Articles: pain-clinics.
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The National Institutes of Health (NIH) HEAL Initiative is making data findable, accessible, interoperable, and reusable (FAIR) to maximize the value of the unprecedented federal investment in pain and opioid-use disorder research. This involves standardizing the use of common data elements (CDE) for clinical research. ⋯ While complex, harmonization across a network of chronic pain and opioid use disorder clinical trials with separate interventions can be optimized through use of CDEs and data standardization processes. This standardization process will support the robust secondary data analyses. Scaling this process could standardize CDE results across interventions or disease state which could help inform insurance companies or government organizations about coverage determinations. The development of the HEAL CDE program supports connecting isolated studies and solutions to each other, but the practical aspects may be challenging for some studies to implement. Leveraging tools and technology to simplify process and create ready to use resources may support wider adoption of consistent data standards.
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Anesthesia and analgesia · Jul 2023
Meta AnalysisAnalgesic Effect of Buprenorphine for Chronic Noncancer Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Transdermal & buccal buprenorphine is associated with a small reduction in pain scores in chronic non-cancer pain.
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Minerva anestesiologica · Jul 2023
ReviewPerfusion index for early identification of regional anesthesia effectiveness: a narrative review.
Regional anesthesia (RA) is a common and irreplaceable technique in clinical, which can be used in different surgery sites and control of acute and chronic pain, especially for outpatients, pediatrics and the elderly. RA demands are increasing during COVID-19 pandemic because many surgeries could be performed under RA to reduce the risk of cross-infection between patients and health care workers. Early and accurate identification of the effects of RA can help physicians make timely decisions about whether to supplement analgesics or switch to general anesthesia, which will save time and improve patient satisfaction in a busy operating room. ⋯ Recently, many studies have assessed the accuracy of PI in early prediction of RA success, including brachial plexus block, sciatic nerve block, neuraxial anesthesia, paravertebral block, caudal block and stellate ganglion block. Successful RA often parallels increased PI. In this narrative review, we describe the principles and influencing factors of PI, and introduce the effects of PI on early identification of RA effectiveness.
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State medical cannabis laws may lead patients with chronic noncancer pain to substitute cannabis in place of prescription opioid or clinical guideline-concordant nonopioid prescription pain medications or procedures. ⋯ National Institute on Drug Abuse.
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Anesthesia and analgesia · Jul 2023
Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients: Part 1.
Pain after thoracic surgery is of moderate-to-severe intensity and can cause increased postoperative distress and affect functional recovery. Opioids have been central agents in treating pain after thoracic surgery for decades. The use of multimodal analgesic strategies can promote effective postoperative pain control and help mitigate opioid exposure, thus preventing the risk of developing persistent postoperative pain. ⋯ It is a systematic review of existing literature for various interventions related to the preoperative and intraoperative pain management of thoracic surgical patients and provides recommendations for providers caring for patients undergoing thoracic surgery. This entails developing customized pain management strategies for patients, which include preoperative patient evaluation, pain management, and opioid use-focused education as well as perioperative use of multimodal analgesics and regional techniques for various thoracic surgical procedures. The literature related to this field is emerging and will hopefully provide more information on ways to improve clinically relevant patient outcomes and promote recovery in the future.