Articles: pain-management-methods.
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Randomized Controlled Trial
Virtual reality exposure before elective day care surgery to reduce anxiety and pain in children: A randomised controlled trial.
Pre-operative anxiety in children is very common and is associated with adverse outcomes. ⋯ In children undergoing elective day care surgery, VRE did not have a beneficial effect on anxiety, pain, emergence delirium or parental anxiety. However, after more painful surgery, children in the VRE group needed rescue analgesia significantly less often, a clinically important finding because of the side effects associated with analgesic drugs. Options for future research are to include children with higher levels of anxiety and pain and to examine the timing and duration of VRE.
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Curr Opin Anaesthesiol · Oct 2019
ReviewPrimer on machine learning: utilization of large data set analyses to individualize pain management.
Pain researchers and clinicians increasingly encounter machine learning algorithms in both research methods and clinical practice. This review provides a summary of key machine learning principles, as well as applications to both structured and unstructured datasets. ⋯ In the coming years, machine learning is likely to become a key component of evidence-based medicine, yet will require additional skills and perspectives for its successful and ethical use in research and clinical settings.
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To explore the data for and against the use of the various components of multimodal analgesia in cranial neurosurgery. ⋯ Opioids are the mainstay for treating acute postcraniotomy pain but should be minimized. The evidence to support a multimodal approach is growing; neuroanesthesiologists and neurosurgeons should seek to incorporate multimodal analgesia into the perioperative care of craniotomy patients. Preoperative and postoperative gabapentin and acetaminophen, intraoperative dexmedetomidine, and scalp blocks over incisional infiltration have the most data for benefit, with good safety profiles. Further research is needed to define the safety, efficacy, and dosing parameters for NSAIDs including COX-2 inhibitors, methocarbamol, ketamine, and intravenous lidocaine in cranial neurosurgery.
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Semin. Arthritis Rheum. · Oct 2019
Meta AnalysisNonsurgical medical treatment in the management of pain due to lumbar disc prolapse: A network meta-analysis.
Evaluate the comparative effectiveness of treatment strategies for patients with pain due to lumbar disc prolapse (LDP). ⋯ No treatment stands out as superior when compared on multiple outcomes and time periods but TESIs show promise as an effective short-term treatment. High quality studies are needed to confirm many nodes of this network meta-analysis.