Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Improving needle visualization by novice residents during an in-plane ultrasound nerve block simulation using an in-plane multiangle needle guide.
Ultrasound-guided regional anesthesia with in-plane needle approaches can be challenging due to difficult needle visualization. We hypothesized that an in-plane, multiangle needle guide can help reduce the time it takes novice regional anesthesiologists to perform a simulated ultrasound-guided nerve-targeting procedure and enhance the visualization of the needle. ⋯ A needle guide can help reduce the time needed to complete a simulated nerve targeting procedure and enhance needle visualization for the novice sonographer in a phantom gel simulation. There was no significant reduction in the number of needle passes or in improvement of target approximation noted.
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The primary objective of this study was to measure prescribing compliance with the Veterans Affairs/Department of Defense treatment guidelines for chronic non-cancer pain (CNCP) in the primary care setting. We also determined the proportion of subjects who demonstrated aberrant drug-related behaviors (ADRBs) and the patient characteristics associated with them. ⋯ This article studied the prescribing practices of opioids in a primary care setting and can be used to enhance provider education regarding chronic pain guidelines.
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Chronic cancer pain is often refractory and difficult to treat. Ketamine is a medication with evidence of efficacy in the treatment of chronic pain. ⋯ Despite limitations in the breadth and depth of data available, there is evidence that ketamine may be a viable option for treatment-refractory cancer pain.
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Randomized Controlled Trial
Auricular acupressure for analgesia in perioperative period of total knee arthroplasty.
We examined whether auricular acupressure (AA) can alleviate postoperative pain and decrease narcotic consumption and its adverse effects for osteoarthritis patients after total knee arthroplasty (TKA). ⋯ Applying auricular acupoint acupressure in the perioperative period of TKA is favorable for alleviating postoperative pain, decreasing opioid consumption and its adverse effects, and promoting early rehabilitation. Also, this intervention has the advantage of lower costs, fewer complications, simple application, and high safety.
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Research has shown significant rates of comorbidity among posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and pain in prior era veterans but less is known about these disorders in Iraq and Afghanistan war era veterans. This study seeks to extend previous work by evaluating the association among PTSD, MDD, and pain (back, muscle, and headache pain) in this cohort. ⋯ Findings highlight the complex comorbid relationship between PTSD, MDD, and pain among Iraq and Afghanistan veterans. This observed association suggests that integrated, multidisciplinary treatments may be beneficial, particularly when multiple psychological and physical health comorbidities are present with pain. Further support may be indicated for ongoing education of mental health and primary care providers about these co-occurring disorders.