Pain practice : the official journal of World Institute of Pain
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In this study, the spread of methylene blue was compared between an ultrasound-guided Pericapsular Nerve Group (PENG) block and a double injection technique, where the approach towards the inferomedial acetabulum was added to the latter. ⋯ Our study demonstrates adequate staining of the iliac bone with comparable distal and medial spread in both techniques, indicating that the PENG block with a single injection is adequate in blocking the hip capsule with 10 mL local anesthetics. Staining of the femoral nerve occurred in 2/6 specimens after the PENG block, and staining of the obturator nerve in 1 specimen in each group.
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Chronic pain is a debilitating, multifactorial condition. The purpose of this study was to examine patient characteristics of those who did not show up for their scheduled first pain medicine appointment in order to identify factors that may improve access to care. ⋯ High no-show rates were present particularly among younger patients. Having a referral from another specialty was an independent predictor of lower no-show rates.
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Chronic pain can negatively impact a child's quality of life. Pediatric Intensive Interdisciplinary Pain Treatment (IIPT) programs aim to improve overall functioning despite pain through various rehabilitative strategies. It is, however, unclear whether improved function corresponds to self-reported decrease in pain levels. Hence, the purpose of this study is to examine the relationship between changes in physical function and perceived pain among children with chronic pain who have undergone inpatient IIPT. ⋯ Self-reported functional gains during IIPT are associated with greater change in perceived pain. Moreover, measures of self-reported physical function can help identify children at risk of minimal pain reduction post-IIPT.
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Complex regional pain syndrome (CRPS) is a clinical disorder that can develop following surgery or trauma. Based on the most prominent underlying pathophysiological mechanisms, CRPS can be classified into different subtypes, namely inflammatory, nociplastic/neuropathic, vasomotor, and motor. Depending on the subtype, personalized treatment can be applied. If conservative treatments are insufficient or ineffective, more invasive treatments may be recommended. This article provides an overview of the most recent insights into CRPS and discusses the most common invasive treatments. ⋯ CRPS is a debilitating condition with an unpredictable course. The effectiveness of treatment varies from patient to patient. When conservative approaches prove insufficient, gradual progression to invasive treatments based on the underlying subtype is recommended.
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Multicenter Study Observational Study
Determinants of successful opioid deprescribing: Insights from French pain physicians-A qualitative study.
Long-term use of opioids does not result in significant clinical improvement and has shown more adverse than beneficial effects in chronic pain conditions. When opioids cause more adverse effects than benefits for the patient, it may be necessary to initiate a process of deprescribing. ⋯ This study underscores the needs to improve the training of healthcare professionals, the effective communication of pertinent information to patients, and the establishment of a therapeutic partnership with the patient. It is therefore essential to carry out the deprescribing process in a collaborative and interprofessional manner, encompassing both pharmaceutical and non-pharmaceutical strategies.