The Clinical journal of pain
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The knee is innervated by the femoral, obturator, and sciatic nerves. An infrainguinal fascia iliaca compartment block (FICB) is often used as a technique for pain management after hip and knee arthroplasty. This approach blocks the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. Previous studies show suprainguinal FICB achieves improved postoperative analgesia compared to infrainguinal FICB after hip fracture. However, the analgesic effects of suprainguinal or infrainguinal FICB on the obturator nerve after total knee arthroplasty (TKA) remain to be established. This study compared the efficacy of suprainguinal versus. infrainguinal FICB for blockade of the obturator nerve using electromyography and quantification of total opioid consumption during the 24 hours after TKA. ⋯ Suprainguinal FICB significantly increased the incidence of successful obturator nerve block and significantly decreased fentanyl consumption 24 hours after TKA compared to infrainguinal FICB.
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This study aimed to analyze the associations among depressive/anxiety and pain symptoms in patients diagnosed with chronic pain. ⋯ The results support focusing psychosocial interventions in chronic pain treatment not only on reducing pain, anxiety and sleep symptoms but also on enhancing positive affect. Future research is needed to replicate these findings using repeated within-person measures designs.
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Pediatric patients with chronic musculoskeletal conditions such as idiopathic scoliosis awaiting surgical correction can experience pain that interferes with their daily functioning. Reports of this interference are commonly gathered from patients through the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference Scale and through parent-proxy scores. However, the child and parent/caregiver reports vary. To provide appropriate treatment for young patients with pain, the nature of the discrepancies and under which circumstances the reports differ needs to be understood. This report offers new information on the level of concordance among parent and child report of pain interference within this patient population, and which parent and child characteristics may influence concordance rates. ⋯ Parent-proxy and child reports generally correspond, but when discrepant, 24% of parents reported higher pain interference in relationship to the child report of pain interference and 31% noted less intense pain interference than their child's pain interference. Given these results, care should be taken when interpreting parent reports of child pain interference, especially when a child reports higher degrees of pain interference.
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To evaluate the efficacy of intraoperative superior hypogastric plexus (SHP) blocks on postoperative pain management in abdominal hysterectomies. ⋯ Intraoperative SHP blocks in abdominal hysterectomies appear to be promising methods for acute postoperative pain management as part of a multimodal analgesia regimen. Although single SHP blocks provide adequate pain relief and reduce analgesic consumption, these blocks might have better results when used together with somatic nerve blocks, including abdominal wall blocks or wound site infiltrations.
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Parents can play an integral role in managing their child's pain, yet many parents remain unaware of evidence-based strategies to support their child during painful experiences. Recent advances in knowledge translation research, which include dissemination and implementation studies, have resulted in programs geared towards parents to offset this knowledge gap. The nature of these programs and the degree to which parents find them useful remains unclear. Our goal was to systematically review programs aimed as disseminating and implementing evidence-based pain-related knowledge to parents. ⋯ Knowledge translation research in pediatric pain is in its infancy. Development of theories and guidelines to increase the utility and quality of evidence are needed.