Pain physician
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Randomized Controlled Trial
Does Intraoperative Multi-Drug Wound Infiltration Relieve Postoperative Pain Following Single-Level TLIF Surgery? A Randomized Controlled Trial.
How to minimize postoperative pain following spinal surgery has been a great challenge for both surgeons and patients. We hypothesized that intraoperative multi-drug wound infiltration could relieve postoperative pain following single-level transforaminal lumbar interbody fusion (TLIF) surgery. ⋯ Intraoperative multi-drug wound infiltration before closure could significantly relieve postoperative pain following single-level TLIF surgery.
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Randomized Controlled Trial
Ultrasound-Guided Transversus Abdominis Plane Block in Treating Abdominal Skin Tension Pain After Kyphosis Surgery: A Pilot Study in Enhanced Recovery After Surgery Setting.
The postsurgical management of patients with ankylosing spondylitis is often only focused on the incision pain, and the pain caused by abdominal skin traction is paid little attention. ⋯ In the first 24 hours after severe kyphosis surgery, TAPB can reduce the pain from abdominal skin tension and increase the comfort scores, but its effects on tension blisters remain to be further studied.
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Randomized Controlled Trial
ED90 of Sufentanil in Epidural Initiation for Labor Analgesia in Latent Phase and Active Phase During the First Labor Stage.
The standard solutions for epidural labor analgesia include both local anesthetics and opioids. The concept of the standard epidural use of local anesthetics in labor analgesia has shifted from high concentrations to high volumes with low concentrations. However, the optimal dosage of opioids needed to initiate and maintain epidural labor analgesia in different phases during the first labor stage has rarely been studied. ⋯ Different sufentanil doses should be adopted in epidural initiation in different phases during the first stage of labor due to the large differences in the demand for sufentanil.
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Randomized Controlled Trial Multicenter Study
Improved Sensation Resulting From Spinal Cord Stimulation for the Treatment of Painful Diabetic Neuropathy: The Possible Role of Stochastic Resonance.
Painful diabetic neuropathy (PDN) is a progressive chronic pain condition that significantly affects the quality of life of patients with long-standing diabetes mellitus. Sensory deficits may result in falls, foot ulceration, and lower limb amputations. Recently, spinal cord stimulation (SCS) was studied for treatment of painful diabetic neuropathy. In addition to pain relief, we were surprised to discover that sensory improvements were also demonstrated. No mechanistic explanation has yet been offered to explain these findings. ⋯ SCS might have unexpected benefits in patients with PDN beyond pain reduction. The Senza-PDN trial is the first to describe improved sensation in association with SCS. While the mechanism of action are still unknown, we hypothesize that noise-enhanced signal processing via stochastic resonance may explain these results. Stochastic resonance, or the benefit of additional randomness, should be further studied in the context of spinal cord stimulation. Further, SCS programming that optimizes for stochastic resonance should also be investigated for restoration of sensory and possibly even motor function.
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Randomized Controlled Trial
The Effect of Tramadol Versus Sufentanil on Controlling Postoperative Pain for Men Who Smoke and Do Not Smoke: A Randomized Clinical Trial.
Smoking behavior alters the analgesic threshold, which challenges postoperative pain management for patients who smoke. ⋯ Our data suggest that tramadol has a better analgesic effect than sufentanil in relieving postoperative pain in patients who smoke.