Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Ropivacaine 0.1% versus 0.2% for continuous lumbar plexus nerve block infusions following total hip arthroplasty: a randomized, double blinded study.
Continuous lumbar plexus blocks provide excellent analgesia for total hip arthroplasty (THA), but their utility has been questioned as they may increase motor weakness. The aim of this study was to compare the efficacy of two different concentrations of ropivacaine on both postoperative analgesia and motor function. ⋯ Following primary THA, lumbar plexus perineural infusion of 0.1% ropivacaine provided similar benefits for postoperative analgesia and functional recovery as 0.2% ropivacaine.
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To determine the effectiveness and risks of fluoroscopically guided cervical transforaminal injection of corticosteroids in the treatment of radicular pain. ⋯ In patients with cervical radicular pain, fluoroscopically guided CTFIS may be effective in easing pain and reducing need for surgery. However, the evidence of effectiveness is of very low quality, and the benefits of the procedure are compromised by the risks of serious complications.
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Randomized Controlled Trial
Efficacy of transversus abdominis plane block for acute postoperative pain relief in kidney recipients: a double-blinded clinical trial.
After renal transplantation, postoperative pain is usually mild to moderate. Postoperative pain is a concern and administration of systemic analgesic may be difficult because of underlying co-morbidities and variable responses of the graft. The transversus abdominis plane (TAP) block is one of the different approaches for postoperative pain relief following abdominal surgeries. We evaluated analgesic efficacy of TAP block on early postoperative pain by numeric rating scale (NRS) and morphine consumption during the first 24 hours after kidney transplantation. ⋯ Ultrasound TAP block can reduce postrenal transplantation pain and the amount of opioids consumption intraoperatively and during the first 24 hours after surgery in kidney recipients.
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There has been a widespread call for an ethics in the management of patients with chronic pain which is patient centered and takes into account the lived experience of the patient. It has been argued in literature that current "duty" or principlist-based models of ethics (so-called 3rd person ethics) have not adequately addressed the needs of either patients or practitioners in this area. ⋯ We outline a patient-centered ethics to underpin contemporary collaborative, multimodal approaches in the management of chronic pain. We firstly describe an agency-oriented, neo-Aristotelian 1st person ethics and then outline a hermeneutic relationship with extant "duty-based," 3rd person bioethics. The utility of the ethics model we propose (the ethical reasoning bridge) lies in its capacity for developing a sense of moral agency for both practitioner and patient, resonating with the current emphasis of seeking active engagement of patients in management.
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Observational Study
Overgeneral autobiographical memory in patients with chronic pain.
Overgenerality and delay of the retrieval of autobiographical memory (AM) are well documented in a range of clinical conditions, particularly in patients with emotional disorder. The present study extended the investigation to chronic pain, attempting to identify whether the retrieval of AM in patients with chronic pain tends to be overgeneral or delayed. ⋯ The retrieval of AM in patients with chronic pain tends to be overgeneral and delayed, and the retrieval style of AM may be contributed to negative emotions and chronic pain conditions.