Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Efficacy of transversus abdominis plane block for acute postoperative pain relief in kidney recipients: a double-blinded clinical trial.
After renal transplantation, postoperative pain is usually mild to moderate. Postoperative pain is a concern and administration of systemic analgesic may be difficult because of underlying co-morbidities and variable responses of the graft. The transversus abdominis plane (TAP) block is one of the different approaches for postoperative pain relief following abdominal surgeries. We evaluated analgesic efficacy of TAP block on early postoperative pain by numeric rating scale (NRS) and morphine consumption during the first 24 hours after kidney transplantation. ⋯ Ultrasound TAP block can reduce postrenal transplantation pain and the amount of opioids consumption intraoperatively and during the first 24 hours after surgery in kidney recipients.
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To determine the effectiveness and risks of fluoroscopically guided cervical transforaminal injection of corticosteroids in the treatment of radicular pain. ⋯ In patients with cervical radicular pain, fluoroscopically guided CTFIS may be effective in easing pain and reducing need for surgery. However, the evidence of effectiveness is of very low quality, and the benefits of the procedure are compromised by the risks of serious complications.
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Multicenter Study Observational Study
Sustained effectiveness of 10 kHz high-frequency spinal cord stimulation for patients with chronic, low back pain: 24-month results of a prospective multicenter study.
The aim of this study was to investigate the long-term efficacy and safety of paresthesia-free high-frequency spinal cord stimulation (HF10 SCS) for the treatment of chronic, intractable pain of the low back and legs. ⋯ In patients with chronic low back pain, HF10 SCS resulted in clinically significant and sustained back and leg pain relief, functional and sleep improvements, opioid use reduction, and high patient satisfaction. These results support the long-term safety and sustained efficacy of HF10 SCS.
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There has been a widespread call for an ethics in the management of patients with chronic pain which is patient centered and takes into account the lived experience of the patient. It has been argued in literature that current "duty" or principlist-based models of ethics (so-called 3rd person ethics) have not adequately addressed the needs of either patients or practitioners in this area. ⋯ We outline a patient-centered ethics to underpin contemporary collaborative, multimodal approaches in the management of chronic pain. We firstly describe an agency-oriented, neo-Aristotelian 1st person ethics and then outline a hermeneutic relationship with extant "duty-based," 3rd person bioethics. The utility of the ethics model we propose (the ethical reasoning bridge) lies in its capacity for developing a sense of moral agency for both practitioner and patient, resonating with the current emphasis of seeking active engagement of patients in management.
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Randomized Controlled Trial Comparative Study
Management of hot flushes in breast cancer survivors: comparison between stellate ganglion block and pregabalin.
Women who have survived breast cancer have hot flushes that are "significantly more frequent, severe, distressing, and of greater duration" than in other women. We compared the efficacy and safety of stellate ganglion block and pregabalin for the relief of hot flushes in breast cancer survivors. ⋯ The stellate ganglion block had superior efficacy in the management of hot flushes in breast cancer survivors.