Pain physician
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The optimal analgesia for video-assisted thoracoscopic surgery (VATS) is still unknown. ⋯ EA and PVB have certain advantages in analgesia, but the incidence of postoperative pruritus after EA is higher. At the same time, considering the risk of coagulation and puncture complications, PVB may be a better choice.
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Randomized Controlled Trial
Comparison of Intravascular Uptake and Technical Ease Between Anteroposterior and Oblique Views During Lumbar Medial Branch Block.
Inadvertent intravascular injection of local anesthetics can lead to false-negative results following lumbar medial branch block (MBB) performed to diagnose facet joint origin pain. A previous study demonstrated that the type of approach method could affect the incidence of intravascular injections and technical ease of the procedure. ⋯ The overall incidence rate of intravascular injection during lumbar MBB showed nearly 20% in both approach methods groups. The OB approach and left side MBBs were associated with a longer total procedure time and a higher radiation dose.
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Randomized Controlled Trial
Pediatric Postoperative Pain Control With Quadratus Lumborum Block and Dexamethasone in Two Routes With Bupivacaine: A Prospective Randomized Controlled Clinical Trial.
Ultrasound-guided Quadratus Lumborum block (QLB) is a regional analgesia approach that has been reported to provide effective post-operative pain relief for both abdominal and retroperitoneal surgery. Bupivacaine is the most often used and well documented local anesthetic medication in children. Dexamethasone is a systemic glucocorticoid that is often used to minimize postoperative nausea, vomiting, and pain to improve recovery quality after surgery. ⋯ Dexamethasone may be more effective when added to bupivacaine than when given systemically in analgesic effects without any impact on the other secondary pain-related outcomes. Dexamethasone as an adjuvant to bupivacaine has a marked hand on prolongation of the postoperative duration of analgesia, less request for rescue analgesia, and fewer side effects as compared to bupivacaine if used as a sole agent in QLB.
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Randomized Controlled Trial
The Effect of Ultrasound-guided Bilateral Erector Spinae Plane Block With and Without Dexmedetomidine on Intraoperative and Postoperative Pain in Laparoscopic Cholecystectomies: A Randomized, Controlled, Double-blind, Prospective Trial.
Laparoscopic cholecystectomy is the most common surgical procedure performed in the Western world. While it is performed with minimally invasive procedures, patients often complain of moderate to severe postoperative pain, and the role of the anesthesiologist for its effective management remains crucial. Modern anesthesiology practices have embraced trunk blocks which can contribute to perioperative, multimodal analgesia. There is emerging literature about the favorable effect of erector spinae plane block in the reduction of pain after laparoscopic cholecystectomy. ⋯ Erector spinae plane block performed either with ropivacaine or with a combination of ropivacaine and dexmedetomidine is a novel and safe method, which was found to be more effective compared to standard analgesia protocols in patients undergoing laparoscopic cholecystectomy and thus, it can improve the quality of perioperative analgesia.
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Randomized Controlled Trial
Nurse-Supported Web-Based Cognitive Behavioral Therapy for Chronic Musculoskeletal Pain: A Randomized Controlled Trial.
Web-based cognitive behavioral therapy (CBT) has increased access to effective pain management. Though efficacy of web-based and face-to-face CBT may be comparable, fewer studies have examined whether remote clinical support in addition to web-based CBT can improve pain-related outcomes. ⋯ Web-based CBT was effective with and without motivational support from nurses. Phone-based support did not enhance pain-related outcomes of web-based CBT. If confirmed in a larger study, web-based CBT without motivational support may be considered as a low-cost treatment intervention for patients with CMP.