Pain physician
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This comprehensive review of pain in paraneoplastic neurological syndromes focuses on current mechanisms that lead to pain, including autoimmune processes as well as the systemic secretion of factors that sensitize nociceptive nerves. Systemic secretion of functional molecules is a well-recognized phenomenon in endocrine paraneoplastic syndromes; however, cancer pain research has predominantly focused on cytokine-nerve interactions in the tumor microenvironment, and few groups have applied the molecular mechanisms of local pain to study widespread neuropathic pain resulting from systemic secretion. We present a novel perspective in the field of pain research by converging data from clinical oncology with recent molecular pain research on cytokine-mediated sensitization of nociceptive nerves. ⋯ Paraneoplastic neurologic syndromes, chronic pain, neuropathic pain, treatment guidelines, cytokines.
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Randomized Controlled Trial
The Associations Between Cognitive Dysfunction, Stress Biomarkers, and Administered Anesthesia Type in Total Knee Arthroplasties: Prospective, Randomized Trial.
Postoperative cognitive dysfunction (POCD) is a serious complication associated with total knee arthroplasty (TKA) and has been shown to increase the length of hospital stay, cause functional impairment, and morbidity. ⋯ Cognitive dysfunction, stress biomarkers, acute pain, regional anesthesia, spinal anesthesia.
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The role of patient satisfaction continues to play an important role in health care quality measures. The use of online review platforms has been adopted by patients to share their perceptions about the quality of care provided by physicians. Chronic pain practice has unique challenges regarding patient satisfaction. ⋯ Chronic pain practice, online review, patient review, patient satisfaction.
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Clinical Trial
A Prospective, Randomized Cross-Over Trial of T2 Paravertebral Block as a Sympathetic Block in Complex Regional Pain Syndrome.
Sympathetic block is commonly performed in clinical practice for management of intractable pain conditions. However, stellate ganglion block (SGB) alone often does not achieve sufficient sympatholysis of the upper extremity. The paravertebral space continues up to the cervical sympathetic chain and includes the stellate ganglion. We compared the sympatholytic and analgesic effect of paravertebral block performed at the T2 level (T2 PVB) with that of SGB in patients with complex regional pain syndrome (CRPS) of the upper extremity. ⋯ Sympathetic block, Complex Regional Pain Syndrome, paravertebral block, stellate ganglion block.
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Beta-blocker Use is Associated with a Reduction in Opioid Use 30 Days After Total Knee Arthroplasty.
Total knee arthroplasty (TKA) can lead to chronic pain and prolonged postoperative opioid use. There are few evidence-based interventions to prevent these outcomes. Recently, beta-blockers have emerged as possible novel analgesics. ⋯ Analgesics, opioid, arthroplasty, replacement, knee, adrenergic beta-antagonists, pain management.