Articles: pain-management.
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Randomized Controlled Trial
Virtual Reality increases pressure pain threshold and lowers anxiety in children compared to control and non- immersive control - a randomized, crossover trial.
Virtual reality (VR) is a promising non-pharmacological pain intervention because it may not only distract but also modulate pain by immersing the user in a three-dimensional 360° alternate reality. In children, VR has been reported to reduce clinical pain and anxiety during medical procedures. However, the effect of immersive VR on pain and anxiety remains to be investigated in randomized controlled trials (RCT). The aim of the present crossover RCT was to assess the effect of VR on pressure pain threshold (PPT) and anxiety level measured with the modified Yale Preoperative Anxiety Scale (mYPAS) in children in a controlled experimental setting. ⋯ Paediatric immersive VR seems to be beneficial although well-controlled studies are pending. We investigated whether immersive VR can modulate children's threshold for pain and anxiety level in an experimental well-controlled setting. We document a modulatory pain threshold increase and anxiety level decrease compared with extensive control conditions. Paediatric immersive VR is effective, feasible and valid for non-pharmacological pain and anxiety management. All efforts to reach the goal that no child should experience pain or anxiety when exposed to medical procedures.
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Randomized Controlled Trial
Mindfulness Combined with Exercise Online (MOVE) Compared with a Self-Management Guide for Adults with Chronic Pain: A Feasibility Randomised Controlled Trial.
Limited studies exist combining mindfulness-based stress reduction (MBSR) and exercise in a pain management programme (PMP), with none thus far delivering a combined intervention as an online PMP. This study aimed to explore the acceptability and feasibility of a combined MBSR and exercise online PMP for adults with chronic pain and to examine the feasibility of conducting a randomized controlled trial (RCT) comparing MBSR and exercise delivered online with an online self-management guide. ⋯ The findings suggest both interventions explored are acceptable and feasible. A fully powered RCT examining the effectiveness of MBSR combined with exercise, delivered live online is warranted.
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Chronic pain is a major health problem given its high prevalence and its multiple consequences on the physical and psychological functioning of patients. It is therefore important to determine the relationship between these consequences and pain management strategies such as activity pacing. This review aimed to examine the association between activity pacing and the level of negative emotions in chronic pain. A second objective was to explore sex differences in this association. ⋯ Pacing is multidimensional and consists of various strategies of pain management which are not equally associated with negative emotions. It is important to use measures reflecting this conception to strengthen knowledges about the role of pacing in the development of negative emotions.
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Randomized Controlled Trial Multicenter Study
The effect of opioid-free anaesthesia on the quality of recovery after endoscopic sinus surgery: A multicentre randomised controlled trial.
It remains to be determined whether opioid-free anaesthesia (OFA) is consistently effective for different types of surgery. ⋯ OFA can provide good intraoperative analgesia and postoperative recovery quality as effectively as conventional opioid anaesthesia in patients undergoing ESS. OFA can be an alternative option in the pain management of ESS.
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Curr Pain Headache Rep · Aug 2023
ReviewA Review of the Paravertebral Block: Benefits and Complications.
Paravertebral nerve blocks (PVB) have experienced a surge over the past 2 decades as improved access to ultrasound has increased ease of performance. The purpose of this review is to identify recent findings with regard to PVB's uses, including benefits, risks, and recommendations. ⋯ PVB is reported as an effective method of analgesia both in intraoperative and postoperative applications, with novel applications showing its potential to replace general anesthesia for certain procedures. The use of PVB as a method of analgesia postoperatively has shown lower opioid usage and faster PACU discharge, when compared to alternative approaches like the intercostal nerve block, erector spinae plane block, pectoralis II block, and patient-controlled analgesia. Thoracic epidural analgesia and a serratus anterior plane block are comparable to PVB and can be used as alternatives. The incidence of adverse events is consistently reported to be very low with few new risks being identified as the use of PVB expands. While there are worthwhile alternatives to PVB, it is an excellent option to consider, particularly for higher-risk patients. For patients undergoing thoracic or breast surgery, PVB can improve opioid usage and shorten the length of stay leading to an overall positive impact on patient recovery and satisfaction. More research is needed to further expand novel applications.