Pain medicine : the official journal of the American Academy of Pain Medicine
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We report on a classification approach using machine learning (ML) algorithms for prediction of postoperative femoral nerve block (FNB) requirement following anterior cruciate ligament (ACL) reconstruction. ⋯ ML classifiers may offer improved predictive capabilities when analyzing medical data sets compared with traditional statistical methodologies in predicting severe postoperative pain requiring peripheral nerve block.
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Randomized Controlled Trial
Effects of corticosteroids injection in rotator cuff tears.
The aim of this study was to evaluate the effect of intraarticular injections of corticosteroids (triamcinolone) in patients with symptomatic rotator cuff tears (RCT). ⋯ Our study indicates that intraarticular injection of triamcinolone improves pain relief for 3 months in RCT and its action is not prolonged or potentiated by two injections of the drug done at 21-day intervals.
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We assessed primary care clinician-provided guideline-concordant care as documented in patients' medical records, predictors of documented guideline-concordant care, and its association with pain-related functioning. Patients were participants in a randomized trial of collaborative care for chronic musculoskeletal pain. The intervention featured patient and primary care clinician education, symptom monitoring and feedback to clinicians by the intervention team. ⋯ As measured by medical record review, additional training and clinician feedback did not increase provision of documented guideline-concordant pain care, and adherence to guidelines by primary care clinicians did not improve clinical outcomes for patients with chronic musculoskeletal pain.
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The purpose of this study was to examine the effect of intrathecal (IT) coadministration of bupivacaine with opioids during the initial phase of opioid titration and up to 1 year after implantation of an IT drug delivery system (IDDS). ⋯ Concomitant initial coadministration of IT bupivacaine with opioids blunts the rate of IT opioid dose escalation during the first year after implant of an IDDS. More studies are necessary to thoroughly examine IT opioid dose escalation and the effects of addition of bupivacaine to IT opioids. Blunting IT opioid dose escalation may be a beneficial long-term effect of IT bupivacaine.
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The physiological sensation of pain and rapid response to stimuli serve as an adaptive way to avoid harmful situations. Our purpose was to investigate why this protection disappears or almost disappears for patients with congenital indifference to pain (CIP). ⋯ We speculate that the mutations may be the cause of partial deletion of pain perceptionin in our probands, and the novel polymorphism V1104L may have a predictive role in the pain sensation of healthy individuals.