Pub Date : 2024-01-10DOI: 10.4103/ijpn.ijpn_117_22
S. M. Arman, H. Usmani, O. Siddiqui, Kulsum Sheikh, S. Amir
Preemptive analgesia is a method of administration of drugs prior to surgery involving blocking noxious stimuli across the perioperative period. It involves blocking the pain pathway preemptively before injury-induced hypersensitivity manifests. To compare the analgesic efficacy of duloxetine with pregabalin as preemptive analgesic in lumbar spine surgeries. Randomised, double-blinded, prospective study. Fifty patients of both sexes between 18-55yrs undergoing elective lumbar spine surgery were randomly allocated into two groups, group P and group D of twenty-five patients each. Group P received 75 mg pregabalin once daily for three days, followed by 150 mg pregabalin daily for the next four days till the day of surgery. Group D received 20 mg duloxetine once daily for three days, followed by 40 mg duloxetine twice daily for the next four days till the day of surgery. Both the groups were primarily evaluated in terms of time for request of 1st rescue analgesic and total intraoperative analgesic requirement in terms of fentanyl boluses required; among other parameters. The time for request of 1st rescue analgesic postoperatively was significantly longer in the pregabalin group (396 ± 267.77 min) than in the duloxetine group (218.4 ± 96.9 min), P = 0.003. Pregabalin recipients required considerably less rescue analgesics in terms of dosage, P = 0.006. Also, pregabalin exhibited better postoperative pain control than duloxetine as reflected by NRS comparative scores. No statistical difference was appreciated in terms of intraoperative fentanyl requirement, intraoperative hemodynamic control; nausea and sleepiness. Pregabalin is more efficacious as a preemptive analgesic than duloxetine in lumbar spine surgery.
{"title":"A Comparative Study of Duloxetine with Pregabalin as a Preemptive Analgesic in Lumbar Spine Surgery: A Prospective Randomized Study","authors":"S. M. Arman, H. Usmani, O. Siddiqui, Kulsum Sheikh, S. Amir","doi":"10.4103/ijpn.ijpn_117_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_117_22","url":null,"abstract":"\u0000 \u0000 \u0000 Preemptive analgesia is a method of administration of drugs prior to surgery involving blocking noxious stimuli across the perioperative period. It involves blocking the pain pathway preemptively before injury-induced hypersensitivity manifests.\u0000 \u0000 \u0000 \u0000 To compare the analgesic efficacy of duloxetine with pregabalin as preemptive analgesic in lumbar spine surgeries.\u0000 \u0000 \u0000 \u0000 Randomised, double-blinded, prospective study.\u0000 \u0000 \u0000 \u0000 Fifty patients of both sexes between 18-55yrs undergoing elective lumbar spine surgery were randomly allocated into two groups, group P and group D of twenty-five patients each. Group P received 75 mg pregabalin once daily for three days, followed by 150 mg pregabalin daily for the next four days till the day of surgery. Group D received 20 mg duloxetine once daily for three days, followed by 40 mg duloxetine twice daily for the next four days till the day of surgery.\u0000 \u0000 \u0000 \u0000 Both the groups were primarily evaluated in terms of time for request of 1st rescue analgesic and total intraoperative analgesic requirement in terms of fentanyl boluses required; among other parameters.\u0000 \u0000 \u0000 \u0000 The time for request of 1st rescue analgesic postoperatively was significantly longer in the pregabalin group (396 ± 267.77 min) than in the duloxetine group (218.4 ± 96.9 min), P = 0.003. Pregabalin recipients required considerably less rescue analgesics in terms of dosage, P = 0.006. Also, pregabalin exhibited better postoperative pain control than duloxetine as reflected by NRS comparative scores. No statistical difference was appreciated in terms of intraoperative fentanyl requirement, intraoperative hemodynamic control; nausea and sleepiness.\u0000 \u0000 \u0000 \u0000 Pregabalin is more efficacious as a preemptive analgesic than duloxetine in lumbar spine surgery.\u0000","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"66 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Praveen Ramasamy, Ilango Ganesan, Premkumar Damodaran, K. S. Narayanan
{"title":"Diagnosis of a Rare Endocrine Disorder – A Pain Physician’s Experience","authors":"Praveen Ramasamy, Ilango Ganesan, Premkumar Damodaran, K. S. Narayanan","doi":"10.4103/ijpn.ijpn_55_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_55_23","url":null,"abstract":"","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"142 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139190751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Among the various techniques described for analgesia in breast surgeries, thoracic epidural and thoracic paravertebral block is the gold standard but have potential complications of hypotension and pneumothorax. Midpoint transverse process to pleura (MTP) block is one of the newest techniques developed to reduce these complications by injection of local anesthetic between the midpoint of the posterior transverse process and pleura. Originally performed at multiple levels, the literature is scant regarding the placement of a catheter. We report MTP block with catheter placement providing continuous infusion in five patients posted for modified radical mastectomy and found it a safe and effective alternative.
{"title":"Midpoint Transverse Process to Pleura Block for Analgesia in Breast Surgeries: A Case Series","authors":"Kriti Chaudhary, R. Sharma, Suyashi Sharma","doi":"10.4103/ijpn.ijpn_61_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_61_22","url":null,"abstract":"Among the various techniques described for analgesia in breast surgeries, thoracic epidural and thoracic paravertebral block is the gold standard but have potential complications of hypotension and pneumothorax. Midpoint transverse process to pleura (MTP) block is one of the newest techniques developed to reduce these complications by injection of local anesthetic between the midpoint of the posterior transverse process and pleura. Originally performed at multiple levels, the literature is scant regarding the placement of a catheter. We report MTP block with catheter placement providing continuous infusion in five patients posted for modified radical mastectomy and found it a safe and effective alternative.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139196201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.4103/ijpn.ijpn_126_23
Samarjit Dey, Prateek Arora, S. Chanu, Indubala Maurya, Sunit Gupta
Chronic pelvic pain (CPP) is a complex and debilitating condition affecting a significant portion of the global population, predominantly women. This review dwells on various interventions to alleviate the burden of CPP and improve patients’ quality of life. Traditional approaches have included patient education, pharmacotherapy, physical therapy, and cognitive behavioral therapy. However, the limited efficacy and potential side effects of long-term medications necessitate a multidisciplinary approach. The review lists a comprehensive tabulation of results from systematic reviews and meta-analyses on CPP interventions published in the past 5 years.
{"title":"A Scoping Review on Interventions for Chronic Pelvic Pain","authors":"Samarjit Dey, Prateek Arora, S. Chanu, Indubala Maurya, Sunit Gupta","doi":"10.4103/ijpn.ijpn_126_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_126_23","url":null,"abstract":"Chronic pelvic pain (CPP) is a complex and debilitating condition affecting a significant portion of the global population, predominantly women. This review dwells on various interventions to alleviate the burden of CPP and improve patients’ quality of life. Traditional approaches have included patient education, pharmacotherapy, physical therapy, and cognitive behavioral therapy. However, the limited efficacy and potential side effects of long-term medications necessitate a multidisciplinary approach. The review lists a comprehensive tabulation of results from systematic reviews and meta-analyses on CPP interventions published in the past 5 years.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.4103/ijpn.ijpn_100_21
Fatemeh Bahramnezhad, Elaheh Salamat, F. Sharifi, Mohammad Amin Valizade Hasanloie
Pain assessment in the intensive care unit (ICU) is a main problem in mechanically ventilated patients (MVPs) as they are not able to self-report pain, hence exposing them to the risk of inadequate pain management that leads to unfavorable consequences. This research aimed to determine and compare pain intensity scores of two scales in predicting the hospitalization consequences of MVPs in ICUs. The analytical-longitudinal study was carried out in ICUs in 2020. Pain intensity was evaluated using observational pain scales in 60 patients who met inclusion criteria in three positions during suctioning once daily for 3 days. There were significant inverse correlations between the Behavioral Pain Scale (BPS) and Critical Care Pain Observational Tool (CPOT) with the duration of hospitalization and mechanical ventilation. No significant relationships were observed between total mean scores obtained from the scales and the incidence of ventilator-associated pneumonia. There were no significant correlations between BPS and CPOT with frequencies and total dose of the prescribed opioid drug. The use of BPS and CPOT can be used for pain assessment and control in MVPs as a positive step towards improving their consequences.
{"title":"Comparing Pain Intensity of Two Instruments in Predicting the Outcomes of Patients Under Mechanical Ventilation Admitted to Intensive Care Units","authors":"Fatemeh Bahramnezhad, Elaheh Salamat, F. Sharifi, Mohammad Amin Valizade Hasanloie","doi":"10.4103/ijpn.ijpn_100_21","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_100_21","url":null,"abstract":"Pain assessment in the intensive care unit (ICU) is a main problem in mechanically ventilated patients (MVPs) as they are not able to self-report pain, hence exposing them to the risk of inadequate pain management that leads to unfavorable consequences. This research aimed to determine and compare pain intensity scores of two scales in predicting the hospitalization consequences of MVPs in ICUs. The analytical-longitudinal study was carried out in ICUs in 2020. Pain intensity was evaluated using observational pain scales in 60 patients who met inclusion criteria in three positions during suctioning once daily for 3 days. There were significant inverse correlations between the Behavioral Pain Scale (BPS) and Critical Care Pain Observational Tool (CPOT) with the duration of hospitalization and mechanical ventilation. No significant relationships were observed between total mean scores obtained from the scales and the incidence of ventilator-associated pneumonia. There were no significant correlations between BPS and CPOT with frequencies and total dose of the prescribed opioid drug. The use of BPS and CPOT can be used for pain assessment and control in MVPs as a positive step towards improving their consequences.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"2013 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.4103/ijpn.ijpn_107_22
Sandeep Diwan, Rajendra Sahoo, Arkesh Madegowda, Avinash Gaikwad, H. Dongre, Sandeep Patwardhan, P. Sancheti
Severe and persistent pain of cancer and noncancer origin in pediatric patients can pose significant challenge to manage. The application of Radiofrequency ablation in Pediatric patients for pain management is not well reported in the literature. Here, we present pediatric cases where pulsed radiofrequency (PRF) treatment of the Lumbosacral plexus was done for pain relief.
{"title":"Pulsed Radiofrequency Ablation of the Lumbar and Sacral Plexus for Intractable Pain in Pediatric Patients","authors":"Sandeep Diwan, Rajendra Sahoo, Arkesh Madegowda, Avinash Gaikwad, H. Dongre, Sandeep Patwardhan, P. Sancheti","doi":"10.4103/ijpn.ijpn_107_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_107_22","url":null,"abstract":"Severe and persistent pain of cancer and noncancer origin in pediatric patients can pose significant challenge to manage. The application of Radiofrequency ablation in Pediatric patients for pain management is not well reported in the literature. Here, we present pediatric cases where pulsed radiofrequency (PRF) treatment of the Lumbosacral plexus was done for pain relief.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"20 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Khare, Beena Thada, Jyoti Meena, Kuldeep Jonwal, Veena Mathur
Intraperitoneal (IP) local anesthetic administration has become a routine in laparoscopic surgeries. An additive to local anesthetic like alpha-2 agonist such as dexmedetomidine may enhance the efficacy of local anesthetic. Our primary objective was to compare the duration of analgesia and our secondary objectives were to compare the total amount of rescue analgesics in 24 h, hemodynamic changes, and adverse effects after the use of dexmedetomidine intraperitoneally versus intravenously in addition to 0.25% ropivacaine instillation intraperitoneally. Eighty patients aged 18–60 years of American Society of Anesthesiologists physical status I and II, undergoing laparoscopic cholecystectomy, were randomly allocated into two groups – Group V (n = 40) received 100 ml normal saline (NS) with 0.7 µg/kg dexmedetomidine over 15 min followed by 30 ml 0.25% ropivacaine intraperitoneally and Group P (n = 40) received 100 ml NS over 15 min followed by 30 ml 0.25% ropivacaine with 0.7 µg/kg dexmedetomidine intraperitoneally soon after removal of gallbladder at the end of surgery. The duration of analgesia was significantly longer in Group V (246.45 ± 27.00 min) as compared to Group P (112.83 ± 11.61 min) (P < 0.0001). The total amount of rescue analgesic consumption in 24 h was significantly reduced in Group V (185.00 ± 73.55 mg) as compared to Group P (225.00 ± 77.63 mg) (P < 0.05). As compared to Group P, patients in Group V had a statistically significant Ramsay Sedation Score. The hemodynamic parameters and side effect profile were comparable in both the groups. IV dexmedetomidine 0.7μg/kg is more efficacious as compared to IP dexmedetomidine along with IP ropivacaine 0.25% in laparoscopic cholecystectomy in terms of prolonged duration of analgesia and decreased requirement of rescue analgesia in 24 h.
{"title":"A Comparative Clinical Study to Evaluate the Antinociceptive Efficacy of Intravenous versus Intraperitoneal Dexmedetomidine with Ropivacaine in Patients Undergoing Laparoscopic Cholecystectomy","authors":"A. Khare, Beena Thada, Jyoti Meena, Kuldeep Jonwal, Veena Mathur","doi":"10.4103/ijpn.ijpn_38_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_38_22","url":null,"abstract":"Intraperitoneal (IP) local anesthetic administration has become a routine in laparoscopic surgeries. An additive to local anesthetic like alpha-2 agonist such as dexmedetomidine may enhance the efficacy of local anesthetic. Our primary objective was to compare the duration of analgesia and our secondary objectives were to compare the total amount of rescue analgesics in 24 h, hemodynamic changes, and adverse effects after the use of dexmedetomidine intraperitoneally versus intravenously in addition to 0.25% ropivacaine instillation intraperitoneally. Eighty patients aged 18–60 years of American Society of Anesthesiologists physical status I and II, undergoing laparoscopic cholecystectomy, were randomly allocated into two groups – Group V (n = 40) received 100 ml normal saline (NS) with 0.7 µg/kg dexmedetomidine over 15 min followed by 30 ml 0.25% ropivacaine intraperitoneally and Group P (n = 40) received 100 ml NS over 15 min followed by 30 ml 0.25% ropivacaine with 0.7 µg/kg dexmedetomidine intraperitoneally soon after removal of gallbladder at the end of surgery. The duration of analgesia was significantly longer in Group V (246.45 ± 27.00 min) as compared to Group P (112.83 ± 11.61 min) (P < 0.0001). The total amount of rescue analgesic consumption in 24 h was significantly reduced in Group V (185.00 ± 73.55 mg) as compared to Group P (225.00 ± 77.63 mg) (P < 0.05). As compared to Group P, patients in Group V had a statistically significant Ramsay Sedation Score. The hemodynamic parameters and side effect profile were comparable in both the groups. IV dexmedetomidine 0.7μg/kg is more efficacious as compared to IP dexmedetomidine along with IP ropivacaine 0.25% in laparoscopic cholecystectomy in terms of prolonged duration of analgesia and decreased requirement of rescue analgesia in 24 h.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In today’s era of digital learning, the utility of laptops has drastically been increased. Sustained postural strain resulting from poor ergonomics while using laptops may lead to musculoskeletal discomforts (MSD). This study aimed to determine touch-typing skills of medical students, quantitative assessment of their postural ergonomics, and implications of their efforts while typing on the prevalence of MSD. Sixty medical students were asked to take an online typing test (www.ratatype.com) and their typing speed in words per minute (WPM) and accuracy (%) were noted. The lateral pictures of the students were taken while performing the typing test and objective ergonomics analysis using craniovertebral angle (CVA) and rapid upper limb assessment (RULA) scoring system. None of the students demonstrated touch typing proficiency. The average typing speed (WPM) and accuracy (%) were observed to be 27.893 and 94.768, respectively. The mean CVA was 33.17, much lower than the average norm. The mean final RULA score was 5.62, indicating a high degree of MSD risk. Moderate-to-severe laptop users (≥4 h/day) showed higher prevalence of MSDs (P < 0.05) as compared to normal-to-mild users. A significant negative correlation was found between CVA and RULA scores. The study concluded average typing speed and accuracy, poor ergonomics (low CVA), and moderate-to-high MSD risk (based on RULA score) were seen among students. A high MSD prevalence was reported in laptop usage of ≥ 4 h/day, which can be ascribed to postural strain from improper typing habits and poor ergonomics.
{"title":"Impact of Laptop Usage, Typing Skills, and Ergonomics on Musculoskeletal Pain among Medical Resident Doctors – An Observational Study","authors":"Sonal Goyal, Bhavna Gupta","doi":"10.4103/ijpn.ijpn_74_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_74_23","url":null,"abstract":"In today’s era of digital learning, the utility of laptops has drastically been increased. Sustained postural strain resulting from poor ergonomics while using laptops may lead to musculoskeletal discomforts (MSD). This study aimed to determine touch-typing skills of medical students, quantitative assessment of their postural ergonomics, and implications of their efforts while typing on the prevalence of MSD. Sixty medical students were asked to take an online typing test (www.ratatype.com) and their typing speed in words per minute (WPM) and accuracy (%) were noted. The lateral pictures of the students were taken while performing the typing test and objective ergonomics analysis using craniovertebral angle (CVA) and rapid upper limb assessment (RULA) scoring system. None of the students demonstrated touch typing proficiency. The average typing speed (WPM) and accuracy (%) were observed to be 27.893 and 94.768, respectively. The mean CVA was 33.17, much lower than the average norm. The mean final RULA score was 5.62, indicating a high degree of MSD risk. Moderate-to-severe laptop users (≥4 h/day) showed higher prevalence of MSDs (P < 0.05) as compared to normal-to-mild users. A significant negative correlation was found between CVA and RULA scores. The study concluded average typing speed and accuracy, poor ergonomics (low CVA), and moderate-to-high MSD risk (based on RULA score) were seen among students. A high MSD prevalence was reported in laptop usage of ≥ 4 h/day, which can be ascribed to postural strain from improper typing habits and poor ergonomics.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"382 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain is a common and devastating complaint in cancer patients. The etiology of pain in these patients is numerous and proper assessment is needed for treatment. Myofascial pain syndrome (MPS) is a common but often neglected cause of pain. Cancer patients are at risk of developing MPS. An accurate and early clinical diagnosis along with appropriate intervention is required to address this cause of pain in order to decrease the sufferings of these patients. Here, we report a patient of metastatic breast carcinoma with severe lower back and lower limb pain, significantly relieved with Minimally invasive pain and spine interventions (MIPSI) of the trigger point in the tensor fascia lata, which is often a missed cause of pain in this subgroup of the patient.
{"title":"Role of Trigger Point Injection in the Management of Proximal Tensor Fascia Lata Myofascial Trigger Point in a Stage 4 Breast Cancer Patient","authors":"Sanjay Kumar, Pratibha Singh, Anil Agarwal, Prashant Kumar Singh","doi":"10.4103/ijpn.ijpn_100_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_100_22","url":null,"abstract":"Pain is a common and devastating complaint in cancer patients. The etiology of pain in these patients is numerous and proper assessment is needed for treatment. Myofascial pain syndrome (MPS) is a common but often neglected cause of pain. Cancer patients are at risk of developing MPS. An accurate and early clinical diagnosis along with appropriate intervention is required to address this cause of pain in order to decrease the sufferings of these patients. Here, we report a patient of metastatic breast carcinoma with severe lower back and lower limb pain, significantly relieved with Minimally invasive pain and spine interventions (MIPSI) of the trigger point in the tensor fascia lata, which is often a missed cause of pain in this subgroup of the patient.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"12 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Digvijay Prakash Singh, Sudhir Kumar Rai, Ram G. Maurya, Harshit Rastogi, Gyan P Singh
The primary aim of this randomized controlled study was to evaluate the effect of the addition of dexmedetomidine to ropivacaine on the onset and duration of sensory and motor blockade and the duration of analgesia in patients undergoing upper limb surgeries under supraclavicular brachial plexus block. A total of 100 patients of age 18–55 years, planned for elective upper limb surgeries under supraclavicular brachial plexus block using a nerve stimulator, were randomly allocated into two groups. Group 1 (n = 50) received 30 mL 0.5% ropivacaine and 1 mL normal saline and Group 2 (n = 50) received 30 mL 0.5% ropivacaine and 1 μg/kg of dexmedetomidine. The onset and duration of sensory and motor block, duration of analgesia, and adverse events during the perioperative period were noted. The onset of sensory and motor block in Group 1 (16. 26 ± 2.23 and 21.68 ± 2.90 min) was slower than those in Group 2 (9.12 ± 2.40 and 12.68 ± 2.62 min), (<0.001). The duration of sensory and motor block in Group 1 was significantly shorter than those in Group 2 (P < 0.001). The duration of analgesia in Group 1 (402.80 ± 28.21 min) was shorter than that in Group 2 (981.00 ± 92.26 min; P < 0.001). There was no statistically significant difference between the two groups in the incidence of the side effects, except in the incidence of sedation which is significantly higher in Group 2, (P < 0.001). Dexmedetomidine with ropivacaine for supraclavicular nerve block resulted in earlier onset and prolonged duration of the sensorimotor blockade and provided a longer pain-free postoperative period without significant hemodynamic alterations.
{"title":"Analgesic Efficacy of Dexmedetomidine as an Adjuvant to Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgeries: A Prospective Randomized Study","authors":"Digvijay Prakash Singh, Sudhir Kumar Rai, Ram G. Maurya, Harshit Rastogi, Gyan P Singh","doi":"10.4103/ijpn.ijpn_38_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_38_23","url":null,"abstract":"The primary aim of this randomized controlled study was to evaluate the effect of the addition of dexmedetomidine to ropivacaine on the onset and duration of sensory and motor blockade and the duration of analgesia in patients undergoing upper limb surgeries under supraclavicular brachial plexus block. A total of 100 patients of age 18–55 years, planned for elective upper limb surgeries under supraclavicular brachial plexus block using a nerve stimulator, were randomly allocated into two groups. Group 1 (n = 50) received 30 mL 0.5% ropivacaine and 1 mL normal saline and Group 2 (n = 50) received 30 mL 0.5% ropivacaine and 1 μg/kg of dexmedetomidine. The onset and duration of sensory and motor block, duration of analgesia, and adverse events during the perioperative period were noted. The onset of sensory and motor block in Group 1 (16. 26 ± 2.23 and 21.68 ± 2.90 min) was slower than those in Group 2 (9.12 ± 2.40 and 12.68 ± 2.62 min), (<0.001). The duration of sensory and motor block in Group 1 was significantly shorter than those in Group 2 (P < 0.001). The duration of analgesia in Group 1 (402.80 ± 28.21 min) was shorter than that in Group 2 (981.00 ± 92.26 min; P < 0.001). There was no statistically significant difference between the two groups in the incidence of the side effects, except in the incidence of sedation which is significantly higher in Group 2, (P < 0.001). Dexmedetomidine with ropivacaine for supraclavicular nerve block resulted in earlier onset and prolonged duration of the sensorimotor blockade and provided a longer pain-free postoperative period without significant hemodynamic alterations.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139188928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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