Pain physician
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Randomized Controlled Trial
Postoperative Pain in Adolescent Idiopathic Scoliosis Surgery: A Randomized Controlled Trial.
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis, and its treatment is essentially surgical for curves above 40 degrees. Posterior spinal instrumentation (PI) is the usual technique, while the vertebral body tethering (VBT) method is tested technique for this study as a new treatment option. ⋯ From our results, both techniques can be employed for AIS surgery, but a meticulous approach is essential for the prevention of acute pain for VBT.
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Thalamic pain (TP), also known as central post-stroke pain, is a chronic neuropathic pain syndrome that follows a stroke and is a severe pain that is usually intractable. No universally applicable and effective therapies have been proposed. Emerging studies have reported that electroacupuncture (EA) can potentially be used as an effective therapy for the treatment of neuropathic pain. However, whether EA influences TP and if so, by what potential mechanism, remains poorly understood. ⋯ EA treatment may promote the recovery of TP model rat by regulating ADCY1 expression.
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The superior and middle cluneal nerves are sources of low back, buttock, and leg pain. These nerves are cutaneous branches of the lateral branches of the dorsal rami of T11- S4. Pain arising from entrapment or dysfunction of one or more of these nerves is called "cluneal nerve syndrome." A clear understanding of the anatomy underlying cluneal nerve syndrome and its treatment has been hampered by the very small size of the cluneal nerves and their complex, varying anatomy. Because of differing methods and foci of investigation, the literature regarding cluneal nerves has been confusing and even contradictory. ⋯ Cluneal nerve syndrome is characterized by a triad of pain, tender points, and relief with local anesthetic injections. The pain is a deep, aching, poorly localized low back pain with variable involvement of the buttocks and/or legs. Tender points are localized at the iliac crest or caudal to the posterior superior iliac spine. Muscle weakness and dermatomal sensory changes are absent in cluneal nerve syndrome. If the pain returns after injections, neuroablation, nerve stimulation, or surgical release may be needed.
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Randomized Controlled Trial
Local Anesthetic and Steroid Injection to Relieve the Distal Lumbosacral Pain in Osteoporotic Vertebral Compression Fractures of Patients Treated with Kyphoplasty.
Percutaneous kyphoplasty (PKP) is widely used in osteoporotic vertebral compression fractures (OVCF). But in some patients, distal lumbosacral pain (DLP) persists even after treatment and affects their quality of life. ⋯ Local anesthetic and steroid injection improved the short-term clinical outcome of PKP for OVCF, which will enhance the confidence of patients in performing out-of-bed activities and functional exercises early after the operation.
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Randomized Controlled Trial
Ultrasound-guided Erector Spinae Muscle Block Versus Ultrasound-guided Caudal Block in Pediatric Patients Undergoing Lower Abdominal Surgeries.
The erector spinae plane block is a new regional anesthetic technique that is gaining popularity in pediatric medicine. ⋯ Ultrasound-guided erector spinae block was safe and effective in pediatric patients undergoing unilateral lower abdominal surgery as it provided a longer duration of analgesia and less analgesic requirement than caudal block and fewer side effects.