Articles: pain-management.
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Cognitive-behavioral therapy (CBT) is commonly adopted in pain management programs for patients with chronic low back pain (CLBP). However, the benefits of CBT are still unclear. ⋯ CBT is beneficial in patients with CLBP for improving pain, disability, fear avoidance, and self-efficacy in CLBP patients. Further study is recommended to investigate the long-term benefits of CBT. This meta-analysis is registered with Prospero (registration number CRD42021224837).
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Review Meta Analysis
A Systematic Review and Meta-Analysis of the Effects of Biopsychosocial Pain Education upon Health Care Professional Pain Attitudes, Knowledge, Behaviour and Patient Outcomes.
Pain is a significant health burden globally and its management frequently fails to comply with evidence based, biopsychosocial guidelines. This may be partly attributable to inadequate biopsychosocial focussed pain education for students and clinicians. We aimed to undertake a systematic review, using Cochrane methodology, of randomized controlled trials with meta-analysis to quantify the effects of biopsychosocial education strategies in changing student/qualified health care professionals (HCPs) pain related attitudes, knowledge, clinical behaviour or patient outcomes. ⋯ PROSPERO systematic review record number, CRD42018082251. PERSPECTIVE: We outline the effectiveness of biopsychosocial pain education for health care professionals and students in improving pain knowledge, attitudes, and evidence-based behaviors. These improvements should enhance clinical outcomes in patients with pain but further evidence is needed to confirm this.
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Randomized Controlled Trial
A Randomized Controlled Trial Examining the Impact of an Anorectal Surgery Multimodal Enhanced Recovery Program on Opioid Use.
Anorectal cases may be a common gateway to the opioid epidemic. Opioid reduction is inherent in enhanced recovery after surgery (ERAS) protocols, but little work has evaluated ERAS in these cases. ⋯ An ERAS protocol in ambulatory anorectal surgery is feasible, and resulted in reduced opioid use, and healthcare utilization, with no difference in pain or patient satisfaction. This challenges the paradigm that extended opioids are needed for effective postoperative pain management.
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Anesthesia and analgesia · Jan 2022
Perioperative Opioid Consumption and Clinical Outcomes in Surgical Patients With a Pre-existing Opioid-Based Intrathecal Drug Delivery System.
Intrathecal drug delivery systems (IDDS) have been utilized for over 3 decades for management of chronic pain and spasticity. Patients with IDDS may present for surgical procedures unrelated to the IDDS device, although data are limited regarding perioperative outcomes. ⋯ Patients with opioid-based IDDS received more perioperative opioids and were more likely to receive postoperative pain service consultation compared to matched controls. There were no significant differences in clinical safety outcomes, suggesting tolerance for higher opioid doses. Further research is warranted to optimize perioperative outcomes in those with IDDS.