Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Randomized Controlled Trial
Effects of 4 mg and 8 mg Dexamethasone Added to Intrathecal Bupivacaine on Perioperative Analgesia Among Adult Orthopedic Patients at Sodo Christian Hospital: A Prospective Cohort Study.
Background: Several adjuvant drugs have been tried to prolong spinal anesthesia block. Currently, dexamethasone appears to be effective in extending the duration of sensory block and enhancing analgesia during surgery. It is unclear, however, whether administering dexamethasone at a dose of 8 mg offers any advantages over administering it at a dose of 4 mg. ⋯ In addition, there was no significant difference (p > 0.05) in postoperative analgesic use, initial analgesia rescue time, or pain severity, as measured by the Numerical Rating Scale (NRS). The addition of dexamethasone did not result in any issues, nor was there a statistically significant difference in the onset time between the two groups. Conclusion: Dexamethasone at a dose of 4 mg extends the duration of sensory, motor, and overall analgesia in a manner similar to that of 8 mg dexamethasone with comparable durations for both the initial analgesic request and overall analgesic use.
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Sacroiliac (SI) joint dysfunction is a common cause of lower back pain. The diagnosis of SI joint pain remains challenging. Sacroiliac joint injection remains the gold standard of diagnosis of SI joint pain as well as providing therapeutic effect. One complication related to SI joint injection is temporary numbness and weakness of the leg. ⋯ Our results indicate that the injection of lower concentration of local anesthetic with less volume may be necessary to decrease the risk of S1 nerve root block and epidural block. Furthermore, to improve the specificity of a diagnostic SI injection, an appropriate evaluation should be considered to rule out any S1 nerve pathology as a significant pain generator.
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Randomized Controlled Trial
Effect of Ondansetron on Postoperative Pain and Vomiting after Acute Appendicitis Surgery: A Placebo-Controlled Double-Blinded Randomized Clinical Trial.
Common postoperative complications following surgery, particularly acute appendicitis surgery, include postoperative pain and vomiting, which can cause discomfort and delay recovery time. ⋯ In conclusion, our study found that ondansetron was effective in reducing postoperative vomiting after acute appendicitis surgery. However, it did not show a clinically significant effect on postoperative pain. This trial is registered with IRCT20230722058883N1.
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Randomized Controlled Trial Comparative Study
Efficacy of Scapular Functional and Cervical Isometric Exercises in the Management of Chronic Mechanical Neck Pain: A Randomized Comparative Trial.
Background: The global rise in work-related musculoskeletal ailments has led to issues like neck discomfort, scapular muscle dysfunction, reduced neck mobility, and functional limitations. This study aimed to evaluate the effectiveness of scapular functional exercises (SFE) and cervical isometric exercises (CIE) on pain, cervical range of motion (CROM), and functional limitations in individuals with chronic mechanical neck pain (CMNP). Methods: A two-arm, parallel group pretest-post-test randomized comparative trial was conducted. ⋯ Conclusions: Adding SFE to CIE and conventional physiotherapy was more effective than just using CIE and conventional physiotherapy alone. This approach better alleviated neck pain, improved CROM (particularly in forward and left-side flexion), and reduced functional limitations in individuals with CMNP. Trial Registration: ClinicalTrials.gov Identifier: NCT05624021.
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Background: Cancer-related pain is a pervasive symptom affecting the quality of life in patients with malignant tumors. For those with refractory pain, palliative sedation combined with pain management is recommended. Dexmedetomidine (DEX), known for its unique "awake sedation" effect, remains relatively unexplored when used in conjunction with patient-controlled analgesia (PCA) for terminal-stage cancer patients. ⋯ While heart rate, blood oxygen saturation, and respiratory rate remained stable, systolic blood pressure and diastolic blood pressure after 1 h of sedation were significantly lower than presedation levels (p = 0.040 and p = 0.044, respectively). Conclusion: DEX emerges as a promising option for palliative sedation in terminal-stage cancer patients. When used in conjunction with PCA, DEX has been shown to effectively, safely, and stably control refractory pain without inducing adverse effects such as respiratory/circulatory depression.