Perioperative lidocaine infusions may reduce the likelihood of developing chronic postsurgical pain.
Adverse events associated with opioids administered for the management of postsurgical and postendoscopy pain may be associated with worse cost and patient outcomes.
The management of postsurgical pain with patient-controlled analgesia pumps may be safe, as indicated by a low rate of device-related error.
In this multicenter, double-blind, placebo-controlled trial, patients (N=409) were randomized 1:1:1 to a postoperative regimen of IV tramadol 50mg, IV tramadol 25mg, or placebo administered over 15 minutes at hours 0, 2, 4, and once every 4 hours thereafter (up to 13 doses).
Researchers conducted a prospective survey of patients to investigate postoperative opioid use.
An elastic net algorithm was used to create a predictive model of postoperative pain in the first 24 hours after surgery using a randomly selected training cohort.
Postoperative pain management that combines a reduction of opioids with the use of intravenous acetaminophen may shorten hospital length of stay, reduce the rate of complications related to opioids, and lower related costs.
Additionally, statistical significance vs placebo was also achieved in total postsurgical opioid consumption through 48 hours (P<0.0001); opioid-free subjects through 48 hours (P<0.01); and time to first opioid rescue through 48 hours (P<0.0001).
Preoperative chronic opioid use is associated with poor outcomes and continued dependence after posterior lumbar fusion.
Multimodal analgesia after hip or knee arthroplasty may be associated with fewer complications and reduced opioid prescriptions and hospital length of stay, compared with unimodal analgesia.
In a preliminary study, high-frequency spinal cord stimulation was found to be more effective in treating chronic pain than conventional stimulation.
Intravenous acetaminophen with or without ketorolac is associated with reduced opioid consumption and cost of care after scoliosis surgery in adolescents.
Ilioinguinal-Transversus Abdominis Plane Block When Standard Analgesia Fails After Cesarean DeliveryFebruary 23, 2018
Ilioinguinal-transversus abdominis plane block was shown to provide superior pain relief compared with a multimodal analgesic regimen in patients undergoing an elective cesarean delivery.
Clinical best practice recommendations for the use of buprenorphine in the perioperative management of patients undergoing interventional pain procedures and other surgeries were recently published.
The most promising tools to predict acute pain after cesarean delivery are local anesthetic infiltration before placement of spinal anesthesia, and asking patients simple questions about anticipated pain and analgesic needs.
The FDA has accepted a New Drug Application for an investigational topical twice-a-day product for the treatment of inflammation and pain in patients who have undergone ocular surgery.
Intravenous Acetaminophen May Reduce Hospital Length of Stay in Adolescents Undergoing Posterior Spinal FusionJanuary 16, 2018
Postoperative management of adolescents undergoing posterior spinal fusion surgery with intravenous acetaminophen may have an opioid-sparing effect, due to a reduced hospital length of stay.
Genetics may be a factor in the experience of chronic postoperative pain as 42 polymorphisms were found to be correlated with chronic postsurgical pain.
Preoperative levels of serum total cholesterol do not correlate with postoperative pain following laparoscopic surgery for gastric cancer.
Parent- and nurse-controlled analgesia may not reduce postoperative pain in children with developmental delay compared with opioids administered by a nurse as needed.
Abstinent smokers may have reduced preoperative pain tolerance and increased postoperative opioid use compared with nonsmokers.
The FDA has granted Fast Track Designation to the investigational treatment CA-008 (Concentric Analgesics) for the treatment of post-surgical pain.
Systematic Review Does Not Identify Patient-Related Risk Factors for Chronic Pain After Total Knee Replacement SurgeryDecember 12, 2017
There is little evidence to suggest that postoperative knee pain, knee function, or various psychosocial factors influence long-term chronic pain following total knee replacement.
Esmolol was shown to reduce the use of opioids during and after surgery without having a significant impact on postoperative pain scores.
Opioid treatment of acute postoperative pain was shown to cause high rates of postoperative nausea and vomiting, particularly in women and younger patients.
Elevated rates of new persistent opioid use were found in patients undergoing both minor and major surgical procedures.
A number of shortcomings are associated with systematic reviews and meta-analyses of postoperative care.
There was a correlation for consistent vitamin D supplementation with increase in physical component of the SF-12 score.
An association was found between sleep quality and next-day pain intensity in children undergoing major surgery.
A standardized process for data analysis and internal benchmarking facilitated a reduction in pain following hip arthroplasty.
Clinical Pain Advisor Articles
- Replacing Sleep, Sedentary Behavior With Physical Activity Beneficial in Knee Osteoarthritis
- FDA Outlines Plan for New Analgesic Guidance to Combat Opioid Crisis
- The Role of Psychological Factors in Phantom Limb Pain Reviewed
- Rates of Concurrent Opioid, Sedative-Hypnotic Prescription Fills in Veterans
- Ozone vs Corticosteroids May Provide Longer-Lasting Effects for Plantar Fasciitis
- Ketamine: Mechanisms of Action, Uses in Pain Medicine, and Side Effects
- Medicinal Cannabis May Not Have Opioid-Sparing Effects in Chronic Noncancer Pain
- Cannabis May Be Effective for Migraine Treatment
- Integrating Psychological Interventions Into Chronic Pain Management
- Chronic Neck Pain: Generators, Clinical Examination, MRI Findings, and Differential Diagnosis
- Pregabalin May Not Improve Analgesia During Medical Abortion
- Investigational Treatment Shows Promise in Chronic Low Back Pain
- Rheumatologist-Assessed vs Criteria for Inflammatory Back Pain in Psoriatic Arthritis
- Incorporating Guidelines Into Clinical Practice: An Interview With Gary L. LeRoy, MD
- Pain Severity May Partly Mediate the Association Between Depression and Physical Performance in Knee OA