Articles: pain.
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There is a complex association between postoperative pain and postoperative delirium, which highlights the need for a more balanced approach to pain management that considers various risk factors. We emphasise the importance of comprehensive documentation and standardised monitoring to improve detection and management of postoperative delirium, ultimately enhancing patient outcomes. We advocate for a precision anaesthesia approach, which tailors care to individual patient profiles, as a potential solution to address these challenges.
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J Pain Symptom Manage · Dec 2024
Cigarette smoking and symptom burden: baseline results from 9 ECOG-ACRIN cancer clinical trials.
Approximately 11% of cancer survivors smoke postdiagnosis. ⋯ Patients currently smoking report greater severity of cancer-related symptoms (i.e., cough, pain) yet were also more likely to believe that smoking helps with nausea, insomnia, and pain. Symptom management should include tobacco cessation, education on smoking and its relationship to symptoms, and strategies to reduce reliance on smoking for symptom relief.
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Curr Pain Headache Rep · Dec 2024
Review Comparative StudyOverview and Comparison of Interscalene Block Techniques for Brachial Plexus Pain Management.
Peripheral nerve blocks are performed using local anesthetics that are commonly performed prior to surgery to either be the sole anesthetic and/or for postoperative pain management. Interscalene blocks are a specific type of nerve block that targets the superior and middle trunks of the brachial plexus inhibiting transmission of pain signals from the upper extremities to the central nervous system making them useful in mitigating pain following surgeries involving the shoulder, upper arm, and elbow. ⋯ Previously, interscalene blocks were performed with a nerve stimulator, which is an instrument designed to generate a twitch in surrounding muscles to verify the anesthetic block was placed in the correct location. However, this approach with a nerve stimulator alone is being done less frequently as physicians now often employ ultrasound either by itself or in conjunction with a nerve stimulator to in the block. Several clinical studies have shown that the use of ultrasound leads to improved safety and effectiveness of the interscalene block as compared to performing the block using a nerve stimulator alone. Clinical studies comparing interscalene blocks done with ultrasound versus ultrasound in conjunction with a nerve stimulator have shown the combination to be slightly safer and more efficacious with reduced side effects, though the difference in these metrics between the two is small. Interscalene blocks are highly effective for postoperative pain related to shoulder and upper extremity surgeries. Ultrasound guided blocks are more effective with reduced adverse effects when compared to nerve stimulation alone. The combination of both ultrasound and nerve stimulation allows for increased efficacy and decreaed side effects in limited clinical investigations. Therefore, more studies are needed to further compare and determine best practice interscalene techniques for shoulder and upper extremity surgeries.
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Pain is common among individuals with high Body Mass Index (BMI). This study investigated weight discrimination as a mediator of the longitudinal relationship between BMI and the presence of moderate/severe pain among adults from the English Longitudinal Study of Ageing (ELSA) cohort. ELSA is a longitudinal study of middle-aged and older adults living in England. ⋯ Weight discrimination may be an overlooked contributor to the transition to more severe pain among individuals of higher body weight. PERSPECTIVE: Weight discrimination may be an overlooked contributor to pain among individuals of higher body weight, particularly transition from lower to higher impact states. Post hoc analyses indicate the effect may be specific, as other forms of discrimination did not mediate the relationship.
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Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) is a trunk block that has been gaining attention for managing postoperative pain following abdominal surgeries since its first report in 2019. We conducted a scoping review on M-TAPA, aiming to comprehensively evaluate existing research, identify the gaps in knowledge, and understand the implications of M-TAPA. ⋯ M-TAPA may be considered a promising technique for postoperative pain management in upper abdominal laparoscopic surgeries. Further studies are warranted to elucidate the precise mechanisms and broader surgical applications.