Articles: acute-pain.
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Millions experience inadequately managed acute pain each year. Opioids are an important tool for managing pain; however, recent reductions in opioid prescriptions have exacerbated preexisting challenges in pain management. Moreover, patient expectations and desires for pain management may drive additional opioid use. There is an important need to characterize patient motivations for using opioids in order to develop promising interventions. The aim of this study was to develop the Decisions To use Opioids (DTO) measure. ⋯ This study provided evidence of content and face validity of the DTO measure for ED patients. Further psychometric evaluation is needed to gather data regarding the DTO's internal consistency, construct validity, and criterion validity.
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Reg Anesth Pain Med · Nov 2024
Earlier preoperative percutaneous intercostal cryoanalgesia improves recovery after pectus excavatum surgery.
Minimally invasive repair of pectus excavatum is associated with intense postoperative pain. We aimed to evaluate the effectiveness of percutaneous intercostal cryoanalgesia according to the different timing of its preoperative application. Outcome variables included pain, drug consumption, time to mobilization, and hospital length of stay. ⋯ This exploratory observational study suggests that the timing of cryoanalgesia may play a crucial role in its efficacy, with earlier placement being associated with improvements in pain, opioid utilization, and length of stay.
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Reg Anesth Pain Med · Nov 2024
Successful cutaneous sensory blockade following single-injection and double-injection techniques of ultrasound-guided superficial parasternal intercostal plane block: a randomized clinical trial.
While superficial parasternal intercostal plane blocks can improve analgesia after cardiac surgery, the optimal site and the number of injections remain uncertain. This study aimed to compare the efficacy of single versus double injections of superficial parasternal blocks, hypothesizing that double injections would achieve superior cutaneous sensory blockade. ⋯ Compared with single injection, double injections of superficial parasternal blocks provided more reliable coverage of the T2-T6 dermatomes, crucial for median sternotomy. However, no differences were observed in intraoperative hemodynamic effects or postoperative pain control after cardiac surgery.
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Acute coronary syndrome (ACS) is a rare cause of chest pain in adolescents and young adults. Kawasaki disease (KD) is an uncommon illness, but coronary artery aneurysms secondary to KD are implicated in approximately 5% of cases of ACS in young adults. Patients with KD may present with catastrophic coronary disease at a young age and thus early recognition of this disease process and lifelong follow-up is essential. ⋯ This case demonstrates the importance of screening after a childhood diagnosis of KD, specifically when caring for the tactical athlete. It also highlights the impact that social determinants of health can have on patient outcomes. Finally, it demonstrates the importance of communication and coordination between military and civilian medical centers across the globe driving the care of our deployed injured and ill active-duty military personnel.