Anesthesiology and Pain Medicine最新文献

{"title":"Comparison of the Effects of Isoflurane and Propofol as Anesthesia Maintenance on Plasma Mitochondrial DNA Levels in Posterior Spinal Fusion Surgeries.","authors":"Faranak Behnaz, Mehrak Erfanian, Azita Chegini","doi":"10.5812/aapm-161767","DOIUrl":"10.5812/aapm-161767","url":null,"abstract":"<p><strong>Background: </strong>Tissue injury resulting from surgical procedures leads to the release of various inflammatory agents, such as mitochondrial DNA (mt-DNA). This can trigger inflammatory mechanisms that may harm different organs.</p><p><strong>Objectives: </strong>In this study, we investigated the effects of isoflurane and propofol on mt-DNA levels during posterior spinal fusion (PSF) surgery.</p><p><strong>Methods: </strong>After meeting the inclusion criteria, 40 patients scheduled for PSF surgery were enrolled in a prospective randomized controlled clinical trial and randomly divided into groups receiving propofol or isoflurane for maintenance of anesthesia. Mitochondrial DNA levels were measured before surgery, one hour after induction of anesthesia, in the recovery unit, and 24 hours post-surgery.</p><p><strong>Results: </strong>There was no statistically significant difference between groups regarding age, gender, and mt-DNA levels prior to surgery (P-value > 0.05). However, mt-DNA levels were significantly higher in the isoflurane group one hour after induction of anesthesia (P-value = 0.001), in the recovery unit (P-value = 0.042), and 24 hours after surgery (P-value = 0.018).</p><p><strong>Conclusions: </strong>Propofol was superior to isoflurane, as demonstrated by a lesser elevation in plasma levels of mt-DNA in PSF patients.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e161767"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Ultrasound-Guided Erector Spinae Plane Block and Retro-laminar Block on Postoperative Pain Following Upper Abdominal Laparoscopic Surgery.","authors":"Poupak Rahimzadeh, Seyed Hamid Reza Faiz, Mahmood-Reza Alebouyeh, Faranak Rokhtabnak, Reza Farahmand Rad, Shima Movaseghi","doi":"10.5812/aapm-158242","DOIUrl":"10.5812/aapm-158242","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain following laparoscopic surgeries, such as laparoscopic cholecystectomy, can be severe. Despite various analgesic methods, high doses of narcotics are often required, leading to complications such as dizziness, respiratory disorders, and postoperative nausea and vomiting (PONV).</p><p><strong>Objectives: </strong>The present study aimed to evaluate the efficacy of two novel analgesic methods, the erector spinae plane block (ESPB) and the retrolaminar block (RLB), performed under ultrasound guidance, in managing pain after upper abdominal laparoscopic surgeries.</p><p><strong>Methods: </strong>In this clinical trial, candidates for elective upper abdominal laparoscopic surgeries were randomly assigned to two groups (40 patients in the ESPB group and 40 in the RLB group). To manage preoperative pain, one group received an ESPB block under ultrasound guidance on the surgical side, while the other group received a RLB. Both groups were equipped with a patient-controlled intravenous analgesia (PCIA) pump containing fentanyl. The analgesic used in both blocks was 0.1% ropivacaine (20 cc) on the surgical side. Patients' pain intensity [based on the Numeric Rating Scale (NRS)], need for additional narcotics, satisfaction, and sedation scores were recorded and analyzed at various time points post-surgery.</p><p><strong>Results: </strong>There was no statistically significant difference in the demographic and baseline characteristics between the two groups. However, the average NRS score was significantly lower in the RLB group at all time points post-surgery, except immediately after surgery (P < 0.001). Patient satisfaction was higher in the RLB group at 20 minutes, 2 hours, 4 hours, and 6 hours post-surgery (P < 0.05). The RLB group also required fewer narcotics, indicating that the RLB is more effective in managing acute postoperative pain.</p><p><strong>Conclusions: </strong>The RLB is more effective than the ESPB in reducing post-laparoscopic cholecystectomy pain. It also decreases narcotic consumption and associated complications. Therefore, it is recommended as a cost-effective method for managing acute pain after laparoscopic cholecystectomy.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e158242"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of the Lateral Approach (Paramedian) Versus the Modified Lateral Approach (Modified Paramedian) in Spinal Anesthesia: Evaluating Ease of Procedure and Patient Satisfaction in Urological Surgeries; A Triple-Blind Randomized Clinical Trial.","authors":"Mehrdad Mesbah Kiaei, Siavash Sangi, Maryam Aligholizadeh, Mahmoud Reza Mohaghegh Dolatabadi, Ali Moshki, Mohsen Abbasi","doi":"10.5812/aapm-161542","DOIUrl":"10.5812/aapm-161542","url":null,"abstract":"<p><strong>Background: </strong>Spinal anesthesia (SA) is preferred over general anesthesia for lower extremity surgeries, but the optimal method of needle placement is debated. Although the paramedian approach reduces the risks of dural puncture, it presents technical difficulties. The modified paramedian technique may increase safety and patient satisfaction by facilitating subarachnoid access and overcoming anatomical challenges, particularly in obese or elderly patients.</p><p><strong>Objectives: </strong>This study aimed to compare the paramedian and modified paramedian techniques from the perspective of anesthesiologists and their impact on postoperative patient satisfaction.</p><p><strong>Methods: </strong>This triple-blind randomized clinical trial investigated the effects of two SA techniques - paramedian and modified paramedian - on patient satisfaction and procedural ease. A total of 112 patients meeting inclusion and exclusion criteria were enrolled. Data were collected using the Iowa Satisfaction with Anesthesia Care Questionnaire. Demographic information was recorded in coded form, and data analysis was performed using SPSS version 19. Statistical methods included the independent <i>t</i>-test for comparing continuous means between groups, the chi-square test for categorical variables, and logistic regression analysis to assess the impact of individual characteristics (age, gender, weight) on the ease of performing spinal anesthesia.</p><p><strong>Results: </strong>The results indicated that the modified paramedian group demonstrated superior performance in terms of success on the first attempt (P = 0.006), reduced need for repositioning (P = 0.038), and fewer repeated attempts (P = 0.017). Additionally, patient satisfaction scores were significantly higher in the modified paramedian group (P = 0.001). Multivariate regression confirmed age and Body Mass Index (BMI) as independent predictors of procedural difficulty (P < 0.05).</p><p><strong>Conclusions: </strong>The modified paramedian technique significantly enhanced the ease of SA administration and patient satisfaction compared to the traditional approach. These findings indicate its potential to improve the anesthesia process, reduce side effects, and elevate patient experience. This study supports broader adoption of the technique in surgical and healthcare settings, advancing anesthesia care quality.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e161542"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Esmolol Versus Dexmedetomidine on Postoperative Pain Control in Endoscopic Sinus Surgery: A Randomized Trial.","authors":"Amany Faheem Omara, Alaa Mohammed Abo Hagar, Asmaa Fawzy Amer","doi":"10.5812/aapm-158065","DOIUrl":"10.5812/aapm-158065","url":null,"abstract":"<p><strong>Background: </strong>Functional endoscopic sinus surgery (FESS) is the cornerstone of treatment for nasal pathology.</p><p><strong>Objectives: </strong>This randomized study compares the ability of preoperative and intraoperative esmolol and dexmedetomidine to induce postoperative analgesia and sedation.</p><p><strong>Methods: </strong>Seventy ASA I and II patients, of either sex, scheduled for FESS, were divided into two groups: The esmolol group (group E) received an intravenous bolus dose of 0.5 mg/kg prior to the induction of anesthesia, followed by 0.05 mg/kg/min and stopped immediately upon extubation, while the dexmedetomidine group (group D) received 1 µg/kg of dexmedetomidine over 10 minutes, immediately before the induction of anesthesia, followed by a 0.5 µg/kg/hour infusion after induction and stopped immediately upon extubation. Mean arterial pressure and heart rate were monitored before induction, before and after intubation, and then every 5 to 30 minutes, as well as every 10 minutes until 90 minutes following the commencement of the IV medication infusion. The sedation level was assessed using the Ramsay sedation scale at 15, 30, and 60 minutes postoperatively. Pain scores were evaluated in the recovery room (on arrival and then 15 minutes, 30 minutes, and 1 hour later) and at 2 hours, 6 hours, 12 hours, and 24 hours. The length of the procedure, the degree of bleeding during the intervention, and the occurrence of any adverse effects were documented. Categorical data were summarized as counts and percentages and compared by the chi-square test. Continuous data were assessed for normality using the Shapiro-Wilk test. The Student's <i>t</i>-test was used for quantitative variables that are normally distributed, whereas the Mann-Whitney test was used for quantitative variables that are not.</p><p><strong>Results: </strong>According to our findings, both esmolol and dexmedetomidine were safe and beneficial in reducing blood loss during FESS, promoting optimal surgical field quality, and improving surgical field visibility. Dexmedetomidine was far more effective in providing postoperative sedation, reducing the need for opioids, and delaying the initial need for postoperative analgesia.</p><p><strong>Conclusions: </strong>It was discovered that esmolol and dexmedetomidine both provided superior surgical field, less nasal hemorrhage, and more successful results. Dexmedetomidine caused effective sedation and a reduced need for analgesics.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e158065"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Surgical Position and Preoperative Antihypertensive Medication on the Incidence of Intraoperative Hypotension in Patients Undergoing Spine Surgery.","authors":"Yei Heum Park, Jae Hong Park, Daeyun Choi, Min Woo Lee, Daeseok Oh, Sung Ho Moon, Ji Yeon Kwon, Myungjin Ko","doi":"10.5812/aapm-161684","DOIUrl":"10.5812/aapm-161684","url":null,"abstract":"<p><strong>Background: </strong>Antihypertensive medications taken before surgery are associated with increased intraoperative hypotension, and patient positioning can further influence hemodynamics during surgery. However, the combined effects of antihypertensive medication use and patient positioning on intraoperative hypotension during spine surgery have not been clearly established.</p><p><strong>Objectives: </strong>This study aimed to investigate the incidence of hypotension in patients undergoing spine surgery according to surgical position, antihypertensive drug use, and patient characteristics through a retrospective analysis of medical records.</p><p><strong>Methods: </strong>This retrospective study analyzed 4,973 patients who had undergone spine surgery. Demographic data, medical history, antihypertensive medication use before surgery, and anesthetic information, including blood pressure during surgery, were collected from electronic medical records (EMRs). The incidence of hypotension according to surgical positioning (supine vs. prone) and antihypertensive medication use was investigated.</p><p><strong>Results: </strong>The incidence of intraoperative hypotension was higher in patients positioned prone (supine: 19.06% vs. prone: 24.91%) and among those taking more antihypertensive medications (no medication: 19.49%; one medication: 25.18%; two or more medications: 32.97%). Logistic regression indicated that patients with a history of hypertension undergoing surgery in the prone position had a significantly greater risk of hypotension [odds ratio (OR) = 1.407] and severe hypotension (OR = 1.940) compared with those with no history of hypertension undergoing surgery in the supine position. Older age, longer anesthesia duration, cervical surgical site, and the use of multiple antihypertensive agents were associated with an increased risk of intraoperative hypotension. In particular, taking two or more antihypertensive drugs (OR = 1.601) and undergoing surgery in the prone position (OR = 1.505) were independent predictors of hypotension and severe hypotension during spine surgery.</p><p><strong>Conclusions: </strong>Preoperative use of two or more antihypertensive medications increases the risk of intraoperative hypotension, and spine surgery in the prone position increases the risk of severe hypotension.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e161684"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Erector Spinae Plane Block in a Patient with Failed Neck Surgery Syndrome: A Case Report and Literature Review.","authors":"Poupak Rahimzadeh, Sara Saadat, Sajede Salehi","doi":"10.5812/aapm-161511","DOIUrl":"10.5812/aapm-161511","url":null,"abstract":"<p><strong>Introduction: </strong>Failed neck surgery syndrome (FNSS) following posterior cervical spine fusion (PSF) presents a considerable challenge in pain management.</p><p><strong>Objective: </strong>This study aims to report the potential utility of the cervical erector spinae plane block (ESPB) as an influential adjunctive therapy in a patient with FNSS who was refractory to medical therapy and unable to undergo spinal cord stimulation (SCS) due to financial constraints.</p><p><strong>Methods: </strong>This case report details a 74-year-old male with persistent, debilitating axial neck pain lasting one year following PSF, without neural or motor deficits, and with device failure ruled out. Given the risks of cervical epidural steroid injection in this patient, a fluoroscopically guided bilateral cervical ESPB at the C7 level was administered for temporary pain relief.</p><p><strong>Result: </strong>This technique was associated with substantial pain relief and improved functional outcomes, as demonstrated by reductions in the Numerical Rating Scale (NRS) and Neck Disability Index (NDI) scores.</p><p><strong>Conclusion: </strong>This case underscores the potential utility of the cervical ESPB as an effective adjunctive therapy for managing pain in FNSS, providing a minimally invasive alternative to conventional treatment approaches.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e161511"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Pulsed and Conventional Radiofrequency Ablation for Resistant Morton's Neuroma: A Case Report and Literature Review.","authors":"Karim Hemati, Sajede Salehi, Parnian Hemati","doi":"10.5812/aapm-161482","DOIUrl":"10.5812/aapm-161482","url":null,"abstract":"<p><strong>Introduction: </strong>Morton's neuroma is a painful, degenerative neuropathy that is initially managed with conservative treatments. In refractory cases, surgical excision is typically indicated. Minimally invasive percutaneous procedures provide a viable alternative to surgery.</p><p><strong>Objective: </strong>While both pulsed radiofrequency (PRF) and conventional radiofrequency (CRF) have been individually reported as effective treatments for Morton's neuroma, we aim to utilize a combination of PRF and CRF for pain management.</p><p><strong>Case presentation: </strong>We report the case of a 61-year-old male with a five-year history of right foot Morton's neuroma, presenting with severe pain that was refractory to conservative management, including multiple corticosteroid injections. Radiofrequency was performed as follows: 5 minutes at 42°C, 1 minute at 60°C, and 1 minute at 70°C.</p><p><strong>Result: </strong>The patient experienced significant pain relief, with follow-up Numerical Rating Scale (NRS) of 1 at two weeks, 1 at one month, and 2 at seven months post-treatment.</p><p><strong>Conclusions: </strong>This case suggests that the combined application of PRF and CRF may serve as a promising alternative for managing refractory Morton's neuroma.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e161482"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Intravenous Dexmedetomidine During Surgery in the Prevention of Shivering After General Anesthesia in Patients Undergoing Spinal Surgery: A Randomized Clinical Trial.","authors":"Mehdi Shokri, Zhale Bakhtiari, Bita Kargar, Amirhossein Hajialigol","doi":"10.5812/aapm-159077","DOIUrl":"10.5812/aapm-159077","url":null,"abstract":"<p><strong>Background: </strong>Postoperative shivering is an involuntary, spontaneous, and repetitive contraction of skeletal muscles that causes patient restlessness, increased oxygen consumption, wound infection, surgical bleeding, and cardiac events. Patients undergoing spine surgery in the prone position are particularly susceptible to hypothermia.</p><p><strong>Objectives: </strong>Given the importance of controlling postoperative shivering in these patients, the present study aimed to investigate the effect of intraoperative dexmedetomidine (Dex) infusion in preventing shivering after general anesthesia in patients undergoing spine surgery in the prone position.</p><p><strong>Methods: </strong>In this double-blind randomized clinical trial, 60 American Society of Anesthesiologists (ASA) class I or II patients undergoing vertebral surgery in the prone position were enrolled. Patients in the study group (n = 30) received Dex infusion during surgery, while those in the placebo group (n = 30) received an equivalent volume of 0.9% normal saline. Hemodynamic variables, frequency and severity of shivering, and drug side effects were recorded.</p><p><strong>Results: </strong>The mean arterial pressure (MAP) at 90 minutes (P = 0.022), immediately before extubation (P = 0.001), and after extubation (P = 0.001), as well as HR values at 60 minutes (P = 0.020), 90 minutes (P = 0.001), immediately before extubation (P = 0.001), and after extubation (P = 0.001), were significantly lower in the study group compared to the placebo group. The frequency of bradycardia (26.7% vs. 0%, P = 0.002) and hypotension (20% vs. 0%, P = 0.012) was significantly higher in the study group. At all evaluated times, the mean body temperature in the study group was significantly higher than in the placebo group (P < 0.05). The frequency (10% vs. 30%, P = 0.003) and intensity (P = 0.001) of shivering in the study group were significantly lower than in the placebo group.</p><p><strong>Conclusions: </strong>This study demonstrated that the preventive use of Dex infusion during surgery reduces the frequency and severity of postoperative shivering in patients undergoing spinal surgery in the prone position. However, this method was associated with hypotension and bradycardia in some patients.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 2","pages":"e159077"},"PeriodicalIF":0.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isometric or Isotonic Exercises in Alleviating Chronic Neck and Shoulder Pain and Enhancing Quality of Life Among Computer Users with Upper Crossed Syndrome: A Randomized Controlled Trial.","authors":"Arash Khaledi, Hooman Minoonejad","doi":"10.5812/aapm-160771","DOIUrl":"10.5812/aapm-160771","url":null,"abstract":"<p><strong>Background: </strong>Millions of computer users experience chronic neck and shoulder pain (CNSP) and reduced health-related quality of life (HRQoL) due to upper cross syndrome (UCS). While strengthening exercises for the posterior trunk alleviate symptoms, it remains unclear whether isometric or isotonic exercises are more effective.</p><p><strong>Objectives: </strong>This study aimed to compare the effects of isometric and isotonic exercises on CNSP and HRQoL in individuals with UCS, and to evaluate these outcomes against a non-intervention group.</p><p><strong>Methods: </strong>In this randomized clinical trial (RCT), 43 UCS patients with CNSP were divided into three groups: Isometric exercises (n = 15), isotonic exercises (n = 14), and a control group (n = 14). Over 8 weeks, exercise groups completed 3 sessions per week (40 - 60 minutes each). Pain was assessed using the Visual Analog Scale (VAS) and HRQoL was assessed using the 36-item short form health survey (SF-36) questionnaire, both pre- and post-intervention.</p><p><strong>Results: </strong>Both isometric and isotonic exercises significantly reduced CNSP and improved HRQoL compared to the control group. Isometric exercises yielded a 70.4% pain reduction (P < 0.001) and a 14.9% HRQoL improvement (P = 0.002), while isotonic training showed a 47.6% pain reduction (P = 0.001) and a 17.7% HRQoL improvement (P < 0.001). Between-group differences were not statistically significant (pain: P = 0.853; HRQoL: P = 0.999). Although isometric exercises slightly favored pain reduction and isotonic exercises showed marginal HRQoL gains, these differences should not be overstated.</p><p><strong>Conclusions: </strong>Both isometric and isotonic exercises improved CNSP and HRQoL in UCS patients, with no significant difference between them. Slight trends favoring each should be interpreted cautiously. Longer-term studies are warranted.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e160771"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy of Cervical Erector Spinae Plane Block Using Ultrasound Versus Fluoroscopic Guidance for Cervical Pain: A Case Series.","authors":"Poupak Rahimzadeh, Sajede Salehi, Sara Saadat, Mahshid Vaziri, Payam Houshyar Azar, Monireh Faghir Ganji","doi":"10.5812/aapm-160776","DOIUrl":"10.5812/aapm-160776","url":null,"abstract":"<p><strong>Background: </strong>The erector spinae plane block (ESPB) has traditionally been performed under ultrasound guidance, while fluoroscopic guidance has emerged as an alternative approach.</p><p><strong>Objectives: </strong>This study aims to compare the efficacy of ESPB using ultrasound and fluoroscopic guidance in patients with cervical pain.</p><p><strong>Methods: </strong>This case series study includes fourteen patients with axial neck pain scheduled for cervical ESPB. According to the approach of ESPB (ultrasound or fluoroscopic guidance), patients were divided into two groups: Eight underwent ultrasound-guided ESPB, and six received fluoroscopy-guided ESPB. Pain and disability were assessed using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) at baseline (pre-procedure), two weeks post-procedure, and three months post-procedure.</p><p><strong>Results: </strong>Both groups demonstrated significant improvements in NRS and NDI scores over time (P = 0.005). However, no statistically significant differences were observed in pain scores or disability indices at any of the evaluation points.</p><p><strong>Conclusions: </strong>This study suggests that fluoroscopy-guided ESPB is as effective as ultrasound-guided ESPB for managing cervical radicular pain, providing a viable alternative for clinicians.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 3","pages":"e160776"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}