Articles: pain-management-methods.
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Multimodal analgesia regimens have been suggested to improve pain control and reduce opioid consumption after surgery. ⋯ Implementation of an evidence-based, multimodal analgesia protocol improved postoperative outcomes, including pain scores, opioid consumption, and length of hospital stay, after posterior lumbar spinal fusion.
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Review Case Reports
Spinal cord stimulation improves functional outcomes in children with CRPS: Case presentation and review of the literature.
In the pediatric population, complex regional pain syndrome (CRPS) is a debilitating chronic pain syndrome that is classically treated with escalating polypharmacy and physical therapy. Failure of therapy is often encountered in both adult and pediatric patients with CRPS, after which invasive neuromodulatory therapy might be considered. Intrathecal drug delivery systems and spinal cord stimulation (SCS) have been reported in the literature as forms of neuromodulation effective in adult CRPS; however, SCS remains inadequately researched and underreported in the pediatric CRPS population. Owing to the differences in patient population characteristics and the specific vulnerability of adolescents to drugs that might be used to manage refractory cases, including but not limited to opioids, we believe that early effective pain management without the use of chronic pain medications is of paramount importance. ⋯ The manuscript objective is to stimulate a discussion for SCS use earlier in the therapeutic management of CRPS in children.
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Randomized Controlled Trial
Contrast Medium Volume Needed to Reach Anterior Epidural Space via the Kambin Triangle or Subpedicular Approach for Transforaminal Epidural Injection.
Transforaminal (TF) lumbar injection is a commonly used minimally invasive intervention for management of chronic low back pain. TF injection can be performed using various approaches to inject the drug to the anterior epidural space (AES). ⋯ Transforaminal injection, subpedicular approach, Kambin triangle approach, contrast medium spread, anterior epidural spread.
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This study describes the use of transversus abdominis plane (TAP) blocks to treat and manage chronic abdominal pain (CAP) in patients who have exhausted other treatment options. Typically, this is a procedure prescribed for treating acute abdominal pain following abdominal surgery. Here we evaluate the use of TAP blocks for longer relief from CAP. ⋯ Abdominal pain, transversus abdominis plane block, chronic pain, chronic abdominal pain, pain management, somatosensory pain, transversus abdominis plane, steroid injection.