Articles: pain-management-methods.
-
Review Meta Analysis
The serratus anterior plane block for analgesia after thoracic surgery: A meta-analysis of randomized controlled trails.
The serratus anterior plane (SAP) block is a newer method that can be used in patients undergoing thoracic surgeries. The postoperative analgesia efficacy of SAP blocks for thoracic surgery remains controversial. We conduct a meta-analysis to evaluate the analgesia of SAP blocks after thoracic surgery. ⋯ The SAP block can play an important role in the management of pain after thoracic surgery by reducing both pain scores and 24-h postoperative opioids consumption. In addition, there is fewer incidence of PONV in the SAP block group.
-
Chronic pain is a leading cause of disability and remains under-treated in nearly half of patients with cancer. The opioid crisis has highlighted an urgent public health need for effective nonpharmacological pain management. Electroacupuncture (EA) and Battlefield Acupuncture (BFA) represent nonpharmacological modalities used in clinical practice to manage pain; however, their effectiveness has not been rigorously evaluated in oncology settings. ⋯ Our findings will advance nonpharmacological pain management in oncology and inform personalized treatment approaches that integrate individuals' expectations and genetic biomarkers to deliver "precision" acupuncture to cancer patients with chronic pain.
-
This work aims at describing a technique "The ALblation technique" for treating migraine headache. This technique describes radiofrequency ablation for supraorbital, supratrochlear, lesser occipital and greater occipital nerves bilaterally for treating migraine headache. This is a novel procedure that was not described before. ⋯ Author published some articles on radiofrequency ablation for the pericranial nerves for treating different types of headache with consistent positive outcomes. Success of this procedure depends on identifying the appropriate nerves to treat the headache and associated neuralgia.
-
Curr Pain Headache Rep · May 2020
ReviewRecommendations for Managing Opioid-Tolerant Surgical Patients within Enhanced Recovery Pathways.
One of the consequences of the opioid epidemic is an increase in the number of opioid-tolerant patients. These patients are at higher risk for readmission and longer hospital stays following surgery. Enhanced recovery after surgery (ERAS) pathways can be used as a framework for providing high-quality comprehensive care to patient population. It is estimated that as many as 15% of all surgery patients in the USA are receiving opioids going into surgery. The number of patients on medication maintenance therapy with long-acting opioids such as methadone or partial mu receptor agonists like buprenorphine is rising, which poses a challenge for perioperative healthcare providers. ⋯ Preoperative opioid tolerance is an independent predictor for increased length of hospital stays, high costs, and increased readmission rates following surgery. Given the recent trends, it is likely that more opioid-tolerant patients will require surgery in near future. Enhanced recovery programs can be used to provide a framework for high-quality care to opioid-tolerant patients throughout all phases of the perioperative process. To improve the quality of care of opioid-tolerant patients, we present five general recommendations for clinicians to consider and possibly incorporate into ERAS programs and care protocols. Recommendations include the following: opioid-tolerant patients should not be excluded from ERAS programs; opioid-tolerant patients should be identified preoperatively; programs should establish standard practices for patients on medication maintenance therapy and buprenorphine; opioid-tolerant patients should receive multimodal analgesia perioperatively; and opioid-tolerant patients should receive coordinated follow up after surgery.