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Therapy: Pain Management
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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
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
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
Omega-3 polyunsaturated fatty acids and the psychiatric post-acute sequelae of COVID-19: A one-year retrospective cohort analysis of 33,908 patients
CONCLUSION: Omega-3 PUFAs may require re-evaluation as a preventive strategy against adverse mental health outcomes post-COVID-19 in placebo-controlled clinical trials.PMID:37716377 | DOI:10.1016/j.bbi.2023.09.008
Source: Brain, Behavior, and Immunity - September 16, 2023 Category: Neurology Authors: Ting-Hui Liu Chung-Han Ho Daniel Tzu-Li Chen Jheng-Yan Wu Po-Yu Huang Chih-Cheng Lai Kuang-Yang Hsieh Kuan-Pin Su Source Type: research
Use of Temporary Percutaneous Peripheral Nerve Stimulation in an Oncologic Population: A Retrospective Review
CONCLUSION: PNS is an emerging technology in neuromodulation that may be useful in managing pain, especially in the oncologic population. Patients with cancer-related and non-cancer-related pain localized to a specific nerve distribution should be considered appropriate candidates for PNS. Further research is needed to optimize patient selection and indications for PNS in the population with cancer.PMID:37715753 | DOI:10.1016/j.neurom.2023.06.009
Source: Cancer Control - September 16, 2023 Category: Cancer & Oncology Authors: Emily Walters Sudek Steven Mach Billy Huh Saba Javed Source Type: research
Omega-3 polyunsaturated fatty acids and the psychiatric post-acute sequelae of COVID-19: A one-year retrospective cohort analysis of 33,908 patients
CONCLUSION: Omega-3 PUFAs may require re-evaluation as a preventive strategy against adverse mental health outcomes post-COVID-19 in placebo-controlled clinical trials.PMID:37716377 | DOI:10.1016/j.bbi.2023.09.008
Source: Brain, Behavior, and Immunity - September 16, 2023 Category: Neurology Authors: Ting-Hui Liu Chung-Han Ho Daniel Tzu-Li Chen Jheng-Yan Wu Po-Yu Huang Chih-Cheng Lai Kuang-Yang Hsieh Kuan-Pin Su Source Type: research
Skin substitutes as treatment for chronic wounds: current and future directions
Front Med (Lausanne). 2023 Aug 29;10:1154567. doi: 10.3389/fmed.2023.1154567. eCollection 2023.ABSTRACTChronic wounds such as diabetic foot ulcers and venous leg ulcers place a significant burden on the healthcare system and in some cases, have 5-year mortality rates comparable to cancer. They negatively impact patients' quality of life due to pain, odor, decreased mobility, and social isolation. Skin substitutes are an advanced therapy recommended for wounds that fail to show decrease in size with standard care. The choice of substitute used should be based on evidence, which often differs based on wound etiology. There a...
Source: Cancer Control - September 15, 2023 Category: Cancer & Oncology Authors: Nicole M Vecin Robert S Kirsner Source Type: research
Application of behavioral economic strategies to enhance recruitment into a pediatric randomized clinical trial for postoperative pain relief: A randomized clinical trial
CONCLUSION: Either approach would be sufficient for patient recruitment for this type of clinical trial since the overall intention to enroll rate was 77%.PMID:37712489 | DOI:10.1111/pan.14755
Source: Paediatric Anaesthesia - September 15, 2023 Category: Anesthesiology Authors: Anitra Karthic Zandantsetseg Orgil Nguyen K Tram Julie Rice-Weimer Jack Stevens Vanessa A Olbrecht Source Type: research
Cardiac Tamponade Secondary to Hemorrhagic Pericardial Effusion: A Complication of STEMI
Conclusion: The differential for hemodynamic compromise in a patient with STEMI is broad, but quickly distinguishing pump failure from other life-threatening causes of shock is imperative to dictate time-sensitive management decisions. The presence of a hemorrhagic pericardial effusion in the setting of STEMI is a surrogate marker for a severe infarct and can help the bedside physician determine whether a patient will be better served in the catheterization lab for revascularization or in the operating room for surgical repair.PMID:37711482 | PMC:PMC10498953 | DOI:10.31486/toj.23.0023
Source: Pain Physician - September 15, 2023 Category: Anesthesiology Authors: Marvin Kajy Amy Rechenberg Connor Kerndt Kevin Wolschleger Source Type: research
