The Clinical journal of pain
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This review aims to analyze the current data for the use of botulinum toxin type A (BTX-A) in the treatment of trigeminal neuralgia (TN) and highlight the evidence for its efficacy and safety. Pain management in patients with TN is challenging, as facial pain often does not respond well to conventional therapies. BTX-A has been suggested as a potential treatment option, but there is limited evidence regarding its long-term efficacy. ⋯ Current evidence indicated BTX-A injection is an effective and safety option for patients with refractory TN or not responding to medical or surgical management. However, more high-quality studies are needed to further confirm its efficacy.
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This study aimed to determine the incidence of complications after landmark-based paravertebral blocks for breast surgery. ⋯ Our study suggests that landmark based paravertebral blocks for breast surgery result in a very low complication rate and are a safe technique for post-surgical analgesia.
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Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain. ⋯ Adolescents often demonstrated active and sound participation in shared opioid decision-making, influenced by complex integration of inputs and self-reflection. Conversely, potential factors that could contribute to risky behaviors included low personal risk perceptions, uncertainty about what constitutes opioid misuse, and avoidance of prescribed opioids despite extreme pain. Future studies may explore associations of adolescents' opioid decision-making with longer-term pain and opioid-related outcomes.
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Perceived injustice (PI), assessed by the Injustice Experience Questionnaire (IEQ), is an important trigger of anger. Both PI and anger are associated with adverse chronic pain outcomes, and with comorbid mental health severity. We aimed to examine the roles of PI and anger in mediating pain across Fibromyalgia patients, with and without comorbid anxiety/depression (FM+A/D, FM-A/D respectively), as well as Rheumatoid Arthritis (RA), and healthy controls (HC). We hypothesized the highest levels of PI, anger, and pain in FM+A/D patients, followed by FM-A/D, RA, and HC, thus also validating a Hebrew version of the IEQ. ⋯ Our findings validate a Hebrew IEQ, and highlight the importance of PI and state and trait anger in the differential manifestation of mental health comorbidity in FM.
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As 2 novel peripheral nerve blocks, the erector spinae plane block (ESPB) and thoracolumbar interfascial plane (TLIP) block can relieve postoperative pain in spinal surgery. This systematic review and meta-analysis aimed to determine the efficacy and safety of ESPB versus TLIP block in patients undergoing spine surgery. ⋯ ESPB and TLIP block are 2 novel and effective block methods. Patients receiving ESPB had lower postoperative opioid consumption and postoperative pain scores compared with patients receiving TLIP block; there was no statistically significant difference's between the 2 groups in intraoperative opioid consumption, adverse events, and rescue analgesia.