Articles: pain-management-methods.
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To identify the efficacy of radiofrequency ablation of pericranial nerves in treating headache. ⋯ Recent studies by the same group showed promising results in treating headache using radiofrequency ablation. Pericranial nerves can be a therapeutic target for treating headache. Our results showed efficacy of radiofrequency ablation. More studies using other modalities as neuromodulation are needed and may show efficacy as well.
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BACKGROUND Regional nerve blocks ideally provide safe and effective post-operative pain control, decrease opiate requirements, and enhance recovery from intense pain following major thoracic, abdominal, and musculoskeletal surgeries. The erector spinae plane block, a recently described novel treatment for chronic neuropathic pain and acute pain after thoracic surgery, can be performed with in plane infiltration and placement of a continuous infusion catheter deep to the erector spinae muscle at the tip of the transverse process, resulting in diffusion of local anesthetic between vertebrae and the paravertebral space with sensory blockade of spinal nerves as well as sympathetic branches. ⋯ The use of the erector spinae block in this context provided effective post-operative analgesia. CONCLUSIONS Additional evidence from clinical trials will be helpful to evaluate the role of this relatively new block for peri-operative analgesia.
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Cochrane Db Syst Rev · Mar 2020
Review Meta AnalysisTranscutaneous electrical nerve stimulation (TENS) for pain management in sickle cell disease.
Sickle cell disease (SCD), one of the most common inherited disorders, is associated with vaso-occlusive pain episodes and haemolysis leading to recurrent morbidity, hospital admissions and work or school absenteeism. The crises are conventionally treated with opioids, non-opioids and other adjuvants with the risk of developing complications, addictions and drug-seeking behaviour. Different non-pharmacological treatments, such as transcutaneous electrical nerve stimulation (TENS) have been used for managing pain in other painful conditions. Hence, the efficacy of TENS for managing pain in SCD needs to be reviewed. ⋯ Since we have only included one small and very low-quality trial, with a high risk of bias across several domains, we are unable to conclude whether TENS is harmful or beneficial for managing pain in people with SCD. There is a need for a well-designed, adequately-powered, RCT to evaluate the role of TENS in managing pain in people with SCD.
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Multicenter Study
Temporal Factors Associated With Opioid Prescriptions for Patients With Pain Conditions in an Urban Emergency Department.
Opioid prescriptions for treatment of pain in emergency departments (EDs) are associated with long-term opioid use. The temporal pattern of opioid prescribing in the context of the opioid epidemic remains unknown. ⋯ There was a substantial temporal decrease in the number of opioid prescriptions within this ED during the study period. This decrease was associated with substantial relative reductions in opioid prescribing for treatment of musculoskeletal pain compared with fractures and kidney stones.
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Pain medicine practices vary across different regions within a country and between countries. ⋯ Antithrombotic agents, epidural steroid, medial branch blocks, pain practice variations, particulate and nonparticulate steroids, radiofrequency denervation, spinal interventions.