Articles: pain-management-methods.
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As interventional pain management has been growing rapidly worldwide and chronic pain management is provided by a diverse range of practitioners, malpractice litigation has increased. Therefore, we examined the characteristics of medical disputes related to chronic pain management from 2009 to 2019 in South Korea. In this retrospective study, we analyzed the Korean Society of Anesthesiologists database covering case files from July 2009 to June 2019. ⋯ The majority of invasive procedure-related cases (82.6%, 38/46) were determined as 'directly related to the procedure'. Of these, the 3 most common damaging events were bleeding, intrathecal injection of local anesthetics, and infectious complications (each n = 6). During a recent decade, there were several typical changes in the characteristics of medical dispute cases related to chronic pain management, including an increasing trend of cases for chronic pain management relative to surgical anesthesia-related cases, a higher severity of complications in cervical procedures, an increase in complex regional pain syndrome-related cases, and an increase in cases involving non-anesthesiologists.
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Comparison between endosonographic ultrasonography (EUS)-guided celiac ganglia neurolysis (CGN) and EUS-guided celiac plexus neurolysis (CPN) in pain management for pancreatic cancer has engendered controversy. To analyze the effectiveness and safety of EUS-CGN and figure out whether EUS-CGN is better than EUS-CPN, a qualitative systematic review was conducted. ⋯ EUS-CGN can be safely performed while it may shorten survival. In terms of short-term pain response, EUS-CGN is better than EUS-CPN while no conclusion of long-term pain control can be drawn.
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Randomized Controlled Trial
Liquid combination of hyaluronan, glucosamine, and chondroitin as a dietary supplement for knee osteoarthritis patients with moderate knee pain: A randomized controlled study.
Hyaluronan (HA), glucosamine, and chondroitin sulfate are widely consumed as dietary supplements for the treatment of knee osteoarthritis (OA). This study aimed to explore the efficacy and safety of a dietary liquid supplement mixture containing HA, glucosamine, and chondroitin in patients with knee OA who had moderate knee pain (visual analogue scale of 4-6 points). ⋯ This present study found that the combination of liquid low molecular weight HA, glucosamine, and chondroitin oral supplement did not effectively improve knee OA pain and symptoms after short-term use in knee OA patients with moderate knee pain. However, these results should be interpreted with caution due to the intrinsic limitation of the study design.
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Randomized Controlled Trial Multicenter Study
Neurolytic Splanchnic Nerve Block and Pain Relief, Survival, and Quality of Life in Unresectable Pancreatic Cancer: A Randomized Controlled Trial.
Neurolytic splanchnic nerve block is used to manage pancreatic cancer pain. However, its impact on survival and quality of life remains controversial. The authors' primary hypothesis was that pain relief would be better with a nerve block. Secondarily, they hypothesized that analgesic use, survival, and quality of life might be affected. ⋯ Neurolytic splanchnic nerve block appears to be an effective option for controlling pain and reducing opioid requirements in patients with unresectable pancreatic cancer.
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Effective pain control is vital for successful surgery in the ambulatory setting. Our study aims to characterize a case series of patients who underwent lumbar decompression (LD) in the ambulatory surgical center (ASC) with the use of a multimodal analgesic (MMA) protocol. ⋯ This is the largest clinical case series focused on LD procedures within an ASC requiring no planned 23-hour observation. This study demonstrates the feasibility of performing LD surgery in an ASC with proper patient selection, surgical technique, and MMA protocol. All patients were discharged from the surgical center on the same day of surgery.