Introduction: Most definitions of pain require individuals experiencing pain to report their pain. There are three groups who may not always report pain including those who: (1) lack the cognitive ability to verbally communicate their pain and also lack a proxy/surrogate to report pain for them; (2) lack the cognitive ability to verbally communicate their pain but have a proxy to report the pain; and (3) have the cognitive ability to verbally report pain but are unable or unwilling to do so. Clinicians may not be able to determine which patients are at risk for unidentified pain. Therefore, in this study, we present a protocol for an integrative review with the aim of identifying existing theoretical approaches to understanding unidentified pain.
Methods And Analysis: We propose a systematic overview of the existing theoretical approaches to understanding 'unidentified pain'. We will use Campbell and colleagues' criteria for systematic reviews of theory and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Our search will be broad to cover theoretical approaches to 'unidentified pain' using MEDLINE, CINAHL, Embase and Google Scholar. Covidence systematic review software will be used for data extraction and analysis. Then, qualitative content analysis will take place. The content analysis will be presented as a narrative.
Ethics And Dissemination: No human or animal subjects will be involved. The results are to be published in peer-reviewed journals and presented at conferences in the USA and internationally.
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http://dx.doi.org/10.1136/bmjopen-2022-065662 | DOI Listing |
PLoS One
January 2025
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea.
Objective: Cubital tunnel syndrome is a common peripheral neuropathy of the upper extremity. Anterior transposition of the ulnar nerve is an established surgical treatment option for this condition. This study aimed to introduce a novel musculofascial lengthening technique that uses only a portion of the flexor-pronator muscle mass for submuscular anterior transposition of the ulnar nerve and investigate its clinical outcomes.
View Article and Find Full Text PDFAnesth Analg
January 2025
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins, All Children's Hospital, St Petersburg, Florida.
Background: Optimal perioperative pain management is unknown for adolescent patients undergoing anterior cruciate ligament reconstruction (ACLR). The study aimed to determine the association of nerve blocks with short- and long-term pain outcomes and factors influencing self-reported neurological symptoms.
Methods: We performed a multisite, prospective observational study of adolescent patients undergoing ACLR.
J Neuroophthalmol
January 2025
Department of Ophthalmology (JGJ-C, TE, Y-HC, LRD, RAG), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Frank H. Netter Medical School (JGJ-C), North Haven, Connecticut; and Department of Anesthesiology (DZ), Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Background: Patients with craniosynostosis are at high risk of developing elevated intracranial pressure (ICP) causing papilledema and secondary optic atrophy. Diagnosing and monitoring optic neuropathy is challenging because of multiple causes of vision loss including exposure keratopathy, amblyopia, and cognitive delays that limit examination. Peripapillary hyperreflective ovoid mass-like structures (PHOMS) are an optical coherence tomography (OCT) finding reported in association with papilledema and optic neuropathy.
View Article and Find Full Text PDFImportance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.
Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.
Rheumatology (Oxford)
January 2025
Leeds Institute of Rheumatic and Musculoskeletal Medicine, School of Medicine, University of Leeds, Leeds, UK.
Objectives: Peripheral Sensory Neuropathy (PSN) is an under-recognized feature in systemic sclerosis (SSc). Moreover, SSc foot involvement is frequent but poorly investigated. We aimed to provide a detailed characterization of foot PSN in a large cohort of SSc patients, describing its associations with disease-specific features, physical disability, and Quality of Life (QoL).
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