Pain medicine : the official journal of the American Academy of Pain Medicine
-
Pain after laparoscopic cholecystectomy is reportedly complex and multifaceted, and has been cited as the most frequent reason for prolonged convalescence. The use of opioid therapy, a common pain management strategy, can be limited by potentially severe adverse events. In this report, I describe the use of liposome bupivacaine, administered via transversus abdominis plane (TAP) infiltration, in a patient undergoing emergency laparoscopic cholecystectomy. ⋯ Liposome bupivacaine administered via TAP infiltration shows potential as part of a multimodal analgesic regimen in laparoscopic cholecystectomy.
-
To quantify the prevalence of potential drug-drug/drug-condition interactions (DDI/DCI) among fibromyalgia patients initiating pregabalin or duloxetine, and to determine the impact of potential DDI/DCI on health care expenditures. ⋯ Among fibromyalgia patients initiating pregabalin or duloxetine, potential duloxetine DDI could be highly prevalent. Among duloxetine initiators, potential duloxetine DDI/DCI were significantly associated with increased health care expenditures.
-
This study seeks to measure the radiation dose incurred in the evaluation of vascular filling during transforaminal epidural steroid injections (TFESI) using conventional fluoroscopy (CF), digital subtraction angiography (DSA), and multislice, pulsed computed tomography fluoroscopy (CT/F). ⋯ The use of DSA imaging to exclude vascular uptake during TFESI increases radiation dose over CF. CT/F incurs additional dose beyond most DSA. Minimizing radiation dose by limiting DSA and CT/F use to spine segments or clinical situations involving higher risk may be desirable. However, the incremental radiation doses incurred by DSA or CT/F are of such low magnitude that health risks cannot currently be estimated.
-
Prior work has not addressed sex differences in the incidence of severe postoperative pain episodes. The goal of this study was to examine sex differences in clinical postoperative pain scores across an array of surgical procedures using direct comparisons of numeric rating scale pain scores as well as using the incidence of severe pain events (SPEs). ⋯ Female patients experience greater mean pain scores, as well as a higher incidence of SPE, on POD 1 for a variety of surgical procedures.