Journal of pain research
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Journal of pain research · Jan 2018
EditorialCryoneurolysis for the treatment of cervical facet joint syndrome: a technical note.
Neck pain has an annual prevalence of 30%. A frequent cause of neck pain is cervical facet joint pain. In cases of refractory cervical facet joint pain, radiofrequency can be employed, but the grade of evidence attested in systematic reviews is fair. Cryoneurolysis has been reported to induce favorable outcomes in lumbar facet joint pain. We sought to examine the feasibility of cervical facet joint cryoneurolysis. ⋯ This is the first report of cryoneurolysis for the treatment of cervical facet joint pain. The technique is feasible and warrants further studies.
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Journal of pain research · Jan 2018
ReviewRediscovery of old drugs: the forgotten case of dermorphin for postoperative pain and palliation.
The repurposing of old drugs for new indications is becoming more accepted as a cost-efficient solution for complicated health problems. However, older drugs are often forgotten when they are not repositioned. This analysis makes a case for re-exploration of dermorphin for intrathecal use in postoperative pain and in a palliative context, with the goal of re-establishing this compound. ⋯ The interest in dermorphin decreased after 1985, and the compound was never again introduced in the clinical setting. Considering the enormous pressure to find superior acting opioids, this is quite puzzling. We suggest new clinical studies to further evaluate the safety and efficacy of dermorphin, especially administered via the intrathecal route in postoperative pain or for palliative use in terminal patients.
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Journal of pain research · Jan 2018
ReviewParavertebral blocks and enhanced recovery after surgery protocols in breast reconstructive surgery: patient selection and perspectives.
The management of postoperative pain is of critical importance for women undergoing breast reconstruction after surgical treatment for breast cancer. Mitigating postoperative pain can improve health-related quality of life, reduce health care resource utilization and costs, and minimize perioperative opiate use. Multimodal analgesia pain management strategies with nonopioid analgesics have improved the value of surgical care in patients undergoing various operations but have only recently been reported in reconstructive breast surgery. ⋯ For each perioperative intervention included in the ERAS protocols, the literature was exhaustively reviewed and evidence-based recommendations were generated using the Grading of Recommendations, Assessment, Development, and Evaluation system methodology. This study provides a comprehensive evidence-based review of interventions to optimize perioperative care and postoperative pain control in breast reconstruction. Incorporating evidence-based interventions into future ERAS protocols is essential to ensure high value care in breast reconstruction.
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Journal of pain research · Jan 2018
Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery.
Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC). ⋯ OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee replacement surgery. These results support OIC screening and management strategies as part of perioperative care management.
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Journal of pain research · Jan 2018
Oral methylnaltrexone does not negatively impact analgesia in patients with opioid-induced constipation and chronic noncancer pain.
An oral formulation of methylnaltrexone has been developed for treating opioid-induced constipation (OIC). This manuscript examines the impact of oral methylnaltrexone, a peripherally acting µ-opioid receptor antagonist, on opioid analgesia. ⋯ Oral methylnaltrexone does not elicit opioid withdrawal or interfere with opioid analgesia.