The Clinical journal of pain
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Review Meta Analysis
Acceptance and Commitment Therapy (ACT) for Chronic Pain: A systematic Review and Meta-analyses.
Chronic pain places a burden on individuals and the economy. Although there is evidence for the effectiveness of cognitive-behavior therapy, it is recognized that the effects are limited. Acceptance and Commitment Therapy (ACT), which aims to increase valued action in the presence of pain, has been suggested as an alternative approach. The objective of this review was to determine the clinical effectiveness of ACT for chronic pain in adults when compared with control conditions and other active treatments. ⋯ ACT was more clinically effective than controls on a number of outcomes. It is possible that methodological limitations, some of which are common to psychological trials, may have led to overestimated effects. Only a few studies compared ACT to active treatments and while the evidence is promising for ACT in the treatment of chronic pain, further methodologically robust trials are required.
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Review Meta Analysis
Evaluation of Transversus Abdominis Plane (TAP) Block in Hernia Surgery: A Meta-analysis.
Transversus abdominis plane (TAP) block reduces opiate requirements and pain scores in abdominal surgery, but the effect has not been evaluated in hernia surgery. The aim of this study was to evaluate the efficacy of TAP block in hernia surgery. ⋯ Within a heterogeneous group of RCTs, TAP block reduces postoperative morphine requirements and the severity of pain after hernia surgery.
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Review Meta Analysis Comparative Study
Adductor Canal Block versus Femoral Nerve Block for Analgesia after Total Knee Arthroplasty: A Systematic Review and Meta-analysis.
The efficacy and safety of adductor canal block (ACB) as compared with femoral nerve block (FNB) for postoperative pain management in total knee arthroplasty (TKA) remains controversial. We therefore performed a meta-analysis of randomized-controlled trials (RCTs) to compare ACB with FNB in TKA. ⋯ ACB may achieve faster mobilization ability recovery for patients after TKA without a reduction in analgesia when compared with FNB in the early postoperative period. However, due to the variations in the included studies, additional studies are needed to validate these conclusions.
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Review Meta Analysis
Meta-Analysis: Postoperative Pain Management in Colorectal Surgical Patients and the Effects on Length of Stay in an ERAS Setting.
Enhanced Recovery After Surgery (ERAS) aims to minimize the length of a negative physiological response to surgical intervention. There are a number of aspects involved in ERAS protocols, one of which is postoperative pain relief. This meta-analysis investigates the current evidence for postoperative pain relief and its effect on patient pain and the length of stay after colorectal surgery. ⋯ In an ERAS setting with regard to a colorectal patient population, the choice of modality for postoperative pain relief does not impact the length of hospital stay, pain, the time to the first bowel motion, or nausea.
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To investigate the efficacy and safety of magnesium sulfate as an adjuvant of local anesthetics in perineural nerve blocks. ⋯ The present study suggests that combined magnesium sulfate and local anesthetics in perineural nerve blocks provided better analgesic efficacy. For it prolongs the postoperative duration time of analgesia, sensory and motor block without increasing the short-term side effects. Magnesium sulfate may be a promising analgesic for perineural nerve blocks, but further studies are required to validate our results.