Pain physician
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Case Reports Meta Analysis
Infections Following Interventional Spine Procedures: A Systematic Review.
Interventional spine procedures, such as discography, epidural steroid injections (ESIs), facet joint procedures, and intradiscal therapies, are commonly used to treat pain and improve function in patients with spine conditions. Although infections are known to occur following these procedures, there is a lack of comprehensive studies on this topic in recent years. ⋯ Based on our systematic review, the risk of infections following interventional spine procedures appears to be low overall. More studies focusing on infectious complications with larger sample sizes are needed, particularly for intradiscal therapies, in which the microbiome may be an underlying cause of disc infection. To achieve a true incidence of the risk of infections with these procedures, large prospective registries that collect complication rates are necessary.
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Clinicians frequently order urine drug testing (UDT) for patients on chronic opioid therapy (COT), yet often have difficulty interpreting test results accurately. ⋯ Interpretations were well received by clinicians but did not significantly improve laboratory-clinician interpretation concordance, interpretation documentation frequency, or opioid-prescribing behavior.
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Randomized Controlled Trial
Efficacy and Safety of Radiofrequency Thermocoagulation with Different Puncture Methods for Treatment of V1 Trigeminal Neuralgia: A Prospective Study.
Radiofrequency thermocoagulation through the supraorbital foramen with a different puncture method is a new approach for the treatment of ophthalmic division trigeminal neuralgia. ⋯ The transverse puncture method during radiofrequency thermocoagulation through the supraorbital foramen had better efficacy and fewer complications in comparison with the vertical puncture method when treating ophthalmic division trigeminal neuralgia.
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Randomized Controlled Trial Comparative Study
Comparative Effectiveness of Parasagittal Interlaminar and Transforaminal Cervical Epidural Steroid Injection in Patients with Cervical Radicular Pain: A Randomized Clinical Trial.
Cervical epidural steroid injections (ESI) are performed either by interlaminar (IL) or transforaminal (TF) approaches; however, there is controversy over which is better for safety and efficacy. ⋯ Parasagittal IL ESI may be recommended over the TF ESI in reducing cervical radicular pain, considering both clinical effectiveness and safety.
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Strategies for reducing postoperative opioid consumption have been explored in many recent studies, due in large part to the recent opioid epidemic. Preemptive analgesia has been proposed as a potential method, but its use is still controversial. ⋯ Preemptive acetaminophen administration significantly reduces opioid consumption within the initial 24 hours following general anesthesia, with lower pain scores at 12 hours after surgery, and less nausea and vomiting. However, well-conducted RCTs are still needed.