Racial Disparities in Opioid Prescribing in the United States from 2011 to 2021: A Systematic Review and Meta-Analysis.

Background: This meta-analysis is an update to a seminal meta-analysis on racial/ethnic disparities in pain treatment in the United States (US) published in 2012. Since then, literature has accumulated on the topic and important policy changes were made.

Objective: Examining racial/ethnic disparities in pain management and investigating key moderators of the association between race/ethnicity and pain outcomes in the US.

Cannabis Use and Anesthesia.

Consistent evidence supporting the use of cannabinoids for management of acute pain is lacking. A small number of observational studies suggest cannabinoid use is associated with reduced opioid use but pain scores remain unchanged. The majority of randomized trials involving a variety of cannabinoid compounds have shown no benefit for acute pain.

Illicitly Manufactured Fentanyl: Anesthesia's Role in the Perioperative Setting.

In wave 4 of the opioid crisis, which is dominated by illicitly manufactured fentanyl (IMF) and stimulant use, anesthesia personnel could play an important role in the perioperative care of these persons. Knowledge of the extent and lethality of opioid use in the current wave of the opioid crisis could raise awareness of the problem among anesthesia personnel. In the absence of research to guide development of best practice recommendations, knowledge of the historical trends in opioid use, the epidemiology of IMF use, and pragmatic clinically-oriented approaches for identifying persons using IMF could provide a general framework for future research.

Integrated pain care models and the importance of aligning stakeholder values.

Sustained widespread deployment of clinically and cost-effective models of integrated pain care could be bolstered by optimally aligning shared stakeholder values.

Low dose lofexidine for medically directed outpatient opioid tapering in adults with chronic pain: a prospective case series.

Background: In adults with chronic pain, mild-to-moderate withdrawal symptoms during medically directed opioid tapering in the outpatient setting may not be accompanied by hypertension or tachycardia. This clinical scenario could limit the use of lofexidine at dosages reported in clinical trials of opioid withdrawal precipitated by abrupt opioid discontinuation. Thus, the primary aim of this prospective case series is to describe the use of low dose lofexidine for opioid withdrawal in patients with chronic pain undergoing medically directed opioid tapering in an outpatient setting.

Preoperative Epidural Steroid Injections and Postoperative Infections After Lumbar or Cervical Spine Surgery: A Systematic Review and Meta-Analysis.

Objective: To determine the risk difference and 95% prediction intervals (PIs) for postoperative infections (POIs) associated with preoperative epidural steroid injections (ESIs) in adults undergoing lumbar or cervical spine surgery.

Methods: Comprehensive database searches were conducted from inception dates through December 2023. Inclusion criteria included all study designs involving adults receiving a preoperative ESI before lumbar or cervical decompression or fusion spine surgery.

Retrospective content analysis of consumer product reviews related to chronic pain.

Chronic pain (CP) lasts for more than 3 months, causing prolonged physical and mental burdens to patients. According to the US Centers for Disease Control and Prevention, CP contributes to more than 500 billion US dollars yearly in direct medical cost plus the associated productivity loss. CP is complex in etiology and can occur anywhere in the body, making it difficult to treat and manage.

Back Pain Consortium (BACPAC): Protocol and Pilot Study Results for a Randomized Comparative-Effectiveness Trial of Antidepressants, Fear Avoidance Rehabilitation, or the Combination for Chronic Low Back Pain and Comorbid High Negative Affect.

Objective: Patients with chronic low back pain (CLBP) and comorbid depression or anxiety disorders are highly prevalent. Negative affect (NA) refers to a combination of negative thoughts, emotions, and behaviors. Patients with CLBP with high NA have greater pain, worse treatment outcomes, and greater prescription opioid misuse.

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids.

Background: The past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear.

Methods: In November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids.

Long-Term Opioid Therapy Among Patients With Systemic Lupus Erythematosus in the Community: A Lupus Midwest Network (LUMEN) Study.

Objective: There is little information about the epidemiology and factors associated with opioid therapy in systemic lupus erythematosus (SLE). We aimed to assess the prevalence of opioid therapy and explore factors associated with long-term opioid therapy (LTOT) in patients with SLE.

Methods: Patients with SLE were matched with controls without SLE in a population-based cohort on January 1, 2015.

Heparin Versus Bivalirudin for Anticoagulation in Adult Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis.

Extracorporeal membrane oxygenation (ECMO) poses unique thrombotic and hemorrhagic risks, and the optimal anticoagulant choice is unknown. We systematically searched Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science Core Collection for randomized-, crossover-, retrospective cohort-, or parallel-designed clinical studies of adult patients receiving ECMO that compared heparin recipients with bivalirudin recipients. Meta-analysis was performed with random-effects models.

Pain, Opioid Analgesics, and Cognition: A Conceptual Framework in Older Adults.

Chronic pain is highly prevalent in older adults and is associated with poor functional outcomes. Furthermore, opioid analgesics are commonly utilized for the treatment of pain in older adults despite well-described adverse effects. Importantly, both chronic pain and opioid analgesics have been linked with impairments in cognitive function, though data are limited.

Best practices for interventional pain procedures in the setting of an iodinated contrast media shortage: A multisociety practice advisory.

Representatives from the Spine Intervention Society (SIS) and American Academy of Pain Medicine (AAPM) have developed the following best practice recommendations for the performance of interventional pain procedures in the setting of an iodinated contrast media shortage. The practice advisory has been endorsed by SIS, AAPM, American Academy of Physical Medicine and Rehabilitation (AAPMR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), North American Neuromodulation Society (NANS), North American Spine Society (NASS), and Society of Interventional Radiology (SIR).

Ultrasound-guided lumbar medial branch blocks and intra-articular facet joint injections: a systematic review and meta-analysis.

There is great interest in expanding the use of ultrasound (US), but new challenges exist with its application to lumbar facet-targeted procedures. The primary aim of this systematic review and meta-analysis was to determine the risk of incorrect needle placement associated with US-guided lumbar medial branch blocks (MBB) and facet joint injections (FJI) as confirmed by fluoroscopy or computerized tomography (CT). An a priori protocol was registered, and a database search was conducted.

A proposed nomenclature for spinal imaging and interventional procedural reporting.

Objective: To develop precise universal standard interventional spine nomenclature for reporting procedural details and anatomy.

Methods: There is no comprehensive nomenclature of spinal imaging anatomy that can be used for anatomical and procedural reporting. Given this critical lack of unifying terminology, a system of nomenclature was developed de novo by expert consensus, based upon clinical needs, and previously published reports.

Comparison of Spinal Cord Stimulation Trial Reporting Protocols and Long-Term Pain Relief Outcomes Following Implantation.

Objectives: Appropriate spinal cord stimulation (SCS) candidates are required to undergo an SCS trial before implant, typically with ≥50% pain relief deemed "successful." However, SCS trialing protocols can vary substantially. The primary aim of this retrospective study is to investigate the associations between SCS trial results and long-term SCS pain outcomes.

Effects of Slow Deep Breathing on Acute Clinical Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Slow deep breathing (SDB) may help patients with acute pain. The primary aim of this systematic review and meta-analysis is to investigate the effects of SDB on acute pain. Secondary aims include investigating the effects of SDB on acute pain-related physical and emotional functioning.