Pain physician
-
Randomized Controlled Trial
Immunosuppressive Effect of Intrathecal Morphine, Dexmedetomidine, or Both in Combination with Bupivacaine on Patients Undergoing Major Abdominal Cancer Surgery.
An impaired immune system in the perioperative period has important clinical implications in patients with cancer. Despite the immunosuppressive properties of opioid therapy, it is still commonly utilized in the intrathecal or epidural space for the treatment of postoperative pain. Also, intrathecal dexmedetomidine has extended analgesic efficacy in postoperative pain; it can significantly affect immune function in perioperative patients. ⋯ Intrathecal dexmedetomidine has the least immunosuppressive effect than morphine and morphine-dexmedetomidine, in combination with bupivacaine.
-
Randomized Controlled Trial Comparative Study
A Comparison of Anesthetic Quality between Single and Septum-based Double Injection for Ultrasound-Guided Costoclavicular Block: A Randomized Controlled Trial.
In a costoclavicular (CC) approach of an ultrasound (US)-guided infraclavicular brachial plexus block (BPB), a septum between the lateral and the medial/posterior cords can result in an incomplete block. We hypothesized that double injections in each compartment between the septum would result in a higher success rate of BPB than a single injection in the center of the CC space. ⋯ Compared with the SI, the septum-based DI of CC approach increased the success rate and the rate of all 4 nerves blockade and shortened the onset time.
-
Randomized Controlled Trial
Radiofrequency Denervation on Lumbar Facet Joint Pain in the Elderly: A Randomized Controlled Prospective Trial.
Lumbar facet joint (LFJ) pain is the most common cause of low back pain in the elderly. Denervation of the medial branch of the spinal dorsal ramus can theoretically achieve long-term pain relief. Yet there is little evidence of high-level prospective randomized controlled research. ⋯ Radiofrequency denervation can effectively reduce LFJ pain and improve movement disorder. The effect is good until 6 months later.
-
Randomized Controlled Trial
Comparison of Different Treatment Regimens of Extracorporeal Shockwave Therapy in Chronic Low-back Pain: A Randomized Controlled Trial.
Extracorporeal shockwave therapy (ESWT) has shown its efficacy in treating chronic pain. Previous evidence has proven that ESWT in patients with chronic low-back pain (CLBP) results in significant reductions in pain. However, the optimal regimen for conducting ESWT in these patients remains unknown. ⋯ Low-intensity ESWT treatment with more sessions is more effective in relieving pain and improving disability in the short-term than medium-intensity treatment with fewer sessions under the same total energy dose.
-
Randomized Controlled Trial
Comparison of Erector Spinae Plane Block at the Level of the Second Thoracic Vertebra With Suprascapular Nerve Block for Postoperative Analgesia in Arthroscopic Shoulder Surgery.
Appropriate postoperative pain management in shoulder surgeries is the mainstay of rehabilitation therapy and subsequent improved functional outcomes. However, adequate pain control either with opioids or interscalene brachial plexus block is often challenged by their side effects. In this context, this study compared the suprascapular nerve block (SSNB) to the newly emerging erector spinae plane block at the second thoracic vertebral level (high thoracic-ESPB) as an alternative pain therapy. ⋯ SSNB is not inferior to high thoracic-ESPB in the context of phrenic nerve sparing pain control for arthroscopic surgeries. Moreover, SSNB is a more established technique with more predicted sensory distributions and a lower risk of LA toxicity.