Pain physician
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Quadratus lumborum (QL) block has shown promising analgesic efficacy in the adult population in previous meta-analyses. However, the response of the pediatric group to pain stimulation is stronger than that in the adult population, and the management of pediatric pain is constrained by limited available analgesia agents. All data analyzed during this study are collected from published articles. ⋯ Our systematic review and meta-analysis suggests QL block use for the pediatric population undergoing lower abdominal surgery, based on the current limited research evidence, as this method was an effective postoperative analgesic technique.
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Epidural injections are one of the commonly performed procedures in managing low back and lower extremity pain. In the past, Pinto et al and Chou et al performed systematic reviews and meta-analyses with a recent update from Oliveira et al showing lack of effectiveness of epidural steroid injections in managing lumbar radiculopathy. In contrast, multiple other systematic reviews and meta-analyses have supported the efficacy and use of epidural injections utilizing fluoroscopic guidance. ⋯ Epidural injections with or without steroids for radiculopathy showed significant effectiveness with Level I or strong evidence for local anesthetic with steroids and Level II to I or moderate to strong evidence with local anesthetic alone.
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Meta Analysis
Comparison of Different Operative Approaches for Lumbar Disc Herniation: A Network Meta-Analysis and Systematic Review.
New approaches and technologies can be beneficial for patients but also bring corresponding complications. Traditional pairwise meta-analyses cannot be used to comprehensively rank all surgical approaches. ⋯ Compared with other approaches used to treat LDH, PED had the best safety and efficacy in general, and TD had the lowest reoperation rate. Finally, we recommended PED for LDH.
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Erector spinae plane block could be a potential alternative to paravertebral block or other analgesic techniques for breast surgery, but the current evidence on erector spinae plane block in breast surgery is conflicting. ⋯ Erector spinae plane block is superior to systemic analgesic within 24 hours after breast surgery and can serve as an alternative to paravertebral block with similar analgesic effects.
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Case Reports Meta Analysis
Infections Following Interventional Spine Procedures: A Systematic Review.
Interventional spine procedures, such as discography, epidural steroid injections (ESIs), facet joint procedures, and intradiscal therapies, are commonly used to treat pain and improve function in patients with spine conditions. Although infections are known to occur following these procedures, there is a lack of comprehensive studies on this topic in recent years. ⋯ Based on our systematic review, the risk of infections following interventional spine procedures appears to be low overall. More studies focusing on infectious complications with larger sample sizes are needed, particularly for intradiscal therapies, in which the microbiome may be an underlying cause of disc infection. To achieve a true incidence of the risk of infections with these procedures, large prospective registries that collect complication rates are necessary.