Pain physician
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Randomized Controlled Trial
Fluoroscopy-guided Intradiscal Radiopaque Gelified Ethanol Injection Using an Anteroposterior View Compared to an Oblique View: A Randomized Controlled Trial.
This study introduces a new fluoroscopy-guided intradiscal radiopaque gelified ethanol injection technique using the antero-posterior view and compare it to conventional oblique view. Intradiscal procedures, are minimally invasive techniques that aim to reduce pain associated with lumbar disc herniation by modifying the disc material and decreasing pressure on surrounding nerves. ⋯ An anteroposterior view radiopaque gelified ethanol injection is a promising alternative to the conventional oblique view technique for radicular leg pain management. This novel approach offers a safer and more efficient treatment option, reducing radiation exposure and procedure time without compromising clinical outcomes. Its potential to minimize patient discomfort and enhance overall management of radicular leg pain warrants further investigation and widespread adoption.
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Randomized Controlled Trial
Adjuvants to Conventional Management of Postdural Puncture Headache Following Obstetric Surgery Under Spinal Anesthesia: Mirtazapine vs. Sumatriptan.
Postdural puncture headache (PDPH) is a debilitating, life-altering complication of the administration of obstetric spinal anesthesia (SA). The lack of evidence-based treatment for PDPH necessitates the implementation of new treatment modalities. Mirtazapine is a noradrenergic and specific serotonergic antidepressant that has been used as a prophylactic treatment for chronic tension-type headaches. Few previous studies have assessed the efficacy of sumatriptan in the treatment of PDPH. ⋯ Adding either mirtazapine or sumatriptan to the CM of PDPH following obstetric SA was associated with lower means of headache intensities, higher rates of complete response to medical treatment, and decreased incidence of refractory headaches. As an antiemetic drug, mirtazapine was found to be effective, inexpensive, safe, well-tolerated, and capable of being used on an outpatient basis.
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Randomized Controlled Trial
Rhomboid Intercostal versus Serratus Anterior Plane Block for Analgesia After Thoracodorsal Artery Perforator Flap Following Partial Mastectomy: A Randomized Controlled Trial.
The thoracodorsal artery perforator (TDAP) flap has been developed to improve the postoperative aesthetic and psychological states of patients who receive breast-conserving surgery (BCS); nonetheless, the TDAP flap exacerbates the pain that occurs at 2 surgical sites. ⋯ Because of its ability to block both the anterior and posterior hemithorax, the RIB, is more efficient than the SAB at controlling acute pain and reducing opioid consumption in patients undergoing BCS followed by TDAP flaps; thus, the RIB can be employed as a potential alternative in these surgeries.
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Observational Study
The Long-term Outcome of Usual and Unusual Indications for Spinal Cord Stimulation: A Prospective Study.
Evidence of the efficacy of spinal cord stimulation (SCS) has been well demonstrated as a method of pain control for patients who exhibit failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), and inoperable peripheral vascular diseases (PVD) ("usual indications"). However, a long-term study comparing the usual indications for which SCS is employed with those of other intractable painful conditions is still lacking. ⋯ Overall, SCS is an effective long-term treatment for chronic refractory pain. However, patients with usual indications for SCS have a higher success rate in SCS trials and a trend toward better outcomes after SCS implantation than do patients with unusual indications.
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Observational Study
Prophylactic Perioperative Fluid Infusion Strategy During Splanchnic Nerve Neurolysis to Prevent Systemic Hypotension: A Case Series of 70 Patients With Cancer.
When performing splanchnic nerve neurolysis (SNN), systemic hypotension may occur due to upper abdominal sympathetic blockade; therefore, appropriate periprocedural fluid resuscitation is crucial. ⋯ Our prophylactic perioperative fluid resuscitation for treating systemic hypotension post-SNN is sufficient and safe.