6,709 results match your criteria multimodal pain


The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial.

J Clin Anesth 2021 Jul 26;74:110403. Epub 2021 Jul 26.

University of Health Science, Konya City Hospital, Department of Anesthesiology and Reanimation, Konya, Turkey.

Study Objective: Laparoscopic cholecystectomy (LC) causes moderate-to-severe postoperative pain. Postoperative pain is one of the leading contributors to respiratory dysfunction following surgery. This study investigated the effect of erector spinae plane (ESP) block on postoperative analgesia and respiratory function in patients undergoing LC. Read More

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Use of tranexamic acid does not influence perioperative outcomes in ambulatory foot and ankle surgery-a prospective triple blinded randomized controlled trial.

Int Orthop 2021 Jul 29. Epub 2021 Jul 29.

Department of Anesthesiology, Mount Sinai Health System, 1000 Tenth Avenue, New York, NY, 10019, USA.

Study Objective: TXA is an antifibrinolytic medication widely used to reduce perioperative blood loss, but it has been seldom used during foot and ankle surgery. Our study evaluates the impact of TXA use on blood loss, post-operative pain, peri-operative opioid consumption, and wound healing in ambulatory outpatient foot and ankle procedures.

Design: Prospective, triple-blinded, randomized controlled trial. Read More

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Anti-nociceptive Effects of Dexmedetomidine Infusion Plus Modified Intercostal Nerve Block During Single-port Thoracoscopic Lobectomy: A Double-blind, Randomized Controlled Trial.

Pain Physician 2021 Aug;24(5):E565-E572

Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.

Background: Multimodal general anesthesia based on modified intercostal nerve block (MINB) has been found as a novel method to achieve an intraoperative opioid-sparing effect. However, there is little information about the effective method to inhibit visceral nociceptive stress during single-port thoracoscopic surgery.

Objective: To investigate whether a low-dose dexmedetomidine infusion followed by MINB might be an alternative method to blunt visceral stress effectively. Read More

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Quadratus Lumborum Block is an Effective Postoperative Analgesic Technique in Pediatric Patients Undergoing Lower Abdominal Surgery: A Meta-Analysis.

Pain Physician 2021 Aug;24(5):E555-E563

Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), Hangzhou, China.

Background: Quadratus lumborum (QL) block has shown promising analgesic efficacy in the adult population in previous meta-analyses. However, the response of the pediatric group to pain stimulation is stronger than that in the adult population, and the management of pediatric pain is constrained by limited available analgesia agents. All data analyzed during this study are collected from published articles. Read More

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Benefits of Transversus Abdominis Plane Block on Postoperative Analgesia after Bariatric Surgery: A Systematic Review and Meta-Analysis.

Pain Physician 2021 Aug;24(5):345-358

Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.

Background: Patients undergoing bariatric surgery present unique analgesic challenges, including poorly controlled pain, increased prevalence of obstructive sleep apnea, and opioid-induced respiratory depression. The transversus abdominis plane (TAP) has been demonstrated to be a safe and effective component of multimodal analgesia for a variety of abdominal surgeries.

Objective: To determine the benefits of the TAP block on postoperative analgesia and recovery in patients undergoing bariatric surgery. Read More

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Pain and Opioid Use in Cancer Survivors: A Practical Guide to Account for Perceived Injustice.

Pain Physician 2021 Aug;24(5):309-317

Pain in Motion International Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussels, Belgium; Rehabilitation Research Department, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussels, Belgium.

Background: The presence of pain decreases survival rates in cancer. Pain management in clinical settings is often suboptimal and secondary to other cancer-related treatments, leaving many people undertreated. Opioid use is associated with side effects and decreased survival rate in cancer patients. Read More

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Publication Trends and Hot Spots in Chronic Postsurgical Pain (CPSP) Research: A 10-Year Bibliometric Analysis.

J Pain Res 2021 21;14:2239-2247. Epub 2021 Jul 21.

Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People's Republic of China.

Purpose: Aging populations and increasing quality of life requirements have attracted growing efforts to study chronic postsurgical pain (CPSP). However, a diverse range of factors are involved in CPSP development, which complicates efforts to predict and treat this disease. To advance research in this field, our study aimed to use bibliometric analysis to quantitatively and qualitatively evaluate CPSP research and predict research hot spots over the last 10 years. Read More

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Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief - A randomised placebo controlled trial.

Indian J Anaesth 2021 Jul 23;65(7):539-544. Epub 2021 Jul 23.

Department of Anaesthesiology and Critical Care, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.

Background And Aims: The multiplicity of the mechanisms of the pain in laparoscopic cholecystectomy inclines us to the usage of multimodal analgesia. Gabapentin is known for its analgesic efficacy when given as premedication in many surgeries. N-methyl-D-aspartate (NMDA) antagonists are used for both acute and chronic pain, but the use of memantine in the perioperative period is less studied. Read More

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Enhanced Recovery Components for Posterior Lumbar Spine Fusion: Harnessing National Data to Compare Protocols.

Clin Spine Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx Department of Orthopedics Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, NY.

Study Design: This was a retrospective cohort study.

Objective: The aim of this study was to assess the most commonly used components of enhanced recovery after surgery (ERAS) combinations and their relative effectiveness.

Summary Of Background Data: Data is lacking on use and effectiveness of various ERAS combinations which are increasingly used in spine surgery. Read More

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Multimodal evaluation of donor site morbidity in transgender individuals after phalloplasty with a free radial forearm flap: a case-control study.

J Plast Reconstr Aesthet Surg 2021 Jun 17. Epub 2021 Jun 17.

Department of Plastic, Hand, Aesthetic and Reconstructive Surgery, Helios University Hospital Wuppertal, Germany.

Background: In phalloplasty, there is a lack of standardized follow-up examinations of motor function and strength after harvesting oversized radial forearm free flaps (RFFF).

Methods: We evaluated the donor site of 20 transmen after phalloplasty, using a multimodal, standardized approach, assessing the following parameters: opposition of the thumb, composite range of motion of the finger joints, grip strength, mobility of the wrist, lesion of the superficial branch of the radial nerve, the dorsal branch of the ulnar nerve, the sensation of pain, and cold intolerance. The contralateral, nonoperated forearm was used as a control. Read More

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The effect of PECS-1 block on postoperative pain in total implantable venous access port catheter (TIVAP) insertion.

J Vasc Access 2021 Jul 28:11297298211034615. Epub 2021 Jul 28.

Department of Anesthesiology and Reanimation, School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.

Background: The aim of this prospective, randomized, controlled study was to evaluate the analgesic effect of US-guided Pectoral (PECS) I blocks on postoperative analgesia after TIVAP insertion.

Methods: A hundred-twenty patients were included in this study. The patients were divided into two groups: Group PECS and Group INF (infiltration). Read More

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[Aspects of multimodal pain therapy in old age].

Z Gerontol Geriatr 2021 Jul 28. Epub 2021 Jul 28.

Medizinische Klinik 2, Schwerpunkt Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Prof. Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.

Chronic pain in older adults should be explained and treated on the basis of the biopsychosocial model. With its interdisciplinary and interprofessional approach, multimodal pain therapy is the method of choice. In old age freedom from pain is usually not the primary goal. Read More

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Opioid-Free Recovery After Hernia Repair with HTX-011 as the Foundation of a Non-Opioid, Multimodal Analgesia Regimen in a Real-World Setting: A Randomized, Open-Label Study.

Pain Ther 2021 Jul 27. Epub 2021 Jul 27.

AdventHealth Celebration, 400 Celebration Place, Celebration, FL, 34747, USA.

Introduction: Helping Opioid Prescription Elimination (HOPE) is a project designed to provide surgeons with practical, real-world solutions to effectively manage postoperative pain and eliminate the need for opioids using HTX-011 (extended-release bupivacaine/low-dose meloxicam). In phase 3 herniorrhaphy and bunionectomy studies, HTX-011 without multimodal analgesia (MMA) was superior to bupivacaine hydrochloride in reducing pain and opioid consumption. Here, we examine the HOPE Hernia-1 study, which was designed to compare alternating ibuprofen/acetaminophen with concurrent use as part of an HTX-011-based non-opioid MMA regimen in patients undergoing herniorrhaphy and to evaluate the effectiveness of a personalized opioid prescription algorithm. Read More

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Implementation of Enhanced Recovery After Surgery (ERAS) protocol for elderly patients receiving surgery for intertrochanteric fracture: a propensity score-matched analysis.

J Orthop Surg Res 2021 Jul 28;16(1):469. Epub 2021 Jul 28.

Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Purpose: Enhanced Recovery After Surgery (ERAS) is a multimodal approach to perioperative care that aims to reduce patient perioperative complications, accelerate patient recovery, and improve patient satisfaction by refining and optimizing all perioperative management processes. By comparing two groups of patients before and after the implementation of ERAS for intertrochanteric fracture (ITF) with a matching analysis of propensity score (PS), we aimed to demonstrate that the implementation of ERAS protocol shortens the length of hospital stay (LOS), reduces pain, decreases the incidence of postoperative complications, and promotes functional recovery of the joint.

Methods: We selected 2 periods of 1 year, before (n=98patients) and after ERAS implementation (n=92patients). Read More

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Evaluation of targeted bupivacaine, bupivacaine-lidocaine-epinephrine, dexamethasone, and meloxicam for reducing acute postoperative pain in cats undergoing routine ovariohysterectomy.

Top Companion Anim Med 2021 Jul 24:100564. Epub 2021 Jul 24.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea. Electronic address:

This study compared bupivacaine (BUP), bupivacaine-lidocaine-epinephrine (BLE), dexamethasone (DEX), and meloxicam (MEL) targeted at specific, potentially painful sites for reducing acute postoperative pain in cats undergoing elective ovariohysterectomy. One hundred fifty-one cats were included in a prospective, randomized, double-blinded clinical trial. Anesthesia consisted of a standardized protocol including buprenorphine, ketamine, dexmedetomidine, and isoflurane. Read More

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Opioid-sparing analgesic effects of peripheral nerve blocks in percutaneous nephrolithotomy: a systematic review.

J Endourol 2021 Jul 27. Epub 2021 Jul 27.

Johns Hopkins University, Brady Urological Institute, Baltimore, Maryland, United States;

Introduction: Multimodal analgesia regimens incorporating peripheral nerve blocks (PNB) have demonstrated reduced postoperative pain, opioid use, and recovery time in various disease states. However, this remains a subject of limited investigation in the percutaneous nephrolithotomy (PCNL) domain. In the face of an ongoing opioid epidemic and collective push to enhance prescribing stewardship, we sought to examine the potential opioid-sparing effect of PNB in PCNL. Read More

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Feasibility and efficacy of cryoneurolysis analgesia in robotic-assisted thoracoscopic surgery (CARTS): a pilot study.

J Robot Surg 2021 Jul 27. Epub 2021 Jul 27.

Virginia Mason Medical Center, Virginia Mason Hospital, Seattle, WA, USA.

Opioid therapy has been the mainstay therapy of post-operative pain management in thoracic surgery patients. With the high incidence of chronic pain in thoracic surgery patients and adverse effects of opioids, we examined the safety and efficacy of cryoneurolysis as an adjunct for narcotic-free pain management in robotic-assisted thoracoscopic lobectomies. Ten consecutive patients undergoing robotic-assisted (DaVinci) pulmonary resection and cryoneurolysis were compared to ten patients managed without intraoperative cryoneurolysis. Read More

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Prophylactic Administration of Diphenhydramine/Acetaminophen and Ondansetron Reduced Postoperative Nausea and Vomiting and Pain Following Laparoscopic Sleeve Gastrectomy: a Randomized Controlled Trial.

Obes Surg 2021 Jul 27. Epub 2021 Jul 27.

Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Imam Khomeini St, Tehran, 11367-46911, Iran.

Purpose: Postoperative nausea and vomiting (PONV) and pain following bariatric surgery are problematic and affect the outcome of patients. Intraoperative multimodal antiemetic prophylaxis is essential to improve postoperative outcomes. This study investigated the effect of adding diphenhydramine to acetaminophen and ondansetron in reducing postoperative nausea and vomiting and pain following laparoscopic sleeve gastrectomy (LSG). Read More

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Retrospective Review of Perioperative Multimodal Analgesia for Orthopedic Patients in a Veterans Affairs Setting.

Sr Care Pharm 2021 Aug;36(8):397-408

Objectives: To determine adherence of perioperative knee/hip arthroplasties and hip fracture repairs to the American Pain Society (APS) guideline recommendations for perioperative pain control. One secondary objective was to perform an internal quality audit on the use of enhanced recovery after surgery (ERAS) protocols; another secondary objective was to design an evidence-based, multi-modal perioperative quick-order menu (if warranted).

Design/patients: A retrospective quality improvement (QI) review of uncomplicated knee/hip replacement and hip fracture repairs from January 2018 through March 2018. Read More

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Recommendations of the Society of Thoracic Surgery and the Section of Cardiothoracic and Vascular Surgery of the Spanish Society of Anesthesia, Resuscitation and Pain Therapy, for patients undergoing lung surgery included in an intensified recovery program.

Rev Esp Anestesiol Reanim 2021 Jul 19. Epub 2021 Jul 19.

Servicio de Anestesia y Reanimación, Hospital Universitario 12 de Octubre, Madrid, España.

In recent years, multidisciplinary programs have been implemented that include different actions during the pre, intra and postoperative period, aimed at reducing perioperative stress and therefore improving the results of patients undergoing surgical interventions. Initially, these programs were developed for colorectal surgery and from there they have been extended to other surgeries. Thoracic surgery, considered highly complex, like other surgeries with a high postoperative morbidity and mortality rate, may be one of the specialties that most benefit from the implementation of these programs. Read More

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Advances in the treatment of neuropathic pain.

Curr Opin Neurol 2021 Jul 23. Epub 2021 Jul 23.

INSERM U987, Ambroise Paré Hospital, APHP, Boulogne-Billancourt F-92100 Université Paris Saclay, Versailles, France.

Purpose Of Review: Neuropathic pain remains difficult to treat. This review provides an update regarding recent advances in therapeutic management, particularly with regards to newer drugs, neurostimulation techniques and original study designs.

Recent Findings: Although the mainstay of neuropathic pain management is still represented by drug therapy, particularly antidepressants and antiepileptics, the place of nonpharmacological therapy including in particular brain neuromodulation techniques has substantially increased in recent years. Read More

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Benefit of Endoscopic Surgery in the Management of Acute Invasive Skull Base Fungal Rhinosinusitis.

J Neurol Surg B Skull Base 2021 Jul 11;82(Suppl 3):e330-e334. Epub 2020 Feb 11.

Department of Neurosurgery, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, United States.

 This article aims to characterize 14 patients who underwent purely endoscopic surgical debridement of acute invasive skull base fungal rhinosinusitis, and to evaluate postoperative outcomes and risk for recurrence.  Retrospective cohort study.  Tertiary single-institution neurosurgery department. Read More

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Comparison of Oral Loading Dose to Intravenous Acetaminophen in Children for Analgesia After Tonsillectomy and Adenoidectomy: A Randomized Clinical Trial.

Anesth Analg 2021 Jul 23. Epub 2021 Jul 23.

From the Department of Anesthesiology and Pain Medicine.

Background: Acetaminophen is a frequently used adjunct analgesic in pediatric patients undergoing tonsillectomy and adenoidectomy. We compared opioid administration following preoperative intravenous (IV) or oral acetaminophen in addition to a standard multimodal regimen to test the hypothesis that 1 loading dose approach would provide superior opioid sparing effects among pediatric surgical patients undergoing tonsillectomy and adenoidectomy.

Methods: This single-center, double-blind, double-dummy prospective randomized study was conducted in patients ages 3 to 15 years undergoing tonsillectomy and adenoidectomy with or without myringotomy and tube placement between September 2017 and July 2019. Read More

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Pre-Hospital Pain Management in Children with Injuries: A Retrospective Cohort Study.

J Clin Med 2021 Jul 9;10(14). Epub 2021 Jul 9.

Department and Clinic of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Wroclaw Medical University, 50-556 Wrocław, Poland.

Background: The all-too-frequent failure to rate pain intensity, resulting in the lack of or inadequacy of pain management, has long ceased to be an exclusive problem of the young patient, becoming a major public health concern. This study aimed to evaluate the methods used for reducing post-traumatic pain in children and the frequency of use of such methods. Additionally, the methods of pain assessment and the frequency of their application in this age group were analysed. Read More

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Enhanced recovery strategies after penile implantation: a narrative review.

Transl Androl Urol 2021 Jun;10(6):2648-2657

Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA.

Optimizing pain management strategies in penile implantation has historically been a challenge to urologists assuming care of patients post-operatively. In addition to the complex pathophysiology of male genital pain, the responsibility of opioid stewardship in the face of the ongoing narcotics epidemic presents its own set of challenges to experienced implanters. Recent innovations in pre- and intra-operative analgesia have provided some improvement in patient-reported pain outcomes. Read More

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The role of the multi-disciplinary team and multi-disciplinary therapeutic protocol in the management of the chronic pelvic pain: There is strenght in numbers!

Arch Ital Urol Androl 2021 Jun 28;93(2):211-214. Epub 2021 Jun 28.

Department of Urology, San Raffaele Hospital, Milan.

Introduction: The aim of the study is to evaluate the effectiveness of a Multi-disciplinary team (MDT) and multi-disciplinary approach in the treatment of Chronic Pelvic Pain (CPP).

Methods: The data of all consecutive patients referred for a CPP from 11/2016 to 2/2019 has been prospectively collected. The sample was divided in two groups: Group A, made by patients managed after the institution of our MDT, and Group B, made of patients managed before this date. Read More

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A Multimodal Pain Management Protocol Including Preoperative Cryoneurolysis for Total Knee Arthroplasty to Reduce Pain, Opioid Consumption, and Length of Stay.

Arthroplast Today 2021 Aug 12;10:87-92. Epub 2021 Jul 12.

OrthoNebraska, Omaha, NE, USA.

Background: A retrospective analysis was conducted to determine if cryoneurolysis of superficial genicular nerves combined with standard care decreased postoperative opioids and pain after total knee arthroplasty (TKA).

Methods: Data from patients who underwent TKA at a single center were analyzed. Patients who received standardized cryoneurolysis before TKA were compared with a historical control group including patients who underwent TKA without cryoneurolysis. Read More

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Techniques and strategies for regional anesthesia in acute burn care-a narrative review.

Burns Trauma 2021 17;9:tkab015. Epub 2021 Jul 17.

Department of Surgery, UW Medicine Regional Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave. Seattle, WA 98104, USA.

Burn injuries and their treatments result in severe pain. Unlike traumatic injuries that are characterized by a discrete episode of pain followed by recovery, burn-injured patients endure pain for a prolonged period that lasts through wound closure (e.g. Read More

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Unilateral rhomboid intercostal and subserratus plane block application for analgesia after laparoscopic cholecystectomy surgery :a quasi-experimental study.

Korean J Anesthesiol 2021 Jul 20. Epub 2021 Jul 20.

Department of Anesthesiology and Reanimation , Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences , Bursa/TURKEY.

Background: Interfascial plane block applications can be used for postoperative pain after laparoscopic surgery. We aimed to investigate the effect of ultrasound-guided unilateral rhomboid intercostal and subserratus plane (RISS) block after laparoscopic cholecystectomy operations on the amount of analgesic use.

Methods: 50 patients underwent laparoscopic cholecystectomy were included in the quasi-experimental study. Read More

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