Articles: acute-pain.
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Review Meta Analysis
Prevention of Post-Operative Pain after Elective Brain Surgery: A Meta-Analysis of Randomized Controlled Trials.
Background and Objective: To analyze the effects of several drug for pain prevention in adults undergoing craniotomy for elective brain surgery. Material and Methods: A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The inclusion criteria were limited to randomized controlled trials (RCTs) that evaluated the effectiveness of pharmacological treatments for preventing post-operative pain in adults (aged 18 years or older) undergoing craniotomies. ⋯ Conclusions: High-certainty evidence suggests that NSAIDs and acetaminophen may have a moderate effect on reducing post-craniotomy pain 24 h after surgery compared to control and that ropivacaine scalp block may have a bigger impact on reducing post-craniotomy pain 6 h after surgery compared to control. Moderate-certainty evidence indicates that NSAIDs may have a more remarkable effect on reducing post-craniotomy pain 12 h after surgery compared to control. No moderate-to-high-certainty evidence indicates effective treatments for post-craniotomy pain prevention 48 h after surgery.
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Post‑viral syndrome is a well‑known medical condition characterized by different levels of physical, cognitive, and emotional impairment that may persist with fluctuating severity after recovering from an acute viral infection. Unsurprisingly, COVID‑19 may also be accompanied by medium- and long‑term clinical sequelae after recovering from a SARS‑CoV‑2 infection. Although many clinical definitions have been provided, "long‑COVID" can be defined as a condition occurring in patients with a history of SARS‑CoV‑2 infection, developing 3 months from the symptoms onset, persisting for at least 2 months, and not explained by alternative diagnoses. ⋯ Long‑COVID primarily encompasses the presence of at least 1 symptom, such as fatigue, dyspnea, cognitive impairment / brain fog, postexertional malaise, memory issues, musculoskeletal pain / spasms, cough, sleep disturbances, tachycardia / palpitations, altered smell / taste perception, headache, chest pain, and depression. The most important demographic and clinical predictors to date are female sex, older age, cigarette smoking, pre‑existing medical conditions, lack of COVID‑19 vaccination, infection with pre‑Omicron SARS‑CoV‑2 variants, number of acute phase symptoms, viral load, severe / critical COVID‑19 illness, as well as invasive mechanical ventilation. Concerning the care for long‑COVID patients, the greatest challenge is the fact that this syndrome cannot be considered a single clinical entity, and thus it needs an integrated multidisciplinary management, specifically tailored to the type and severity of symptoms.
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Postoperative delirium is a common postoperative complication of neurocognitive dysfunction, especially in elderly surgical patients. Postoperative delirium not only damages patients' recovery but also increases social costs. ⋯ As traditional acupuncture therapy has been shown to be an effective treatment in many neurological disorders, and in recent years, it has begun to be clinically used as an intervention for postoperative delirium. Although most clinical and animal studies confirm that multiple types of acupuncture interventions can alleviate or prevent postoperative delirium by relieving acute postoperative pain, reducing the consumption of anesthetics and analgesics, attenuating neuroinflammation and neuronal lesions, while more evidence-based medical evidence and clinical validation are needed for these encouraging effects.
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Cochrane Db Syst Rev · Apr 2023
ReviewThe McKenzie method for (sub)acute non-specific low back pain.
There is widespread agreement amongst clinicians that people with non-specific low back pain (NSLBP) comprise a heterogeneous group and that their management should be individually tailored. One treatment known by its tailored design is the McKenzie method (e.g. an individualized program of exercises based on clinical clues observed during assessment). ⋯ Based on low- to very low-certainty evidence, the treatment effects for pain and disability found in our review were not clinically important. Thus, we can conclude that the McKenzie method is not an effective treatment for (sub)acute NSLBP.