Pain physician
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Recurrent LDH (rLDH) is one of the most common causes of unsatisfactory outcomes after discectomy, which usually needs secondary surgery and leads to physical and psychological suffering for patients and substantial costs for society. ⋯ This study demonstrated that the recurrence rate of LDH at 5-year follow-up was 6.27% and there was a significant statistical relationship between FO, DHI, and Modic changes and early rLDH. Surgeons should take FO angles, DHI, and Modic change into consideration before surgery to achieve a satisfactory postoperative outcome and a relatively lower early recurrence rate. More patients and further investigation should be taken to assess the risk factors for early rLDH.
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The optimal analgesia for video-assisted thoracoscopic surgery (VATS) is still unknown. ⋯ EA and PVB have certain advantages in analgesia, but the incidence of postoperative pruritus after EA is higher. At the same time, considering the risk of coagulation and puncture complications, PVB may be a better choice.
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Randomized Controlled Trial
Comparison of Intravascular Uptake and Technical Ease Between Anteroposterior and Oblique Views During Lumbar Medial Branch Block.
Inadvertent intravascular injection of local anesthetics can lead to false-negative results following lumbar medial branch block (MBB) performed to diagnose facet joint origin pain. A previous study demonstrated that the type of approach method could affect the incidence of intravascular injections and technical ease of the procedure. ⋯ The overall incidence rate of intravascular injection during lumbar MBB showed nearly 20% in both approach methods groups. The OB approach and left side MBBs were associated with a longer total procedure time and a higher radiation dose.
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Randomized Controlled Trial
Pediatric Postoperative Pain Control With Quadratus Lumborum Block and Dexamethasone in Two Routes With Bupivacaine: A Prospective Randomized Controlled Clinical Trial.
Ultrasound-guided Quadratus Lumborum block (QLB) is a regional analgesia approach that has been reported to provide effective post-operative pain relief for both abdominal and retroperitoneal surgery. Bupivacaine is the most often used and well documented local anesthetic medication in children. Dexamethasone is a systemic glucocorticoid that is often used to minimize postoperative nausea, vomiting, and pain to improve recovery quality after surgery. ⋯ Dexamethasone may be more effective when added to bupivacaine than when given systemically in analgesic effects without any impact on the other secondary pain-related outcomes. Dexamethasone as an adjuvant to bupivacaine has a marked hand on prolongation of the postoperative duration of analgesia, less request for rescue analgesia, and fewer side effects as compared to bupivacaine if used as a sole agent in QLB.
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Meta Analysis
Efficacy of Scrambler Therapy for Management of Chronic Pain: A Meta-Analysis of Randomized Controlled Trials.
Although several randomized controlled trials (RCTs) have reported the efficacy of scrambler therapy (ST) for the management of chronic pain, those findings remain inconsistent. ⋯ ST seems to be effective in the management of patients with chronic pain. However, further, large RCTs are warranted to confirm our findings.