Understanding the Physiopathology of Pain Pathways for a Practical Approach of Cancer Pain Management.

Pain associated with cancer is often the first symptom reported with major repercussions on patient's quality of life. Mechanical compression, release of algogenic substances by the tumor or the complications of oncologic treatment represent the major causes. Nociceptive and neuropathic pain are both induced by different mediators that give rise to a neuroinflammation creating a peripheral and central sensitization responsible of chronic pain.

Single-bolus injection of local anesthetic, with or without continuous infusion, for interscalene brachial plexus block in the setting of multimodal analgesia: a randomized controlled unblinded trial.

Introduction: Previous trials favored a continuous interscalene brachial plexus block over a single injection for major shoulder surgery. However, these trials did not administer a multimodal analgesic regimen. This randomized, controlled unblinded trial tested the hypothesis that a continuous infusion of local anesthetic for an interscalene brachial plexus block still provides superior analgesia after major shoulder surgery when compared with a single injection in the setting of multimodal analgesia, inclusive of intravenous dexamethasone, magnesium, acetaminophen and ketorolac.

Cryoneurolysis of alveolar nerves for chronic dental pain: A new technique and a case series.

Background: Chronic neuropathic dental pain has a poor prognosis with a low chance of significant spontaneous improvement. Local or oral therapies may be efficient, however short in terms of duration with potential side effects. Cryoneurolysis has been described to prevent acute postoperative pain or to treat some chronic pain conditions; however, application to dental orofacial pain has not been reported so far.

[Intrathecal drug delivery for chronic pain management].

Intrathecal drug delivery appeared in the early eighties and allows to administer high concentrate analgesic medications in the cerebrospinal fluid with higher efficacy and a limited incidence of systemic side effects. Opioids are still the first line treatment with high-quality evidence for chronic cancer pain, and limited evidence for chronic non-cancer pain, being often considered as a last resort therapy. Device implantation requires a strict patient's selection with a close follow-up in order to adapt therapy, refill the reservoir and detect and prevent potential severe complications.

[Cryotherapy for pain treatment: An overview].

The role of cryotherapy in the treatment of pain has been known since the Egyptians. For fifty years, techniques initially dedicated to the whole body have evolved into more specific approaches by targeting nerve structures. Several indications for the treatment of acute and chronic pain have emerged and are supported by scientific evidence.