Articles: pain.
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Persistent spinal pain syndrome (PSPS) poses a significant medical challenge, often leading to diminished quality of life for affected individuals. In response to this clinical dilemma, spinal cord stimulation (SCS) has emerged as a promising intervention aimed at improving the functional outcomes and overall well-being of patients suffering from this debilitating syndrome. In case a therapy with percutaneous lead fails (e.g., due to a dislocation), surgical lead can be used as a stable alternative. This results in a more invasive procedure and does not allow for intraoperative monitoring. The aim of this study is to investigate the efficacy and safety of the use of surgical leads, as there have been only a few case series published so far. ⋯ SCS with surgical leads is a safe secondary technique to treat PSPS, where treatment with percutaneous leads fail. The results show a promising long-term effect concerning pain intensity and functional outcome.
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This case series included 10 patients who underwent clavicular fracture surgery under general anesthesia. A novel analgesic approach combining 2 distinct nerve block techniques-serratus posterior superior intercostal plane block (SPSIPB) and clavipectoral plane block (CPPB)-was used for postoperative pain management. ⋯ The combination of SPSIPB and CPPB demonstrated variable efficacy in controlling postoperative pain. Future studies may explore potential improvements through dosage optimization, the use of adjuvants, or targeting higher anatomical levels.
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Journal of anesthesia · Dec 2024
Lower extremity pain and/or numbness after laparoscopic surgery and robot-assisted surgery in the lithotomy position combined with the Trendelenburg position.
The purpose of this study was to investigate the incidence and risk factors of lower extremity pain and/or numbness after laparoscopic colorectal surgery and robot-assisted laparoscopic radical prostatectomy in the lithotomy position combined with the Trendelenburg position. The relationship between creatine kinase (CK) levels and lower extremity pain and/or numbness was also investigated. ⋯ The incidence of lower extremity pain and/or numbness after laparoscopic colorectal surgery was comparable to that after robot-assisted laparoscopic radical prostatectomy. Prolonged duration of surgery contributed to lower extremity pain and/or numbness. Significantly elevated CK levels in patients with lower extremity pain and/or numbness suggest the involvement of muscle injury in these symptoms.
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Thoracic discectomy procedures require early and adequate pain control to alleviate patient discomfort after surgery. The intraoperative placement of a nerve block after intercostal nerve violation can offer early pain management after thoracic discectomy. ⋯ Intercostal nerve blockage offers a valuable addition to postoperative pain management and may be considered as an available pain relief option for patients undergoing thoracic discectomy.