94.3%) completed the BPRT protocol. Acceptability ratings for BPRT were high (62.0 out of 70 on the Treatment Acceptability/Adherence Scale). BPRT completers reported significant reductions in average pain intensity (B=-0.645, 95% CI -0.896 to -0.395, p<0.001; 1-month d=0.56, 2-month d=0.80, 3-month d=0.89), pain interference (B=-2.19, 95% CI -3.06 to -1.31, p<0.001; 1-month d=0.76, 2-month d=1.02, 3-month d=1.06), and pain-related fear (B=-2.29, 95% CI -3.07 to -1.51, p<0.001; 1-month d=0.60, 2-month d=0.88, 3-month d=1.04). At the 3-month follow-up, 42.3% of completers reported being 'much improved' or 'very much improved.'</p><p><strong>Conclusions: </strong>BPRT is feasible and acceptable, with promising preliminary efficacy for reducing pain, pain interference, and pain-related fear in FM. These findings highlight the possibility of reducing FM pain and interference using a brief telehealth intervention. Larger randomized controlled trials are needed to rigorously evaluate the efficacy and mechanisms of BPRT.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092922","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":"Rates of delirium by age group among surgical and non-surgical patients receiving low-dose ketamine infusion.","authors":"Priyanka Singla, Lynn Kohan, Siny Tsang, Nabil Elkassabany","doi":"10.1136/rapm-2025-106858","DOIUrl":"https://doi.org/10.1136/rapm-2025-106858","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076495","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":"Global usage of spinal cord stimulation therapy for chronic pain syndromes: a systematic review and meta-analysis.","authors":"Peter D Vu, Noushad Mamun, Lei Feng, Kathryn J Krause, Billy Huh, Ryan S D'Souza, Saba Javed","doi":"10.1136/rapm-2025-106806","DOIUrl":"10.1136/rapm-2025-106806","url":null,"abstract":"<p><strong>Background/importance: </strong>Spinal cord stimulation (SCS) is an established therapy for chronic pain conditions when conventional treatments fail. However, global research implementation varies significantly due to patient demographics, healthcare infrastructure, and economic factors, creating disparities in access that directly impact patient care and public health outcomes.</p><p><strong>Objective: </strong>To evaluate the global landscape of SCS research by analyzing patient demographics, geographic distribution, funding sources, and pain conditions treated across chronic pain populations aged 18 years and older, with primary focus on associations between geographic regions and patient age demographics.</p><p><strong>Evidence review: </strong>We conducted a systematic literature review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, searching five major databases through October 2024. Studies from 2000 onward reporting SCS in adults with chronic pain lasting 3 months or longer were included. We included randomized trials, comparative studies, and case series with at least 10 patients, excluding commentaries, reviews, and insurance databases.</p><p><strong>Findings: </strong>Analysis of 187 studies revealed heterogeneity in age distributions across geographic regions, with Asian studies showing higher mean ages compared to North America, while European showed lower mean ages. Research concentration was predominantly in high-income regions, with 57% of studies receiving industry funding and significant associations between funding source and geographic origin. Post-surgical pain syndrome-thoracolumbar emerged as the most prevalent condition globally, representing 44.9% of cases.</p><p><strong>Conclusions: </strong>Significant associations exist between geographic regions and patient demographics in SCS research, with notable disparities in research concentration highlighting the need for broader investigation in underrepresented areas to optimize global application of this chronic pain management therapy.</p><p><strong>Prospero registration number: </strong>CRD42025635147.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978922","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":"Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (fifth edition).","authors":"Sandra L Kopp, Erik Vandermeulen, Robert D McBane, Anahi Perlas, Lisa Leffert, Terese Horlocker","doi":"10.1136/rapm-2024-105766","DOIUrl":"10.1136/rapm-2024-105766","url":null,"abstract":"<p><p>Hemorrhagic complications associated with regional anesthesia are extremely rare. The fifth edition of the American Society of Regional Anesthesia and Pain Medicine's Evidence-Based Guidelines on regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy reviews the published evidence since 2018 and provides guidance to help avoid this potentially catastrophic complication.The fifth edition of the American Society of Regional Anesthesia and Pain Medicine's Evidence-Based Guidelines on regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy uses similar methodology as previous editions but is reorganized and significantly condensed. Therefore, the clinicians are encouraged to review the earlier texts for more detailed descriptions of methods, clinical trials, case series and pharmacology. It is impossible to perform large, randomized controlled trials evaluating a complication this rare; therefore, where the evidence is limited, the authors continue to maintain an 'antihemorrhagic' approach focused on patient safety and have proposed conservative times for the interruption of therapy prior to neural blockade. In previous versions, the anticoagulant doses were described as prophylactic and therapeutic. In this version, we will be using 'low dose' and 'high dose,' which will allow us to be consistent with other published guidelines and more accurately describe the dose in the setting of specific patient characteristics and indications. For example, the same 'high' dose may be used in one patient as a treatment for deep venous thrombosis (DVT) and in another patient as prophylaxis for recurrent DVT. Due to the increasing ability to obtain drug-specific assays, we have included suggestions for when ordering these tests may be helpful and guide practice. Like previous editions, at the end of each recommendation the authors have clearly noted how the recommendation has changed from previous editions.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068673","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":"Feeding following cleft palate surgery: a prospective randomized clinical trial comparing suprazygomatic maxillary nerve block and greater palatine nerve block.","authors":"Vrushali Ponde, Hanna Smeds, Parit Ladani, Jacob Karlsson, Per-Arne Lonnqvist, Srinitya Kollu","doi":"10.1136/rapm-2025-106743","DOIUrl":"https://doi.org/10.1136/rapm-2025-106743","url":null,"abstract":"<p><strong>Introduction: </strong>In the context of cleft-lip and palate surgery, both suprazygomatic maxillary nerve blocks (SZMNB) and greater palatine nerve blocks (GPNB) have been shown to provide improved postoperative pain relief. In this context, both pain relief and early postoperative feeding are of great importance. However, these two techniques have so far not been properly compared with regard to these characteristics.</p><p><strong>Methods: </strong>Children 1-10 years of age undergoing palate surgery were randomized to either SZMNB or GPNB. Primary aim was early (0-24 hour) postoperative feeding (%) in relation to full normal oral feeding. Secondary aims were postoperative pain scores and need for rescue paracetamol administration (pain score >4).</p><p><strong>Results: </strong>30 patients were randomized to each study group (no missing data). Patients in group SZMNB displayed significantly better oral feeding during the first 24 hours compared with the GPNB group (median 80% [range 70-90%] and median 60% [range 40-70], respectively; p<0.00001). Group SZMNB did also show lower pain scores during 0-12 hour postoperatively (p<0.05-0.001) and fewer patients needed rescue paracetamol (p<0.05) compared with the GPNB group.</p><p><strong>Conclusion: </strong>The use of bilateral suprazygomatic maxillary nerve blocks was found superior to greater palatine blocks with regard to the amount of postoperative feeding in children undergoing palate surgery. Bilateral suprazygomatic maxillary nerve blocks were also associated with lower postoperative pain scores during the first 12 hours postoperative, further reflected by the reduced need for postoperative rescue administration of intravenous paracetamol.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042222","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":"Extended analgesia, enhanced recovery: optimizing outcomes after total knee arthroplasty with continuous adductor canal block.","authors":"Ryan S D'Souza, Yehoshua Gleicher, Hipolito Labandeyra","doi":"10.1136/rapm-2025-107146","DOIUrl":"https://doi.org/10.1136/rapm-2025-107146","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042220","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":"Letter: response to the letter by Dr Gregory Allen.","authors":"Ellen M Soffin, Faraj W Abdallah, Edward R Mariano","doi":"10.1136/rapm-2025-107131","DOIUrl":"https://doi.org/10.1136/rapm-2025-107131","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034628","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}