Pain physician
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Randomized Controlled Trial
Analgesic Effect of Addition of Pectointercostal Block to Serratus Anterior Plane Block in Breast Surgeries: A Randomized, Controlled Trial.
Ultrasound-guided serratus anterior plane block (SAPB) is an efficient perioperative analgesic modality for breast surgeries. SAPB does not block the anterior cutaneous branches of the intercostal nerves; thus, it does not provide adequate analgesia for the parasternal region and the medial side of the breast. A new parasternal block, the pectointercostal fascial plane block (PIFB) has been developed to overcome this issue. ⋯ The number of patients who needed intraoperative fentanyl, as well as the MABP and heart rate were significantly lower in Group 2 (SAPB+PIFB). Postoperative vital signs, VAS, postoperative analgesic requirements, and opioid consumption were comparable for both groups. Patient satisfaction was comparable for both groups, while surgeon satisfaction was higher in Group 2 (SAPB+PIFB) but statistically not significant.
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In the medical setting, clinicians frequently attend to patients with chronic musculoskeletal pain. Recent literature demonstrates diet may play a role in inflammation and musculoskeletal pain. ⋯ Clinicians can play a role in the well-being of patients with chronic musculoskeletal pain through holistic interventions such as a dietary emphasis on plant-based regimes. Further research is necessary to elucidate the relationship between diet, inflammatory markers, and disease states, as well as the safety and contraindications of these dietary changes.
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Randomized Controlled Trial
Comparison of the Low Back Pain Relief and Spread Level After Upper and Lower Lumbar Erector Spinae Plane Block.
The erector spinae plane block (ESPB), which was introduced to manage the thoracic pain, is an ultrasound-guided technique that is relatively easy, less invasive, and safer. In spite of its technical ease and safety of ESPB, few studies have explored the analgesic efficacy and the exact spread level of injected local anesthetics. ⋯ Both the L2 and L4 ESPB groups demonstrated a significant reduction in low back pain and improvement in disability. The L2 ESPB group demonstrated a significantly increased spread level compared to the L4 ESPB group.
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Randomized Controlled Trial
Combined Infraclavicular-Suprascapular Nerve Blocks Compared With Interscalene Block for Arthroscopic Rotator Cuff Repair: A Prospective, Randomized, Double-blind, and Comparative Clinical Trial.
The gold standard postoperative analgesia protocol for arthroscopic rotator cuff repair procedures is the interscalene block (ISB), which prevents the significant consequences of phrenic nerve block associated with hemidiaphragmatic paralysis (HDP). The infraclavicular brachial plexus block (BPB) combined with the suprascapular nerve block (SSNB) had the same analgesic efficacy as the infraclavicular BPB alone, with no effect on respiration. ⋯ The employment of the costoclavicular block in combination with the suprascapular block may provide a comparable analgesic potency to the sole use of the standard ISB with no HDP.
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Randomized Controlled Trial Multicenter Study
The Safety and Effectiveness of Orthobiologic Injections for Discogenic Chronic Low Back Pain: A Multicenter Prospective, Crossover, Randomized Controlled Trial with 12 Months Follow-up.
Chronic low back pain is one of the most common causes of disability, affecting more than 600 million people worldwide with major social and economic costs. Current treatment options include conservative, surgical, and minimally invasive interventional treatment approaches. Novel therapeutic treatment options continue to develop, targeting the biological cascades involved in the degenerative processes to prevent invasive spinal surgical procedures. Both intradiscal platelet-rich plasma (PRP) and bone marrow concentrate (BMC) applications have been introduced as promising regenerative treatment procedures. ⋯ This is the only human lumbar disc study that evaluates both PRP and BMC in the same study and compares it to placebo. PRP and BMC were found to be superior to placebo in improving pain and function; however, larger randomized clinical trials are needed to answer further questions on the comparative effectiveness of various biologics as well as to identify outcome differences specific to disc pathology.