Can recent chronic pain techniques help with acute perioperative pain?

This article discussed how the knowledge and technique of a few chronic pain procedures benefited the perioperative clinicians in their care of patients receiving specific orthopaedic surgical procedures. Recent findings Recent emerging interest in hip and knee denervation for chronic pain management secondary to osteoarthritis stimulates publications on the new understanding of hip and knee joint innervation. The improved understanding of the anatomy allows better precision in targeting the articular branches. The procedures for chronic joint pain such as radiofrequency ablation, chemical neurolysis and neuromodulation procedure have recently been applied to the perioperative care in orthopaedic procedures because of the potential long-lasting analgesia, opioid-sparing effect and consequent improvement in physical function and health-related quality of life after surgery. Summary Despite the widespread use of regional anaesthesia and multimodal analgesia in the perioperative pain management, more than two-third of the patients reported severe postoperative pain. Therefore, other therapeutic strategies used in chronic pain management such as radiofrequency ablation and neuromodulation have been proposed to optimize acute postsurgical pain. The early experience with those techniques is encouraging, and more studies are required to explore the incorporation of these procedures in the perioperative care.
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Nabil Elkassabany Source Type: research

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Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM. Introduction Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Conclusion: The present study suggests that the extract of LMZ attenuates CFA-induced inflammatory pain by suppressing the ERK1/2 and NF-κB signaling pathway at both peripheral and central level. Introduction Pain is one of the most common symptoms in clinical practice, and inflammatory pain is the most important type of pain (Patapoutian et al., 2009). Inflammatory pain is a growing global health problem. In generally, there is a common course of progression in inflammation and pain share. When patients experience inflammation, they may develop hyperalgesia or allodynia to various mechanical, thermal, or che...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Rationale: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease with a poor prognosis, characterized by chronic thromboembolic obstruction of the pulmonary arteries and pulmonary hypertension. Balloon pulmonary angioplasty (BPA) is a newly emergent treatment for CTEPH, which may substitute pulmonary endarterectomy, the standard but more invasive treatment for CTEPH. Here, we report the case of a CTEPH patient who underwent 2 noncardiac surgeries without complications after preoperative intervention of BPA. Patient concerns: A 79-year-old man presented with severe osteoarthritis of bilateral knees, with a...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Femoral nerve block analgesia was deemed to the gold standard for acute pain management after total knee arthroplasty (TKA). But effect on chronic pain management is not investigated fully. We conducted a retrospective study to explore the effect of single-injection femoral nerve block on postsurgical chronic pain. All medical records of patients undertaking TKA between January, 2013 and June, 2014 were reviewed via the Docare anesthesia database. Patients who administrated with the self-controlled intravenous analgesia were assigned to group P. Patients who received a single-injection femoral never block combined with pa...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Conclusions The frequency map of the articular branches provides an anatomical basis for the development of new clinical protocols for knee radiofrequency denervation and perioperative pain management.
Source: Regional Anesthesia and Pain Medicine - Category: Anesthesiology Tags: Chronic and Interventional Pain: Original Articles Source Type: research
Mona K Patel, Alan D Kaye, Richard D UrmanJournal of Anaesthesiology Clinical Pharmacology 2018 34(1):111-116 In recent years, nerve growth factor (NGF) and the NGF receptor have become potential therapeutic targets in the treatment of acute and chronic pain states. NGF is a neurotrophin involved in regulating the function of sensory and sympathetic neurons during development. Numerous pain states have been linked to elevated levels of NGF and its role in increasing the perception of pain. Tanezumab, a recombinant humanized monoclonal antibody (IgG), was developed to target NGF, binding both circulating and local tissue N...
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
This study compared long-term clinical safety and effectiveness of cooled radiofrequency ablation (CRFA) with intra-articular steroid (IAS) injection in managing OA-related knee pain. Methods This is a prospective, multicenter, randomized trial with 151 subjects with chronic (≥6 months) knee pain that was unresponsive to conservative modalities. Knee pain (Numeric Rating Scale [NRS]), Oxford Knee Score, overall treatment effect (Global Perceived Effect), analgesic drug use, and adverse events were compared between CRFA and IAS cohorts at 1, 3, and 6 months after intervention. Results There were no differences in d...
Source: Regional Anesthesia and Pain Medicine - Category: Anesthesiology Tags: Chronic and Interventional Pain: Original Article Source Type: research
The nation's crisis in pain treatment and need to reduce opioid dependence has lifted a powerful chorus of voices to change insurance practices. The American Medical Association is among the organizations urging payers to cover non-pharmacological approaches. Many specifically extend this call to integrative treatments. The statements were discovered by representatives of the Acupuncture Now Foundation (ANF) and the American Society of Acupuncturists (ASA) among comments submitted to the USA Center for Disease Control and Prevention (CDC). CDC had a public comment period prior to its March 2016 issuance of its Guidelines ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Conclusions Intra-articular 0.5% lidocaine injection under ultrasound guidance has a potential role in the management of chronic knee pain due to osteoarthritis for a 3-month period.
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
This study teaches us that poor wound healing and wrinkling and sagging that occur in aging skin share similar mechanisms." Reduced cell cohesiveness of outgrowths from eccrine sweat glands delays wound closure in elderly skin Human skin heals more slowly in aged vs. young adults, but the mechanism for this delay is unclear. In humans, eccrine sweat glands (ESGs) and hair follicles underlying wounds generate cohesive keratinocyte outgrowths that expand to form the new epidermis. Our results confirm that the outgrowth of cells from ESGs is a major feature of repair in young skin. Strikingly, in aged s...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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