A Brief Review on the Novel Therapies for Painful Diabetic Neuropathy
AbstractPurpose of ReviewAlmost half of people diagnosed with diabetes mellitus will develop painful diabetic neuropathy (PDN), a condition greatly impacting quality of life with complicated pathology. While there are different FDA approved forms of treatment, many of the existing options are difficult to manage with comorbities and are associated with unwanted side effects. Here, we summarize the current and novel treatments for PDN.Recent FindingsCurrent research is exploring alternative pain management treatments from the first line options of pregabalin, gabapentin, duloxetine, and amitriptyline which often have side e...
Source: Current Pain and Headache Reports - July 1, 2023 Category: Neurology Source Type: research
Perioperative Use of Ketamine
This article highlights the current use and advances surrounding the perioperative use of ketamine.Recent FindingsKetamine has antidepressive effects at subanesthetic doses. Intraoperative ketamine may be beneficial in reducing postoperative depression. Additionally, newer studies are exploring whether ketamine can be useful in reducing postoperative sleep disturbances.SummaryKetamine continues to be a great tool in perioperative pain control, especially during an opioid epidemic. As its use continues to expand and gain more popularity in the perioperative period, more research could shed light on the additional nonanalges...
Source: Current Pain and Headache Reports - July 1, 2023 Category: Neurology Source Type: research
Postoperative Rebound Pain: Our Current Understanding About the Role of Regional Anesthesia and Multimodal Approaches in Prevention and Treatment
AbstractPurpose of ReviewRebound pain (RP) is a common occurrence after peripheral nerve block placement, especially when blocks are used for orthopedic surgery. This literature review focuses on the incidence and risk factors for RP as well as preventative and treatment strategies.Recent FindingsThe addition of adjuvants to a block, when appropriate, and starting patients on oral analgesics prior to sensory resolution are reasonable approaches. Using continuous nerve block techniques can provide extended analgesia through the immediate postoperative phase when pain is the most intense.SummaryPeripheral nerve blocks (PNBs)...
Source: Current Pain and Headache Reports - June 30, 2023 Category: Neurology Source Type: research
Multi-agent Systems and Cancer Pain Management
AbstractPurposeThe present investigation explores multi-agent systems, their function in cancer pain management, and how they might enhance patient care. Since cancer is a complex disease, technology can help doctors and patients coordinate care and communicate effectively. Even when a patient has a dedicated team, treatment may be fragmented. Multi-agent systems (MAS) are one component of technology that is making progress for cancer patients. Wireless sensory networks (WSN) and body area sensory networks (BASN) are examples of MAS.Recent FindingsTechnology is advancing the care of patients, not only in everyday clinica...
Source: Current Pain and Headache Reports - June 29, 2023 Category: Neurology Source Type: research
Episodic Migraine and Psychiatric Comorbidity: A Narrative Review of the Literature
AbstractPurpose of ReviewWe evaluate the evolving evidence of psychiatric comorbidities associated with episodic migraine. Utilizing recent research publications, we aim to assess traditional treatment option considerations and discuss recent and evolving non-pharmacologic treatment progress for episodic migraine and related psychiatric conditions.Recent FindingsRecent findings indicate that episodic migraine is strongly linked to comorbid depression, anxiety, posttraumatic stress disorder, and sleep disorders. Not only do patients with episodic migraine have higher rates of psychiatric comorbidity, but a higher number of ...
Source: Current Pain and Headache Reports - June 29, 2023 Category: Neurology Source Type: research
The Emerging Role of Ketamine in Acute Postoperative Pain Management
AbstractPurpose of ReviewPostoperative pain (POP) is among the most unpleasant experiences that patients face after surgery. Interest in and use of N-methyl-D-aspartate (NMDA) receptor antagonists for the management of POP has increased over the years with ketamine being the most popular drug of this class.Recent FindingsSeveral randomized controlled trials found that the use of ketamine either alone or in combination with other medications leads to decreased postoperative pain and opioid consumption. However, there are other studies that have not found these benefits. The results as of now suggest that the role of intraop...
Source: Current Pain and Headache Reports - June 28, 2023 Category: Neurology Source Type: research
The Acute Perioperative Pain Service: Impact, Organization, and Future Directions
AbstractPurpose of ReviewThe Acute Perioperative Pain Service has been established as a relatively new but important concept and service in clinical patient care. Many surgical institutions have dedicated inpatient acute pain services with variable compositions. This review aims to investigate the purpose, clinical and economic implications, and future direction of the Acute Perioperative Pain Service (APPS).Recent FindingsThere is growing evidence of the multiple benefits of a dedicated APPS, especially pertaining to patients at higher risk of poorly controlled postoperative pain. Healthcare providers furthermore realize ...
Source: Current Pain and Headache Reports - June 24, 2023 Category: Neurology Source Type: research
Acupuncture for the Treatment of Migraine: An Overview of Systematic Reviews
In conclusion, most included SRs/MAs suggested that acupuncture was more effective than the control group in the treatment of migraine. However, the quality evidence of most of the studies still needs to be improved. (Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - June 17, 2023 Category: Neurology Source Type: research
A Review of the Paravertebral Block: Benefits and Complications
AbstractPurpose of ReviewParavertebral nerve blocks (PVB) have experienced a surge over the past 2 decades as improved access to ultrasound has increased ease of performance. The purpose of this review is to identify recent findings with regard to PVB ’s uses, including benefits, risks, and recommendations.Recent FindingsPVB is reported as an effective method of analgesia both in intraoperative and postoperative applications, with novel applications showing its potential to replace general anesthesia for certain procedures. The use of PVB as a method of analgesia postoperatively has shown lower opioid usage and faster PA...
Source: Current Pain and Headache Reports - June 9, 2023 Category: Neurology Source Type: research
Meditation as an Adjunct to the Management of Acute Pain
AbstractPurpose of ReviewWe aim to present current understanding and evidence for meditation, mostly referring to mindfulness meditation, for the management of acute pain and potential opportunities of incorporating it into the acute pain service practice.Recent FindingsThere is conflicting evidence concerning meditation as a remedy in acute pain. While some studies have found a bigger impact of meditation on the emotional response to a painful stimulus than on the reduction in actual pain intensities, functional Magnet Resonance Imaging has enabled the identification of various brain areas involved in meditation-induced p...
Source: Current Pain and Headache Reports - June 7, 2023 Category: Neurology Source Type: research
Sleep as a Therapeutic Target for Pain Management
AbstractPurpose of ReviewThe purpose of this review is to provide a summary of the utilization of sleep as a therapeutic target for chronic pain and to evaluate the recent literature on current and proposed pharmacologic and non-pharmacologic sleep interventions used in the management of pain disorders.Recent FindingsSleep is a promising therapeutic target in the treatment of pain disorders with both non-pharmacologic and pharmacologic therapies. Non-pharmacologic therapies include cognitive behavioral therapy and sensory-based therapies such as pink noise, audio-visual stimulation, and morning bright light therapy. Pharma...
Source: Current Pain and Headache Reports - May 10, 2023 Category: Neurology Source Type: research
Shared Decision-Making in Acute Pain Services
AbstractPurpose of ReviewThe implementation of shared decision-making (SDM) in acute pain services (APS) is still in its infancies especially when compared to other medical fields.Recent FindingsEmerging evidence fosters the value of SDM in various acute care settings. We provide an overview of general SDM practices and possible advantages of incorporating such concepts in APS, point out barriers to SDM in this setting, present common patient decisions aids developed for APS and discuss opportunities for further development.SummaryEspecially in the APS setting, patient-centred care is a key component for optimal patient ou...
Source: Current Pain and Headache Reports - May 8, 2023 Category: Neurology Source Type: research
Supraorbital Nerve Stimulation for Facial Pain
We describe the possibility of proposing peripheral nerve stimulation of the supraorbital nerves to treat patients with medically intractable facial pain. Stimulation of the supraorbital nerves is performed using percutaneously inserted electrodes that are positioned in the epi-fascial plane, traversing the course of the supraorbital nerves. The procedure has two phases starting with a trial by temporary electrodes that are inserted under fluoroscopic guidance and are anchored to the skin. This trial usually lasts for a few days to 2 weeks. If successful, we proceed to the insertion of a permanent electrode that is tunne...
Source: Current Pain and Headache Reports - May 2, 2023 Category: Neurology Source Type: research
Treatment of Acute Pain in Patients on Naltrexone: A Narrative Review
AbstractPurpose of ReviewThe tissue damage and trauma associated with surgery almost always result in acute postoperative pain. The intensity of postoperative pain can range from mild to severe. Naltrexone is suitable for patients who do not wish to be on an agonist treatment such as methadone or buprenorphine. However, naltrexone has been shown to complicate postoperative pain management.Recent FindingsMultiple studies have found that the use of naltrexone can increase the opioid requirement for postoperative pain control. Other modalities exist that can help outside of opioids such as ketamine, lidocaine/bupivacaine, dul...
Source: Current Pain and Headache Reports - April 28, 2023 Category: Neurology Source Type: research
Flushing After Lumbar Epidural Steroid Injection with Dexamethasone
AbstractPurpose of ReviewEpidural steroid injections are an accepted treatment for low back pain and radicular symptoms. While epidural steroid injections are routinely performed without complications, side effects can be seen, including flushing. Flushing has been studied using various steroid preparations, including dexamethasone, but at significantly higher doses. This was a prospective cohort study that examines the rate of flushing in ESIs with a lower dose (4 mg) of dexamethasone. Subjects undergoing lumbar epidural steroid injection were asked about the presence of flushing following the procedure prior to dischar...
Source: Current Pain and Headache Reports - April 28, 2023 Category: Neurology Source Type: research
