Articles: pain-management-methods.
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Anesthesia and analgesia · Apr 2019
ReviewPain Management for Ambulatory Arthroscopic Anterior Cruciate Ligament Reconstruction: Evidence-Based Recommendations From the Society for Ambulatory Anesthesia.
Local anesthetic infiltration provides the best balance of efficacy and risk for arthroscopic anterior crucial ligament repair.
pearl -
Aesthetic plastic surgery · Apr 2019
Randomized Controlled Trial Comparative StudyUltrasound-Guided Bilateral Erector Spinae Block Versus Tumescent Anesthesia for Postoperative Analgesia in Patients Undergoing Reduction Mammoplasty: A Randomized Controlled Study.
The aim of this prospective, randomized, double-blind study was to compare the tumescent anesthesia method and erector spinae block with respect to postoperative analgesia consumption, pain scores and patient satisfaction, in patients receiving breast reduction surgery under general anesthesia. ⋯ This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Providers who treat patients with chronic pain face a dual challenge: providing adequate access to opioid therapies for appropriate pain management while adopting strategies to minimize the risk for abuse. Commonly prescribed opioids have substantial abuse potential when administered intravenously, and extended-release (ER)/long-acting (LA) opioids may be targeted for IV abuse because of the higher per-dose medication level. The consequences of IV opioid abuse are severe and increase the risks for adverse outcomes, including mortality due to acute health events, serious infections, and deep vein thrombosis, to name a few. ⋯ Findings from in vitro laboratory tests of abuse deterrence for opioid ADFs are described herein, as are data from human abuse potential studies for IV abuse of those ADF products, for which such studies are feasible (ie, abuse-deterrent agonist-antagonist formulations). The available ADF opioids may decrease both the attractiveness and the feasibility of IV abuse. The adoption of ADF opioids represents one tactic for providing access to needed medication for patients with chronic pain, while potentially reducing the risk for opioid abuse, in a comprehensive effort to combat the opioid epidemic.
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Post-traumatic neuropathic pain in the head and face is a condition that is often refractory to medical management. Peripheral nerve stimulation (PNS) can be an effective treatment. Successful implantation of a novel minimally invasive wireless device is reported here. ⋯ High-frequency stimulation with an external pulse generator and minimally invasive, percutaneous, and bilateral placement of 2 passive INSs on the supraorbital nerves resulted in a significant pain relief in this patient with post-traumatic SON. The device was safe and effective, and the cosmesis was satisfactory.
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The review article was designed to assess the effectiveness of regional anesthesia (RA), specifically peripheral nerve blocks, in the treatment of burn pain; with noting of clinical indications and contraindications for peripheral nerve block application, along with discussion of evidence-based analgesic strategies for providing improved, comprehensive burn pain management. ⋯ RA techniques are an adjunct therapy currently used worldwide to improve patient pain outcomes and reduce the adverse effects associated with general anesthetic. RA presents a safe and effective intervention for acute pain resulting from burn-acquired injury. This review of current literature supports the use of RA as a treatment to manage pain associated with burn-related care procedures as an addition to multimodal pain treatment. To date there is limited evidence showing the use of RA in the burns' patient population. In addition, there appear to be no particular risks to using the technique of RA in this group. Further prospective studies are required to provide information about the benefits and limitations of RA.