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重型创伤性脑损伤去骨瓣减压应用改良Paine点穿刺监测脑室内颅内压的优势 被引量:1
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作者 田和平 钟琦 +1 位作者 王耿焕 周海航 《解放军医学杂志》 CAS CSCD 北大核心 2024年第2期182-187,共6页
目的探讨重型创伤性脑损伤(TBI)开颅去骨瓣减压术(DC)中应用改良Paine点穿刺行脑室内颅内压(ICP)监测探头置入的优势。方法回顾性分析2020年4月-2022年4月嘉兴市第二医院收治的48例重型TBI患者的临床资料。所有患者均行DC联合脑室内ICP... 目的探讨重型创伤性脑损伤(TBI)开颅去骨瓣减压术(DC)中应用改良Paine点穿刺行脑室内颅内压(ICP)监测探头置入的优势。方法回顾性分析2020年4月-2022年4月嘉兴市第二医院收治的48例重型TBI患者的临床资料。所有患者均行DC联合脑室内ICP监护术,按照ICP监测术式的不同,分为观察组(23例)与对照组(25例),其中观察组行DC切口内改良Paine点穿刺脑室内ICP监测探头置入术,对照组行传统DC对侧切口颅骨钻孔经Kocher点脑室内ICP监测探头置入术。比较两组术前一般资料、手术用时、术后甘露醇使用剂量及持续时间、ICP监测持续时间、术后再出血率、颅内感染率、术后3个月时格拉斯哥预后评分(GOS)。结果两组一般资料、甘露醇使用剂量、甘露醇持续时间和ICP监测持续时间比较差异均无统计学意义(P>0.05);观察组手术用时、术后再出血率、颅内感染率明显少于或低于对照组(P<0.05);两组术后3个月GOS评分比较差异无统计学意义(P>0.05)。结论相较传统的DC对侧切口颅骨钻孔经Kocher点行脑室内ICP监测探头置入术,重型脑外伤DC术中通过切口内改良Paine点穿刺行脑室内ICP监测探头置入术可缩短手术用时,降低术后再出血率、颅内感染率。 展开更多
关键词 重型创伤性脑损伤 去骨瓣减压术 脑室内颅内压监测探头置入术 改良paine点脑室穿刺
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Rehabilitation care for pain in elderly knee replacement patients 被引量:3
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作者 Li Liu Qiao-Zhen Guan Li-Fang Wang 《World Journal of Clinical Cases》 SCIE 2024年第4期721-728,共8页
BACKGROUND Total knee arthroplasty(TKA)is recognized as the most effective surgical intervention for relieving pain and improving joint mobility and deformity in patients with knee osteoarthritis and other synovial di... BACKGROUND Total knee arthroplasty(TKA)is recognized as the most effective surgical intervention for relieving pain and improving joint mobility and deformity in patients with knee osteoarthritis and other synovial diseases.The application of accelerated postoperative rehabilitation(enhanced recovery after surgery)has demonstrated its efficacy in improving patient outcomes,and early postoperative joint function exercise has become a key prognostic factor in knee replacement.The unexpected appearance of limb pain and swelling hindered the patient’s tendency for early mobilization,leading in prolonged hospitalization,delayed functional recovery and negative psychological responses.A retrospective analysis was conducted on a cohort of 116 patients who under-went TKA at our hospital between July 2019 and July 2021.The patients were divided into two groups:A control group(n=58)receiving programmatic nur-sing,and an observed group(n=58)receiving programmed nursing combined with a collaborative nursing model.A pain management team consisting of attending physicians,head nurses,and responsible nurses was established.Outcome measures included visual analogue scale(VAS)scores,activities of daily living(ADL)scale scores,and functional scores.The ADL scores of patients in both groups exhibited a continuous increase.However,there was no statistically significant difference in the ADL scores between the two groups at 48 h and the 7th d post-surgery(P>0.05).Upon reexamination at the 3rd mo,the observation group demonstrated higher ADL scores compared to the control group(67.48±14.69 vs 59.40±16.06,P<0.05).The VAS scores of both groups significantly decreased,with no significant difference observed between the groups at each time point(P>0.05).The functional status of patients in both groups exhibited a gradual increase prior to intervention and at the 1st,2nd,and 3rd month following discharge(P<0.05).There was no statistically significant difference in knee joint function scores between the two groups at the 1st month after discharge(47.52 vs 45.81,P>0.05).However,the knee joint function scores of patients in the observation group were significantly higher than those in the control group at the 2nd(59.38 vs 53.19,P<0.05)and 3rd month(71.92 vs 64.34,P<0.05)following discharge.CONCLUSION The utilization of programmed pain nursing in conjunction with collaborative nursing for out-of-hospital care of TKA patients has demonstrated favorable outcomes,encompassing pain reduction,enhanced prognosis,and improved nursing quality for patients. 展开更多
关键词 Programmed pain nursing Collaborative nursing Total knee arthroplasty
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Effect of ankle versus thigh tourniquets on post-operative pain in foot and ankle surgery 被引量:1
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作者 Ashish Mishra Ahmed Barakat +5 位作者 Jitendra Mangwani Jakub Kazda Sagar Tiwatane Sana Mohammed Aamir Shaikh Linzy Houchen-Wolloff Vipul Kaushik 《World Journal of Orthopedics》 2024年第2期163-169,共7页
BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ... BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site. 展开更多
关键词 Lower limb surgery Tourniquet time Tourniquet pressure Tourniquet site Post-operative pain pain scores
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Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study 被引量:1
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作者 Xiao-Wen Sun Jing-Yi Xu +3 位作者 Chang-Zhen Zhu Si-Jia Li Lu-Jia Jin Zhi-Dong Zhu 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期731-739,共9页
BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in ... BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition score 28 d after surgery(4.80±0.41)was also higher than that at 14 d post-surgery(4.01±0.62).The mean physical health score 28 d after surgery(32.10±2.96)was significantly higher than that at 14 d post-surgery(23.41±2.85).The mean psychological health score 28 d after surgery(27.22±1.62)was significantly higher than that at 14 d post-surgery(21.37±1.70).The mean social relations score 28 d after surgery(12.21±1.59)was significantly higher than that at 14 d post-surgery(6.32±1.66).The mean surrounding environment score 28 d after surgery(37.13±2.88)was significantly higher than that at 14 d post-surgery(28.42±2.86).The differences in quality-of-life scores at day 14 and day 28 post-surgery were ob-served to be statistically significant(P<0.001).CONCLUSION Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients.Age,sex,and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy. 展开更多
关键词 HEMORRHOIDS Mixed hemorrhoids Milligan organ hemorrhoidectomy Postoperative pain Quality of life Anesthesia mode
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Differences between the healthcare systems of Quebec and France for the treatment of pain due to spinal disorders
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作者 Lea Evangeline Boyer Mathieu Boudier-Revéret Min Cheol Chang 《World Journal of Clinical Cases》 SCIE 2024年第15期2682-2685,共4页
In Quebec,Canada,the public healthcare system offers free medical services.However,patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy coverage.In contras... In Quebec,Canada,the public healthcare system offers free medical services.However,patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy coverage.In contrast,private clinics provide expedited care but are relatively scarce and entail out-of-pocket expenses.Once a patient with pain caused by a spinal disorder meets a pain medicine specialist,spinal intervention is quickly performed when indicated,and patients are provided lifestyle advice.Transforaminal epidural steroid injections are frequently administered to patients with radicular pain,and steroid injections are administered on a facet joint to control low back or neck pain.Additionally,medial branch blocks are performed prior to thermocoagulation.France’s universal healthcare system ensures accessibility at controlled costs.It emphasizes physical activity and provides free physical therapy services.However,certain interventions,such as transforaminal and interlaminar epidural injections,are not routinely used in France owing to limited therapeutic efficacy and safety concerns.This underutilization may be a potential cause of chronic pain for many patients.By examining the differences,strengths,and weaknesses of these two systems,valuable insights can be gained for the enhancement of global spinal pain management strategies,ultimately leading to improved patient outcomes and satisfaction. 展开更多
关键词 Spinal pain Healthcare system FRANCE Quebec pain treatment
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Comparing role of ATP between acute pain in neuromyelitis optica spectrum disorder and peripheral neuropathic pain
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作者 Teruyuki Ishikura Tatsusada Okuno 《Neural Regeneration Research》 SCIE CAS 2025年第1期184-185,共2页
In this article, we present our previous research, which highlighted adenosine triphosphate(ATP) as the cause of neuropathic pain during the acute phase of neuromyelitis optica spectrum disorder(NMOSD). In NMOSD patho... In this article, we present our previous research, which highlighted adenosine triphosphate(ATP) as the cause of neuropathic pain during the acute phase of neuromyelitis optica spectrum disorder(NMOSD). In NMOSD pathology, damageassociated molecular patterns(DAMPs), including ATP, are released from damaged astrocytes, triggering the activation of innate immune cells. ATP is a central mediator of acute pain in NMOSD. 展开更多
关键词 pain ACUTE PATHOLOGY
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Phrenic nerve block: the key to managing acute biliary pain?
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作者 Michael Shalaby Joshua Luftig 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第1期62-63,共2页
Over the past two decades,the USA has witnessed a steep rise in the incidence of acute cholecystitis(AC),[1]even among children,[2]with over 200,000 cases annually.[3]Patients with AC often present to the emergency de... Over the past two decades,the USA has witnessed a steep rise in the incidence of acute cholecystitis(AC),[1]even among children,[2]with over 200,000 cases annually.[3]Patients with AC often present to the emergency department(ED)experiencing severe distress,with most describing their pain level as“intolerable.”[4]Furthermore,there is usually a considerable delay before surgery,with a median time from diagnosis of AC to surgery of 28.5 h,[5]and a substantial percentage of patients wait as long as 10 d.[6]Prolonged delays before surgery lead to increased opioid use,which is associated with extended hospital stays and higher rates of readmission after cholecystectomy.[7]Furthermore,opioids can lead to vomiting,respiratory depression,delirium,and ultimately addiction.[8]We propose a novel regional anesthesia technique for managing AC:right phrenic nerve blockade.This method could offer improved pain control and a more favorable risk profile in selected patients when compared to current ED practices. 展开更多
关键词 pain ANESTHESIA DIAGNOSIS
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Protocol for lower back pain management: Insights from the French healthcare system
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作者 Lea Evangeline Boyer Mathieu Boudier-Revéret Min Cheol Chang 《World Journal of Clinical Cases》 SCIE 2024年第11期1875-1880,共6页
In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with ... In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems. 展开更多
关键词 Lower back pain PROTOCOL FRANCE TREATMENT Chronic pain
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Acute abdominal pain from ovarian endometriosis
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作者 Zhengyun Chen Tao Shen +3 位作者 Yongqing Zhang Yuanyuan Zhou Xiaoyong Li Jiabin Lin 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第5期407-409,共3页
Endometriosis is a common,estrogen-dependent,inflammatory,gynecologic disease process in which normal endometrial tissue is abnormally present outside the uterine cavity.[1]Endometriosis is a common cause of chronic p... Endometriosis is a common,estrogen-dependent,inflammatory,gynecologic disease process in which normal endometrial tissue is abnormally present outside the uterine cavity.[1]Endometriosis is a common cause of chronic pain,dyspareunia,dysmenorrhea,and infertility.Most commonly,endometriosis is found within the pelvis,specifically on the ovaries.Because of rupture,bleeding,infection,or torsion,ovarian endometriosis(OMA)may cause acute abdominal pain,which is similar to acute abdominal pain caused by other reasons and is not easy to diagnose.[2,3]Determining the clinical and pathological features of OMA is crucial for accurate assessment,diagnosis,and treatment. 展开更多
关键词 pain ENDOMETRIOSIS ACUTE
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Commentary on“Synchronized activity of sensory neurons initiates cortical synchrony in a model of neuropathic pain”
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作者 Lorenzo Di Cesare Mannelli Carla Ghelardini 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第4期728-728,共1页
In pat i e nt s,a s well as in animal mod e l s,hypersensitivity to external stimuli(hyperalgesia and allodynia)or spontaneous pain is often the first,and the most disabling,symptom of neuropathy(Davis et al.,2020).Th... In pat i e nt s,a s well as in animal mod e l s,hypersensitivity to external stimuli(hyperalgesia and allodynia)or spontaneous pain is often the first,and the most disabling,symptom of neuropathy(Davis et al.,2020).The increased activity of sensitive neurons drives pain development,making ion channel modulation a fundamental target for current pharmacotherapy as well as one of the most investigated by the R&D departments of pharmaceutical companies(Bennett et al.,2019). 展开更多
关键词 COMPANIES pain ENT
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Percutaneous cervical cordotomy for managing refractory pain in a patient with a Pancoast tumor:A case report
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作者 Kuan-Yu Lu Feng-Sheng Lin +1 位作者 Chia-Shiang Lin Hsuan-Chih Lao 《World Journal of Clinical Cases》 SCIE 2024年第21期4770-4776,共7页
BACKGROUND According to the World Health Organization analgesic ladder,cancer-related pain generally begins with pharmacotherapy in a stepwise approach.Nevertheless,some patients continue to experience poorly controll... BACKGROUND According to the World Health Organization analgesic ladder,cancer-related pain generally begins with pharmacotherapy in a stepwise approach.Nevertheless,some patients continue to experience poorly controlled pain despite medications,particularly when considering adverse effects and self-care quality.Percutaneous cervical cordotomy is an alternative interventional procedure for unremitting unilateral intractable cancer-related pain.CASE SUMMARY The patient was diagnosed with lung cancer with destruction of the brachial plexus and ribs.For 2 mo,the patient experienced progressive severe weakness and pain in the right upper extremity.Notably,the pain intensity reached an extreme level,particularly when lying supine,even under heavy sedation.This heightened pain response posed a significant challenge;as a result,the patient was unable to undergo further evaluation through magnetic resonance imaging.Ultimately,he underwent percutaneous cervical cordotomy for symptom relief,resulting in complete resolution of right arm pain.After a 3-mo follow-up,the pain did not recur,and only a flurbiprofen local patch was required for mild scapular tightness.CONCLUSION Cordotomy,under careful patient selection,appears to enhance the quality of life of patients with unilateral cancerrelated pain. 展开更多
关键词 Cordotomy Cancer pain Intractable pain FLUOROSCOPY Radiofrequency therapy Case report
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Early Application Study of Intravenous Pain Pump Combined with Parecoxib Injection in Relieving Pain in Patients after Thoracoscopy
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作者 Heping Wu Linjuan Zeng 《Journal of Cancer Therapy》 2024年第4期212-218,共7页
Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Met... Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Methods: Eighty patients who underwent thoracoscopic surgery in a tertiary hospital were selected as the study subjects and randomly divided into two groups, with 40 patients in each group. The control group received routine postoperative treatment with intravenous pain pump, while the experimental group received Parecoxib in addition to the standard postoperative pain pump treatment. Visual Analog Scale (VAS) pain scores were used to evaluate postoperative pain relief in both groups, along with adverse reactions, postoperative complications, and patient satisfaction with pain relief. Results: Patients who received Parecoxib injection in addition to the routine use of intravenous pain pump had VAS pain scores lower than 3 points at 6 h, 12 h, 24 h, and 36 h postoperatively compared to those in the control group. The incidence of postoperative lung collapse, pleural effusion, and pulmonary infections was also significantly lower in the experimental group. The differences between the two groups were statistically significant (P Conclusion: Early combined use of Parecoxib injection in the early postoperative period after thoracoscopic surgery has shown good clinical efficacy. It can reduce the level of pain in patients, promote effective coughing and expectoration, facilitate early mobilization of patients, improve patient compliance, reduce complications, shorten hospital stay, and expedite patient recovery. Therefore, it is worth promoting the widespread clinical application of Parecoxib injection in this setting. 展开更多
关键词 PARECOXIB Combined Use thoracoscopic Surgery Intravenous pain Pump Postoperative pain
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Brain regulates weight bearing bone through PGE2 skeletal interoception: implication of ankle osteoarthritis and pain
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作者 Feng Gao Qimiao Hu +8 位作者 Wenwei Chen Jilong Li Cheng Qi Yiwen Yan Cheng Qian Mei Wan James Ficke Junying Zheng Xu Cao 《Bone Research》 SCIE CAS CSCD 2024年第1期107-121,共15页
Bone is a mechanosensitive tissue and undergoes constant remodeling to adapt to the mechanical loading environment.However,it is unclear whether the signals of bone cells in response to mechanical stress are processed... Bone is a mechanosensitive tissue and undergoes constant remodeling to adapt to the mechanical loading environment.However,it is unclear whether the signals of bone cells in response to mechanical stress are processed and interpreted in the brain.In this study,we found that the hypothalamus of the brain regulates bone remodeling and structure by perceiving bone prostaglandin E2(PGE2)concentration in response to mechanical loading.Bone PGE2 levels are in proportion to their weight bearing.When weight bearing changes in the tail-suspension mice,the PGE2 concentrations in bones change in line with their weight bearing changes.Deletion of cyclooxygenase-2(COX2)in the osteoblast lineage cells or knockout of receptor 4(EP4)in sensory nerve blunts bone formation in response to mechanical loading.Moreover,knockout of TrkA in sensory nerve also significantly reduces mechanical load-induced bone formation.Moreover,mechanical loading induces cAMP-response element binding protein(CREB)phosphorylation in the hypothalamic arcuate nucleus(ARC)to inhibit sympathetic tyrosine hydroxylase(TH)expression in the paraventricular nucleus(PVN)for osteogenesis.Finally,we show that elevated PGE2 is associated with ankle osteoarthritis(AOA)and pain.Together,our data demonstrate that in response to mechanical loading,skeletal interoception occurs in the form of hypothalamic processing of PGE2-driven peripheral signaling to maintain physiologic bone homeostasis,while chronically elevated PGE2 can be sensed as pain during AOA and implication of potential treatment. 展开更多
关键词 pain ELEVATED PGE2
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Trends in oxycodone and oxycodone-containing analgesics administration for back pain in emergency departments in the USA(2007–2018)
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作者 Jonathan Chabon Jemer Garrido +2 位作者 Deanna Schreiber-Gregory Jefferson Drapkin Sergey Motov 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第3期169-174,共6页
BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gather... BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gathered from the National Hospital Ambulatory Medical Care Survey(NHAMCS) from 2007 to 2018.The study population included individuals of all ages presenting to USA EDs.The NHAMCS reasons for visit and oxycodone drug ID codes were used to isolate patients with back pain.The main outcome was the proportion of oxycodone and oxycodone-containing analgesics prescribed for back pain in the EDs over the specified time period.RESULTS:There was a relative decrease in the overall administration of oxycodone for back pain in the EDs by 62.3% from 2007(244,000 visits) to 2018(92,000 visits).The proportion of ED patients prescribed with oxycodone-containing analgesics for back pain increased among patients aged 45 years and older(from 43.8% to 57.6%),female patients(from 54.5% to 62.0%),black patients(from 22.5% to 30.4%),and Hispanic/Latino patients(from 9.4% to 19.6%).Oxycodone/acetaminophen was most prescribed and accounted for 90.2% of all oxycodone-containing analgesics in 2007,with a decrease to 68.5% in 2018.Pure oxycodone was the second most prescribed medication,accounting for 6.1% in 2007 and 31.5% in 2018.CONCLUSION:The overall number of oxycodone-containing analgesics decreased significantly from 2007 to 2018.However,that number trended upward in 45-year-old and older,female,black,or Hispanic/Latino patients from 2007 to 2018.The total amount of pure oxycodone increased significantly from 2007 to 2008. 展开更多
关键词 OXYCODONE Back pain Emergency department
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Reconstructive surgery for phantom and residual limb pain in post-conflict settings
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作者 Damián Palafox 《Chinese Journal of Plastic and Reconstructive Surgery》 2024年第1期54-55,共2页
Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several ele... Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several elective surgical procedures available for both conditions,such as neuroma excision followed by nerve reconstruction,nerve relocation,e.g.,surgically implanting a transected nerve into a muscle,nerve transfers in cases of associated paralysis,and most recently,regenerative peripheral nerve interface surgery.Whenever possible in the post-conflict phase,a coordinated effort between traveling humanitarian surgeons specializing in reconstructive microsurgery and local healthcare providers is essential for successfully treating phantom and chronic residual limb pain in post-conflict amputees.While providing a detailed logistical framework for global humanitarian missions is beyond the scope of this article,we provide a brief perspective on a topic of utmost importance for reconstructive surgeons worldwide:the high-quality care and treatment of refugees and those whose lives have been impacted by conflict,disaster,or displacement. 展开更多
关键词 Residual limb pain Phantom limb pain Refugees Reconstructive surgery MICROSURGERY AMPUTEES
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Complex Regional Pain Syndrome: Outpatient Pain Management in the Chronic Setting: A Case Report
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作者 Julie Chege Ngugi Kinyungu 《Open Journal of Anesthesiology》 2024年第5期137-144,共8页
Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a d... Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function. 展开更多
关键词 Chronic Regional pain Syndrome (CRPS) Multimodal Management Chronic pain SEQUELAE
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Optimizing pain management in elderly patients post-knee surgery:A novel collaborative strategy
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作者 Abdulqadir J Nashwan 《World Journal of Clinical Cases》 SCIE 2024年第15期2475-2478,共4页
Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of suc... Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery. 展开更多
关键词 ELDERLY Postoperative pain management Rehabilitation care Multimodal pain strategy Total knee arthroplasty Enhanced recovery after surgery
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Evaluation of Procedural Pain in Neonates in Cameroon
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作者 Claude-Audrey Meguieze Rose Bidias +1 位作者 Etouckey Georges Eric Nseme Koki Ndombo Paul Olivier 《Open Journal of Pediatrics》 2024年第3期568-578,共11页
Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been s... Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been scarcely explored, thus constituting an impediment to the management of care-induced pain. Objective: Assess procedural pain in neonates in Yaoundé. Material and Methods: We conducted a cross sectional study with prospective data collection over a period of eight months (October 2022 to May 2023) in three hospitals. We included neonates who were being cared for and were not crying prior to the onset of healthcare, whose parents consented to the study. Assessments were done using the DAN scale, which is specific to care-induced pain. Data was entered and analyzed using SPSS 23.0 software. Results: A total of 161 newborns were included. The hospital prevalence of care-induced pain in neonates was 85%. Neonatal sepsis was the main cause for admission (96.6%). The most common procedures were venous blood sampling (94.4%) and insertion of peripheral venous lines (93.8%). The pain intensity for these procedures was severe (83.9%). The most painful procedure was lumbar tap, followed by venous access procedures. Conclusion: Neonates in hospitals are subjected to many painful procedures. The pain experienced during these procedures is severe. The most nociceptive procedure is a lumbar puncture. 展开更多
关键词 ASSESSMENT Procedural pain NEONATE Yaoundé Cameroon
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Galvanic Skin Response—Extinction Biofeedback Training for Psychogenic Abdominal Pain: A Validation Protocol
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作者 Maddalena Castelletti Enrico Berné +2 位作者 Erasmo Dionigio Carlo Castagnoli Alberto Montagna Giorgio Tonon 《Journal of Biosciences and Medicines》 2024年第5期190-201,共12页
Abdominal and pelvic pain of psychogenic origin is a widespread, disabling, difficult to identify, and often inadequately treated medical condition. This condition is often associated with poor quality of life due to ... Abdominal and pelvic pain of psychogenic origin is a widespread, disabling, difficult to identify, and often inadequately treated medical condition. This condition is often associated with poor quality of life due to high pain interference with daily activities. Cognitive behavioral psychological therapy and neuromodulation with biofeedback are validated therapies for the treatment of this condition. Aim of the present research work is the validation of a therapeutic protocol that involves the use of both techniques in combination. 20 patients diagnosed with psychogenic abdominal pain, of both sexes, aged between 18 and 60 years who had not benefited from pharmacological therapies were enrolled. 10 patients were randomly assigned to the control group (psychological treatment only), another 10 patients were assigned to the study group (neuromodulation with biofeedback-Galvanic skin response-extinction in combination with psychological therapy). For both groups, the pain score, interference of pain with daily living activities, pain relief, and the share of anxiety associated with the pain condition were evaluated (pre- and post-treatment). The patients who underwent the combined treatment achieved statistically significant better scores than patients in the control group, respectively −4.9 ± 0.9 vs −1.0 ± 0.4 for Pain;−5.1 ± 1.1 vs −0.9 ± 0.3 for Interference with life;−7.2 ± 3.7 vs −2.2 ± 2.1 for HAMA;4.6 ± 1.2 vs 1.1 ± 0.6 for Relief. 展开更多
关键词 Chronic Abdominal and Pelvic Psychogenic pain (PAP) Biofeedback Training pain Management Galvanic Skin Response (GSR)
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Use of artificial intelligence in the field of pain medicine
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作者 Min Cheol Chang 《World Journal of Clinical Cases》 SCIE 2024年第2期236-239,共4页
In this editorial we comment on the article“Potential and limitations of ChatGPT and generative artificial intelligence in medial safety education”published in the recent issue of the World Journal of Clinical Cases... In this editorial we comment on the article“Potential and limitations of ChatGPT and generative artificial intelligence in medial safety education”published in the recent issue of the World Journal of Clinical Cases.This article described the usefulness of artificial intelligence(AI)in medial safety education.Herein,we focus specifically on the use of AI in the field of pain medicine.AI technology has emerged as a powerful tool,and is expected to play an important role in the healthcare sector and significantly contribute to pain medicine as further developments are made.AI may have several applications in pain medicine.First,AI can assist in selecting testing methods to identify causes of pain and improve diagnostic accuracy.Entry of a patient’s symptoms into the algorithm can prompt it to suggest necessary tests and possible diagnoses.Based on the latest medical information and recent research results,AI can support doctors in making accurate diagnoses and setting up an effective treatment plan.Second,AI assists in interpreting medical images.For neural and musculoskeletal disorders,imaging tests are of vital importance.AI can analyze a variety of imaging data,including that from radiography,computed tomography,and magnetic resonance imaging,to identify specific patterns,allowing quick and accurate image interpretation.Third,AI can predict the outcomes of pain treatments,contributing to setting up the optimal treatment plan.By predicting individual patient responses to treatment,AI algorithms can assist doctors in establishing a treatment plan tailored to each patient,further enhancing treatment effectiveness.For efficient utilization of AI in the pain medicine field,it is crucial to enhance the accuracy of AI decision-making by using more medical data,while issues related to the protection of patient personal information and responsibility for AI decisions will have to be addressed.In the future,AI technology is expected to be innovatively applied in the field of pain medicine.The advancement of AI is anticipated to have a positive impact on the entire medical field by providing patients with accurate and effective medical services. 展开更多
关键词 Artificial intelligence pain medicine DIAGNOSIS PREDICTION IMAGE
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