Pain medicine : the official journal of the American Academy of Pain Medicine
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To assess the pain prevalence, pain intensity, and pain medication use in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI). ⋯ Outpatient memory clinic patients with mild to moderate AD and MD are less likely to report pain than patients with SCI. No difference in self-reported pain intensity was present. The high percentage of patients with and without dementia who do not use analgesics when in pain raises the question of whether pain treatment is adequate in older patients.
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The purpose of this study was to assess the correlation between skin-to-epidural space depth, as measured on cervical magnetic resonance imaging (MRI), and actual needle depth, as measured by Tuohy needle markings during cervical epidural steroid injections. ⋯ Estimates of needle depth made with MRI were consistently slightly deeper than the actual loss-of-resistance needle depth, indicating that the provider should employ caution when using MRI predictive depths. Information garnered from preprocedure MRIs can be used to improve the safety of cervical epidural steroid injection procedures.
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Review Meta Analysis
Effect of Continuous Local Anesthetic in Post-Cardiac Surgery Patients: A Systematic Review.
The purpose of this review was to determine the effect of CLA infusion post cardiac surgery on pain, time to ambulation, severe adverse events, patient satisfaction, time to extubation, length of stay in the intensive care unit and in the hospital, total narcotic consumption, and pulmonary function. ⋯ CLA infusion after cardiac surgery reduces pain score at 72 hours, shortens time to ambulation, and reduces morphine consumption at 48 hours.
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Lumbar intervertebral disk herniation (LDH) is considered one of the major risk factors for lower back pain, mainly caused by irritation of a spinal nerve or its root. One of the genes related to pain perception is SCN9A, which encodes the voltage gated sodium channel NaV1.7, a key molecule involved in peripheral pain processing. It had been presented before that a common polymorphism within SCN9A (rs6746030: G > A, R1150W) might influence nociception in the general population. Hence, the present study was aimed at investigating the association between SCN9A polymorphism and pain sensitivity. ⋯ Our results suggest that the SCN9A rs6746030 polymorphism may be associated with pain intensity in patients suffering from symptomatic disc herniation.
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Review
Review of Factors, Methods, and Outcome Definition in Designing Opioid Abuse Predictive Models.
Several opioid risk assessment tools are available to prescribers to evaluate opioid analgesic abuse among chronic patients. The objectives of this study are to 1) identify variables available in the literature to predict opioid abuse; 2) explore and compare methods (population, database, and analysis) used to develop statistical models that predict opioid abuse; and 3) understand how outcomes were defined in each statistical model predicting opioid abuse. ⋯ We identified variables used to predict opioid abuse from electronic health records and administrative data. Medication variables are the recurrent variables in the articles reviewed (33 variables). Age and gender are the most consistent demographic variables in predicting opioid abuse. Overall, there is similarity in the sampling method and inclusion/exclusion criteria (age, number of prescriptions, follow-up period, and data analysis methods). Intuitive research to utilize unstructured data may increase opioid abuse models' accuracy.