Articles: acute-pain.
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The topic of this article is the team in interdisciplinary multimodal pain therapy (IMPT) in the context of the development of the team concept. The starting points are historical developments, both social and scientific. After World War II numerous war victims continued to suffer from persistent pain. ⋯ Crucial for functioning teams is an effective cooperation and interaction. Related organizational issues, conflicts, peculiarities, and possibilities for solutions are presented. In the meantime, IMPT as a procedure has become a regular service provided in health care.
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Randomized Controlled Trial
Bilateral corticomotor reorganisation and symptom development in response to acute unilateral hamstring pain: A randomised, controlled study.
Accumulating evidence demonstrates that pain induces adaptations in the corticomotor representations of affected muscles. However, previous work has primarily investigated the upper limb, with few studies examining corticomotor reorganization in response to lower limb pain. This is important to consider, given the significant functional, anatomical, and neurophysiological differences between upper and lower limb musculature. ⋯ These effects persisted for at least 75 minutes after pain resolution. PERSPECTIVE: These findings suggest that individual patterns of corticomotor reorganization may contribute to ongoing functional deficits of either limb following acute unilateral lower limb pain. Further research is required to assess these adaptations and the possible long-term implications for rehabilitation and reinjury risk in cohorts with acute hamstring injury.
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Inadequately managed postoperative pain remains a common issue. Examining factors like pain sensitivity, pain catastrophizing, and pain self-efficacy can help improve postoperative pain management. While these factors have been identified as potential predictors of acute postoperative pain, their effects have been inconsistent. Few studies have explored the interactions between these factors. ⋯ The severity of postoperative acute pain can be predicted by pain self-efficacy and pain catastrophizing, and the connection between moderate pain sensitivity and postoperative acute pain severity is mediated by them. Therefore, intervention programs aimed at boosting pain self-efficacy and reducing pain catastrophizing can enhance postoperative pain outcomes for abdominal surgery patients.
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Anesthesia and analgesia · Apr 2024
Mild Traumatic Brain Injury-Induced Augmented Postsurgical Pain Is Driven by Central Serotonergic Pain-Facilitatory Signaling.
Individuals recovering from mild traumatic brain injury (mTBI) have increased rates of acute and chronic pain. However, the mechanism through which mTBI triggers heightened pain responses and the link between mTBI and postsurgical pain remain elusive. Recent data suggest that dysregulated serotonergic pain-modulating circuits could be involved. We hypothesized that mTBI triggers dysfunction in descending serotonergic pain modulation, which exacerbates acute pain and delays pain-related recovery after surgery. ⋯ Collectively, our results show that descending serotoninergic pain-facilitating signaling is responsible for nociceptive sensitization after mTBI and that central endogenous opioid tone opposes serotonin's effects. Understanding brain injury-related changes in endogenous pain modulation may lead to improved pain control for those with TBI undergoing surgery.
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Editorial
Just the facts: brachial plexus blocks for upper extremity injuries in the emergency department.
Ultrasound-guided nerve blocks (UGNBs) are becoming a more common method for pain control in the emergency department. Specifically, brachial plexus blocks have shown promise for acute upper extremity injuries as well as an alternative to procedural sedation for glenohumeral reductions. Unfortunately, there is minimal discussion in the EM literature regarding phrenic nerve paralysis (a well-known complication from brachial plexus blocks). ⋯ The focus on patient safety is paramount, and those with preexisting respiratory conditions, extremes of age or weight, spinal deformities, previous neck injuries, and anatomical variations are at greater risk. We put forth different block strategies for risk mitigation, including patient selection, volume and type of anesthetic, block location, postprocedural monitoring, and specific discharge instructions. Understanding the benefits and risks of UGNBs is critical for emergency physicians to provide effective pain control while ensuring optimal patient safety.