Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2015
Pressure Pain Sensitivity in Patients With Suspected Opioid-Induced Hyperalgesia.
This study was designed to test whether a brief quantitative sensory testing assessment could be used to detect hyperalgesia in patients with suspected opioid-induced hyperalgesia (OIH). ⋯ Whereas there were no differences between patients suspected of having OIH and the healthy controls, the finding that higher doses of opioids were associated with more sensitivity suggests that dose might be an important factor in the development of hyperalgesia. In addition, male patients demonstrated a hyperalgesic response after a bolus of fentanyl. Future studies are needed to develop better diagnostics for detecting hyperalgesia in the clinical setting.
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Reg Anesth Pain Med · Nov 2015
ReviewA Review of Local Anesthetic Systemic Toxicity Cases Since Publication of the American Society of Regional Anesthesia Recommendations: To Whom It May Concern.
Local anesthetic systemic toxicity (LAST) occurrence may cross several medical specialties. In 2010, the American Society of Regional Anesthesia and Pain Medicine (ASRA) published the first algorithm on LAST management, introducing the use of lipid emulsion (ILE) treatment. ⋯ We also focused on the treatment measures that were applied in the different cases, especially on the use of ILE and adherence to ASRA recommendations. Despite the limits of a review of case reports, the present study calls attention to the insidious nature of LAST, especially its atypical manifestations, and shows that ILE may currently be underadministered in daily clinical practice, especially in nonanesthesiology practice.
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Reg Anesth Pain Med · Nov 2015
Case ReportsUnilateral Transversus Abdominis Plane Block Catheter for the Treatment of Abdominal Wall Pain in Pregnancy: A Case Report.
The transversus abdominis plane (TAP) block anesthetizes the anterior branches of spinal nerves that innervate the abdominal wall from T6 to L1 dermatomes and provide effective postoperative analgesia after abdominal surgery. Several applications of TAP catheters are described for both acute and chronic abdominal wall pain, but there are no reported cases of TAP catheters used during pregnancy. ⋯ A TAP catheter inserted under ultrasound guidance can be effective for the treatment of chronic abdominal pain during pregnancy and may provide an alternative analgesic modality when intravenous opioids are not providing relief or when neuraxial analgesia techniques are not feasible or contraindicated.
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Reg Anesth Pain Med · Nov 2015
Review Meta AnalysisPreventive Acetaminophen Reduces Postoperative Opioid Consumption, Vomiting, and Pain Scores After Surgery: Systematic Review and Meta-Analysis.
Preventive analgesia has been proposed as a potential strategy to reduce postoperative pain. However, there is currently no review that focuses on acetaminophen for preventive analgesia. ⋯ To our knowledge, this is the first review to describe a potential preventive effect of acetaminophen. However, well-conducted randomized controlled trials are necessary to substantiate the conclusions of this review.