Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jun 2024
Artificial intelligence and regional anesthesiology education curriculum development: navigating the digital noise.
Artificial intelligence (AI) has demonstrated a disruptive ability to enhance and transform clinical medicine. While the dexterous nature of anesthesiology work offers some protections from AI clinical assimilation, this technology will ultimately impact the practice and augment the ability to provide an enhanced level of safe and data-driven care. Whether predicting difficulties with airway management, providing perioperative or critical care risk assessments, clinical-decision enhancement, or image interpretation, the indications for AI technologies will continue to grow and are limited only by our collective imagination on how best to deploy this technology. ⋯ Curriculum development in this context frequently requires substantial efforts to identify baseline knowledge, learning needs, content requirement, and education strategies. Large language models offer the promise of targeted and nimble curriculum and content development that can be individualized to a variety of learners at various stages of training. This technology has not yet been widely evaluated in the context of education deployment, but it is imperative that consideration be given to the role of AI in curriculum development and how best to deploy and monitor this technology to ensure optimal implementation.
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Reg Anesth Pain Med · Jun 2024
Lessons learned from the experiences of patients with chronic pelvic pain syndrome (CPP syndrome) with a multidisciplinary consultation: a qualitative study.
Chronic pelvic pain syndrome is a complex multifactorial condition with an increasing prevalence probably due to a rising awareness. Chronic pelvic pain syndrome is pain in the pelvic area and often accompanied with complaints in other organ systems of the lesser pelvis. Patients with chronic pelvic pain syndrome who present at our center are evaluated in a standardized care pathway with an integrated multidisciplinary consultation. The team works in a single center and consists of gynecologists, pain specialists, urologists, a pelvic floor physiotherapist and a psychologist. The aim of this interview study is to evaluate the value of the multidisciplinary consultation from the patient's perspectives. ⋯ A multidisciplinary consultation is of value from the patients' perspective. A suggestion for improvement emerged where the multidisciplinary consultation should occur at the beginning of the patient journey.
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Reg Anesth Pain Med · Jun 2024
Comparison of analgesic effect of pericapsular nerve group block and supra-inguinal fascia iliaca compartment block on dynamic pain in patients with hip fractures: a randomized controlled trial.
Patients with hip fracture often experience severe pain, particularly during movement or slight positional change, prior to the occurrence of surgery. It is essential to explore the appropriate analgesic methods before surgery in patients with hip fracture, especially those capable of alleviating dynamic pain. Pericapsular nerve group (PENG) block was introduced as a useful technique for hip analgesia. In this study, we aimed to compare the reduction in dynamic pain between the PENG block and supra-inguinal fascia iliaca compartment block (SIFICB). ⋯ PENG block and SIFICB could effectively provide analgesia for dynamic pain in patients with hip fractures, with no significant difference between the two groups.
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Reg Anesth Pain Med · Jun 2024
Low-dose ketamine infusion to facilitate opioid tapering in chronic non-cancer pain with opioid-use disorder: a historical cohort study.
Long-term opioid use is associated with pharmacological tolerance, a risk of misuse and hyperalgesia in patients with chronic pain (CP). Tapering is challenging in this context, particularly with comorbid opioid-use disorder (OUD). The antihyperalgesic effect of ketamine, through N-methyl-D-aspartate (NMDA) antagonism, could be useful. We aimed to describe the changes in the dose of opioids consumed over 1 year after a 5-day hospitalisation with ketamine infusion for CP patients with OUD. ⋯ A 5-day hospitalisation with a low-dose ketamine infusion appeared useful to facilitate opioid tapering in long-term opioid users with CP and OUD. Ketamine was well tolerated, and patients did not present significant withdrawal symptoms. Prospective and comparative studies are needed to confirm our findings.