Articles: pain-management.
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Kratom is used commonly in the United States, usually to mitigate pain, opioid withdrawal, or fatigue. A comprehensive discussion on kratom, tailored to pain management physicians, is needed, given its associated risks and potential interactions. ⋯ The use of kratom as an opioid-sparing alternative as a part of a multimodal pain regimen is not without significant risks. It is of utmost importance for pain physicians to be aware of the risks and adverse effects associated with kratom use.
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Curr Opin Anaesthesiol · Oct 2024
ReviewAn update on the perioperative management of postcraniotomy pain.
Pain after craniotomy is often severe and undertreated. Providing adequate analgesia while avoiding medication adverse effects and physiological complications of pain remains a perioperative challenge. ⋯ Improving analgesia following craniotomy continues to be a challenge that should be managed with multimodal medications and regional techniques. Additional studies are needed to identify the most effective regimen, balancing efficacy and adverse drug effects.
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With the help of specialized outpatient palliative care teams (German abbreviation: SAPV), seriously ill and dying patients in Germany can be adequately cared for in their home environment until the end of their lives; however, there are no uniform standards or guidelines for well-executed pain management right now. ⋯ This cross-sectional study is the first of its kind to provide a general overview of the treatment options for pain management in German outpatient palliative care. In comparison with international studies, the question arises as to whether uniform therapy schemes and a reduction in the medication available in the individual SAPV teams could lead to an improvement in patient care.
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Review
Mindful Breathing as an Adjunctive Approach to Chronic Low Back Pain Management: A Scoping Review.
Chronic low back pain (CLBP) is a common and challenging condition. This scoping review explores the literature on mindful breathing's role in managing CLBP, either alone or alongside physiotherapy. ⋯ Mindful breathing holds promise for chronic low back pain management, with studies revealing pain reduction and improved quality of life. Combining it with core stability exercises enhances outcomes. However, standardized protocols are lacking, limiting clinical use. Future research should focus on precise guidelines for integration into practice. Mindful breathing offers a holistic approach to pain management.
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Randomized Controlled Trial
Preoperative Bilateral External Oblique Intercostal Plus Rectus Sheath Block for Postoperative Pain Management following Laparoscopic Cholecystectomy: A Non-inferior Double-blind Placebo-controlled Trial.
The transversus abdominis plane (TAP) block has proven efficacy and is an important component of multimodal analgesia in laparoscopic cholecystectomy (LC). The external oblique intercostal (EOI) block can provide a dermatomal sensory blockade of T6 to T10 using an anterior axillary line injection. The bilateral rectus sheath (RS) block can significantly reduce early postoperative pain caused by umbilical or periumbilical incisions. The current study aimed to compare the analgesic efficacies of ultrasound-guided subcostal TAP (UG-TAP) combined with the RS block and ultrasound-guided EOI (UG-EOI) combined with the RS block for LC. ⋯ These findings suggest that UG-EOI combined with an RS block was superior to UG-TAP combined with an RS block for postoperative pain management in patients undergoing LC.