Pain physician
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Thoracotomy is associated with severe postoperative pain. Effective management of acute pain after thoracotomy may reduce complications and chronic pain. Epidural analgesia (EPI) is considered the gold standard for postthoracotomy analgesia; however, it is associated with complications and limitations. Emerging evidence suggests that an intercostal nerve block (ICB) has a low risk of severe complications. Anesthetists will benefit from a review that assesses the advantages and disadvantages associated with ICB and EPI in thoracotomy. ⋯ ICB may be as effective as EPI for pain relief after thoracotomy.
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Meta Analysis
Effects of Ketamine on Chronic Postsurgical Pain in Patients Undergoing Surgery: A Systematic Review and Meta-analysis.
Chronic postsurgical pain (CPSP) has become a common complication during the perioperative period. The efficacy of one of the most potent strategies, ketamine, remains unclear. ⋯ We discovered that intravenous ketamine may reduce the incidence of CPSP in patients undergoing surgery, especially 3 - 6 months postsurgery. Because of the small sample size and high heterogeneity of the included studies, the effect of ketamine in the treatment of CPSP still needs to be explored in future large-sample, standardized-assessment studies.
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Randomized Controlled Trial
Sub-Anesthesia Dose of S-Ketamine Reduces Postoperative Pain and Anxiety in Patients Receiving Breast and Thyroid Surgery: A Randomized, Controlled Trial.
Postoperative pain and anxiety affect patients' recovery and increase the family burden. S-ketamine presents analgesic effects and anti-depressive effects in clinics. The effect of a sub-anesthesia dose of S-ketamine on postoperative pain and anxiety remains to be clarified. ⋯ Intraoperative sub-anesthesia dose of S-ketamine reduces postoperative pain and anxiety intensity. Anxiety before surgery is a risk factor, and S-ketamine and regular exercise are protective factors for postoperative pain. The study was registered at www.chictr.org.cn with the number: ChiCTR2200060928.
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Randomized Controlled Trial
Pre-incisional Preventive Precise Multimodal Analgesia May Enhance the Rehabilitation Process of Acute Postoperative Pain Following Total Laparoscopic Hysterectomy: A Randomized Controlled Trial.
There has been limited research regarding the effect of preventive precise multimodal analgesia (PPMA) on the duration of acute postoperative pain after total laparoscopic hysterectomy (TLH). This randomized controlled trial aimed to evaluate how PPMA affects pain rehabilitation. ⋯ Pre-incisional PPMA may enhance the rehabilitation process of acute postoperative pain after TLH.