scholarly journals New Thoracotomy Closure, a Simple Way to Decrease Chronic Post-Operative Pain in Selected Patients—Blinded Prospective Study

2021 ◽  
Vol 11 (10) ◽  
pp. 1007
Author(s):  
Ioan Adrian Petrache ◽  
Cristian Oancea ◽  
Elisei Moise Hasan ◽  
Octavian Constantin Neagoe ◽  
Emanuela Tudorache ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Randomized Study ◽  
Pain Syndrome ◽  
Intercostal Nerve ◽  
Mean Value ◽  
Ease Of Use ◽  
Pain Level ◽  
Closure Technique ◽  
Strong Argument ◽  
Post Operative Pain

Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS) is a very common and uncomfortable complication, occurring frequently after thoracic operations, leading to the necessity of further medication and hospitalizations. One important risk factor in developing chronic pain is the chest closure technique, which can lead to chronic intercostal nerve damage. This study proposes an alternative nerve-sparring closure technique to standard peri-costal sutures, aimed toward minimizing the risk of chronic pain in selected patients. Materials and Methods: We performed a prospective randomized study on 311 patients operated for various thoracic pathology over a period of 12 months, evaluating incision types, chest closure technique, and number of drains with drainage duration. The patients were divided into three groups: peri-costal (PC), proposed extra-costal (EC), and simple (SC) suture, respectively. Pain was measured on day 1, 2, 5, 7, and at 6 months post-operatively using the Visual Analogic Scale. Results: No significant differences in pain level were recorded in the first two post-operative days between the PC and EC groups. However, a significant decrease in pain level was observed on day 5 and at 6 months post-operatively, with a mean level of 3.5 ± 1.8, 1.2 ± 1 for the EC group compared to a mean value of 5.3 ± 1.6, 3.2 ± 1.5, respectively. No significant differences were observed regarding other evaluated variables. Conclusions: The lower recorded pain scores in patients with extra-costal chest closure are a strong argument to use this technique. Its ease of use is similar to the classic peri-costal closure, and the time needed to perform it is not significantly increased. The association of this technique with less invasive procedures and short drainage duration limits chronic post-operative pain. This procedure may represent an option for decreasing healthcare costs associated with the management of PTPS.

scholarly journals Post – operative analgesia in patients under thoracotomy

2019 ◽  
Vol 2 (1) ◽  
pp. 7
Author(s):  
Evangelos Giavasopoulos
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Pain Control ◽  
Postoperative Morbidity ◽  
Significant Risk ◽  
Pain Syndrome ◽  
Multimodal Approach ◽  
Postoperative Pain Control ◽  
Post Operative Pain ◽  
Respiratory Physiotherapy

The thoracotomy is one of the most painful surgery operations, and the final outcome is directly associated with the postoperative pain control, because it allows quick mobilization, intense respiratory physiotherapy and reduces postoperative morbidity. Unfortunately, patients under thoracotomy, incur a significant risk of chronic pain. Although there are guidelines for the management of post-operative pain relief in these patients, however there is no widespread surgical or anesthetic "gold standard."  In the present article it has been investigated the current literature related to the proposed therapies and other interventions that were recommended for  post-operative pain relief  after thoracotomy. The treatment of chronic pain after thoracotomy is difficult and includes physical rehabilitation techniques and multimodal approach. More and more researchers support that minimization of acute post-operative pain is the best method so as to avoid, prevent or reduce post- thoracotomy pain syndrome.

scholarly journals The Effect of Psychodrama on Fibromyalgia Syndrome: A Case Report

2021 ◽  
Vol 8 (4) ◽  
pp. 237-245
Author(s):  
Özlem ŞENER
Keyword(s):  
Chronic Pain ◽  
Case Report ◽  
Chest Pain ◽  
Group Psychotherapy ◽  
Fibromyalgia Syndrome ◽  
Pain Syndrome ◽  
Pain Level ◽  
Chronic Pain Syndrome ◽  
Physical Methods ◽  
Informed Consent Form

Fibromyalgia Syndrome (FMS) is a chronic pain syndrome that often coexists with common musculoskeletal pain, sleep disorders, bowel syndrome, mood disorders, and fatigue. Although the aetiology of FMS pain has not been elucidated yet, psychotherapy methods are used in addition to physical methods to treat these pains.  This study aims to examine the effect of psychodrama on a 62-year-old patient with back and chest pain and who lived alone.  This patient participated in psychodrama group psychotherapy with 8 members who were all female and diagnosed with FMS. An informed consent form was obtained from the case for the study. This research is important because there are very few studies on fibromyalgia complaints with psychodrama group therapy, and it contributes to the literature. Studying the case with past trauma and losses in the psychodrama scene has led to a significant reduction in fibromyalgia complaints. As a result, the patient's pain level decreased from 90% to 32.5%, and the anxiety level decreased from advanced to normal. Thus, psychodrama group psychotherapy was found to be effective in reducing FMS pain.

CHRONIC PAIN SYNDROME IN PEDIATRIC ONCOLOGICAL PALLIATIVE PATIENTS IN RUSSIA

2019 ◽  
Vol 98 (1) ◽  
pp. 115-121
Author(s):  
A.V. Pshonkin ◽  
◽  
I.V. Serkova ◽  
N.V. Myakova ◽  
N.N. Kotskaya ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Palliative Patients

scholarly journals Prospects for the Personalized Multimodal Therapy Approach to Pain Management via Action on NO and NOS

Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2431
Author(s):  
Natalia A. Shnayder ◽  
Marina M. Petrova ◽  
Tatiana E. Popova ◽  
Tatiana K. Davidova ◽  
Olga P. Bobrova ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Molecular Genetic ◽  
Pain Syndrome ◽  
Medical Problem ◽  
Single Nucleotide Variants ◽  
Genetic Studies ◽  
Pain Syndromes ◽  
Nos Inhibitors ◽  
Peripheral Pain

Chronic pain syndromes are an important medical problem generated by various molecular, genetic, and pathophysiologic mechanisms. Back pain, neuropathic pain, and posttraumatic pain are the most important pathological processes associated with chronic pain in adults. Standard approaches to the treatment of them do not solve the problem of pain chronicity. This is the reason for the search for new personalized strategies for the prevention and treatment of chronic pain. The nitric oxide (NO) system can play one of the key roles in the development of peripheral pain and its chronicity. The purpose of the study is to review publications devoted to changes in the NO system in patients with peripheral chronical pain syndromes. We have carried out a search for the articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, and Google Scholar databases. The search was carried out using keywords and their combinations. The role of NO and NO synthases (NOS) isoforms in peripheral pain development and chronicity was demonstrated primarily from animal models to humans. The most studied is the neuronal NOS (nNOS). The role of inducible NOS (iNOS) and endothelial NOS (eNOS) is still under investigation. Associative genetic studies have shown that single nucleotide variants (SNVs) of NOS1, NOS2, and NOS3 genes encoding nNOS, iNOS, and eNOS may be associated with acute and chronic peripheral pain. Prospects for the use of NOS inhibitors to modulate the effect of drugs used to treat peripheral pain syndrome are discussed. Associative genetic studies of SNVs NOS1, NOS2, and NOS3 genes are important for understanding genetic predictors of peripheral pain chronicity and development of new personalized pharmacotherapy strategies.

scholarly journals Persistent Spinal Pain Syndrome: a proposal for Failed Back Surgery Syndrome and ICD-11

Pain Medicine ◽  
2021 ◽  
Author(s):  
Nick Christelis ◽  
Brian Simpson ◽  
Marc Russo ◽  
Michael Stanton-Hicks ◽  
Giancarlo Barolat ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Spine Surgery ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Failed Back Surgery Syndrome ◽  
Medical Professionals ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Spinal Pain Syndrome

Abstract Objective For many medical professionals dealing with patients with persistent pain following spine surgery, the term failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading and potentially troublesome. It misrepresents causation. Alternative terms have been suggested but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS. Methods This article provides arguments and rationale for a replacement definition. In order to propose a broadly applicable yet more precise and clinically informative term, an international group of experts was established. Results 14 candidate replacement terms were considered and ranked. The application of agreed criteria reduced this to a shortlist of four. A preferred option – Persistent spinal pain syndrome – was selected by a structured workshop and Delphi process. We provide rationale for using Persistent spinal pain syndrome and a schema for its incorporation into ICD-11. We propose the adoption of this term would strengthen the new ICD-11 classification. Conclusions This project is important to those in the fields of pain management, spine surgery and neuromodulation, as well as patients labelled with FBSS. Through a shift in perspective it could facilitate the application of the new ICD-11 classification and allow clearer discussion amongst medical professionals, industry, funding organisations, academia, and the legal profession.

Article Commentary: Pain after Mastectomy and Breast Reconstruction

2008 ◽  
Vol 74 (4) ◽  
pp. 285-296 ◽  
Author(s):  
Nalini Vadivelu ◽  
Maggie Schreck ◽  
Javier Lopez ◽  
Gopal Kodumudi ◽  
Deepak Narayan
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Minimally Invasive ◽  
Breast Reconstruction ◽  
Sentinel Node ◽  
Breast Cancer Surgery ◽  
Phantom Pain ◽  
Preventative Measures ◽  
Pain Syndromes ◽  
Post Operative Pain

Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer has increased. However, pain after breast cancer surgery is a major problem and women undergoing mastectomy and breast reconstruction experience postoperative pain syndromes in approximately one-half of all cases. Patients post mastectomy and breast reconstruction can suffer from acute nociceptive pain and chronic neuropathic pain syndromes. Several preventative measures to control acute post operative pain and chronic pain states such as post mastectomy pain and phantom pain have been tried. This review focuses on the recent research done to control acute and chronic pain in patients receiving minimally invasive therapies for breast cancer, such as breast conserving therapies of mastectomies and breast reconstruction, sentinel node biopsies, and early treatments of radiation and chemotherapy.

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