Pain physician
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Postoperative pain management has increasingly become a public health problem worldwide. Psychological factors can be considered as independent risk factors for the intensity of postoperative pain and the occurrence of postoperative chronic pain. ⋯ These findings suggest that chronic restraint stress may influence postoperative hyperalgesia and NLRP3-mediated neuroinflammation, which may in turn contribute to stress-induced postoperative pain exacerbation.
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Thoracolumbar interfascial plane (TLIP) block as a novel plane block technique was proposed in 2015 and can be performed in patients undergoing lumbar spine surgery. However, no meta-analysis demonstrates the effects of TLIP block on postoperative pain undergoing lumbar spine surgery. ⋯ The TLIP block is an effective strategy to improve postoperative pain at rest/movement and to reduce PCA consumption in patients undergoing lumbar spine surgery, which exerts significant analgesia. In the future, it is worth being applied in lumbar spine surgery extensively.
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Chronic pain affects 20 to 30% of the adult population worldwide and is consequently the leading cause of disability. Current developments in brain imaging technology are increasing the understanding of the pathophysiology of (chronic) pain and enabling the possibility to objectify pain. As a result, our view of the brain has evolved from a static organ to a dynamic organ that constitutes an adaptable network of linked regions. Graph theory has emerged as a framework to analyze such networks and can be applied to investigate a range of topological properties of both the functional and structural brain network or connectome, thus providing meaningful information about the organization of human brain networks. ⋯ Differences between chronic pain patients and healthy controls were mostly observed for the global graph measures. Future research is still needed to validate the obtained findings and to expand this knowledge to the chronic pain populations that were not discussed in the included papers.
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Randomized Controlled Trial
Comparative Study Between Dexmedetomidine and Fentanyl as an Adjuvant to Intraarticular Bupivacaine for Postoperative Analgesia after Knee Arthroscopy.
Intraarticular bupivacaine produces sufficient analgesia after arthroscopic knee surgery, but its analgesic duration is short. There is a need to search for an adjuvant with a longer duration of analgesia. ⋯ Fifty µg of fentanyl as an adjuvant to intraarticular bupivacaine produces effective and safe analgesia after knee arthroscopy as 100 µg of dexmedetomidine and has a longer analgesia duration in the first postoperative 24 hours.
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Randomized Controlled Trial
The Effect of Medial Branch Block on Postoperative Residual Pain Relieve After Percutaneous Kyphoplasty: A Randomized Controlled Trial With 12-Month Follow-up.
Percutaneous kyphoplasty (PKP) is a minimally invasive technique, and effective treatment, for an osteoporotic vertebral compression fracture (OVCF). Residual back pain is the most common complication of PKP. Medial branch block (MBB) is a treatment option for painful OVCF, it can break the vicious cycle to release short- or long-term pain. ⋯ MBB can effectively relieve back pain and reduce the incidence of residual back pain in OVCF patients after PKP surgery. Besides, it can also significantly improve postoperative physical function and patients' satisfaction with treatment.