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Postoperative intravenous lidocaine infusion for pain management in pelvic bone tumor surgery patients: a randomized, double-blind, controlled trial.

BACKGROUND: Previous studies have demonstrated that perioperative use of lidocaine effectively reduces opioid requirements in various surgic … (13 (0-52) mg vs. 25 (14-85) mg, P = 0.043). Additionally, the proportion of patients experiencing breakthrough pain was significantly lower in the L Group compared to the C Group (33.33% vs. 75.76%, P = 0.001). No significant differences were noted between the groups in secondary outcomes, including the incidence of PONV, numerical pain scores at rest or during m …

Effect of NSAID Use on Bone Healing in Pediatric Fractures: A Preliminary, Prospective, Randomized, Blinded Study.

BACKGROUND: This study aimed to investigate if nonsteroidal anti-inflammatory drugs (NSAIDs) used in the acute phase of bone healing in chil … on and instead prescribed weight-based acetaminophen. Both groups were allowed to use oxycodone for breakthrough pain. The primary outcome was fracture healing assessed at 2, 6, and 10 weeks. RESULTS: One-hundred-two patients were enrolled between February 6, 2014 and September 23, 2016. Ninety-five patients (with 97 fractures) completed a 6-month follow-up (46 pa …

How should clinicians assess acute dental pain?: A review.

Pain is the most common complaint in the dental field and may have a significant impact on the patients' quality of life. However, objective pain assessment is sometimes difficult, and medical and dental clinicians may encounter cases of pain in the head and neck region, making it difficult to establish differential diagnoses. This study aimed to review acute pain in clinical dentistry at each phase of dental procedures and discuss the current status and issues in the development of acute dental pain assessment methods in the future. Acute pain in clinical dentistry may differ in nature and mo

Treatment of rheumatic musculoskeletal disorders.

Non-medicinal therapies with water, salts, exercise, massage, supportive devices, and electricity have been used for centuries and continue to be of benefit for some people with musculoskeletal disorders. Historical texts refer to the two electuaries mithridatium and theriaca as early therapeutic attempts of man to provide relief of musculoskeletal symptoms and attempt disease cures. For over 200 years, morphine-derived products have been used for musculoskeletal pain. The development of acetyl salicylic acid was a major breakthrough in joint pain management. This was followed by the introduct

Cesarean delivery: Clinical updates.

This article offers a comprehensive clinical update on best practices for neuraxial and general anesthesia in cesarean delivery, the most frequently performed major surgical procedure globally. Current evidence-based strategies to address common anesthetic challenges, such as maternal hypotension and intraoperative breakthrough pain, are discussed in detail. Practical approaches for optimizing maternal hemodynamic stability, including the use of vasopressors, fluid management and maternal positioning, are reviewed. Additionally, the article explores best practices for general anesthesia, with …

Opioid Use in Older Adults with Cancer Pain Admitted to an Acute Palliative Care Unit: Does Age Matter? A Secondary Analysis.

BACKGROUND: Cancer pain in older adults presents unique management challenges because of age-related pharmacokinetic and pharmacodynamic changes. Data on age-stratified opioid prescribing within acute palliative care units remain scarce. OBJECTIVE: We aimed to evaluate the influence of age on opioid dosing, drug selection, and breakthrough pain management in patients with advanced cancer admitted to an acute palliative care unit. METHODS: We conducted a secondary analysis of a prospective observational study conducted over 5 months. Patients were stratified into three cohorts: adults (A, age…

Randomized clinical trial comparing pericapsular nerve group (PENG) block and periarticular local anesthetic infiltration for total hip arthroplasty.

BACKGROUND: This randomized trial compared pericapsular nerve group block and periarticular local anesthetic infiltration in patients undergoing primary total hip arthroplasty. We hypothesized that, compared with pericapsular nerve group block, periarticular local anesthetic infiltration would decrease the postoperative incidence of quadriceps weakness at 3 hours fivefold (ie, from 45% to 9%). METHODS: Sixty patients undergoing primary total hip arthroplasty under spinal anesthesia were randomly allocated to receive a pericapsular nerve group block (n=30) using 20 mL of adrenalized bupivacain

The Use of Parenteral Opioids in Cancer Pain Management.

Opioids should be offered to patients with moderate-to-severe pain related to cancer or active cancer treatment unless contraindicated. Although oral administration of opioids is generally preferable, a parenteral route may be advisable and mandatory in some clinical circumstances. Parenteral administration of opioids may accelerate the achievement of analgesia. The intravenous route fits the need of rapid achievement of analgesia in patients poorly responsive to other opioids and provides a fast analgesia in patients with breakthrough pain, that has a specific temporal pattern requiring a rap…

Living liver donor pain management.

PURPOSE OF REVIEW: Optimal pain control in living liver donors undergoing hepatectomy is strongly recommended considering their unique statu … opioids is important to avoid adverse effects, and they should be reserved for rescue medication or breakthrough pain. SUMMARY: Applying the principles of ERAS and multimodal analgesia to living liver donors can effectively control pain while promoting early recovery.

A case report of dexmedetomidine used to treat intractable pain and delirium in a tertiary palliative care unit.

BACKGROUND: This case report describes an end-stage cancer patient with intractable neuropathic pain and delirium who was successfully managed during the last 3 weeks of her life with a continuous subcutaneous infusion of dexmedetomidine. CASE PRESENTATION: A 55-year-old woman with locally advanced cervical cancer and uncontrolled pelvic pain was admitted to a tertiary palliative care unit for pain management. As her disease progressed, the patient's pelvic pain intensified despite treatment with methadone, gabapentin, ketamine, and hydromorphone administered by continuous subcutaneous infusi

Buprenorphine for the Treatment of Pain in Cancer Patients.

BACKGROUND: Opioids remain the cornerstone for the treatment of moderate to severe cancer pain. Due to benefits over full agonist opioids (FAO), buprenorphine has emerged as an alternative treatment. PURPOSE/HYPOTHESIS: Buprenorphine is only approved for the treatment of pain that is chronic non-cancer. Cancer-related pain is often progressive with breakthrough pain. There is limited evidence for using short-acting FAO in combination with buprenorphine. There are concerns about withdrawal and the efficacy of pain control using buprenorphine. We hypothesize buprenorphine, in combination with s…

Bupivacaine usage for post-operative bladder spasm.

Successful pain management following bladder surgery in children is often complicated by bladder spasms. Although current management for bladder spasm, such as opioids, sedatives, anticholinergics, and epidural anaesthesia can be effective, breakthrough spasms often occur and side effects of the above measures commonly result. Intravesical bupivacaine is a new method used to suppress post-operative bladder spasm at Royal Children's Hospital, Melbourne. This survey study investigated nursing staffs' experience with this method, and found 89% had confidence in this method to control bladder spas

Management of post-operative bladder spasm.

OBJECTIVE: Pain management following bladder surgery in children is often complicated by bladder spasm. The overall severity of spasm can be reduced with opioids, anticholinergic medication and sedatives, although breakthrough spasms often occur. At the Royal Children's Hospital, Melbourne, intravesical bupivacaine has been used to manage postoperative bladder spasm to good effect. The administration of intravesical bupivacaine is analysed in this prospective audit of locally applied intravesical anaesthetic and compared with other methods. METHOD: From February to August 2003, histories of 5

Opioid Use Following Spine Surgery: Strategies for a Multimodal Approach To Pain Management.

Chronic back pain is highly prevalent and closely associated with opioid misuse, particularly in patients undergoing spine surgery. Optimizi … pain, although its opioid-sparing effects remain uncertain. Opioid prescribing should be limited to breakthrough pain and integrated into structured tapering strategies. Optimizing postoperative analgesia in spine surgery requires a multimodal approach, interdisciplinary collaboration, and individualized prescribing-potentially guided by emerging tools such as phar …

Регулирование причиняемой раком боли в хосписе и паллиативном уходе.

Раковая боль в костях (CIBP) one - наиболее распространенные симптомы инвалидности, встречающиеся в хосписе и паллиативном уходе. Метастазы костей особенно часто встречаются у пациентов с множественной миеломой, раком груди и раком простаты, и они могут вызывать непрерывную фоновую боль, боль, связанную с движением, патологический перелом, злокачественное сжатие спинного мозга и гиперкальцемию злокачественности. CIBP является результатом сложного взаимодействия ноцицептивных, подстрекательских и нейропатических механизмов, обусловленных взаимодействием опухолей со стромой и центральной сенсиби

Совпадение в аннотации оригинала
Cancer-induced bone pain (CIBP) is one of the most prevalent and disabling symptoms encountered in hospice and palliative care. Bone metastases are particularly common in patients with multiple myeloma, breast cancer, and prostate cancer, and may cause continuous background pain, movement-related breakthrough pain, pathologic fracture, malignant spinal cord …

The applicability and efficacy of magnetic resonance-guided high intensity focused ultrasound system in the treatment of primary trigeminal neuralgia.

Primary trigeminal neuralgia is a common clinical refractory neuralgia characterized by an onset of excruciating pain that can severely affect patients' quality of life. Long-term suffering from this pain may lead to depression, anxiety, and suicide. Current treatments, however, are associated with high recurrent rates and severe complications. We hypothesize that both the applicability and efficacy of magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) treatment in primary trigeminal neuralgia can be achieved under the following conditions: a specific target focus and incide

Rampant caries from oral transmucosal fentanyl citrate lozenge abuse.

BACKGROUND: Oral transmucosal fentanyl citrate lozenges (lollipops) are indicated for the oral management of breakthrough cancer pain. When abused, these sucrose-containing lozenges can cause rampant dental caries. CASE DESCRIPTION: The authors examined a 19-year-old man whose dentist referred him because of total dental coronal destruction. After the authors questioned the patient, they concluded that his frequent oral use of sucrose-containing opioid fentanyl citrate lozenges across a three-year period caused the dental condition. CLINICAL IMPLICATIONS: Dentists should be aware that oral t

Current Status of Protein Biomarkers in Urolithiasis-A Review of the Recent Literature.

Urolithiasis is an increasingly common clinical problem worldwide. The formation of stones is a combination of metabolic status, environmental factors, family history and many other aspects. It is important to find new ways to quickly detect and assess urolithiasis because it causes sudden, severe pain and often comes back. One way to do this is by exploring new biomarkers. Current advances in proteomic studies provide a great opportunity for breakthroughs in this field. This study focuses on protein biomarkers and their connection to kidney damage and inflammation during urolithiasis.

[Case of non-cancer abdominal pain successfully treated by a large amount of oral morphine].

A 34-year-old woman, with intractable non-cancer abdominal pain was successfully treated with large amounts of oral morphine. Medical records showed that she had been suffering from severe upper right abdominal pain with nausea and vomiting for 11 years. The pain continued all day long and the breakthrough pain occurred sometimes accompanied by nausea and vomiting. Various medical examinations including psychosocial exploration had been done to explain her pain mechanism and vomiting but causes were unknown. Psychological examination revealed she had no mental problems. A year and 6 months, sh…

Cancer treatment-induced mucositis pain: strategies for assessment and management.

Mucositis pain is a major clinical problem associated with cancer treatment. Mucosal tissue injury is a dose-limiting side effect and also limits nutritional intake and oral function, resulting in weight loss and nutritional deficits for many patients. The pathophysiology of mucositis is thought to be a complex array of cytokine-mediated events, which begins with mucosal atrophy and eventually leads to the painful ulceration of the mucosa. This article reviews current research related to pain management for mucositis. Effective treatment for mucositis pain must be targeted at the various facto