The Clinical journal of pain
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Pain disorders tend to run in families, and children of individuals with chronic pain have been found to report lower functioning. Drawing upon a social learning perspective, the current study examined how diverse maternal pain coping responses (ie, pain catastrophizing and distraction) may, via corresponding child pain coping responses, act as a vulnerability or protective factor for child functioning in the context of parental chronic pain (CP). ⋯ The current findings demonstrated that child functioning was associated with maternal and child pain catastrophizing, but only in children of mothers without CP. No evidence was found in support of maternal pain coping responses as vulnerability or protective factors in the context of parental CP.
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Occipital nerve block (ONB) is an effective procedure for treating occipital headache pain. However, traditional suboccipital approaches to ONB remain underutilized in acute and chronic settings. An alternative location for ONB is the superior nuchal line, where anatomic studies show a reliable relationship between the occipital artery (OA) and greater occipital nerve. This study evaluated the efficacy and validity of an alternative, single skin insertion, paresthesia-based approach to block both the greater and lesser occipital nerve. ⋯ The results suggest that this alternative approach to ONB effectively reduces occipital headache pain and reliably predicts OA pulse and related greater occipital nerve location as confirmed by paresthesia.
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Randomized Controlled Trial Comparative Study
Electromyographic Comparison of the Efficacy of Ultrasound-guided Suprainguinal and Infrainguinal Fascia Iliaca Compartment Block for Blockade of the Obturator Nerve in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial.
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 with 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 the 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 with infrainguinal FICB.
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Randomized Controlled Trial
Efficacy of Nalbuphine as an Adjuvant to Ropivacaine in Ultrasound Guided Supraclavicular Brachial Block - A Prospective Randomized Controlled Study.
A brachial plexus block (BPB) provides anesthesia and analgesia with limited duration. Various opioids have been used as adjuvants of local anesthetics to improve the effects. ⋯ Nalbuphine is an effective adjuvant to 0.5% ropivacaine in ultrasound-guided supraclavicular BPB. The dosage of 10 mg improves the quality of the anesthesia with less incidence of side effects.
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Current treatments for chronic pain have limited effectiveness and tolerability. With growing interest in the potential of cannabinoids, there is a need to inform risk-benefit considerations. Thus, this focused systematic review assesses the quality of safety assessment and reporting in chronic noncancer pain cannabinoid trials. ⋯ Better harms assessment and reporting are needed in chronic pain cannabinoid trials. Improvements may be achieved through: expanded education/knowledge translation increased research regulation by ethics boards, funding agencies and journals, and greater emphasis on safety assessment and reporting throughout research training.