Articles: chronic-pain.
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Anaesth Intensive Care · Feb 2025
Survey of administration of intravenous ketamine for perioperative pain management in Australia and New Zealand.
Ketamine is an N-methyl-d-aspartate receptor antagonist approved for use in anaesthesia, with analgesic properties. Despite publication of numerous trials and expert guidelines on its use for pain management, administration of ketamine as part of multimodal perioperative analgesia remains 'off-label'. We conducted an online, prospective survey of ANZCA Fellows, exploring current prescribing practices of intravenous ketamine for perioperative analgesia. ⋯ Postoperative ketamine infusion was most commonly prescribed as third-line or rescue analgesia. The majority of respondents thought it either 'likely' or 'very likely' ketamine would reduce postoperative chronic pain after thoracic surgery, but not in other surgical categories. Our findings suggest that off-label perioperative administration of ketamine at analgesic dose ranges is routine or common practice in major surgery for a majority of specialist anaesthetists in Australia and New Zealand.
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Reg Anesth Pain Med · Feb 2025
Analysis of complications of minimally invasive approaches for symptomatic lumbar spinal stenosis.
Current treatment modalities of lumbar spinal stenosis range from conservative medical management and physical therapy to open surgical decompression. Minimally invasive lumbar decompression (MILD) and Superion interspinous spacers (SISS) Vertiflex offer the promise of effective pain relief with shorter recovery time and lesser potential complications compared with open surgical decompression procedures and general anesthesia. Despite their increasing utilization, their complication profile is not well established in the literature. ⋯ As with any new intervention, we must proceed with caution and evaluate the procedure performance over time. Such data should aid physicians to make informed decisions before choosing either technique for their patients. The findings from this study provide insight into the complication profile associated with both MILD and Vertiflex procedures, highlighting the need for continued evaluation and careful consideration in clinical decision-making.
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Curr Pain Headache Rep · Feb 2025
ReviewThe Potential of Wearable, Modular Devices in Monitoring Functional Clinical Metrics in Patients Suffering from Chronic Pain.
This review assesses the role of wearable technologies in pain management, emphasizing their capability to transcend subjective pain evaluations with objective functional outcome tracking. We explore the types and veracity of health metrics wearable devices track, illustrating how this technological evolution can significantly enhance patient care in the context of chronic pain prevention and management. ⋯ The advancements in modular wearable technology offer new avenues to track a variety of health outcomes, including aerobic capacity, physical activity, stress, and sleep quality. This provides objective measurements that can aid in the management of chronic conditions and can offer a more comprehensive assessment of a patient's pain and function. Although the initial approach to pain management that emphasized pain as the fifth vital sign had unintended devastating consequences, leveraging wearable technology for objective outcomes tracking presents an opportunity to optimize pain management strategies. Wearable technologies capture functional metrics that provide insight into many aspects of the biopsychosocial model of pain. Utilizing function as the key performance indicator has the potential to improve treatment outcomes and, ultimately, patient care.