Background: Given the ongoing battle with opioid abuse and overuse in the United States, new strategies are consistently being implemented to reduce opioid utilization and overprescribing.
Objectives: The purpose of this study was to determine if a more regulated explicit pain management instruction plan could reduce the number of opioids taken.
Methods: Blinded randomized prospective study comparing a total of 110 (Group A = 55, Group B = 55) women who underwent elective outpatient bilateral breast reduction surgery by 2 different plastic surgeons. Patients were randomly divided into either Group A (control) that received general pain management instructions or Group B (experimental) that received explicit pain management instructions from the surgeons and nurses. Participants were asked to record the number of times they treated their pain with each separate modality. They were also asked to record their average daily pain scale for the days that they were treating their pain.
Results: Patients in Group B took on average 1.5 oxycodone (5 mg) and patients in Group A took on average 5.7 oxycodone (5 mg) (P < 0.01). Thirty-four patients in Group B took no oxycodone. Patients in Group B also had statistically significant lower subjective pain scores.
Conclusions: Based on these results, it appears that standardizing how patients are instructed to treat their pain postoperatively may reduce the number of narcotics needed, thus reducing the number of narcotics prescribed without compromising pain control.
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http://dx.doi.org/10.1093/asj/sjab435 | DOI Listing |
JMIR Form Res
January 2025
Department of Computer Science, University of California, Irvine, Irvine, CA, United States.
Background: Acute pain management is critical in postoperative care, especially in vulnerable patient populations that may be unable to self-report pain levels effectively. Current methods of pain assessment often rely on subjective patient reports or behavioral pain observation tools, which can lead to inconsistencies in pain management. Multimodal pain assessment, integrating physiological and behavioral data, presents an opportunity to create more objective and accurate pain measurement systems.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Faculty of Medicine, Azad Tehran University of Medical Sciences, Tehran, Iran.
Background: Pedicle screw insertion in posterior spinal surgery can cause vascular injuries, including rare intercostal artery pseudoaneurysms, which are typically discovered incidentally during reimaging. Onyx embolization is an effective treatment for small artery pseudoaneurysms.
Observations: A 36-year-old man who had initially presented with back pain that remained unresponsive to nonsteroidal anti-inflammatory drugs was diagnosed with a T7-8 sarcomatous lesion confirmed by magnetic resonance imaging and biopsy.
Acta Orthop Belg
December 2024
Percutaneous intra-meniscal platelet-rich plasma (PRP) is a promising tool for managing low-grade meniscal injuries in non-athletic patients. The study evaluates the clinical and radiological outcomes of PRP intra-meniscal injection in meniscal tears. Forty-eight patients were injected with 3 injections of PRP at an interval of one week with a standardised technique under sonographic guidance.
View Article and Find Full Text PDFUnlabelled: TKA is routinely done orthopaedic procedure done that aims at improving the quality of patients' life by providing pain relief, functional improvement and deformity correction. This study aims to study the efficacy and safety of a Periarticular analgesic cocktail including ropivacaine injection and epidural ropivacaine for early rehabilitation after a total knee replacement.
Methods: Total of 100 patients divided into two groups, one group received epidural ropivacaine and second group given periarticular cocktail containing ropivacaine.
Circulation
January 2025
Divisions of Cardiac Surgery (H.T., A.Q., R.E., R.V., M.M., J.H.C., S.V.), Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto, Ontario, Canada.
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