Nowadays, obstetrical anesthesia-related mortality is a very rare complication in industrialized countries. The recommended choice of intrathecal opioid for spinal anesthesia in the context of a multimodal peripartum pain management concept is discussed in this narrative review. Nowadays, there is a consensus that a perioperative multimodal pain concept should be used for caesarean delivery. This pain concept should include neuraxial opioids for spinal anesthesia, acetaminophen, NSAIDs, intravenous dexamethasone, and postoperative local or regional anesthetic procedures. Long-acting lipophobic opioids (diamorphine and morphine) have a significant analgesic advantage over short-acting lipophilic opioids (sufentanil and fentanyl). The risk of clinically relevant respiratory depression after neuraxial long-acting opioids is nowadays considered negligible, even if the data situation is weak in this regard. The question remains as to whether a pain concept that is ideally adapted to a neuraxial short-acting opioid shows benefit to a pain concept that is optimally adapted to neuraxial morphine. If long-acting opioids are used, the timing of each additional component of the multimodal analgesia strategy could ideally be adjusted to this longer duration of action.
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http://dx.doi.org/10.3390/medicina60030358 | DOI Listing |
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.
Pain
January 2025
Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia.
Physiotherapists are critically positioned to integrate education into patient care, including pain science education (PSE) to enhance management and outcomes. Anecdotally, many physiotherapists report difficulty providing PSE in private practice settings. Here, we aimed to explore current PSE use, knowledge, and barriers to implementation.
View Article and Find Full Text PDFEur J Phys Rehabil Med
January 2025
Preventive Medicine, Epidemiology and Public Health Area, Department of Biomedical and Diagnostic Sciences, University of Salamanca, Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain -
Background: Neck and back pain pathologies are currently the main cause of absenteeism from work in Spain and in the European Union, and represent a high socio-labor, economic and health cost for the Health Systems.
Aim: To assess the effectiveness of a Back School Program of a Spanish mutual insurance company (risk factors, pain and disability scales) in women workers with low back or neck pain.
Design: We combined a descriptive study of first-session data collected in the total sample and a prospective multicenter intervention study in those participants who completed the second and third check-up at 6 and 9 months.
Interv Pain Med
March 2025
Department of Anesthesiology, Perioperative, and Pain Medicine, Weill Cornell Medicine, New York, NY, USA.
•: The AI-assisted VR module enables learners to engage in a 360-degree immersive environment, manipulating holographic anatomy models and simulating fluoroscopic guidance to perform the Gasserian ganglion block.•: Key anatomical landmarks, like the foramen ovale, are highlighted, and proper C-arm positioning is demonstrated, helping practitioners localize the target area for needle advancement.•: The module includes AI-driven multi-language options and AI-generated multiple-choice questions to enhance learning and retention.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry (IFMPEGKC), RWTH University Hospital Aachen, Aachen, Germany.
Musicians and researchers are creative professions that share many similarities. They both aim to bring joy and progress to humanity. In recent decades, it has been shown that music has the ability to alleviate pain, improve heart function, reduce anxiety, and stimulate the release of endogenous opioids in the brain.
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