Articles: pain.
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Various regional anesthesia techniques have been studied for blunt chest wall trauma over the past decades, but their impact on patient outcomes remains unclear. This systematic review and Bayesian network meta-analysis aimed to identify the most effective regional anesthesia techniques for different outcomes in blunt thoracic trauma patients. ⋯ Various locoregional techniques are being investigated for managing pain in blunt thoracic trauma, with thoracic epidural showing consistent positive effects on pain and other key outcomes. Fascial blocks are emerging as potential alternatives with similar pain relief, though evidence on other outcomes is limited. Future studies should compare the efficacy of these techniques on more definitive endpoints.
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Background and Objectives: This study aimed to evaluate the role of A-PRF (advanced platelet-rich fibrin) in the enhancement of wound healing and protecting the periodontal health of mandibular second molars after the extraction of mandibular third molars. Additionally, the study assessed the levels of pro-inflammatory cytokines in the gingival crevicular fluid (GCF) of mandibular second molars as markers of inflammation. Materials and Methods: Twenty-five systemically healthy adult patients with bilateral removal of impacted mandibular third molars were included. ⋯ Pain and swelling scores were notably lower on the 7th postoperative day in the A-PRF group. A-PRF also reduced pro-inflammatory cytokines in GCF, significantly more than in control sites, at three months post-surgery. Conclusions: A-PRF enhances the periodontal and inflammatory status of adjacent teeth and wound healing after the extraction of mandibular third molars.
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J Pain Palliat Care Pharmacother · Dec 2024
Intravenous Magnesium Sulfate as an Adjunct to Intravenous Ketamine for Acute Pain: A Case Series.
Intravenous (IV) magnesium sulfate, a versatile electrolyte, plays a pivotal role across various medical domains. From cardiac care to obstetrics, gastrointestinal to pulmonary therapies, the impact is far-reaching among acute care services. ⋯ This case series describes the difficulties experienced with postoperative analgesia in three patient cases with complex comorbidities and discusses the beneficial impact observed when magnesium was administered concomitantly with ketamine. Further research is necessary to outline the specific role, ideal population, and recommended bolus and infusion rate for optimal analgesic efficacy.
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Arch Orthop Trauma Surg · Dec 2024
Randomized Controlled TrialEfficacy of preemptive multimodal analgesia initiated at various time points before total knee arthroplasty: a prospective, double-blind randomized controlled trial.
Preemptive multimodal analgesia (PMA) is commonly employed for pain control after total knee arthroplasty (TKA). However, the optimal timing for initiating PMA remains unclear. This study aimed to compare the efficacy of PMA administered at different time points before TKA. ⋯ In comparison with PMA starting at 1 h preoperatively, initiating PMA at 24 and 48 h preoperatively provided better postoperative pain relief. Considering the aim of minimizing the amount of ineffective medication received by patients, initiating PMA at 24 h preoperatively may be a more favorable option for patients undergoing TKA. However, the clinical significance of our results and the optimal starting time for PMA require further investigation.
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As part of a continuing medical education activity, primary care physicians in Arizona were asked to draw how they feel about treating patients with chronic pain and addiction. Their drawings, complete with cliffs, walls, torn-out hair, and connected hearts, make for a harrowing look at burnout, angst, and empathy among physicians who treat this subset of patients. Public health and exercise facilitators were troubled, leading them to publish this essay along with a selection of the drawings that depict the feelings of the physicians who feel ill-prepared to treat this patient population, which is only growing in number and needs.