Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Apr 2024
Review Meta AnalysisDoes industry funding and study location impact findings from randomized controlled trials of spinal cord stimulation? A systematic review and meta-analysis.
Concerns have been raised that effects observed in studies of spinal cord stimulation (SCS) funded by industry have not been replicated in non-industry-funded studies and that findings may differ based on geographical location where the study was conducted. ⋯ All outcomes of SCS versus usual care were not significantly different between studies funded by industry and those independent from industry. Pain intensity score and change in pain intensity from baseline for comparisons of HF-SCS to LF-SCS seem to be impacted by industry funding.
-
Reg Anesth Pain Med · Apr 2024
Review Meta AnalysisDoes industry funding and study location impact findings from randomized controlled trials of spinal cord stimulation? A systematic review and meta-analysis.
Concerns have been raised that effects observed in studies of spinal cord stimulation (SCS) funded by industry have not been replicated in non-industry-funded studies and that findings may differ based on geographical location where the study was conducted. ⋯ All outcomes of SCS versus usual care were not significantly different between studies funded by industry and those independent from industry. Pain intensity score and change in pain intensity from baseline for comparisons of HF-SCS to LF-SCS seem to be impacted by industry funding.
-
Reg Anesth Pain Med · Mar 2024
ReviewDorsal root ganglion: a key to understanding the therapeutic effects of the erector spinae plane (ESP) and other intertransverse process blocks?
Since its description in 2016, the erector spinae plane block (ESPB) has become a widely employed regional anesthetic technique and kindled interest in a range of related techniques, collectively termed intertransverse process blocks. There has been ongoing controversy over mechanism of action of the ESPB, mainly due to incongruities between results of cutaneous sensory testing, clinical efficacy studies, and investigations into the neural structures that are reached by injected local anesthetic (LA). ⋯ We hypothesize that the DRG, due to its unique and complex microarchitecture, represents a key therapeutic target for modulation of nociceptive signaling in regional anesthesia. This paper discusses how the anatomical and physiological characteristics of the DRG may be one of the factors underpinning the clinical analgesia observed in ESPB and other intertransverse process blocks.
-
Reg Anesth Pain Med · Mar 2024
ReviewLocal anesthetic dosing and toxicity of adult truncal catheters: a narrative review of published practice.
Anesthesiologists frequently use truncal catheters for postoperative pain control but with limited characterization of dosing and toxicity. ⋯ Practitioners frequently administer ropivacaine and bupivacaine above the package insert limits, at doses associated with toxicity. Patient safety would benefit from more specific recommendations to limit excessive dose and risk of toxicity.
-
Reg Anesth Pain Med · Feb 2024
ReviewMethodological and statistical characteristics of meta-analyses on spinal cord stimulation for chronic pain: a systematic review.
A growing number of meta-analyses (MA) have investigated the use of spinal cord stimulation (SCS) as a treatment modality for chronic pain. The quality of these MAs has not been assessed by validated appraisal tools. ⋯ CRD42023431155.