Current anesthesiology reports, Год журнала: 2024, Номер 15(1)
Опубликована: Дек. 26, 2024
Язык: Английский
Frontiers in Pharmacology, Год журнала: 2023, Номер 14
Опубликована: Дек. 15, 2023
Current evidence suggests that activation of glial and immune cells leads to increased production proinflammatory mediators, creating a neuroinflammatory state. Neuroinflammation has been proven be fundamental mechanism in the genesis acute pain its transition neuropathic chronic pain. A noxious event stimulates peripheral afferent nerve fibers may also activate pronociceptive receptors situated at dorsal root ganglion horn spinal cord, as well cells, setting off so-called sensitization spreading neuroinflammation brain. Once activated, microglia produce cytokines, chemokines, neuropeptides can increase sensitivity firing properties second-order neurons, upregulating signaling nociceptive information cerebral cortex. This process, known central sensitization, is crucial for chronification Immune-neuronal interactions are implicated lesser-known complex regulatory relationship between opioids. activated alter neuronal function, induce, maintain pathological pain, disrupt analgesic effects opioid drugs by contributing development tolerance dependence, even causing paradoxical hyperalgesia. Such alterations occur when environment impacted trauma, inflammation, immune-derived molecules, or opioids induce activation. Hence, understanding these intricate help managing efficacy beyond classical pharmacological approach.
Язык: Английский
Процитировано
17
Anesthesiology, Год журнала: 2024, Номер 141(2), С. 286 - 299
Опубликована: Апрель 26, 2024
The amount of same-day surgery has increased markedly worldwide in recent decades, but there remains limited evidence on chronic postsurgical pain this setting.
Язык: Английский
Процитировано
4
Journal of Nursing Care Quality, Год журнала: 2025, Номер unknown
Опубликована: Фев. 25, 2025
Background: Postoperative pain is a common complication that can delay recovery and increase hospital stays costs. Accurate assessments are essential for effective management. Local Problem: Compliance with evidence-based assessment protocols in the Anesthesia Intensive Care Unit (AICU) at teaching Hefei, China, was suboptimal. Methods: This implementation project, conducted from December 2023 to August 2024, utilized Joanna Briggs Institute (JBI) Implementation Framework Model of Evidence-Based Health Care. A baseline audit 23 nurses 50 patients followed by post-implementation audit. Data were analyzed using JBI’s PACES software. Interventions: Educational programs stakeholder focus groups introduced enhance compliance protocols. Results: 3 criteria increased 66% 92% following intervention. Conclusions: The project successfully enhanced assessment, improving postoperative management AICU.
Язык: Английский
Процитировано
0
Mindfulness, Год журнала: 2024, Номер 15(4), С. 914 - 930
Опубликована: Март 2, 2024
Язык: Английский
Процитировано
3
Current Opinion in Anaesthesiology, Год журнала: 2023, Номер 36(5), С. 580 - 588
Опубликована: Июль 27, 2023
Purpose of review Prognostic models for chronic postsurgical pain (CPSP) aim to predict the likelihood development and severity CPSP in individual patients undergoing surgical procedures. Such might provide valuable information healthcare providers, allowing them identify at higher risk implement targeted interventions prevent or manage effectively. This discusses latest developments prognostic CPSP, their challenges, limitations, future directions. Recent findings Numerous studies have been conducted aiming develop using various perioperative factors. These include patient-related factors like demographic variables, preexisting conditions, psychosocial aspects, procedure-specific characteristics, analgesic strategies, postoperative complications and, as indicated most recently, biomarkers. Model generation, however, varies performance accuracy differ between several reasons validation is rather scarce. Summary Precise methodology model needs advancements field CPSP. Development more accurate, validated refined large-scale cohorts needed improve reliability applicability clinical practice are necessary further refine
Язык: Английский
Процитировано
7
Frontiers in Pain Research, Год журнала: 2024, Номер 5
Опубликована: Фев. 22, 2024
Introduction Pain is highly prevalent in older adults and often contextualized by multiple clinical conditions (pain comorbidities). comorbidities increase with age this makes decisions more complex. To address gaps training geriatric pain management, we established the Aging—Educational Assessment of Need (PAEAN) project to appraise impacts medical mental health on decision-making regarding pain. We here report development pilot testing PAEAN survey instrument assess clinician perspectives. Methods Mixed-methods approaches were used. Scoping review methodology was applied both research literature selected Medicare-based data. A geographically professionally diverse interprofessional advisory panel experts research, education, geriatrics formed advise list potentially impacting healthcare professional decision-making. developed, tested licensed practitioners from 2 institutions. Respondents asked rate agreement impact using a 5-point Likert scale. Items scored for percent agreement. Results reviews indicated that are but not universally recognized. found no directly guiding educators designing education modules mirror adult complexity. The identified 26 common inclusion instrument. Conditions fell into three main categories: “major medical”, i.e., cardio-vascular-pulmonary; metabolic; neuropsychiatric/age-related. surveying clinically active providers, e.g., physicians, nurse practitioners, who all responded completely. Median completion time less than 3 min. Conclusion This study, developing our “Pain Need” instrument, suggests 1) many decision-making, 2) about feasible. Given challenges intrinsic safe effective care pain, attendant risks, together paucity existing relevant work, much needed.
Язык: Английский
Процитировано
2
Current Opinion in Supportive and Palliative Care, Год журнала: 2023, Номер 17(4), С. 324 - 337
Опубликована: Сен. 8, 2023
Purpose of review Pain is an expected consequence a surgery, but it far from being well controlled. One major complication acute pain its risk persistency beyond healing. This so-called chronic post-surgical (CPSP) defined as new or increased due to surgery that lasts for at least 3 months after surgery. CPSP frequent, underlies complex bio-psycho-social process and constitutes important socioeconomic challenge with significant impact on patients’ quality life. Its importance has been recognized by inclusion in the eleventh version ICD (International Classification Diseases). Recent findings Evidence most pharmacological non-pharmacological interventions preventing inconsistent. Identification associated patient-related factors, such psychosocial aspects, comorbidities, surgical trajectories, biomarkers may allow stratification selection treatment options based underlying individual mechanisms. Consequently, identification patients implementation individually tailored, preventive, multimodal reduce transition facilitated. Summary will give update current knowledge mechanism-based risk, prognostic predictive factors adults, preventive therapeutic approaches, how use them patient future.
Язык: Английский
Процитировано
5
Frontiers research topics, Год журнала: 2024, Номер unknown
Опубликована: Янв. 1, 2024
it is a pioneering approach to the world of academia, radically improving way scholarly research managed.The grand vision Frontiers where all people have an equal opportunity seek, share and generate knowledge.Frontiers provides immediate permanent online open access its publications, but this alone not enough realize our goals. journal seriesThe series multi-tier interdisciplinary set openaccess, journals, promising paradigm shift from current review, selection dissemination processes in academic publishing.All journals are driven by researchers for researchers; therefore, they constitute service community.At same time, operates on revolutionary invention, tiered publishing system, initially addressing specific communities scholars, gradually climbing up broader public understanding, thus serving interests lay society, too. Dedication qualityEach article landmark highest quality, thanks genuinely collaborative interactions between authors review editors, who include some world's best academicians.Research must be certified peers before entering stream knowledge that may eventually reach -and shape society; only applies most rigorous unbiased reviews.Frontiers revolutionizes freely delivering outstanding research, evaluated with no bias both social point view.By applying advanced information technologies, catapulting into new generation.
Язык: Английский
Процитировано
0
Journal of the American Academy of Orthopaedic Surgeons, Год журнала: 2024, Номер unknown
Опубликована: Апрель 30, 2024
Introduction: Severe pain after orthopaedic surgery is common and often results in chronic postsurgical opioid use (COU). Poor alleviation (PPA) a well-described modifiable risk factor of COU. Although PPA's role inducing COU recognized other areas, it not well defined surgery. The aim this study was to evaluate the influence PPA on population who underwent Methods: Medical records from large academic medical center 2015 2018 were available for analysis. Patients undergoing nononcologic surgical procedures by service that also required at least 24 hours hospital stay control included study. Surgery type, body location, basic demographics, preoperative use, comorbidities, medications administered hospital, prescription discharge, length recorded. as continued ≥ 3 months, 6 or 9 months having recorded score eight more, between 4 12 apart, three times during stay. Results: A total 7,001 patients identified. overall rate 25.3% Charlson Comorbidity Index > 0 statistically significant predictors all time points. Preoperative naivety associated with decreased type location COU, controlling baseline variables. Conclusion: Our findings demonstrated an high known factors evident our population, particularly acute PPA. Better management may lead decrease rates group.
Язык: Английский
Процитировано
0
Current Medical Research and Opinion, Год журнала: 2024, Номер 40(7), С. 1187 - 1193
Опубликована: Май 29, 2024
Objective: The incidence and factors associated with chronic postsurgical pain (CPSP) after ambulatory surgeries have not been well studied. Our primary objective was to determine the of CPSP, secondary objectives included assessment intensity moderate-to-severe exploration CPSP.
Язык: Английский
Процитировано
0