Clavipectoral plane block as a sole anesthetic technique for clavicle surgery - A case report -

Background: The clavipectoral fascial plane block was introduced by Dr. Luis Valdes in a symposium at the 2017 European Society of Regional Anesthesia and Pain Therapy Congress. Case: Clavipectoral plane block (CPB) with intravenous sedation provided surgical anesthesia and analgesia in a 39-year-old male patient with a right midshaft clavicle fracture. This in-plane technique was used to deposit 30 ml of a local anesthesia mixture between the clavipectoral fascia and periosteum on both the medial and lateral sides of the fracture line. Conclusions: Excellent anesthesia and analgesia for up to 16 h post-block were provided by CPB during the clavicle surgery.

Penerapan Mendengarkan Murottal Untuk Menurunkan Nyeri Dismenore Pada Remaja

Dsymenorrhea is pain in the abdomen which comes from uterine cramps and it occurs during menstruation. One of non-pharmacological therapies to overcome pain is by listening murottal surah Ar-Rahman. This study aims to apply the therapy in the order to reduce the pain in adolescent. It focused on 6 teenagers who had dysmenorrhea pain when getting menstruation. The result stated before appiying the method, they got pain in scale 7-8. Then after appiying murottal listening, this pain reduced into scale 0-3. The conclusion is by listening murottal expected for the teenagers who have this pain to listen murottal. Murottal listening therapy that is done by each member of the special group for teenagers has different declines. Suggestions for members of special groups for adolescents for patients are expected to be able to overcome pain by applying murottal listening according to what has been taught.Keywords: Dysmenorrhea; pain; therapy off murottal AbstrakDismenore merupakan nyeri pada bagian perut yang berasal dari kram rahim dan terjadi selama menstruasi. Terapi nonfarmakologi untuk mengatasi dismenore yaitu dengan mendengarkan murottal surat Ar-Rahman. Tujuan studi kasus adalah menerapkan terapi murottal untuk menurunkan nyeri dismenore pada remaja. Fokus studi kasus ini adalah menerapkan terapi murottal pada remaja yang mengalami dismenore dengan anggota kelompok 6 orang. Hasil penurunan skala nyeri yang sebelum dilakukan terapi murottal 7-8, setelah mendengarkan murottal Ar-rahman skala nyeri turun 0-3. Kesimpulannya adalah mendengarkan murottal dapat menurunkan nyeri dismenore pada anggota kelompok khusus remaja. Terapi mendengarkan murottal yang dilakukan setiap anggota kelompok khusus remaja penurunannya berbeda-beda. Saran bagi anggota kelompok khusus remaja bagi pasien diharapkan dapat mengatasi nyeri dengan penerapan mendengarkan murottal sesuai yang telah diajarkan.Kata kunci: Dismenore; nyeri; terapi murottal

Mindfulness Meditation for the Treatment of Chronic Low Back Pain: A Preliminary Quasi-randomized Controlled Pilot Study

Objective: To investigate the effectiveness of Mindfulness-Based Pain Therapy (MBPT) a treatment combining mindfulness meditation and several interventions taken from cognitive therapy within the frame of the multimodal pain therapy program, in patients suffering from chronic low back pain (CLBP).Design: A quasi-randomized case-control study. Subjects: The study included 20 subjects with chronic low back pain were recruited and quasi-randomly allocated to a standard multimodal pain therapy (n=10) or to a multimodal pain therapy group with MBPT (n=10). The intervention was identical for both groups except for the mindfulness meditation program.Methods. Both groups participated in a 4-week training, 5 times/week. All subjects underwent the same measurement protocol before and after the intervention. The program was evaluated on the basis of measure of pain, quality of life, disability, pain catastrophizing and depression. Results: The trial group displayed significant reduction in pain intensity, improvement in the quality of life, reduction in pain disability, in depression and pain catastrophizing. Conclusion: The study indicated that mindfulness meditation can influence the treatments and lead to a significant improvement in the overall result of the multimodal pain therapy.

Autosuggestion: a cognitive process that empowers your brain?

Autosuggestion is a cognitive process that is believed to enable control over one’s own cognitive and physiological states. Despite its potential importance for basic science and clinical applications, such as in rehabilitation, stress reduction, or pain therapy, the neurocognitive mechanisms and psychological concepts that underlie autosuggestion are poorly defined. Here, by reviewing empirical data on autosuggestion and related phenomena such as mental imagery, mental simulation, and suggestion, we offer a neurocognitive concept of autosuggestion. We argue that autosuggestion is characterized by three major factors: reinstantiation, reiteration, and volitional, active control over one’s own physiological states. We also propose that autosuggestion might involve the ‘overwriting’ of existing predictions or brain states that expect the most common (but not desired) outcome. We discuss potential experimental paradigms that could be used to study autosuggestion in the future, and discuss the strengths and weaknesses of current evidence. This review provides a first overview on how to define, experimentally induce, and study autosuggestion, which may facilitate its use in basic science and clinical practice.

The Kynurenine Pathway as a Potential Target for Neuropathic Pain Therapy Design: From Basic Research to Clinical Perspectives

Accumulating evidence suggests the key role of the kynurenine pathway (KP) of the tryptophan metabolism in the pathogenesis of several diseases. Despite extensive research aimed at clarifying the mechanisms underlying the development and maintenance of neuropathic pain, the roles of KP metabolites in this process are still not fully known. Although the function of the peripheral KP has been known for several years, it has only recently been acknowledged that its metabolites within the central nervous system have remarkable consequences related to physiology and behavior. Both the products and metabolites of the KP are involved in the pathogenesis of pain conditions. Apart from the neuroactive properties of kynurenines, the KP regulates several neurotransmitter systems in direct or indirect ways. Some neuroactive metabolites are known to have neuroprotective properties (kynurenic acid, nicotinamide adenine dinucleotide cofactor), while others are toxic (3-hydroxykynurenine, quinolinic acid). Numerous animal models show that modulation of the KP may turn out to be a viable target for the treatment of diseases. Importantly, some compounds that affect KP enzymes are currently described to possess analgesic properties. Additionally, kynurenine metabolites may be useful for assessing response to therapy or as biomarkers in therapeutic monitoring. The following review describes the molecular site of action and changes in the levels of metabolites of the kynurenine pathway in the pathogenesis of various conditions, with a particular emphasis on their involvement in neuropathy. Moreover, the potential clinical implications of KP modulation in chronic pain therapy as well as the directions of new research initiatives are discussed.