Pain physician
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Randomized Controlled Trial
Ultrasound-guided Techniques for Perioperative Analgesia in Pediatric Lower Abdominal Surgeries: Quadratus Lumborum Block with Bupivacaine versus Caudal Bupivacaine and Neostigmine.
Ultrasound-guided regional anesthesia techniques for perioperative analgesia in pediatric patients scheduled for lower abdominal surgeries can be achieved either by quadratus lumborum block (QLB) or caudal block (CB). Neostigmine was co-administered with caudal bupivacaine to shorten the onset and extend the duration of analgesia. ⋯ Postoperative analgesia for pediatric patients undergoing lower abdominal surgeries can be safely and effectively achieved by QLB with bupivacaine and a CB with a bupivacaine/neostigmine mixture with priority given to CB, especially in resource-limited settings.
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Zoster-associated pain (ZAP) represents an important medical, social, and economic problem. The treatment approach for ZAP continues to be challenging. Tender point infiltration (TPI) with local anesthetic and steroids has been demonstrated to have potential in the treatment of severe pain, but there are rare reports of the efficacy and security of TPI for acute and subacute ZAP. ⋯ TPI can be a useful and safe option for the control of acute and subacute ZAP with high feasibility. Early application of TPI in the acute phase of herpes zoster pain may show better clinical outcomes.
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Interlaminar epidural injection (ILEI) is used to relieve low back pain, with or without radiating pain. The distance from the skin to the epidural space determines the needle depth and may be influenced by the patient's body measurements. ⋯ Height combined with weight and BMI can help estimate the optimal needle depth from the skin to the epidural space. Needle depth in L5-S1 and caudal angle in L3-4 and L4-5 of MRI were correlated with those of fluoroscopy of ILEI.
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Pain-depression comorbidity has become a great burden to individuals and society. Nevertheless, the mechanisms underlying comorbid diseases have still not been fully revealed. Ultrasound-guided pulsed radiofrequency (PRF) on peripheral nerves, which produces remarkable analgesia via high-frequency electromagnetic energy, has become a main, minimally invasive treatment for chronic neuropathic pain. ⋯ These findings suggest that ultrasound-guided PRF on sciatic nerve could alleviate pain-induced depression. The mechanisms of this treatment may be involved in the downregulated spinal IRF8 and the increased BDNF in PFC.