Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Oct 2024
Hidden influence? Unmasking conflicts of interest from randomized clinical trials on spinal cord stimulation for chronic pain.
Randomized clinical trials (RCTs) are considered the gold standard for evaluating the efficacy of healthcare interventions. However, conflicts of interest (COIs) can compromise the scientific integrity in these trials. This study characterized COIs in RCTs on spinal cord stimulation for chronic pain, focusing on the prevalence, disclosure, and monetary value of COIs. ⋯ A substantial majority of RCTs reported COIs with many authors having undisclosed conflicts, highlighting the need for stringent COI disclosure guidelines to maintain research integrity. Expanding COI registry systems globally and increasing non-industry funding are crucial steps toward enhancing transparency and reducing biases in medical research.
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Reg Anesth Pain Med · Sep 2024
Comparing modalities of opioid education in patients undergoing total knee arthroplasty: a randomized pilot trial.
Patients undergoing total knee arthroplasty (TKA) experience significant postoperative pain and routinely require opioids, yet they often lack knowledge regarding appropriate use and handling of these medications. Evidence suggests that educational interventions in various formats may help reinforce proper usage and improve postoperative pain control. The aim of this study is to compare the institution standard of care (webinar) with two novel educational interventions-one in-person and the other a video recording-that focus specifically on the use of opioids and pain control. ⋯ Overall, patients in each group did well with postoperative pain management after TKA and had minimal opioid refill requests. There were no statistically significant differences in outcomes of NRS pain scores or opioid usage among groups suggesting that educational interventions were similarly effective. As a pilot trial, study demonstrated successful recruitment and retention of participants, and important feedback was elicited from patients regarding education, as well. Of note, this was a pilot study and was likely underpowered to detect a difference.
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Reg Anesth Pain Med · Sep 2024
Evolving Regional Anesthesiology and Acute Pain Medicine fellowship application process: a program director survey.
Most Regional Anesthesiology and Acute Pain Medicine (RAAPM) fellowship programs transitioned to virtual interviews in 2020 because of the COVID-19 pandemic. Then, the RAAPM fellowship match started in 2023 in order to make the application process more equitable. In this study, we surveyed RAAPM fellowship program directors (PDs) to determine how such major events of the early 2020s shaped the fellowship application process. ⋯ Most RAAPM programs continued to conduct virtual interviews exclusively. Majority of program directors preferred the fellowship match. PDs ranked the interview as the most important selection factor. Most PDs thought virtual interviews were not inferior to in-person interviews, but they remained divided on which format they prefer.