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Postoperative Pain Management Considerations in Patients with Type 2 Diabetes Mellitus.

It is not uncommon for a patient to judge the success or failure of a surgical procedure by the pain or lack thereof that they experience during the postoperative period. Limb preservation surgery affects more than 160,000 Americans annually; many of these patients suffer from diabetes mellitus and have altered protopathic and epicritic sensation. However, diabetes mellitus and depressive symptoms are bidirectionally associated, and depression is a risk factor for opioid misuse. Appropriate pain management in this population can be complex and often requires a "patient-centric and procedure-fo…

Digital gamification in chronic pain management in adulthood: a systematic review.

BACKGROUND: Chronic pain is a leading cause of disability. Existing evidence on digital gamification remains mixed. This systematic review a … h should explore personalized gamification strategies and underlying mechanisms to optimize chronic pain management.

[Deprescribing methadone for chronic non-cancer pain: management of withdrawal symptoms].

In this case report, a 60-year-old patient was referred to a multidisciplinary pain clinic to discontinue methadone. Before referral, a self-managed dose reduction from 40 to 15 mg had led to loss of function due to withdrawal symptoms. After referral, methadone was successfully deprescribed over three months. Withdrawal symptoms were managed through an individually tailored plan, supportive consultations with a nurse, and the use of clonidine. The patient regained function after deprescribing methadone. Deprescribing opioids can be managed through a patient-centered approach and close monitor

Targeting Cav2.2 channels for pain management: challenges, innovations, and future perspectives.

N-type voltage-gated calcium channels (Cav2.2) are validated targets for chronic pain management. Although ziconotide is clinically effective, its use is hampered by a narrow therapeutic window and severe side effects. This review examines the subunit structure of Cav2.2 and its fundamental role in nociceptive signaling. We focus on emerging therapeutic strategies developed in recent years, including the optimization of direct blockade, the inhibition of channel trafficking, the modulation of signaling pathways, and targeted channel depletion. These advancements provide a deeper understanding …

Low-Dose Oral Ketamine for Pain Management: A Primer for Clinicians.

OBJECTIVE: To critically evaluate the available evidence for low-dose oral ketamine for analgesia and provide summary recommendations for cl … es, improved quality of life, and decreased opioid requirements in line with low-dose infusions for pain management. Weight-based doses above 6 mg/kg corresponded with an increase in adverse effects. Optimal parenteral-to-oral dose conversions are not known; however, dose reductions by 75% from the daily infusion dose maintained analgesia in a small number of cas …

Scoping review on orofacial pain management in older adults with dementia.

BACKGROUND/OBJECTIVES: Orofacial pain in older adults with dementia is often overlooked due to cognitive decline and impaired communication, impairing patients' quality of life and exacerbating neuropsychiatric behavioural symptoms. This scoping review aimed to map available evidence regarding prevalence, assessment tools, clinical management strategies and research gaps, with the aim of informing clinical practice and guiding future research. METHODS: Systematic literature searches were performed in PubMed, Web of Science, Embase and Cochrane Library from database inception to December 2025.

Global Pain Management Trends and Barriers to Care in Hidradenitis Suppurativa.

INTRODUCTION: Pain is the most impactful symptom of hidradenitis suppurativa (HS), and understanding its management practices can guide improvements in care. This study aimed to describe HS pain severity and associated factors, evaluate pain management practices, and identify barriers to pain management. METHODS: A cross-sectional survey of self-identified adults with HS was conducted from June 13, 2021 to June 30, 2021. Participants were 18 years or older with a confirmed HS diagnosis by a medical provider or a validated questionnaire. Exposures include demographic, clinical factors. PRIMAR…

Pain in Parkinson's disease: bridging pathophysiology, clinical features, and personalized management.

Pain is a highly prevalent and disabling non-motor symptom of Parkinson's disease (PD), yet it remains underrecognized and frequently undertreated in clinical practice. Although long considered a secondary consequence of motor dysfunction, pain in PD is now increasingly understood as a manifestation of disease-related alterations in nociceptive processing. These changes extend beyond dopaminergic deficiency and involve broader neurotransmitter imbalances and impaired descending inhibitory control across different neuroanatomical regions, providing a framework for understanding pain as an intri

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 metasta … linary approach, informed by the concept of "total pain," remains the cornerstone of effective bone pain management at the end of life.

Multimodal Approaches for Pain Management and Improving Functional Outcomes Following Amputation.

In the United States, limb amputation affects around 2.3 million people, with projected numbers rising due to the higher levels of diabetes and peripheral vascular disease. Amputee patients not only encounter mobility loss but also residual limb pain, psychological stress, and disparities in access to healthcare. This article presents a critical review of the current literature on functional outcomes and pain management for patients who underwent limb amputation. In terms of pharmacological therapies, gabapentinoids and antidepressants provide minimal relief for post amputation pain, whereas s…

Nursing-Led Pain Management: Impact on Patient Satisfaction Following Abdominal Surgery.

BACKGROUND: The post-operative phase is critical among patients who are vulnerable to complications due to psychological and physiological s … pre-operative needs of the patient and incorporate various evidence-based interventions to improve pain management and satisfaction among patients.

Virtual Reality for Pediatric Postoperative Pain Management: Exploring Methods and Efficacy.

Ineffective postoperative pain management affects more than 25% of hospitalized children, leading to increased morbidity, impaired physical function, delayed recovery, prolonged opioid use, and heightened health care costs. Traditional pharmacological interventions have limitations, particularly given growing concerns over long-term opioid use in pediatric populations. Virtual reality (VR) has emerged as a promising nonpharmacological intervention for pediatric pain management, offering immersive, multisensory experiences that can effectively distract and engage patients' attention away from p…

Social Determinants of Health Among Individuals Receiving Opioids for Pain Management.

OBJECTIVE: Individuals receiving opioids for pain management are at risk for negative outcomes. However, it is not clear whether social determinants of health (SDOH) predict outcomes a year after starting a prescription opioid. The purpose was to examine associations between SDOH with psychiatric-related, pain-related, and opioid-related outcomes at a 12-month follow-up. METHODS: Participants (N=783) with a new period of 30 to 90-day opioid use completed baseline and 12-month follow-up questionnaires regarding SDOH, depressive symptoms, pain severity, pain interference, and opioid use. Multiv…

Pecto-Intercostal Fascial Plane Block for Pain Management after Cardiothoracic Surgery.

PURPOSE OF REVIEW: Cardiac surgery is associated with significant postoperative pain. Compared to traditional analgesics, regional nerve blocks target specific anatomical areas to improve analgesia and to reduce postoperative opioid consumption. RECENT FINDINGS: Pecto-intercostal fascial plane block (PIFB) is a novel analgesic technique that involves ultrasound-guided injection of anesthetic between pectoralis major and external intercostal muscles. Since PIFB is a relatively underexplored method of analgesia, to date, few manuscripts have reviewed and synthesized current literature related t

Vagus nerve stimulation for chronic pain management: Mechanisms and clinical advances.

BACKGROUND: Chronic pain poses a significant challenge to the general population, especially in older adults. As a result, there is a growing emphasis on developing novel treatment options and expanding the use of emerging technologies. OBJECTIVE: This comprehensive review aims to guide practitioners in chronic pain management by extending the current application of vagus nerve stimulation (VNS). The review examined peer-reviewed studies, including multicenter cohort studies and clinical trials, published within the past 25 years. VNS has shown the most promising results in pain reduction for…

Acute pelvic pain: Diagnosis and management of ruptured hemorrhagic ovarian cyst.

Acute pelvic pain in reproductive-aged persons who are assigned female at birth is associated with an extensive differential diagnosis, with possible causes ranging from the genitourinary or gastrointestinal to the musculoskeletal or neurovascular, in some cases even extending to psychological and dermatologic presentations. This article presents a case study that serves as an exemplar of the differential diagnosis of acute pelvic pain, culminating in diagnosis of the patient with a hemorrhagic ovarian cyst as well as a review of outpatient surveillance guidelines for adnexal masses. Managemen

Comprehensive pain management in spinal surgery: The role of botulinum toxin.

The use of botulinum toxin in pre- and post-operative management of pain in spinal surgery is described, following a specific administration protocol. The initial encouraging results (particularly the absence of opioid use in the post-operative period) support the potential role of BoNT-A (Botulinum Neurotoxin type A) as a targeted therapeutic option in this specific clinical setting.