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Evaluation of Continuous Peripheral Nerve Block in Total Knee Arthroplasty Post-Operative pain management

Journal of Pharmacy and Pharmacology 2018年第8期6卷 760-764页

作者： James Hillman Midwestern University 555 31st St Downers Grove IL 60515 USA

Total knee arthroplasty （TKA） can contribute to significant pain for the patient. Continuous peripheral nerve blocks （CPNBs） have been shown to be efficacious in treating post-surgical pain. The objective of this study is to determine the efficacy of a bupivacaine 0.2% solution administered via CPNB plus standard of care （SOC） compared to SOC alone. SOC for this institution includes the use of opioid analgesics, non-opioid analgesics, regional anesthesia, and other adjuncts. The primary outcome is the overall use of post-operative pain medication. Secondary outcomes include the average length of stay and average pain scores. Methods： A data surveillance system was used to retrospectively identify all patients who underwent TKA with and without the use of CPNB. To be included, patients must have been male or female ≥ 18 years of age who underwent TKA from September 2016 through September 2017. And 70 patients were included in both the CPNB and SOC groups. A retrospective chart review determined the following data： The types and amounts of pain medications used, the length of stay, and patient-reported pain scores. Results： There was an increase in the amount of as needed pain medication use in the CPNB ＋ SOC vs. SOC group with 12.97 administrations vs. 12.67 administrations respectively. Length of stay was increased in the CPNB ＋ SOC vs. SOC group with 3.65 days in the CPNB ＋ SOC group vs. 3.5 days in the SOC group. pain scores were increased in the CPNB ＋ SOC group with a patient average pain score of 4.5 vs. the SOC groups average pain score of 4.4. Conclusions： The use of a 0.2% bupivacaine solution administered via CPNB in addition to SOC resulted in increased utilization of as needed pain medication administration, increased average length of stay, and increased average pain scores when compared to SOC alone.

关键词： CPNB pain management TKA.

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Pancreatic cancer-related pain:mechanism and management

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Journal of Pancreatology 2023年第4期6卷 202-209页

作者： Meijing Wu Afang Zhu Le Shen Department of Anesthesiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College HospitalBeijingChina

Pancreatic cancer-related pain(PCRP)gains widespread attention for its high prevalence,extreme complexity,poor prognosis,and decreased survival *** treatment of PCRP remains unsatisfactory since the underlying mechanism is not *** occurrence of PCRP is mainly related to the neurotropic nature of pancreatic cancer,and perineural invasion,neural remodeling and plasticity play important *** the understanding of PCRP mechanism,the management of PCRP is a multidisciplinary and multifaceted *** pain medications,invasive or intervention treatment,psychological support,integrative therapy,and palliative care are all the potential aspects for the management of PCRP.

关键词： Neural remodeling and plasticity pain management Pancreatic cancer-related pain Perineural invasion

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Enhancing perianal disease management with integrated physical and psychological approaches

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World Journal of Clinical Cases 2025年第2期13卷 59-63页

作者： Uchenna E Okpete Haewon Byeon Department of Digital Anti-aging Healthcare(BK21) Inje UniversityGimhae 50834South Korea

This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal *** study sheds light on how illness perception,anxiety,and depression significantly influence recovery *** et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor *** article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for *** study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.

关键词： Perianal disease Post-operative recovery Anxiety Depression pain management Emotional well-being Multidisciplinary approach

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management of procedural pain in the intensive care unit

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World Journal of Clinical Cases 2022年第5期10卷 1473-1484页

作者： Na-Na Guo Hong-Liang Wang Ming-Yan Zhao Jian-Guo Li Hai-Tao Liu Ting-Xin Zhang Xin-Yu Zhang Yi-Jun Chu Kai-Jiang Yu Chang-Song Wang Department of Critical Care Medicine Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina Department of Critical Care Medicine The Second Affiliated Hospital of Harbin Medical UniversityHarbin 150081Heilongjiang ProvinceChina Department of Critical Care Medicine The First Affiliated Hospital of Harbin Medical UniversityHarbin 150081Heilongjiang ProvinceChina Department of Intensive Care Unit Zhongnan Hospital of Wuhan UniversityWuhan 430000Hubei ProvinceChina Department of Orthopedics The Second Affiliated Hospital of Harbin Medical UniversityHarbin 150081Heilongjiang ProvinceChina

pain is a common experience for inpatients,and intensive care unit(ICU)patients undergo more pain than other departmental patients,with an incidence of 50%at rest and up to 80%during common care *** present,the management of persistent pain in ICU patients has attracted considerable attention,and there are many related clinical studies and ***,the management of transient pain caused by certain ICU procedures has not received sufficient *** reviewed the different management strategies for procedural pain in the ICU and reached a *** management is a process of continuous quality improvement that requires multidisciplinary team cooperation,painrelated training of all relevant personnel,effective relief of all kinds of pain,and improvement of patients'quality of *** clinical work,which involves complex and diverse patients,we should pay attention to the following points for procedural pain:(1)Consider not only the patient's persistent pain but also his or her procedural pain;(2)Conduct multimodal pain management;(3)Provide combined sedation on the basis of pain management;and(4)Perform individualized pain *** now,the pain management of procedural pain in the ICU has not attracted extensive ***,we expect additional studies to solve the existing problems of procedural pain management in the ICU.

关键词： Procedural pain Persistent pain Transient pain pain management Topical anesthesia Intensive care unit

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Diabetic peripheral neuropathy and neuromodulation techniques:a systematic review of progress and prospects

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Neural Regeneration Research 2025年第8期20卷 2218-2230页

作者： Rahul Mittal Keelin McKenna Grant Keith Evan McKenna Joana R.N.Lemos Jeenu Mittal Khemraj Hirani Diabetes Research Institute University of Miami Miller School of MedicineMiamiFLUSA Department of Otolaryngology University of Miami Miller School of MedicineMiamiFLUSA Herbert Wertheim College of Medicine Florida International UniversityMiamiFLUSA School of Medicine and Public Health University of WisconsinMadisonWIUSA

Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this *** peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and *** aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this *** investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord *** systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral *** the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic *** these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.

关键词： diabetes mellitus diabetic peripheral neuropathy neuromodulation neurostimulation therapy non-pharmacological treatment pain management

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Endoscopic ultrasonography guided celiac plexus neurolysis and celiac plexus block in the management of pain due to pancreatic cancer and chronic pancreatitis

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World Journal of Gastroenterology 2007年第26期13卷 3575-3580页

作者： Anthony J Michaels Peter V Draganov University of Florida Department of GastroenterologyHepatology and NutritionUnited States

pain is a common symptom of pancreatic disease and is frequently difficult to manage. pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to pain management in pancreatic disease is the use of celiac plexus block (CPB) or neurolysis (CPN). Originally performed by anesthesiologists and radiologists via a posterior approach,recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus block/ neurolysis is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior approach. EUS guided CPN should be considered first line therapy in patients with pain due to pancreatic cancer. It provides superior pain control compared to traditional management with narcotics. A trend for improved survival in pancreatic cancer patients treated with CPN has been reported,but larger studies are needed to confirm this finding. At this time,the use of EUS guided CPB cannot be recommended as routine therapy for pain in chronic pancreatitis since only one-half of the patients experience pain reduction and the beneficial effect tends to be short lived. EUS guided CPB and CPN should be used as part of a multidisciplinary team approach for pain management.

关键词： Celiac plexus Celiac plexus neurolysis Celiacplexus block Endoscopic ultrasound pain management

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Insight into orthodontic appliance induced pain:Mechanism,duration and management

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World Journal of Anesthesiology 2016年第1期5卷 28-35页

作者： Yasemin Kartal Omur Polat-Ozsoy Department of Orthodontics Baskent UniversityFaculty of Dentistry

Most of the orthodontic patients experience pain during treatment and this significantly influences their attitudes and the approach towards treatment. A number of factors that influence pain response include age, gender, personal pain threshold, mood and stress level of the person, cultural differences and types of orthodontic treatment. pain is a often overlooked subject by orthodontists, it is nevertheless important to understand the source and mechanism of the pain that occurs during treatment, as well as the methods for managing and controlling this pain. This review attempts to overview the mechanism, duration and current management strategies of orthodontic treatment.

关键词： Orthodontic appliance pain mechanism Orthodontic treatment pain pain management

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Transdermal Fentanyl for management of Cancer pain in Elderly Patients in China

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The Chinese-German Journal of Clinical Oncology 2004年第2期3卷 85-89,125页

作者：于世英孙燕张海春吴一龙秦叔逵谢广茹刘淑俊隋广杰武汉华中科技大学同济医学院附属同济医院肿瘤科 430030

Objective: Objective: To assess the effect and adverse effects of transdermal fentanyl for elderly patients with cancer pain in China. Methods: A total of 1664 elderly patients (aged 65-90 with mean age of 72.6) with cancer pain enrolled in the multicenter study from 136 institutes in China. Of them, 408 (28.8%) patients were 75 years old or older. All patients received transdermal fentanyl for the management of cancer pain. The patients were asked to record the attacks of pain, quality of life, and any side effects of the treatment. Results: Baseline mean of pain intensity was 7.34. On day 1, 3, 6, 9 15, and 30, the pain mean scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, 1.64 (P=0.000). The effective rate was 97.18%. The mean doses of fentanyl was 31.34 g/h (25-150 g/h) initially, and 40.59 g/h and 47.50 g/h (25-200 g/h) at day 15 and day 30. At treatment day 15, the dose of fentanyl was ranger from 25 to 50 g/h in 91.8% of patients, 75 to 100 g/h in 7.5% patients, and 125 to 200 g/h only in 0.8% patients. The fine quality of life was in 25.4% patients before treatment, and was 71.15% and 73.04% at day 15 and day 30 respectively (P=0.0000). The common side effects were constipation (10.70%), nausea (11.96%), dizzy (6.85%), vomiting (3.85%), sedation (2.40%), Respiratory depression (0.12%). 86.2% patients preferred continue treated by transdermal fentanyl. Conclusions: Transdermal fentanyl for the elderly with cancer pain is effective, safe, convenient, and can improve the quality of life. Transdermal fentanyl can be recommended as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain, and the initial doses is recommended as 25 g/h.

关键词： elderly cancer pain transdermal fentanyl pain management

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Engineering Microneedle Patches for Improved Penetration:Analysis,Skin Models and Factors Affecting Needle Insertion

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Nano-Micro Letters 2021年第6期13卷 190-230页

作者： Pooyan Makvandi Melissa Kirkby Aaron RJHutton Majid Shabani Cynthia K.Y.Yiu Zahra Baghbantaraghdari Rezvan Jamaledin Marco Carlotti Barbara Mazzolai Virgilio Mattoli Ryan F.Donnelly Istituto Italiano Di Tecnologia Centre for Materials InterfaceViale Rinaldo Piaggio 3456025 PontederaPisaItaly School of Pharmacy Queen’s University Belfast97 Lisburn RoadBelfast BT97BLUK The BioRobotics Institute Scuola Superiore Sant’AnnaViale Rinaldo Piaggio 3456025 PontederaPisaItaly Paediatric Dentistry and Orthodontics Faculty of DentistryThe University of Hong KongPrince Philip Dental HospitalHong Kong SARChina Department of Chemical Materials and Industrial Production EngineeringUniversity of Naples FedericoⅡ80125 NaplesItaly Center for Advanced Biomaterials for Health Care(iit@CRIB) Italian Institute of Technology80125 NaplesItaly

Transdermal microneedle(MN)patches are a promising tool used to transport a wide variety of active compounds into the *** serve as a substitute for common hypodermic needles,MNs must pierce the human stratum corneum(~10 to 20μm),without rupturing or bending during *** ensures that the cargo is released at the predetermined place and ***,the ability of MN patches to sufficiently pierce the skin is a crucial *** the current review,the pain signal and its management during application of MNs and typical hypodermic needles are presented and *** is followed by a discussion on mechanical analysis and skin models used for insertion tests before application to clinical *** that affect insertion(e.g.,geometry,material composition and cross-linking of MNs),along with recent advancements in developed strategies(e.g.,insertion responsive patches and 3D printed biomimetic MNs using two-photon lithography)to improve the skin penetration are highlighted to provide a backdrop for future research.

关键词： Insertion responsive Implantable microneedles Skin indentation Transdermal microneedles pain management

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Electroacupuncture for abdominal pain relief in patients with acute pancreatitis:A three-arm randomized controlled trial

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Journal of Integrative Medicine 2023年第6期21卷 537-542页

作者： Dong Kee Jang Jun Kyu Lee Chan Yung Jung Kyung Ho Kim Ha Ra Kang Yeon Sun Lee Jong Hwa Yoon Kwang Ro Joo Min Kyu Chae Yong Hyeon Baek Byung-Kwan Seo Sang Hyub Lee Chiyeon Lim Department of Internal Medicine Seoul Metropolitan Government Boramae Medical CenterSeoul National University College of MedicineSeoul 07061Republic of Korea Department of Internal Medicine Dongguk University Ilsan HospitalDongguk University College of MedicineGoyang 10326Republic of Korea Department of Acupuncture and Moxibustion Dongguk University Ilsan Oriental HospitalCollege of Korean MedicineDongguk UniversityGoyang 10326Republic of Korea Department of Korean Medicine Dongguk UniversityGoyang 10326Republic of Korea Department of Acupuncture and Moxibustion College of Korean MedicineDongguk UniversityGyeongju 38067Republic of Korea Department of Gastroenterology Kyung Hee University Hospital at GangdongSeoul 05278Republic of Korea Department of Acupuncture and Moxibustion Kyung Hee University Korean Medicine Hospital at GangdongSeoul 05278Republic of Korea Department of Internal Medicine and Liver Research Institute Seoul National University HospitalSeoul National University College of MedicineSeoul 03080Republic of Korea Department of Biostatistics College of MedicineDongguk UniversityGoyang 10326Republic of Korea

Background: Electroacupuncture(EA) may reduce the severity of acute pancreatitis(AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients with AP has not been well ***: This study was undertaken to compare the pain-relieving effects of EA and conventional treatment in patients with ***, setting, participants and interventions: This study was conducted using a randomized, controlled,three-arm, parallel-group and multi-center design. Patients diagnosed with AP were randomly and equally assigned to EA1, EA2 or control groups. All participants received conventional standard-of-care therapy for AP. Local EA alone was administered in EA1, and local plus distal EA was given in *** EA included two abdominal acupoints, while distal EA included twelve peripheral acupoints. EA groups underwent one session of EA daily for 4 days(days 1–4), or until pain was resolved or *** outcome measures: The primary outcome measure was the change in the visual analogue scale(VAS;0–100) pain score between baseline and day ***: Eighty-nine participants were randomized into EA1, EA2 and control groups, and 88(EA1, 30;EA2, 29;control, 29) were included in the full-analysis set. VAS score change(median [interquartile range]) on day 5 was(12.3 ± 22.5) in the EA1 group,(10.3 ± 21.5) in the EA2 group, and(8.9 ± 15.2) in the control group. There were not significant differences in the change in VAS score among treatments(P = 0.983). However, time to food intake was significantly shorter in the EA group(EA1 + EA2) than in the control group(median 2.0 days vs 3.0 days), with a hazard ratio of 0.581(P = 0.022;95% CI,0.366–0.924). No significant adverse events ***: EA treatment did not significantly reduce pain after 4 days of treatment in patients with AP-associated abdominal pain but significantly reduced time to first food intake.

关键词： Acute pancreatitis Electroacupuncture pain management Abdominal pain Randomized controlled trial

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