Articles: pain.
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Peripheral optogenetics is an emerging neuromodulation technique that regulates the activity of the nervous system outside the brain through the expression of photosensitive proteins and the application of photic stimulation. This article reviews recent advances in applying optogenetics to the spinal cord and peripheral nerves, offering a comprehensive understanding of the functions and regulatory mechanisms of the peripheral nervous system through the modulation of specific neuronal activities. ⋯ Despite current challenges, such as operability, effectiveness, and selective neuron targeting, peripheral optogenetics holds significant potential for advancing neuromodulation. Continued research and technological innovations will further expand its role, offering new possibilities for understanding and treating disorders involving the peripheral nervous system.
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Retrospective controlled cohort. ⋯ In postoperative PSF for patients with AIS receiving LB through ESPB, those who did not receive a PCA had lower opioid consumption without worse pain scores or mobility and had a lower LOS. Adding LB through ESPB to postoperative pain regimens effectively replaces a PCA by providing the same pain control and reducing overall opioid consumption and LOS.
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Journal of neurosurgery · Feb 2025
Effects of the length of preoperative conservative management on postoperative outcomes after primary microvascular decompression for trigeminal neuralgia.
Although trigeminal neuralgia (TN) is initially managed conservatively, approximately half of all patients will eventually undergo surgery. Despite this outcome, there is limited understanding of the relationship between preoperative length of conservative management and pain outcomes after microvascular decompression (MVD). In this study, the authors aimed to describe the relationship between the duration of preoperative conservative management and postoperative outcomes in patients undergoing MVD for TN. ⋯ In the setting of primary MVD for patients with TN, a longer duration of preoperative conservative management was associated with higher postoperative BNI pain scores and increased risk of pain recurrence. These findings suggest a potential beneficial role for early surgical intervention.
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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
Review Meta AnalysisPrognostic factors of chronic postsurgical pain in children and adolescents: a systematic review and meta-analysis.
Approximately 28% of children and adolescents undergoing major surgery develop chronic postsurgical pain (CPSP; pain persisting>3 months). A previous review attempted to investigate biopsychosocial prognostic factors for pediatric CPSP; however, due to lack of data, no meta-analytic techniques were employed. Since that review, numerous studies have investigated risk/protective factors that fall within an Interpersonal Fear Avoidance Model for CPSP, thus warranting a reinvestigation of prognostic factors. ⋯ CRD42022306340.