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Protocol for a double-blinded randomised controlled trial investigating the use of adjunct bicarbonate in carpal tunnel release: a single-centre study
This study aims to compare the effectiveness of buffered and non-buffered long-acting local anaesthetics in pain relief during and after carpal tunnel release (CTR) surgery. Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome. Surgical treatment of CTS, CTR, is the most common hand surgical operation. CTR is usually performed under local anaesthesia, the application of which is often the most painful event during the procedure. One important aspect of patient satisfaction is adequate pain management during and after CTR. Long-acting local anaesthetics provide good postoperative pain control...
Source: BMJ Open - September 18, 2023 Category: General Medicine Authors: Hytönen, M., Nietosvaara, Y., Reito, A., Sirola, J., Heikkinen, N., Savolainen, A., Räisänen, M. P. Tags: Open access, Surgery Source Type: research

Cancer Pain Management in Patients Receiving Inpatient Specialized Palliative Care Services
This study is aimed at assessing the time needed to achieve cancer pain management goals through specialized palliative care (SPC).
Source: Journal of Pain and Symptom Management - September 18, 2023 Category: Palliative Care Authors: Keita Tagami, Shih-Wei Chiu, Kazuhiro Kosugi, Hiroto Ishiki, Yusuke Hiratsuka, Masaki Shimizu, Masanori Mori, Emi Kubo, Tomoo Ikari, Sayaka Arakawa, Tetsuya Eto, Mayu Shimoda, Hideyuki Hirayama, Kaoru Nishijima, Kota Ouchi, Tatsunori Shimoi, Tomoko Shigen Tags: Original Article Source Type: research

Global, regional, and national epidemiology of migraine and tension-type headache in youths and young adults aged 15 –39 years from 1990 to 2019: findings from the global burden of disease study 2019
ConclusionMigraine and TTH represent formidable challenges in global health. The intensity of their impact exhibits marked disparities across nations and is distinctly elevated among women, individuals within the 30 –39 age bracket, and populations characterized by a high SDI. The results of our research emphasize the imperative of assimilating migraine and TTH management into contemporary healthcare paradigms. Such strategic integration holds the potential to amplify public cognizance regarding pertinent ris k factors and the spectrum of therapeutic interventions at hand.
Source: The Journal of Headache and Pain - September 18, 2023 Category: Neurology Source Type: research

Randomized Trial Examining Efficacy of Mentha piperita in Reducing Chronic Headache Discomfort in Youth
Headache is a common source of pediatric disability and significantly affects school and social functioning (Nieswand et al., 2020). Headache is cited as a leading reason for health care utilization, and the third leading cause of referral to pediatric emergency departments (Kabbouche& Linder, 2005). A systematic review of pediatric chronic or recurrent pain by King et al. (2011) found a wide range of reported prevalence. Specific to pediatric headache, prevalence was found to be 8-83% amid the studies meeting inclusion criteria (n = 29,746).
Source: Pain Management Nursing - September 18, 2023 Category: Nursing Authors: Rae Ann Kingsley Tags: Original Research Source Type: research

Dancing around the hexaflex: Using ACT in practice 5
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists can use ACT in session (remember ACT is open for anyone to use it!). Values: Qualities of living Oh so much has been written about values…Values bring meaning to what w...
Source: HealthSkills Weblog - September 17, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Occupational therapy Pain conditions Psychology Science in practice acceptance and commitment therapy Clinical reasoning Health pain management Therapeutic approach Source Type: blogs

Opioid-Prescribing Approaches-One-Size-Fits-All versus Patient-Centric and Procedure-Focused-Among Podiatric Physicians: A Cross-Sectional Study
CONCLUSIONS: Podiatric physicians who used a one-size-fits-all opioid-prescribing approach prescribed more postoperative opioid dosage units regardless of the scenario. Given that the patient population requiring foot surgery is diverse and may have multiple comorbidities, the management of postoperative pain, likewise, should be diverse and nuanced. The patient-centric and procedure-focused approach is suited to limit excess prescribing while defending the physician-patient relationship.PMID:37717232 | DOI:10.7547/21-246
Source: Journal of the American Podiatric Medical Association - September 17, 2023 Category: Podiatry Authors: Brandon M Brooks Reed W R Bratches Kristina B Wolff Mickey D Stapp Kyle W Bruce Dyane E Tower Source Type: research

Perioperative Pain Management
Orthop Clin North Am. 2023 Oct;54(4):xv-xvi. doi: 10.1016/j.ocl.2023.06.008. Epub 2023 Jul 21.NO ABSTRACTPMID:37718089 | DOI:10.1016/j.ocl.2023.06.008
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Frederick M Azar Source Type: research

Strategies for Reducing Perioperative Opioid Use in Foot and Ankle Surgery: Education, Risk Identification, and Multimodal Analgesia
Orthop Clin North Am. 2023 Oct;54(4):485-494. doi: 10.1016/j.ocl.2023.04.006. Epub 2023 Jun 1.ABSTRACTThere remains a high prevalence and substantial risks of opioid utilization amongst orthopedic patients. The goal of this review is to discuss strategies for responsible opioid use in the perioperative setting following foot and ankle orthopedic surgeries. We will highlight 1) education interventions, 2) risk identification, and 3) non-opioid alternatives for postoperative pain management.PMID:37718087 | DOI:10.1016/j.ocl.2023.04.006
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Amy L Xu Casey Jo Humbyrd Source Type: research

Perioperative Pain Management for Distal Radius Fractures
Orthop Clin North Am. 2023 Oct;54(4):463-470. doi: 10.1016/j.ocl.2023.05.006. Epub 2023 Jun 26.ABSTRACTDistal radius fractures have a high incidence among both young and elderly patients, and in many instances require operative intervention. When operative intervention is employed, adequate pain management is essential to decrease postoperative complications, such as chronic pain and disability, while minimizing the risk of prolonged opioid use and dependence. Strategies to optimize pain management include regional anesthesia, preoperative dosing of medication, multimodal regimens, long-acting selective opioids at the time...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Nolan Farrell Paul T Greenfield Paul T Rutkowski William Jacob Weller Source Type: research

Evolution of Perioperative Pain Management in Shoulder Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):435-451. doi: 10.1016/j.ocl.2023.04.004. Epub 2023 Jun 20.ABSTRACTHistorically, opioids have been used as a primary conservative treatment for pain related to glenohumeral osteoarthritis (GHOA). However, this practice is concerning as it often leads to overuse, which has contributed to the current epidemic of addiction and overdoses in the United States. Studies have shown that preoperative opioid use is associated with higher complication rates and worse outcomes following surgery, particularly for shoulder arthroplasty. To address these concerns, perioperative pain management for shou...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Vani Sabesan Hans Lapica Carlos Fernandez Clyde Fomunung Source Type: research

Cannabis and Pain Control After Total Hip and Knee Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):407-415. doi: 10.1016/j.ocl.2023.04.002. Epub 2023 Jun 5.ABSTRACTCannabis use among the elderly has increased over the previous 2 decades. This has translated to a greater proportion of orthopedic procedures being undertaken on these patients. This review provides clinicians with evidence-based information on the effects of cannabis on pain control in THA and TKA, to help counsel these patients and facilitate their perioperative management. The review specifically focuses on the following: origins of cannabis; biochemistry of cannabis; medical versus recreational cannabis; pharmacology ...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Babar Kayani Lisa C Howard Michael E Neufeld Donald S Garbuz Bassam A Masri Source Type: research

Analgesic Trends in the Management of Pain Following Total Knee Arthroplasty: A Comparison of Peri-Articular Infiltration, Adductor Canal Block, and Adjuvant Treatment for Posterior Knee Pain
Orthop Clin North Am. 2023 Oct;54(4):369-376. doi: 10.1016/j.ocl.2023.05.004. Epub 2023 Jul 5.ABSTRACTThe rising number of total knee arthroplasties (TKA's) in the United States increases demand for perioperative pain modalities, which can promote early mobilization and discharge. Over the decades, a focus has shifted from opioid-dominant regimens to motor-sparing multimodal protocols, which have not only improved pain scores and reduced opioid consumption but also improved overall patient outcomes. In this article, we briefly review the evolution of post-operative pain management in patients undergoing TKA and summarize t...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Rutuja R Sikachi Brett Campbell Ezra Kassin Giles R Scuderi Joseph Marino Source Type: research

Modern Perioperative Pain Management Strategies to Minimize Opioids after Total Knee Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):359-368. doi: 10.1016/j.ocl.2023.05.002. Epub 2023 Jun 20.ABSTRACTTotal Knee Arthroplasty is associated with significant postoperative pain that can limit functional outcomes and patient satisfaction. In recent years, the standard of care for postoperative pain management has reduced reliance on opioids in favor of multimodal analgesia. These regimens consist of systemic medications such as COX-2 inhibitors, acetaminophen, corticosteroids, and gabapentinoids, as well as regional and local approaches such as peripheral nerve blocks and local infiltrative analgesics. Newer therapies, such...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Charles W Hansen Elizabeth K Carlino Lauren A Saunee Vinod Dasa Amit K Bhandutia Source Type: research

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