Regional Anesthesia and Pain Medicine最新文献

{"title":"To the editor.","authors":"Gregory Allen","doi":"10.1136/rapm-2025-107002","DOIUrl":"https://doi.org/10.1136/rapm-2025-107002","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":"145034657","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":"Block, pain, and nausea: a causal triangle or just a coincidence?","authors":"Periklis Giannakis, Renee Ren, Stavros G Memtsoudis, Jashvant Poeran","doi":"10.1136/rapm-2025-107089","DOIUrl":"https://doi.org/10.1136/rapm-2025-107089","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024761","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":"Intravenous methocarbamol for acute pain after spine surgery: a target trial emulation.","authors":"Paul Potnuru, Adriana Baranov, Mohammad Khudirat, Alparslan Turan","doi":"10.1136/rapm-2025-107010","DOIUrl":"https://doi.org/10.1136/rapm-2025-107010","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle relaxants are often included in multimodal analgesic regimens following spine surgery, but their actual effectiveness remains unclear due to limited and inconsistent evidence. We aimed to evaluate the effectiveness of intravenous methocarbamol in reducing acute postoperative pain and opioid consumption after elective spine surgery.</p><p><strong>Methods: </strong>This emulated target trial used electronic health record data from patients undergoing elective spine surgery (posterior spinal fusion, anterior cervical discectomy and fusion, laminectomy/laminotomy) between January 1, 2020 and December 31, 2023. The exposure was intravenous methocarbamol (≥500 mg) administered within 2 hours postoperatively compared with usual care without methocarbamol. The primary outcome was the time-weighted average pain score in the 6-hour follow-up window after treatment assignment. The secondary outcome was cumulative opioid use measured in oral morphine equivalents (OMEs) over the same period. We used 1:1 time-varying propensity score matching to adjust for confounding.</p><p><strong>Results: </strong>The matched cohort included 1270 patients (median (IQR) age, 61 (50-68) years; 765 (60.2%) female). Administration of intravenous methocarbamol was not associated with significant reductions in postoperative pain scores (adjusted mean difference, 0.1; 95% CI, -0.1 to 0.4) or opioid consumption (adjusted mean difference, 0.6 OME; 95% CI, -1.4 to 2.5) compared with controls. Sensitivity analyses generally confirmed primary results, except the marginal structural model indicated slightly increased pain scores in the methocarbamol group (adjusted mean difference, 0.5; 95% CI, 0.3 to 0.7), though this was not clinically meaningful.</p><p><strong>Conclusions: </strong>In this emulated target trial of elective spine surgery, intravenous methocarbamol did not reduce acute postoperative pain or opioid consumption. These findings suggest a lack of analgesic benefit from intravenous methocarbamol use after spine surgery.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024750","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":"Response to the letter entitled \"Erector Spinae Plane Block and Postoperative Nausea and Vomiting\".","authors":"Gokhan Erdem, Fatma Kavak Akelma, Burak Nalbant, Nihal Gökbulut Özaslan","doi":"10.1136/rapm-2025-107086","DOIUrl":"https://doi.org/10.1136/rapm-2025-107086","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024793","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":"Response to the letter entitled \"block, pain, and nausea: a causal triangle or just a coincidence?\"","authors":"Gokhan Erdem, Burak Nalbant, Fatma Kavak Akelma","doi":"10.1136/rapm-2025-107114","DOIUrl":"https://doi.org/10.1136/rapm-2025-107114","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024806","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":"Comment on \"Single versus two-level superficial parasternal intercostal plane block: cadaveric evaluation of injectate spread with needle tip position on anterior surface of costal cartilage\".","authors":"Burhan Dost","doi":"10.1136/rapm-2025-106804","DOIUrl":"https://doi.org/10.1136/rapm-2025-106804","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006896","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":"Efficacy of pulsed radiofrequency treatment duration to the lumbar dorsal root ganglion in lumbar radicular pain: a double-blind randomized controlled trial.","authors":"Jae Ni Jang, Soyoon Park, Ji-Hoon Park, Young-Soon Choi, Sukhee Park","doi":"10.1136/rapm-2025-106908","DOIUrl":"https://doi.org/10.1136/rapm-2025-106908","url":null,"abstract":"<p><strong>Background: </strong>Pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) is a minimally invasive treatment for lumbar radicular pain (LRP), but the optimal stimulation duration remains uncertain. Preclinical evidence suggests that extended PRF may enhance neuromodulation, yet comparative clinical data are limited. This randomized, double-blind controlled trial aimed to compare the efficacy according to duration of PRF of DRG in patients with LRP.</p><p><strong>Methods: </strong>A total of 60 patients with chronic unilateral LRP were allocated to receive PRF of the DRG for 4 min (group A), 6 min (group B) or 8 min (group C). The primary outcome was pain intensity, measured by the Numeric Rating Scale (NRS) assessed at 1 week, 2 weeks, 1 month, 3 months, and 6 months. Secondary outcomes included functional disability (Oswestry Disability Index, ODI) and patient satisfaction (Global Perceived Effect, GPE) assessed at 1 month, 3 months and 6 months. The primary analysis followed an intention-to-treat (ITT) approach with the last observation carried forward. A per-protocol (PP) analysis was also conducted to validate results.</p><p><strong>Results: </strong>All groups demonstrated significant improvement in NRS and ODI over time (p<0.001). At 6 months, group B showed significantly greater pain reduction compared with group A (mean difference=-1.35, SE=0.69, p=0.031). Group C also showed improved NRS and the lowest ODI scores, though not statistically significant in the ITT analysis. However, PP analysis revealed statistically significant NRS reduction in both groups B and C compared with group A. Group C was the only group to demonstrate significant within-group improvement in GPE over time.</p><p><strong>Conclusions: </strong>A 6 min PRF duration provided the most consistent and statistically significant improvement in pain and function, supporting its use as a clinical standard. The 8 min duration may yield additional subjective and functional benefits in selected patients. PRF was safe and well tolerated across all groups.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001986","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":"Narrative reviews in anesthesia and pain medicine: guidelines for producers, reviewers and consumers.","authors":"George A Kelley, Ryan S D'Souza","doi":"10.1136/rapm-2024-105661","DOIUrl":"10.1136/rapm-2024-105661","url":null,"abstract":"<p><p>Well-established guidelines and checklists for authors, reviewers, and readers of systematic reviews and scoping reviews are readily available. However, the availability of such for narrative reviews is lacking, including, but not limited to, field-specific guidelines in the field of anesthesia and pain medicine. In this brief article, we review the differences between the major types of reviews, followed by a more detailed description of narrative reviews that clearly differentiates them from other types of reviews. We include a recommended checklist that will aid producers, editors, reviewers, and consumers of narrative reviews as well as examples specific to the field of anesthesia and pain medicine. It is the hope that the guidelines recommended here will aid producers, editors, reviewers, and consumers of narrative reviews in anesthesia and pain medicine, including <i>Regional Anesthesia & Pain Medicine</i> Adherence to such should help differentiate between narrative reviews and other types of reviews as well as provide consistency in what elements are necessary to include in a narrative review in the field of anesthesia and pain medicine.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"725-729"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433361","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":"Use of regional anesthesia within a pediatric interventional radiology suite reduced periprocedural opioid use without delaying the overall workflow: a retrospective study.","authors":"Jordan I Gaelen, Chunyi Wu, Amy Yang, Shankar Rajeswaran, Alina Lazar, Eric C Cheon, Angelica A Vargas","doi":"10.1136/rapm-2024-105416","DOIUrl":"10.1136/rapm-2024-105416","url":null,"abstract":"<p><strong>Background: </strong>Nerve block utility has been extensively described in the operating room, however, there is a paucity of evidence regarding blocks in the interventional radiology (IR) suite, with no studies examining its safety and efficacy in children.</p><p><strong>Methods: </strong>A retrospective study was conducted at a single tertiary-care children's hospital to evaluate the analgesic utility of nerve blocks during IR-performed sclerotherapy for bone cysts, venous malformations, and lymphatic malformations. Lymphatic and venous malformations were combined for final analysis. Patients between January 2016 and September 2022 had their medical records reviewed for procedural data, postprocedural pain scores, and analgesic administration data.</p><p><strong>Results: </strong>309 patients were included in the final analysis. Opioids were required significantly less frequently intraprocedurally and postprocedurally across subgroups. The proportion of patients who received opioids during their hospital course was significant between block and non-block patients, respectively: bone cyst: 62.7% vs 100% (p<0.001); venous and lymphatic malformation: 65.7% vs 97.4% (p<0.001). Average maximum postanesthesia care unit (PACU) pain scores were significantly lower in bone cyst patients with no significant difference seen in pain scores among venous and lymphatic malformation patients. There were no reported nerve block-related complications.</p><p><strong>Discussion: </strong>Nerve blocks demonstrated an opioid-sparing effect intraprocedurally and postprocedurally for all subgroups. Their use among bone cyst patients was associated with significant reductions in average maximum PACU pain scores. Nerve blocks may constitute an effective opioid-sparing component of multimodal analgesia in pediatric patients undergoing IR sclerosis procedures. Prospective data are needed to establish the optimal utility of nerve blocks in the IR setting.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"730-736"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460739","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":"Radiofrequency ablation for patients with lumbar spinal arthritis provides quantifiable improvement in gait velocity: a prospective study.","authors":"Johnathan Heck Goree, Leah R Tobey-Moore, Erika Petersen, Cale White, Daniel Judkins, George Austin Brown, Tuhin Virmani","doi":"10.1136/rapm-2023-105244","DOIUrl":"10.1136/rapm-2023-105244","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"762-763"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934182","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}