scholarly journals A Review of Adjunctive Therapies for Burn Injury Pain During the Opioid Crisis

2019 ◽  
Vol 40 (6) ◽  
pp. 983-995 ◽  
Author(s):  
Daniel E Kim ◽  
Kaitlin A Pruskowski ◽  
Craig R Ainsworth ◽  
Hans R Linsenbardt ◽  
Julie A Rizzo ◽  
...  
Keyword(s):  
Pain Management ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Burn Injury ◽  
The United States ◽  
Pain Severity ◽  
Controlled Trials ◽  
Burn Patients ◽  
Opioid Use ◽  
Randomized Controlled

Abstract Opioids are the mainstay of pain management after burn injury. The United States currently faces an epidemic of opioid overuse and abuse, while simultaneously experiencing a nationwide shortage of intravenous narcotics. Adjunctive pain management therapies must be sought and utilized to reduce the use of opioids in burn care to prevent the long-term negative effects of these medications and to minimize the dependence on opioids for analgesia. The purpose of this review was to identify literature on adjunctive pain management therapies that have been demonstrated to reduce pain severity or opioid consumption in adult burn patients. Three databases were searched for prospective studies, randomized controlled trials, and systematic reviews that evaluated adjunctive pain management strategies published between 2008 and 2019 in adult burn patients. Forty-six studies were analyzed, including 24 randomized controlled trials, six crossover trials, and 10 systematic reviews. Various adjunctive pain management therapies showed statistically significant reduction in pain severity. Only one randomized controlled trial on music therapy for acute background pain showed a reduction in opioid use. One cohort study on hypnosis demonstrated reduced opioid use compared with historical controls. We recommend the development of individualized analgesic regimens with the incorporation of adjunctive therapies in order to improve burn pain management in the midst of an abuse crisis and concomitant national opioid shortage.

Nonpharmacologic Management of Procedural Pain in Pediatric Burn Patients: A Systematic Review of Randomized Controlled Trials

2021 ◽  
Author(s):  
Matthew Gillum ◽  
Samantha Huang ◽  
Yuki Kuromaru ◽  
Justin Dang ◽  
Haig A Yenikomshian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Randomized Controlled Trials ◽  
Burn Injury ◽  
Pediatric Population ◽  
Procedural Pain ◽  
Controlled Trials ◽  
Burn Patients ◽  
Randomized Controlled ◽  
Effective Adjunct

Abstract Pain following burn injury is associated with long-term health consequences in the pediatric population. Literature suggests nonpharmacologic treatment may provide improved pain control as an effective adjunct for these patients. This study aims to summarize randomized controlled trials on nonpharmacologic procedural pain management in pediatric burn patients. A systematic review was conducted on nonpharmacologic procedural pain management techniques used in the pediatric burn population. Fifteen studies were included and involved virtual reality, distraction devices, child life therapy, directed play, digital tablet games, cartoons, hypnosis, and music therapy. Treatment was effective in 8 out of 15 studies. Compared to controls, nonpharmacologic treatments reduced mid procedure pain by 19.7% and post procedure pain by 20.1%. This study demonstrates nonpharmacologic therapy can be an effective adjunct in pediatric procedural burn pain management, however further studies are needed to develop standardized algorithms to integrate nonpharmacologic treatments with pharmacologic therapies.

Erector spinae plane block in acute interventional pain management: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Dmitriy Viderman ◽  
Anar Dautova ◽  
Antonio Sarria-Santamera
Keyword(s):  
Pain Management ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Erector Spinae ◽  
Controlled Trials ◽  
Comprehensive Overview ◽  
Simple Method ◽  
Randomized Controlled ◽  
Erector Spinae Plane Block ◽  
Interventional Pain Management

Abstract Erector Spinae Plane Block (ESPB) was described by Forero in 2016. ESPB is currently widely used in acute postoperative pain management. The benefits of ESPB include simplicity and efficacy in various surgeries. The aim of this review was to conduct a comprehensive overview of available evidence on erector spinae plane block in clinical practice. We included randomized controlled trials and systematic reviews reporting the ESPB in human subjects. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-one articles including five systematic reviews and 16 randomized controlled trials were included and analyzed. ESPB appears to be an effective, safe, and simple method for acute pain management in cardiac, thoracic, and abdominal surgery. The incidence of side effects has been reported to be rare. A critical issue is to make sure that new evidence is not just of the highest quality, in form of well powered and designed randomized controlled trials but also including a standardized and homogeneous set of indicators that permit to assess the comparative effectiveness of the application of ESPB in acute interventional pain management.

scholarly journals Cochrane Schizophrenia Group’s Study-Based Register of Randomized Controlled Trials: Development and Content Analysis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Farhad Shokraneh ◽  
Clive E Adams
Keyword(s):  
Content Analysis ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Research Policy ◽  
Cochrane Review ◽  
Gis Mapping ◽  
Controlled Trials ◽  
Policy And Practice ◽  
Randomized Controlled ◽  
Review Team

Abstract Background Study-based registers facilitate systematic reviews through shortening the process for review team and reducing considerable waste during the review process. Such a register also provides new insights about trends of trials in a sub-specialty. This paper reports development and content analysis of Cochrane Schizophrenia Group’s Study-Based Register. Methods The randomized controlled trials were collected through systematic searches of major information sources. Data points were extracted, curated and classified in the register. We report trends using regression analyses in Microsoft Excel and we used GIS mapping (GunnMap 2) to visualize the geographical distribution of the origin of schizophrenia trials. Results Although only 17% of trials were registered, the number of reports form registered trials is steadily increasing and registered trials produce more reports. Clinical trial registers are main source of trial reports followed by sub-specialty journals. Schizophrenia trials have been published in 23 languages from 90 countries while 105 nations do not have any reported schizophrenia trials. Only 9.7% of trials were included in at least one Cochrane review. Pharmacotherapy is the main target of trials while trials targeting psychotherapy are increasing in a continuous rate. The number of people randomized in trials is on average 114 with 60 being the most frequent sample size. Conclusions Curated datasets within the register uncover new patterns in data that have implications for research, policy, and practice for testing new interventions in trials or systematic reviews.

Pain Management After Shoulder Arthroplasty: A Systematic Review of Randomized Controlled Trials

2021 ◽  
Author(s):  
Matthew R. Cohn ◽  
Kyle N. Kunze ◽  
Joshua Wright-Chisem ◽  
Johnathon R. McCormick ◽  
Garrett S. Bullock ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Randomized Controlled Trials ◽  
Shoulder Arthroplasty ◽  
Controlled Trials ◽  
Randomized Controlled

Tools to Assess the External Validity of Randomized Controlled Trials in Systematic Reviews: a Systematic Review of Measurement Properties

2021 ◽  
Author(s):  
Andres Jung ◽  
Julia Balzer ◽  
Tobias Braun ◽  
Kerstin Luedtke
Keyword(s):  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
External Validity ◽  
Measurement Properties ◽  
Controlled Trials ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Quality Of Evidence ◽  
Randomized Controlled

Abstract Background: Internal and external validity are the most relevant components when critically appraising randomized controlled trials (RCTs) for systematic reviews. However, there is no gold standard to assess external validity. This might be related to the heterogeneity of terminology as well as to unclear evidence of the measurement properties of available tools. The aim of this review was to identify tools to assess the external validity of RCTs in systematic reviews and to evaluate the quality of evidence regarding their measurement properties.Methods: A two-phase systematic literature search was performed in four databases: MEDLINE via PubMed, Scopus, PsycINFO via OVID, and CINAHL via EBSCO. First, tools to assess the external validity of RCTs were identified. Second, studies aiming to investigate the measurement properties of these tools were selected. The measurement properties of each included tool were appraised using an adapted version of the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.Results: 34 publications reporting on the development or validation of 26 included tools were included. For 62% of the included tools, there was no evidence of any measurement property. For the remaining tools, reliability was assessed most frequently. Reliability was judged as “sufficient” for three tools (very low quality of evidence). Content validity was rated as “sufficient” for one tool (moderate quality of evidence).Conclusions: Based on these results, no available tool can be fully recommended to assess the external validity of RCTs in systematic reviews. Several steps are required to overcome the identified difficulties to either adapt and validate available tools or to develop a new one. There is a need for more research for this purpose.Trial registration: Prospective registration at Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/PTG4D

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