Pain physician
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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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Observational Study
Effects of Hypovitaminosis D on Preoperative Pain Threshold and Perioperative Opioid Use in Colorectal Cancer Surgery: A Cohort Study.
Postoperative pain after colorectal cancer surgery has a significant impact on postoperative physical and mental health. Vitamin D deficiency has been correlated with both acute pain states, including postoperative and post-traumatic pain, and several chronic pain diseases. The effects of hypovitaminosis D on preoperative pain threshold and perioperative opioid use in colorectal cancer surgery still need to be studied. ⋯ On the basis of the study results, hypovitaminosis D is associated with increased perioperative opioid consumption in colorectal cancer surgery. Sensory perception and pain threshold of patients with insufficient 25 (OH) D3 concentration were more sensitive, and PET was lower. History of DM, vitamin D, and vitamin C may be factors related with SSI. Future studies are needed to investigate their relationship further and discover if postoperative pain and pain threshold can benefit from vitamin D supplementation in these patients.
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Pelvic floor dysfunction and its associated symptoms are a common clinical challenge in the cancer population. Despite the noninvasive nature of pelvic floor rehabilitation (PFR) for this condition and the promising clinical results observed with its use, PFR appears to be an underused therapy. ⋯ PFR is an effective tool for treating the pain associated with pelvic floor dysfunction and its related symptoms. This conservative approach can contribute to lowering the use of opiate analgesics.
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Hemifacial spasm (HFS) is mainly characterized by paroxysmal involuntary twitches of one side of the facial muscles. We developed an awake CT-guided percutaneous puncture of the stylomastoid foramen for radiofrequency ablation (RFA) therapy for the treatment of hemifacial spasm and successfully used it in our clinic. ⋯ There was no difference in the operation time or efficacy between the 2 approaches. The anterior mastoid approach is easier to perform and is recommended based on our experience.
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Approximately 70% of Americans use social media platforms, and use of specific platforms, such as Instagram, Twitter, Snapchat, and TikTok, is especially common among adults under 30. The presence of social media accounts among residency and fellowship programs in academic medicine has been used to connect with other specialties, highlight achievements and research, disseminate information to the general public, and as a recruiting tool for applicants. ⋯ Less than 20% of the pain fellowship programs are currently utilizing Twitter and/or Instagram. When compared to primary anesthesiology residencies, social media presence among pain fellowships is much lower. By utilizing basic social media strategies, including image-based content posting, hashtags, and videos, programs can increase their engagement with the social media community, and increase their overall number of followers, thus expanding their potential reach to prospective applicants. Although social media can be an effective tool for branding purposes, it is vital to address the safe use of social media among all trainees.