Articles: pain-management.
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Multicenter Study
Development and internal validation of a clinical risk tool to predict chronic postsurgical pain in adults: a prospective multicentre cohort study.
Chronic postsurgical pain (CPSP) is a highly prevalent condition. To improve CPSP management, we aimed to develop and internally validate generalizable point-of-care risk tools for preoperative and postoperative prediction of CPSP 3 months after surgery. A multicentre, prospective, cohort study in adult patients undergoing elective surgery was conducted between May 2021 and May 2023. ⋯ These models demonstrated good calibration and clinical utility. The primary CPSP model demonstrated fair predictive performance including 2 significant predictors. Derivation of a generalizable risk tool with point-of-care predictors was possible for the threshold-based CPSP models but requires independent validation.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Multicenter StudyThe Use of Methadone and Ketamine for Intraoperative Pain Management in Cardiac Surgery: A Retrospective Cohort Study.
To evaluate whether the addition of ketamine to intraoperative methadone is associated with superior postoperative pain management and decreased opioid consumption compared with methadone alone in cardiac surgery patients. ⋯ Adding ketamine to methadone prolonged the time to first opioid consumption postoperatively but showed no benefits beyond POD 0. Future studies should consider protocolized dosing to optimize pain control.
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Randomized Controlled Trial Multicenter Study
Reduction of postoperative pain and opioid consumption by VVZ-149, first-in-class analgesic molecule: A confirmatory phase 3 trial of laparoscopic colectomy.
VVZ-149 is a small molecule that inhibits the glycine transporter type 2 and the serotonin receptor 5-hydroxytryptamine 2 A. In this Phase 3 study, we investigated the efficacy and safety of VVZ-149 as a single-use injectable analgesic for treating moderate to severe postoperative pain after laparoscopic colectomy. ⋯ Trial Number NCT05764525.
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Eur J Trauma Emerg Surg · Jan 2025
Multicenter Study Observational StudyCostal fracture assessment for relief and enhancement of quality of life-CARE study.
Rib fractures account for 10-15% of trauma-related hospital admissions. Few data are available regarding long-term follow-up of patients undergoing non-operative management. Our aim is to evaluate quality of life at 1, 2, 4, 12 and 24 weeks from the trauma. Pain management, respiratory infection rate and length of hospitalization (LOS) will be recorded. ⋯ The results could have broad practical applications, providing guidance on best practices for rib fracture treatment. This could lead to greater efficacy in management protocols, reducing or increasing the need for surgical interventions. The study could have a significant impact on the health-care system by providing evidence to optimize healthcare resources through more targeted management. If the results demonstrate that conservative treatment is ineffective for certain types of fractures, these patients could be selected for surgical treatment, resulting in savings for the healthcare system and improvement in patient quality of life.
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Reg Anesth Pain Med · Jan 2025
Multicenter Study Comparative StudyContinuous erector spinae plane block versus thoracic epidural analgesia in video-assisted thoracoscopic surgery: a prospective randomized open-label non-inferiority trial.
The evolving surgical techniques in thoracoscopic surgery necessitate the exploration of anesthesiological techniques. This study aimed to investigate whether incorporating a continuous erector spinae plane (ESP) block into a multimodal analgesia regimen is non-inferior to continuous thoracic epidural analgesia (TEA) in terms of quality of postoperative recovery for patients undergoing elective unilateral video-assisted thoracoscopic surgery. ⋯ The continuous ESP block is non-inferior to TEA in video-assisted thoracoscopic surgery.