Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Efficacy and Safety of Intraperitoneal Dexmedetomidine with Bupivacaine in Laparoscopic Colorectal Cancer Surgery, a Randomized Trial.
Our objective is to investigate the efficacy and safety of intraperitoneal dexmedetomidine (Dex) combined with bupivacaine in patients undergoing laparoscopic colorectal cancer surgery. ⋯ We conclude that intraperitoneal administration of Dex 1 μg/kg combined with bupivacaine improves the quality and the duration of postoperative analgesia and provides an analgesic sparing effect compared to bupivacaine alone without significant adverse effects in patients undergoing laparoscopic colorectal cancer surgery.
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Methods of blinding have been infrequently investigated. This study assessed data collector blinding within an investigation of endogenous pain modulation. ⋯ Collection of participants' pain responses led to frequent episodes of unblinding. However, it may be misleading to only consider the frequency of correct suspicions as successful or unsuccessful blinding.
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Randomized Controlled Trial
Pain Perception in Healthy Young Men Is Modified by Time-Of-Day and Is Modality Dependent.
Several physiological processes exhibit 24-hour oscillations termed circadian rhythms. Despite numerous investigations on the circadian dynamics of pain perception, findings related to this issue remain inconsistent. This study aimed to assess the effect of time-of-day on multimodal experimental pain perception in healthy males, including "static" and "dynamic" quantitative sensory tests. ⋯ Thermal pain scores varies during the day and morning seems to be the time-of-day most insensitive to pain. Also, dynamic tests and the mechanical pain model are not appropriate for detecting diurnal variability in pain. The results of this study may be partially explained by a potential analgesic effect of some hormones known to have diurnal variation (e.g., melatonin and cortisol).
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To document staffing (medical, nursing, allied health [AH], administrative) in Australian multidisciplinary persistent pain services and relate them to clinical activity levels. ⋯ Reasonable consistency was demonstrated in the range and mix of most disciplines employed, suggesting they represented workable clinical structures. The greater number of medical and nursing staff within Level 1 clinics may indicate a lower multidisciplinary focus, but this needs further exploration. As the first multidisciplinary staffing data for persistent pain clinics, this provides critical information for designing and implementing clinical services. Mapping against clinical outcomes to demonstrate the impact of staffing patterns on safe and efficacious treatment delivery is required.
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Cancer pain is difficult to treat, often requiring a multimodal approach. While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects. ⋯ TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy.