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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain
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Novel Technologies in Interventional Pain Management.

Yashar Eshraghi1, Jay D Shah2, Maged Guirguis1

  • 1Department of Anesthesiology & Interventional Pain Management, Ochsner Health System, 2820 Napoleon Avenue, Ste. 900, New Orleans, LA 70115, USA; University of Queensland - Ochsner Clinical School, Australia; Louisiana State University School of Medicine, School of Medicine, New Orleans, LA 70112, USA.

Physical Medicine and Rehabilitation Clinics of North America
|May 8, 2022
PubMed
Summary
This summary is machine-generated.

Novel minimally invasive techniques offer effective management for chronic lower back pain, including lumbar spinal stenosis (LSS) and vertebrogenic pain, with increasing long-term data supporting their safety and sustainability.

Keywords:
Basivertebral nerve ablationEmerging technologiesIntraceptLigamentum flavum dissectionLumbar spinal stenosisPercutaneous lumbar decompressionSuperionmild (minimally invasive lumbar decompression)

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Area of Science:

  • Interventional Pain Management
  • Spinal Surgery
  • Regenerative Medicine

Background:

  • Chronic lower back pain affects millions globally, often necessitating advanced treatment options.
  • Traditional surgical approaches may pose risks or be unsuitable for certain patient populations.
  • Emerging technologies are crucial for improving outcomes in managing complex spinal conditions.

Purpose of the Study:

  • To review three significant novel technologies for chronic lower back pain management.
  • To evaluate the efficacy and safety of percutaneous interspinous spacer implantation and minimally invasive lumbar decompression.
  • To discuss a new approach for vertebrogenic back pain and establish an evaluation framework for new interventional pain management technologies.

Main Methods:

  • Review of current literature and clinical data on novel spinal technologies.
  • Analysis of follow-up data for percutaneous interspinous spacer implantation and minimally invasive lumbar decompression.
  • Assessment of a novel solution for vertebrogenic back pain, focusing on safety and sustainability.

Main Results:

  • Percutaneous interspinous spacer implantation and minimally invasive lumbar decompression demonstrate significant impact on lumbar spinal stenosis (LSS).
  • These procedures are particularly beneficial for patients unsuitable for open spinal surgery.
  • Up to 4-6 year follow-up data confirm the increasing evidence base for these techniques.
  • A novel vertebrogenic back pain solution shows promising safety and sustainability in follow-up studies.

Conclusions:

  • Novel minimally invasive techniques provide effective alternatives for managing chronic lower back pain and LSS.
  • Emerging solutions for vertebrogenic pain are safe and sustainable.
  • A structured framework is essential for evaluating new interventional pain management technologies.