Articles: pain.
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Meta Analysis
Cannabinoids for Acute Postoperative Pain Management: A Systematic Review and Meta-Analysis of Clinical Trials.
Poor acute postoperative pain control, coupled with the use of intravenous medications with a limited and unsafety efficacy spectrum, has led to new therapeutic alternative explorations to reduce adverse events while increasing its analgesic efficacy. There cannabinoids have been proposed as a useful control agent in post-surgical pain. Nevertheless, to date, there is no solid evidence to evaluate them. The current article sought to determine cannabinoids' effectiveness and safety in the aforementioned context. ⋯ The management of severe pain after surgery, and the use of intravenous drugs with limited and potentially unsafe effectiveness, has led to the exploration of new treatment options to minimize side effects while improving pain relief. Cannabinoids have been suggested as a potential solution for managing post-surgical pain, but there is currently insufficient evidence to assess their effectiveness. The purpose of this article was to evaluate the effectiveness and safety of cannabinoids in this context.
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Review
Discordance between preclinical and clinical testing of Na V 1.7-selective inhibitors for pain.
The voltage-gated sodium channel Na V 1.7 plays an important role in pain processing according to genetic data. Those data made Na V 1.7 a popular drug target, especially since its relatively selective expression in nociceptors promised pain relief without the adverse effects associated with broader sodium channel blockade. Despite encouraging preclinical data in rodents, Na V 1.7-selective inhibitors have not yet proven effective in clinical trials. ⋯ Nearly all preclinical studies gave a single dose of drug unlike the repeat dosing used clinically, thus precluding preclinical data from demonstrating whether tolerance or other slow processes occur. In summary, preclinical testing of Na V 1.7-selective inhibitors aligned poorly with clinical testing. Beyond issues that have already garnered widespread attention in the pain literature, our results highlight the treatment regimen and choice of pain model as areas for improvement.
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Acta Anaesthesiol Scand · Mar 2025
Review Meta AnalysisHigh-dose glucocorticoids in the treatment of postoperative pain after video-assisted thoracoscopic surgery-protocol for systematic review and meta-analysis.
Video-assisted thoracoscopic surgery (VATS) is widely used in lung cancer surgery, as this technique causes less pain and faster recovery than open thoracotomy. However, significant postoperative pain persists in a number of patients, often leading to increased opioid use and opioid-related adverse events in addition to prolonged admission times. Perioperatively administered glucocorticoids have been demonstrated effective in reducing pain after other types of surgeries, but the effect in VATS remains unclear. ⋯ This systematic review and meta-analysis will provide an overview of the current evidence of how glucocorticoids affect postoperative pain and recovery in adult patients undergoing VATS.
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The management of peri-operative pain is one of the pillars of anaesthesia and is of particular importance in patients undergoing surgery for solid malignant tumours. Amongst several options, the most commonly employed analgesic regimens involve opioids, NSAIDs and regional anaesthesia techniques with different local anaesthetics. In recent years, several research reports have tried to establish a connection between peri-operative anaesthesia care and outcome after cancer surgery. ⋯ The reason for this might lie with the nature of tumour biology itself, and in the diversity of patient and tumour phenotypes. In a translational approach, future research should therefore concentrate on patient and tumour-related factors or biomarkers, which might either influence the tumour and its microenvironment or predict potential responses to interventions, including the choice of the analgesic. This might not only be relevant for the daily practice of clinical anaesthesia, but would also be of great importance for patients undergoing cancer surgery, who might be able to receive an individualised anaesthetic regimen based on their phenotypic profile.
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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.