Analgesic efficacy of sacral neuromodulation for chronic pelvic cancer pain.

Background: Neuromodulation has provided promising results in chronic pain management. Sacral neurostimulation (SNS) is a neuromodulatory technique, where the sacral nerve roots are electrically stimulated.

Objective: Evaluate the efficacy of the trial phase to control severe cancer pain in pelvic organs.

Could epidural analgesia be safely used for acute postoperative pain in older adults to enhance recovery?

Epidural analgesia is often considered cornerstone in multimodal analgesia when used in major surgeries. However, its role in managing acute postoperative pain in elderly patients is debatable because of its known potential complications. Furthermore, postoperative pain in elderly patients is under-treated because of complex comorbidities, and they are more prone to adverse events related to pain therapies.

The teratogenic effect of pregabalin on heart, liver and kidney in rats: a light microscopic, electron microscopic and immunohistochemical study.

Background: Pregabalin (PGB) was approved as new anti-epileptic drugs with little information about its teratogenic effect.

Aim Of The Work: to evaluate the developmental toxicity of PGB.

Materials And Methods: 60 pregnant albino rats were divided into three groups.

The Efficacy of Preoperative Duloxetine in Patients Undergoing Major Abdominal Cancer Surgery: A Randomized Controlled Trial.

Objective: We aimed to evaluate the analgesic efficacy as well as the postoperative quality of recovery of preoperative oral duloxetine a serotonin and norepinephrine reuptake inhibitor for patients undergoing major abdominal cancer surgery.

Materials And Methods: Sixty-two patients, undergoing major abdominal cancer surgery were divided into 2 equal groups, received oral duloxetine 60 mg (2 h preoperative) or placebo. Postoperative 48 hours morphine consumption, visual analog scale pain score, and quality of recovery were measured.

Preoperative Duloxetine to improve acute pain and quality of recovery in patients undergoing modified radical mastectomy: A dose-ranging randomized controlled trial.

Objective: Duloxetine has been recently used as a part of multimodal analgesia in perioperative settings, yet the optimal dose of Duloxetine is not determined.

Design: A parallel, randomized, placebo-controlled trial.

Setting: Tertiary level oncology center.

Radiofrequency Thoracic Sympathectomy for Sympathetically Maintained Chronic Post-Mastectomy Pain, a Preliminary Report: 6-Month Results.

Aim: Evaluation of the analgesic efficacy of radiofrequency thoracic sympathectomy for sympathetically maintained post-mastectomy pain syndrome (PMPS).

Methods: Patients with PMPS randomized to Group TS (n = 33) received radiofrequency thoracic sympathectomy, and those randomized to Group Sham (n = 33) received no radiofrequency current. Postoperative pain treatment consisted of duloxetine, pregabalin, and tramadol for both groups.

Pulsed Radiofrequency of the Sacral Roots Improves the Success Rate of Superior Hypogastric Plexus Neurolysis in Controlling Pelvic and Perineal Cancer Pain.

Background: Superior hypogastric plexus neurolytic (SHP-N) block is the mainstay management for pelvic cancer pain of visceral origin when oral opioids fail due to inefficacy or intolerance to side effects. Unfortunately, SHP-N has the potential to control pelvic pain in 62%-72% of patients at best, because chronic pelvic pain may assume additional characteristics other than visceral.

Objective: Combining SHP-N with pulsed radiofrequency (PRF) of the sacral roots might block most of the pain characteristics emanating from the pelvic structures and improve the success rate of SHP-N in controlling pelvic and perineal cancer pain.

Pulsed Radiofrequency on Thoracic Dorsal Root Ganglion Versus Thoracic Paravertebral Nerve for Chronic Postmastectomy Pain, A Randomized Trial: 6-Month Results.

Background: Pharmacologic treatment is not successful in all cases of postmastectomy pain syndrome (PMPS). Some patients continue suffering pain while taking their medications, and others cannot tolerate the side effects of antineuropathic analgesics. Radiofrequency technology has provided promising results in the management of chronic neuropathic pain.

Efficacy of Atlantoaxial Joint Glucocorticoid Injection in Patients with Rheumatoid Arthritis: A Randomized Trial.

Background: The atlantoaxial joint (AAJ) plays a pivotal role in the cervical spine motion. Unfortunately, it is the most common cervical spine joint that is affected in patients with rheumatoid arthritis. Inflammation of the AAJ results in neck disability, nerve root compression, and finally spinal cord compression.

Epidural dexmedetomidine infusion for perioperative analgesia in patients undergoing abdominal cancer surgery: randomized trial.

Objective: To assess the postoperative analgesic efficacy of epidural dexmedetomidine added to bupivacaine infusion for patients undergoing major abdominal cancer surgery.

Methods: Patients scheduled for major upper abdominal cancer surgery were allocated to group bupivacaine (n =32), in which patients received epidural bupivacaine infusion (6 mL/h bupivacaine 0.1%) for 48 hours postoperatively, or group bupivacaine + dexmedetomidine (n=32), in which patients received epidural dexmedetomidine added to bupivacaine infusion (6 mL/h of bupivacaine 0.

Pulsed Radiofrequency Treatment for Chronic Post-Surgical Orchialgia: A Double-Blind, Sham-Controlled, Randomized Trial: Three-Month Results.

Background: Chronic post-surgical pain in the groin region represents a challenge for the managing physician and is a burden on the quality of life of the patient. None of the existing interventions or medical treatment is satisfactory.

Objectives: We aim to evaluate the analgesic efficacy of pulsed radiofrequency (PRF) applied to the ilioinguinal nerve and the genital branch of the genitofemoral nerve for patients suffering from chronic post-surgical orchialgia.

Efficacy of local dexmedetomidine add-on for spermatic cord block anesthesia in patients undergoing intrascrotal surgeries: randomized controlled multicenter clinical trial.

Study Objective: The objective of this study was to evaluate the effect of adding dexmedetomidine (DEX) to bupivacaine on the quality of spermatic cord block anesthesia and postoperative analgesia.

Design: This is a randomized, double-blind study.

Setting: This study was performed in an educational and research hospital.

Thoracic epidural analgesia reduces myocardial injury in ischemic patients undergoing major abdominal cancer surgery.

Background And Objectives: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA) on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery.

Patients And Methods: One hundred and twenty patients (American Society of Anesthesiologists grade II and III) of either sex were scheduled for elective upper gastrointestinal cancer surgeries.

Analgesic efficacy of pregabalin in acute postmastectomy pain: placebo controlled dose ranging study.

Study Objective: We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption.

Design: Prospective randomized controlled clinical trial.

Setting: Postanesthesia care unit.

Pectoralis-serratus interfascial plane block vs thoracic paravertebral block for unilateral radical mastectomy with axillary evacuation.

Study Objective: The aim of this study was to evaluate the analgesic efficacy and safety of pectoralis-serratus interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain.

Design: A prospective randomized controlled study.

Setting: Tertiary center, university hospital.

Effect of thoracic epidural analgesia on pro-inflammatory cytokines in patients subjected to protective lung ventilation during Ivor Lewis esophagectomy.

Background: Thoracic epidural analgesia (TEA) has a well-known effect on neurohormonal response. Attenuation of stress response by post-operative epidural analgesia has shown beneficial effects such as lower pain scores and less immunological alterations.

Objectives: Investigation of the combined effects of TEA and protective lung ventilation on pro-inflammatory cytokines and patients' outcome after Ivor Lewis esophagectomy.