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Condition: Pain
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Opioid-Prescribing Approaches-One-Size-Fits-All versus Patient-Centric and Procedure-Focused-Among Podiatric Physicians: A Cross-Sectional Study
CONCLUSIONS: Podiatric physicians who used a one-size-fits-all opioid-prescribing approach prescribed more postoperative opioid dosage units regardless of the scenario. Given that the patient population requiring foot surgery is diverse and may have multiple comorbidities, the management of postoperative pain, likewise, should be diverse and nuanced. The patient-centric and procedure-focused approach is suited to limit excess prescribing while defending the physician-patient relationship.PMID:37717232 | DOI:10.7547/21-246
Source: Journal of the American Podiatric Medical Association - September 17, 2023 Category: Podiatry Authors: Brandon M Brooks Reed W R Bratches Kristina B Wolff Mickey D Stapp Kyle W Bruce Dyane E Tower Source Type: research
Psychological factors influencing the experience of menstrual pain - the role of pain catastrophizing
CONCLUSION: The results showed that it is worth examining the personality characteristics among the factors influencing the extent of menstrual pain; the results can be incorporated into diagnostic and therapeutic work. Orv Hetil. 2023; 164(37): 1469-1475.PMID:37717237 | DOI:10.1556/650.2023.32857
Source: Orvosi Hetilap - September 17, 2023 Category: General Medicine Authors: Erika Nyitrai Szabolcs Tak ács Source Type: research
Perioperative Pain Management
Orthop Clin North Am. 2023 Oct;54(4):xv-xvi. doi: 10.1016/j.ocl.2023.06.008. Epub 2023 Jul 21.NO ABSTRACTPMID:37718089 | DOI:10.1016/j.ocl.2023.06.008
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Frederick M Azar Source Type: research
Perioperative Analgesia in Spine Surgery: A Review of Current Data Supporting Future Direction
Orthop Clin North Am. 2023 Oct;54(4):495-506. doi: 10.1016/j.ocl.2023.05.007. Epub 2023 Jul 4.ABSTRACTThis Clinical Research discusses the diverse nature of spine surgery procedures and the use of multimodal analgesia within enhanced recovery after surgery (ERAS) protocols to improve patient outcomes. Spine surgeries range from minor decompressions to extensive tumor resections, performed by neurosurgeons or orthopedic spine surgeons on adults and children. To manage perioperative pain effectively, various methods have been employed, including multimodal analgesia within ERAS protocols. Incorporating ERAS protocols into sp...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: William Michael Bullock Amanda H Kumar Erin Manning Jerry Jones Source Type: research
Strategies for Reducing Perioperative Opioid Use in Foot and Ankle Surgery: Education, Risk Identification, and Multimodal Analgesia
Orthop Clin North Am. 2023 Oct;54(4):485-494. doi: 10.1016/j.ocl.2023.04.006. Epub 2023 Jun 1.ABSTRACTThere remains a high prevalence and substantial risks of opioid utilization amongst orthopedic patients. The goal of this review is to discuss strategies for responsible opioid use in the perioperative setting following foot and ankle orthopedic surgeries. We will highlight 1) education interventions, 2) risk identification, and 3) non-opioid alternatives for postoperative pain management.PMID:37718087 | DOI:10.1016/j.ocl.2023.04.006
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Amy L Xu Casey Jo Humbyrd Source Type: research
Perioperative Pain Management for Distal Radius Fractures
Orthop Clin North Am. 2023 Oct;54(4):463-470. doi: 10.1016/j.ocl.2023.05.006. Epub 2023 Jun 26.ABSTRACTDistal radius fractures have a high incidence among both young and elderly patients, and in many instances require operative intervention. When operative intervention is employed, adequate pain management is essential to decrease postoperative complications, such as chronic pain and disability, while minimizing the risk of prolonged opioid use and dependence. Strategies to optimize pain management include regional anesthesia, preoperative dosing of medication, multimodal regimens, long-acting selective opioids at the time...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Nolan Farrell Paul T Greenfield Paul T Rutkowski William Jacob Weller Source Type: research
Evolution of Perioperative Pain Management in Shoulder Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):435-451. doi: 10.1016/j.ocl.2023.04.004. Epub 2023 Jun 20.ABSTRACTHistorically, opioids have been used as a primary conservative treatment for pain related to glenohumeral osteoarthritis (GHOA). However, this practice is concerning as it often leads to overuse, which has contributed to the current epidemic of addiction and overdoses in the United States. Studies have shown that preoperative opioid use is associated with higher complication rates and worse outcomes following surgery, particularly for shoulder arthroplasty. To address these concerns, perioperative pain management for shou...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Vani Sabesan Hans Lapica Carlos Fernandez Clyde Fomunung Source Type: research
Accelerated Protocols in Adolescent Idiopathic Scoliosis Surgery
Orthop Clin North Am. 2023 Oct;54(4):427-433. doi: 10.1016/j.ocl.2023.04.003. Epub 2023 Jun 26.ABSTRACTAdolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. Treatment depends on the degree of curvature, skeletal maturity, and age of the patient. Once the curve reaches 50 degrees, posterior spinal fusion (PSF) is necessary to stabilize the spine and prevent further progression of the curve. PSF causes significant trauma to the tissues and often results in significant pain postoperatively. The purpose of this article is to provide the audience with a review of preoperative, intraoperative, and postopera...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Lindsey L Locke Leslie N Rhodes Benjamin W Sheffer Source Type: research
Lower Extremity Peripheral Nerve Blocks for Patients at Risk for Acute Compartment Syndrome
Orthop Clin North Am. 2023 Oct;54(4):417-425. doi: 10.1016/j.ocl.2023.06.003.ABSTRACTA delayed acute compartment syndrome (ACS) diagnosis often results in devastating complications; however, the sensitivity of the classic signs and symptoms is very low. All analgesic modalities have been implicated in delaying the diagnosis, but there is very little evidence linking peripheral nerve blocks (PNBs) with delays in diagnosis. In fact, there is evidence that PNBs may facilitate an early diagnosis; this may be in part due to differences in how ischemic and inflammatory pain is transmitted through unique nociceptive pathways. Col...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Jerry Jones Kevin Lee Madeline Jones Jeff Gadsden Source Type: research
Cannabis and Pain Control After Total Hip and Knee Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):407-415. doi: 10.1016/j.ocl.2023.04.002. Epub 2023 Jun 5.ABSTRACTCannabis use among the elderly has increased over the previous 2 decades. This has translated to a greater proportion of orthopedic procedures being undertaken on these patients. This review provides clinicians with evidence-based information on the effects of cannabis on pain control in THA and TKA, to help counsel these patients and facilitate their perioperative management. The review specifically focuses on the following: origins of cannabis; biochemistry of cannabis; medical versus recreational cannabis; pharmacology ...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Babar Kayani Lisa C Howard Michael E Neufeld Donald S Garbuz Bassam A Masri Source Type: research
Treating Sleep Disorders After Total Hip and Total Knee Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):397-405. doi: 10.1016/j.ocl.2023.05.008. Epub 2023 Jul 11.ABSTRACTDisorders of sleep are common after total hip and knee arthroplasty and may contribute to patient dissatisfaction and poorer outcomes in the early postoperative period. Multiple factors contribute to sleep disorders, including poorly controlled pain, opioid medication, perioperative stress, and anxiety. Both pharmacologic and nonpharmacologic methods have been used for perioperative sleep disorders, but there is no consensus on the optimal treatment.PMID:37718079 | DOI:10.1016/j.ocl.2023.05.008
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Kevin F Purcell Nicholas Scarcella Danielle Chun Christopher Holland Taylor P Stauffer Michael Bolognesi Paul Lachiewicz Source Type: research
The Influence of Tourniquet and Adductor Canal Block Use on Pain and Opioid Consumption after Total Knee Arthroplasty
This study evaluated inpatient opioid consumption and pain between patients with TKA based on tourniquet and/or ACB use. Pain and opioid consumption were highest when a tourniquet, but no ACB was used, and lowest when an ACB, but no tourniquet was used - though absolute differences in pain scores were not clinically significant. Tourniquet and ACB use should be considered as part of TKA opioid-sparing protocols.PMID:37718078 | DOI:10.1016/j.ocl.2023.05.005
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Kyle W Lawrence Weston Buehring Akram A Habibi David L Furgiuele Ran Schwarzkopf Joshua C Rozell Source Type: research
Decreasing Post-Operative Narcotic Usage Following Total Knee Arthroplasty Requires More than Simple Education: A Blinded Randomized Controlled Trial
Orthop Clin North Am. 2023 Oct;54(4):377-382. doi: 10.1016/j.ocl.2023.06.001. Epub 2023 Jul 21.ABSTRACTThe purpose of this study was to understand if including a patient opioid education document would decrease opioid consumption following TKA. Patients were balanced between the control and intervention group based on age, sex, and date of surgery. At 5 weeks following surgery, there were significantly fewer patients driving in the education cohort as compared to the control cohort. There was not a significant difference in mean 2-week post-operative VAS pain score, mean 5 weeks post-operative VAS pain score, mean number o...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: William H Cusma Benjamin J Davis Ryan A Mak Nicholas M Brown Source Type: research
Analgesic Trends in the Management of Pain Following Total Knee Arthroplasty: A Comparison of Peri-Articular Infiltration, Adductor Canal Block, and Adjuvant Treatment for Posterior Knee Pain
Orthop Clin North Am. 2023 Oct;54(4):369-376. doi: 10.1016/j.ocl.2023.05.004. Epub 2023 Jul 5.ABSTRACTThe rising number of total knee arthroplasties (TKA's) in the United States increases demand for perioperative pain modalities, which can promote early mobilization and discharge. Over the decades, a focus has shifted from opioid-dominant regimens to motor-sparing multimodal protocols, which have not only improved pain scores and reduced opioid consumption but also improved overall patient outcomes. In this article, we briefly review the evolution of post-operative pain management in patients undergoing TKA and summarize t...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Rutuja R Sikachi Brett Campbell Ezra Kassin Giles R Scuderi Joseph Marino Source Type: research
Modern Perioperative Pain Management Strategies to Minimize Opioids after Total Knee Arthroplasty
Orthop Clin North Am. 2023 Oct;54(4):359-368. doi: 10.1016/j.ocl.2023.05.002. Epub 2023 Jun 20.ABSTRACTTotal Knee Arthroplasty is associated with significant postoperative pain that can limit functional outcomes and patient satisfaction. In recent years, the standard of care for postoperative pain management has reduced reliance on opioids in favor of multimodal analgesia. These regimens consist of systemic medications such as COX-2 inhibitors, acetaminophen, corticosteroids, and gabapentinoids, as well as regional and local approaches such as peripheral nerve blocks and local infiltrative analgesics. Newer therapies, such...
Source: The Orthopedic Clinics of North America - September 17, 2023 Category: Orthopaedics Authors: Charles W Hansen Elizabeth K Carlino Lauren A Saunee Vinod Dasa Amit K Bhandutia Source Type: research
