Anesthetic Management for Chronic Pain Surgery

This chapter discusses scoliosis repair, one of the most common major orthopedic surgeries performed in pediatric patients. Adolescent idiopathic scoliosis is the most common form and affects 1% to 3% of children and adolescents between the ages of 10 and 16. The anesthetic management of these patients can be challenging due to potential physiologic derangements that may be present. Adequate perioperative pain management is crucial, given the potential for significant postoperative and chronic pain conditions following repair. The rate of chronic postsurgical pain following scoliosis repair in pediatric patients averages about 20%. A balanced approach to analgesic management is best utilized to optimize pain relief while limiting side effects. Proper preparation for the perioperative experience, including setting expectations and planning for pain management, is a key factor in a successful recovery.

Download Full-text

Anaesthetic Challenges with DBS Device In Situ: Case Series with Review of Literature

10.52916/jcar204004 ◽

2020 ◽

pp. 1-2

Author(s):

Parin Lalwani

Keyword(s):

Chronic Pain ◽

Deep Brain Stimulation ◽

Neurological Diseases ◽

Anesthetic Management ◽

Case Series ◽

Review Of Literature ◽

Effective Treatment Option ◽

Laser Devices ◽

Deep Brain

Deep Brain Stimulation (DBS) can be an effective treatment option for patients with essential tremors, Parkinson’s disease, dystonia, epilepsy, chronic pain, major depression, and its role is being evaluated in a variety of other neurological diseases. Anesthesia concerns take into account the primary pathology for which the device was inserted, assessment of device functioning and its interference with diathermy, electrical electromagnetic, ultrasound, and laser devices used perioperatively for different purposes. We discuss anesthetic management with a brief review of two cases with DBS device In Situ.

Download Full-text

Factors affecting the incidence of chronic pain following breast cancer surgery: Preoperative history, anesthetic management, and surgical technique

Journal of Surgical Oncology ◽

10.1002/jso.26176 ◽

2020 ◽

Vol 122 (7) ◽

pp. 1307-1314

Author(s):

Jack M. Berger ◽

Yaroslava Longhitano ◽

Christian Zanza ◽

Stephen F. Sener

Keyword(s):

Breast Cancer ◽

Chronic Pain ◽

Surgical Technique ◽

Anesthetic Management ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Factors Affecting

Download Full-text

Perioperative management of opioid-tolerant chronic pain patients

Journal of Opioid Management ◽

10.5055/jom.2006.0052 ◽

2006 ◽

Vol 2 (6) ◽

pp. 353 ◽

Cited By ~ 8

Author(s):

Dima Rozen, MD ◽

Noah P. DeGaetano, MD

Keyword(s):

Chronic Pain ◽

Personal Experience ◽

Clinical Utility ◽

Perioperative Management ◽

Anesthetic Management ◽

Chronic Pain Management ◽

Opioid Use ◽

Chronic Pain Patients ◽

The Impact ◽

Pain Patients

Opioids occupy a position of unsurpassed clinical utility in the treatment of many types of painful conditions. In recent years there has been a noticeable shift regarding the use of opioids for the treatment of both benign and malignancy-related pain. As acceptance of the prescribing of opioids for chronically painful conditions has grown, many more opioid-tolerant patients are presenting for surgical procedures. It is therefore imperative that practicing anesthesiologists become familiar with currently available opioid formulations, including data regarding drug interactions and side effects, in order to better plan for patients’ perioperative anesthetic needs and management. Unfortunately, there is a lack of scientifically rigorous studies in this important area, and most information must be derived from anecdotal reports and the personal experience of anesthesiologists working in this field. In this review, we shall discuss current chronic pain management and the impact of opioid use and tolerance on perioperative anesthetic management.

Download Full-text