Pain physician
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Randomized Controlled Trial
Comparison of Changes in the Optic Nerve Sheath Diameter Following Thoracic Epidural Normal Saline Injection in Laparoscopic Surgery.
Thoracic epidural analgesia is useful for postoperative pain control after upper abdominal surgery. However, epidural analgesia in patients undergoing laparoscopic surgery may potentiate an increase in intracranial pressure (ICP). ICP can be effectively evaluated by measuring the optic nerve sheath diameter (ONSD). ⋯ The lapa-saline group showed the most pronounced increase in the ONSD. The ONSD values higher than 5.8 mm were observed only in the lapa-saline group. The increase in the ONSD continued even after the deflation of pneumoperitoneum only in the lapa-saline group.
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Randomized Controlled Trial
Ultrasound-Guided Oblique Sagittal Anterior Quadratus Lumborum Block in Total Hip Arthroplasty: A Randomized Controlled Trial.
The anterior quadratus lumborum block (QLB) is gaining popularity in total hip arthroplasty (THA) surgeries for postoperative pain management and this technique rarely results in lower limb muscle weakness. However, no studies have described the range of its blockade. ⋯ Ultrasound-guided oblique sagittal anterior QLB can reduce the analgesics required after and during THA and the postoperative VAS pain scores, but it rarely affects muscle strength.
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Prescription opioid misuse is an ongoing epidemic in the United States. Though the number of people misusing prescription opioids is declining, the prevalence of abuse and dependence remains stable. This highlights the need to identify and intervene in factors leading to the escalation of prescription opioid misuse. ⋯ Study results suggest the importance of the frequency of prescription opioid misuse as a possible risk factor for dependence and emphasize the need to monitor for misuse even in instances of acute pain.
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Chronic neuropathic pain is a disabling condition that affects quality of life. Despite recommendations and guidelines, treatment remains suboptimal as it often does not result in significant symptom relief. Capsaicin 8% patch has been used for the treatment of several peripheral neuropathic pain etiologies with encouraging results. ⋯ Capsaicin 8% patch is a valuable option for the treatment of peripheral neuropathic pain, providing a significant reduction in pain intensity and painful area. It is well tolerated and has a high treatment compliance.Ethics Committee Reference Number: 16/16//04/2021.
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At present, there are many surgical treatments for primary hyperhidrosis (PH), but their medium- and long-term effects remain unclear. ⋯ This is the first clinical study to evaluate the efficacy of RFS and compare it with PES in treating primary hyperhidrosis. RFS significantly decreased hyperhidrosis and had a higher 2-year effective rate compared to PES.