Articles: acute-pain.
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While the development of artificial intelligence (AI) technologies in medicine has been significant, their application to acute and chronic pain management has not been well characterized. This systematic review aims to provide an overview of the current state of AI in acute and chronic pain management. ⋯ This review characterizes current applications of AI for pain management and discusses barriers to their clinical integration. Our findings support continuing efforts directed towards establishing comprehensive systems that integrate AI throughout the patient care continuum.
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Eur J Trauma Emerg Surg · Feb 2025
ReviewOptimizing acute pain management in trauma care: the role, structure and core principles of acute trauma pain services.
Trauma injuries, both accidental and violence-related, account for a significant number of fatalities and non-fatal injuries annually, with pain being a predominant symptom affecting trauma patients. Despite its prevalence, pain is often undertreated in emergency settings, leading to adverse outcomes such as delayed recovery, impaired respiratory function, and increased risk of chronic pain and post-traumatic stress disorder. ⋯ Effective pain management not only improves immediate patient well-being but also reduces long-term complications and economic burdens associated with extended hospital stays and readmissions. The integration of Acute pain service in trauma care emphasizes the importance of pain management as an integral part of patient recovery, highlighting the need for specialized services to enhance the quality and efficacy of trauma care.
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Reg Anesth Pain Med · Feb 2025
ReviewRisk factors for persistent postoperative opioid use: an entity distinct from chronic postsurgical pain.
Despite a decline in opioid prescriptions over the past decade, patients commonly receive opioid analgesics as a treatment for postoperative pain in the USA. One complication that patients may experience after surgery is persistent postoperative opioid use (PPOU), or opioid use beyond the typical recovery period. Often defined as beyond 3 months postsurgery, PPOU is frequently conflated with chronic postsurgical pain (CPSP), where pain persists well after the expected healing time following surgery. ⋯ Despite the overlap of some factors, studies typically employ different frameworks when examining PPOU and CPSP, with a biopsychosocial model applied for CPSP and little emphasis on an individual's social environment employed for PPOU. Additionally, existing studies predominantly rely on retrospective insurance claims data, which may not capture the full scope of risk factors. To fill gaps in understanding, investigations may prospectively assess and analyze patient-reported outcomes, implement similar frameworks, and concurrently measure both conditions to advance the scientific understanding of PPOU and CPSP.
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Reg Anesth Pain Med · Feb 2025
ReviewUpskilling pain relief after surgery: a scoping review of perioperative behavioral intervention efficacy and practical considerations for implementation.
Perioperative skills-based interventions may support non-pharmacological management of pain and opioid reduction after surgery. Such interventions may target and enhance predictors for surgical recovery and possibly reduce chronic postsurgical pain. Existing meta-analyses are limited by inclusion of studies that are either non-surgical or with outcomes occurring only in the hours after surgery. ⋯ No studies tested whether the interventions enhanced time to pain cessation after surgery. Four studies demonstrated durable analgesic effects at 3-12 months after surgery. We describe the real-world practicality of intervention integration into the perioperative pathway and provide dissemination and implementation methodologies that may increase intervention uptake and therefore fulfill calls from national agencies to better integrate behavioral pain treatments into perioperative care.
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Reg Anesth Pain Med · Feb 2025
ReviewTen years of transitional pain service research and practice: where are we and where do we go from here?
Chronic postsurgical pain (CPSP) is a prevalent yet unintended consequence of surgery with substantial burdens to the individual and their family, the healthcare system, and society at large. The present article briefly reviews the evidence for transitional pain services (TPSs) that have arisen in an effort to prevent and mange CPSP and persistent opioid use, and provides an update on recent novel risk factors for CPSP. Available evidence from one randomized controlled trial (RCT) and three non-randomized cohort studies suggests that TPS treatment is associated with better opioid use outcomes, including fewer opioid tablets prescribed at discharge, better opioid weaning results, a lower incidence of new-onset chronic opioid use, and lower consumption of opioids even at later time points up to 1 year after surgery. ⋯ While these preliminary studies are generally positive, large-scale, RCTs are needed to provide a more definitive picture of whether TPSs are effective in reducing opioid consumption and improving pain and mental health outcomes in the short and long term. With the expansion of TPSs across North America and globally, perioperative care focused on reducing the transition to pain chronicity has the potential to help millions of patients. With additional evidence from well-controlled RCTs, TPSs are well poised to continue to evolve and strengthen the role of multidisciplinary care teams in the immediate postdischarge period and beyond.