Subjects -> MEDICAL SCIENCES (Total: 8697 journals)
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ANAESTHESIOLOGY (121 journals)                     

Showing 1 - 121 of 121 Journals sorted alphabetically
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 62)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 16)
Advances in Anesthesia     Full-text available via subscription   (Followers: 31)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 9)
Ain-Shams Journal of Anaesthesiology     Open Access   (Followers: 2)
Ain-Shams Journal of Anesthesiology     Open Access   (Followers: 1)
Ambulatory Anesthesia     Open Access   (Followers: 9)
Anaesthesia     Hybrid Journal   (Followers: 242)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 72)
Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 62)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 28)
Anaesthesia Reports     Hybrid Journal  
Anaesthesia, Pain & Intensive Care     Open Access  
Anaesthesiology Intensive Therapy     Open Access   (Followers: 9)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 7)
Anestesia Analgesia Reanimación     Open Access   (Followers: 1)
Anestesia en México     Open Access   (Followers: 1)
Anesthesia & Analgesia     Hybrid Journal   (Followers: 276)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Anesthesia Progress     Hybrid Journal   (Followers: 6)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology     Hybrid Journal   (Followers: 233)
Anesthesiology and Pain Medicine     Open Access   (Followers: 23)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25)
Anesthesiology Research and Practice     Open Access   (Followers: 15)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Annales Françaises d'Anesthésie et de Réanimation     Full-text available via subscription   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 15)
BDJ Team     Open Access   (Followers: 1)
Best Practice & Research Clinical Anaesthesiology     Hybrid Journal   (Followers: 15)
BJA : British Journal of Anaesthesia     Hybrid Journal   (Followers: 245)
BJA Education     Hybrid Journal   (Followers: 70)
BMC Anesthesiology     Open Access   (Followers: 18)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 47)
Brazilian Journal of Anesthesiology     Open Access   (Followers: 5)
Brazilian Journal of Anesthesiology (Edicion en espanol)     Open Access  
Brazilian Journal of Anesthesiology (English edition)     Open Access   (Followers: 1)
Brazilian Journal of Pain (BrJP)     Open Access  
British Journal of Pain     Hybrid Journal   (Followers: 28)
Canadian Journal of Anesthesia/Journal canadien d'anesthésie     Hybrid Journal   (Followers: 48)
Case Reports in Anesthesiology     Open Access   (Followers: 11)
Clinical Journal of Pain     Hybrid Journal   (Followers: 19)
Colombian Journal of Anesthesiology : Revista Colombiana de Anestesiología     Hybrid Journal   (Followers: 1)
Current Anaesthesia & Critical Care     Full-text available via subscription   (Followers: 36)
Current Anesthesiology Reports     Hybrid Journal   (Followers: 4)
Current Opinion in Anaesthesiology     Hybrid Journal   (Followers: 61)
Current Pain and Headache Reports     Hybrid Journal   (Followers: 2)
Der Anaesthesist     Hybrid Journal   (Followers: 9)
Der Schmerz     Hybrid Journal   (Followers: 4)
Der Schmerzpatient     Hybrid Journal  
Douleur et Analgésie     Hybrid Journal  
Egyptian Journal of Anaesthesia     Open Access   (Followers: 3)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
EMC - Anestesia-Reanimación     Hybrid Journal  
EMC - Anestesia-Rianimazione     Hybrid Journal  
EMC - Urgenze     Full-text available via subscription  
European Journal of Anaesthesiology     Hybrid Journal   (Followers: 30)
European Journal of Pain     Full-text available via subscription   (Followers: 27)
European Journal of Pain Supplements     Full-text available via subscription   (Followers: 5)
Global Journal of Anesthesiology     Open Access   (Followers: 2)
Headache The Journal of Head and Face Pain     Hybrid Journal   (Followers: 5)
Indian Journal of Anaesthesia     Open Access   (Followers: 7)
Indian Journal of Pain     Open Access   (Followers: 2)
Indian Journal of Palliative Care     Open Access   (Followers: 8)
International Anesthesiology Clinics     Hybrid Journal   (Followers: 9)
International Journal of Clinical Anesthesia and Research     Open Access  
Itch & Pain     Open Access   (Followers: 2)
JA Clinical Reports     Open Access  
Journal Club Schmerzmedizin     Hybrid Journal  
Journal of Anesthesia & Clinical Research     Open Access   (Followers: 10)
Journal of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8)
Journal of Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Anesthesia History     Full-text available via subscription   (Followers: 1)
Journal of Anesthesiology and Clinical Science     Open Access   (Followers: 1)
Journal of Cellular and Molecular Anesthesia     Open Access  
Journal of Clinical Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Critical Care     Hybrid Journal   (Followers: 42)
Journal of Headache and Pain     Open Access   (Followers: 3)
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Neurosurgical Anesthesiology     Hybrid Journal   (Followers: 8)
Journal of Obstetric Anaesthesia and Critical Care     Open Access   (Followers: 22)
Journal of Pain     Hybrid Journal   (Followers: 19)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 45)
Journal of Pain Research     Open Access   (Followers: 10)
Journal of Palliative Care     Full-text available via subscription   (Followers: 20)
Journal of Society of Anesthesiologists of Nepal     Open Access   (Followers: 2)
Journal of the Bangladesh Society of Anaesthesiologists     Open Access  
Jurnal Anestesi Perioperatif     Open Access  
Jurnal Anestesiologi Indonesia     Open Access  
Karnataka Anaesthesia Journal     Open Access   (Followers: 2)
Le Praticien en Anesthésie Réanimation     Full-text available via subscription   (Followers: 2)
Local and Regional Anesthesia     Open Access   (Followers: 8)
Medical Gas Research     Open Access   (Followers: 3)
Medycyna Paliatywna w Praktyce     Open Access   (Followers: 1)
OA Anaesthetics     Open Access   (Followers: 3)
Open Anesthesia Journal     Open Access  
Open Journal of Anesthesiology     Open Access   (Followers: 10)
Pain     Hybrid Journal   (Followers: 61)
Pain Clinic     Hybrid Journal   (Followers: 1)
Pain Management     Hybrid Journal   (Followers: 18)
Pain Medicine     Hybrid Journal   (Followers: 13)
Pain Research and Management     Open Access   (Followers: 7)
Pain Research and Treatment     Open Access   (Followers: 2)
Pain Studies and Treatment     Open Access   (Followers: 2)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Revista Chilena de Anestesia     Open Access   (Followers: 1)
Revista Colombiana de Anestesiología     Open Access   (Followers: 1)
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista da Sociedade Portuguesa de Anestesiologia     Open Access  
Revista Española de Anestesiología y Reanimación     Hybrid Journal  
Revista Española de Anestesiología y Reanimación (English Edition)     Full-text available via subscription   (Followers: 2)
Romanian Journal of Anaesthesia and Intensive Care     Open Access   (Followers: 1)
Saudi Journal of Anaesthesia     Open Access   (Followers: 7)
Scandinavian Journal of Pain     Hybrid Journal   (Followers: 1)
Southern African Journal of Anaesthesia and Analgesia     Open Access   (Followers: 8)
Sri Lankan Journal of Anaesthesiology     Open Access   (Followers: 2)
Survey of Anesthesiology     Full-text available via subscription   (Followers: 12)
Techniques in Regional Anesthesia and Pain Management     Hybrid Journal   (Followers: 11)
Topics in Pain Management     Full-text available via subscription   (Followers: 2)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)

           

Similar Journals
Journal Cover
Current Pain and Headache Reports
Journal Prestige (SJR): 0.738
Citation Impact (citeScore): 3
Number of Followers: 2  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1534-3081 - ISSN (Online) 1531-3433
Published by Springer-Verlag Homepage  [2626 journals]
  • Neurogenic Claudication: a Review of Current Understanding and Treatment
           Options
    • Abstract: Purpose of Review With an aging population and increased prevalence of the disease, we set out to evaluate the validity of current diagnostic criteria for neurogenic claudication as well as the efficacy of the treatment options for the main cause, lumbar spinal stenosis (LSS). Recent Findings Epidural steroid injections (ESI) were most efficacious when the injectate is a steroid combined with lidocaine or lidocaine only. There are promising results regarding the efficacy of the minimally invasive lumbar decompression (MILD) procedure as well as interspinous process spacers (IPS) compared to surgical alternatives. Spinal cord stimulators are gaining ground as an effective alternative to surgery in patients with lumbar spinal stenosis that is not responsive to conservative measures or epidural injections. Summary We found that there continues to be a lack of consensus on the diagnostic criteria, management, and treatment options for patients with LSS. The Delphi consensus is the most current recommendation to assist clinicians with making the diagnosis. Physical therapy, NSAIDs, gabapentin, and other conservative therapy measures are unproven in providing long-lasting relief. In patients with radicular symptoms, an ESI may be indicated when a combination of lidocaine with steroids is used or using lidocaine alone. In addition, there is not enough high-quality evidence to make a recommendation regarding the use of MILD versus interspinous spacers for neurogenic claudication. There remains a need for high-quality evidence regarding the efficacy of different conservative treatments, interventional procedures, and surgical outcomes in patients with neurogenic claudication in LSS.
      PubDate: 2019-03-19
       
  • The Utilization of Mu-Opioid Receptor Biased Agonists: Oliceridine, an
           Opioid Analgesic with Reduced Adverse Effects
    • Abstract: Purpose of Review The purpose of this review is to summarize the current understanding of opioid pathways in mediating and/or modulating analgesia and adverse effects. Oliceridine is highlighted as a novel mu-opioid receptor agonist with selective activation of G protein and β-arrestin signaling pathways. Recent Findings Oliceridine (TRV130; [(3-methoxythiophen-2-yl)methyl]({2-[(9R)-9-(pyridin-2-yl)-6-oxaspiro[4.5]decan-9-yl]ethyl})amine) is a novel MOR agonist that selectively activates G protein and β-arrestin signaling pathways. A growing body of evidence suggests that compared to existing MOR agonists, Oliceridine and other G protein-selective modulators may produce therapeutic analgesic effects with reduced adverse effects. Summary Oliceridine provides analgesic benefits of a pure opioid agonist while limiting related adverse effects mediated through the β-arrestin pathway. Recent insights into the function and structure of G protein-coupled receptors has led to the development of novel analgesic therapies.
      PubDate: 2019-03-18
       
  • The Hypertensive Headache: a Review
    • Abstract: Purpose of Review The purpose of this review is to provide an overview and update on the common causes of headache attributed to arterial hypertension with a focus on secondary headache disorders. We will also highlight uncommon and recent findings in this area of research. Recent Findings There is some controversy in the relationship between chronic hypertension and headache, particularly migraine; recent research suggests that there may be a link, but it is likely complex and multifactorial. Many recent studies and case reports demonstrate that the pathophysiology underlying the onset of headache as it relates to abrupt rises in blood pressure seems to lie at the cellular level and mechanically becomes an issue with disruption of the blood-brain barrier. Although not a formally defined headache entity, carotid revascularization syndrome demonstrates this phenomenon and also has a recent set of proposed criteria that include headache and elevated blood pressure. Summary This paper reviews the various etiologies of hypertensive headaches, mostly in regard to headache as a secondary symptom of elevated blood pressure. We will also discuss trends of hypertensive headache in pregnancy. Finally, we will touch on controversy that exists in relation to chronic hypertension and its causal relationship to headache as well as the relationship between hypertension and migraine.
      PubDate: 2019-03-14
       
  • Spinal Cord Stimulation: Comparing Traditional Low-frequency Tonic
           Waveforms to Novel High Frequency and Burst Stimulation for the Treatment
           of Chronic Low Back Pain
    • Abstract: Purpose of Review The purpose of the present investigation is to summarize supporting evidence for novel sub-perception spinal cord stimulation (SCS) therapy over traditional paresthesia inducing low-frequency waveforms for the treatment of chronic pain. The focus of this review is to summarize key studies comparing traditional low-frequency tonic waveforms to modern high frequency and burst stimulation for the treatment of patients with chronic intractable low back pain and/or leg pain. Recent Findings Several recent studies have demonstrated the benefit of novel SCS therapies over traditional low-frequency SCS for the treatment of patients with chronic low back and/or leg pain. SENZA-RTC showed that paresthesia-free high-frequency SCS was superior to low-frequency stimulation for treatment of chronic low back pain with leg pain. The SUNBURST crossover trial recently found that high-frequency burst stimulation was preferred over low-frequency tonic SCS with patients citing better pain relief and a preference for paresthesia-free SCS. The new ongoing EVOLVE workflow retrospective multicenter study uses technology that can deliver both low-dose and high-dose SCS. Further, the wavewriter technology addresses patient variability with its ability to layer sub-perception waveforms and paresthesia inducing low-frequency stimulation tailored to patient needs via an interactive feedback feature. Summary Neuromodulation for the treatment of chronic pain is rapidly evolving with technology at its forefront. Modern SCS systems use novel waveforms, frequencies, and stimulation modes to deliver paresthesia-free pain relief to patients suffering from chronic low back pain and/or leg pain with better results than traditional tonic low-frequency SCS. As the field advances, new studies are needed comparing new waveform and delivery systems to optimize patient selection and treatment response.
      PubDate: 2019-03-14
       
  • Enhanced Recovery for Breast Reconstruction Surgery
    • Abstract: Purpose of Review Enhanced recovery pathways are a well-described perioperative healthcare program involving evidence-based interventions. Enhanced recovery is designed to standardize techniques such as drug selection and nerve blocks in order to speed recovery and reduce overall hospital costs. Recent Findings A PubMed literature search was performed for articles that included the terms enhanced recovery and breast reconstruction surgery. The present investigation summarizes enhanced recovery literature related to breast surgery with a focus on breast reconstruction. Summary Enhanced recovery considerations discussed in this review include patient education, preadmission optimization, perforator flap planning, anesthetic techniques, optimized fasting, venous thrombosis prophylaxis, early mobilization, and antimicrobial prophylaxis.
      PubDate: 2019-03-14
       
  • Enhanced Recovery Pathways for Cardiac Surgery
    • Abstract: Purpose of Review Enhanced recovery after surgery (ERAS) has become a widespread topic in perioperative medicine over the past 20 years. The goals of ERAS are to improve patient outcomes and perioperative experience, reduce length of hospital stay, minimize complications, and reduce cost. Interventions and factors before, during, and after surgery all potentially play a role with the cumulative effect being superior quality of patient care. Recent Findings Preoperatively, patient and family education, optimization of nutritional status, and antibiotic prophylaxis all improve outcomes. Recovery is also expedited by the use of multimodal analgesia, regional anesthesia, and opioid reducing approaches. Intraoperatively, the anesthesiologist can have an impact by using less-invasive monitors appropriately to guide fluid and hemodynamic management as well as maintaining normothermia. Postoperatively, early enteral feeding, mobilization, and removal of invasive lines support patient recovery. Implementation of ERAS protocol in cardiac surgery faces challenges by some unique perioperative perspectives in cardiac surgery, such as systemic anticoagulation, use of cardiopulmonary bypass, significantly more hemodynamic variations, larger volume replacement, postoperative intubation and mechanical ventilation and associated sedation, and potentially significantly more co-existing morbidities than other surgical procedures. Summary ERAS in cardiac surgery may benefit patients more related to its high risk and high cost nature. This manuscript specifically reviews the unique aspects of enhanced recovery in cardiac surgery.
      PubDate: 2019-03-14
       
  • Regional Catheters for Outpatient Surgery—a Comprehensive Review
    • Abstract: Purpose of Review This review summarizes and discusses the history of continuous catheter blockade (CCB), its current applications, clinical considerations, economic benefits, potential complications, patient education, and best practice techniques. Recent Findings Regional catheters for outpatient surgery have greatly impacted acute post-operative pain management and recovery. Prior to development, options for acute pain management were limited to the use of opioid pain medications, NSAIDS, neuropathic agents, and the like as local anesthetic duration of action is limited to 4–8 h. Moreover, delivery of opioids post-operatively has been associated with respiratory and central nervous depression, development of opioid use disorder, and many other potential adverse effects. CCB allows for faster recovery time, decreased rates of opioid abuse, and better pain control in patients post-operatively. Summary Outpatient surgical settings continue to focus on efficiency, quality, and safety, including strategies to prevent post-operative nausea, vomiting, and pain. Regional catheters are a valuable tool and help achieve all of the well-established endpoints of enhanced recovery after surgery (ERAS). CCB is growing in popularity with wide indications for a variety of surgeries, and has demonstrated improved patient satisfaction, outcomes, and reductions in many unwanted adverse effects in the outpatient setting.
      PubDate: 2019-03-14
       
  • Current Approach to Undifferentiated Headache Management in the Emergency
           Department
    • Abstract: Purpose of Review To discuss pharmacological interventions in the emergency department (ED) setting for the management of acute primary headache. Recent Findings Acute headache treatment in the ED has seen an expansion in terms of possible pharmacological interventions in recent years. After a thorough evaluation ruling out dangerous causes of headache, providers should take the patient’s history, comorbidities, and prior therapy into consideration. Summary Antidopaminergics have an established role in the management of acute, severe, headache with manageable side-effect profiles. However, recent studies suggest anesthetic and anti-epileptic drugs may play roles in headache treatment in the ED. Current literature also suggest steroids as a promising tool for emergency department clinicians combating the readmission of patients with recurrent headaches. Emergency medicine providers must be cognizant of these traditional and emerging therapies in order to optimize the care of headache patients.
      PubDate: 2019-03-14
       
  • CGRP Antagonists for the Treatment of Chronic Migraines: a Comprehensive
           Review
    • Abstract: Purpose of Review The purpose of the following review is to summarize the most recent understanding of migraine pathophysiology, as well as of basic and clinical science pharmacologic literature regarding the development of calcitonin gene receptor peptide (CGRP) antagonists as a novel therapeutic modality for the treatment of migraine headaches. A review is provided of erenumab, the first of its class FDA approved CGRP antagonist. Recent Findings Despite its high prevalence, the occurrence and treatment of migraine headaches is poorly understood. Erenumab and CGRP antagonists as a whole significantly reduce the average number of migraine days experienced in migraine sufferers. Summary CGRP antagonists appear to significantly improve treatment outcomes in patients who suffer from episodic and chronic migraines. Erenumab is the first CGRP antagonist to be FDA approved for public use; however, further development of biologics in this class is underway.
      PubDate: 2019-03-14
       
  • Essential Elements for Enhanced Recovery After Intra-abdominal Surgery
    • Abstract: Purpose of Review Enhanced recovery pathways provide a framework outlining the best perioperative care for intra-abdominal surgical procedures. To date, no evidence-based umbrella guidelines exist for all intra-abdominal surgeries. Recent Findings A PubMed and worldwide web search was performed with the keywords: “ERAS,” “enhanced recovery after surgery”, ± “protocol.” Manuscripts addressing intra-abdominal procedures were selected, resulting in studies with the date range: 2012–2017. The basic philosophy behind enhanced recovery is the realization that a traditional hospital works in silos that need to be broken to ensure a care protocol that follows and optimizes the journey the patient makes during the perioperative care. Enhanced recovery interventions can be categorized into preoperative, perioperative, and postoperative interventions. By design, each intervention is planned and coordinated by a multidisciplinary ERAS team. Depending on the particular procedure and patient receiving the interventions, some of the interventions below may be more or less applicable. Summary In this review, the most common elements of ERAS protocols in intra-abdominal procedures are reviewed, particularly those which provided the best outcomes and are most generalizable to all intra-abdominal procedures.
      PubDate: 2019-03-11
       
  • Regenerative Techniques for Neuraxial Back Pain: a Systematic Review
    • Abstract: Purpose of Review Regenerative modalities have been identified in numerous clinical studies as beneficial in various settings. The focus of this review is to summarize key studies and current concepts for the role of regenerative medicine in the treatment of neuraxial back pain. Recent Findings Recent studies have demonstrated the benefit of regenerative therapies for the treatment of neuraxial back pain. A literature review of clinical trials published between 2015 and 2017 was performed using OVID, PubMed, and Google Scholar to identify investigations attempting to determine the efficacy of various regenerative modalities on two primary sources of low back pain: facet arthropathy and degenerative disc disease. The seven articles analyzed in this systematic review present promising data regarding the use of these autologous biologic treatments, but many of these investigations have several limitations in common including small sample size. Summary Regenerative medicine has been shown to demonstrate efficacy in the treatment of neuraxial back pain. As the field advances, new studies are needed comparing efficacy and safety profiles to better determine best practice techniques and standards in the future.
      PubDate: 2019-03-11
       
  • Analysis of Multiple Routes of Analgesic Administration in the Immediate
           Postoperative Period: a 10-Year Experience
    • Abstract: Purpose of Review An increasing amount of literature supports a multimodal approach to analgesic administration in the management of postoperative pain. The purpose of this study and review was to further evaluate the differences in efficacy in controlling immediate postoperative pain among the various routes of analgesia administration. Recent Findings This study consisted of an analysis of the various routes of analgesic administration (parental, neuraxial, and oral/rectal) in 107,671 consecutive surgical cases performed over a 10-year period at Yale New Haven Hospital. This study included variables of postoperative pain score at initial request for analgesic, pain score at discharge, nausea and vomiting in the post-anesthesia care unit, and gender. The most common route of administration of analgesia in our study was via the parenteral route (29,962), and the least common route was the neuraxial route (1319). There was a significant decrease in pain scores at the time of discharge in all three groups relative to the pain score at first request for analgesia. Summary Multimodal analgesia via various routes of administration targets numerous proponents of the nervous system with the intent to reduce the adverse side effects of the individual analgesics if given alone or as an additive to produce synergistic analgesia. Our study suggests that although all the routes investigated (parenteral, neuraxial (intrathecal/epidural), and per os or per rectum (PO/PR)) promote significant pain relief on discharge from the PACU, the group that received neuraxial analgesia reported the lowest incidence of nausea and vomiting.
      PubDate: 2019-03-11
       
  • Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and
           Treatment
    • Abstract: Purpose of Review Low back pain encompasses three distinct sources: axial lumbosacral, radicular, and referred pain. Annually, the prevalence of low back pain in the general US adult population is 10–30%, and the lifetime prevalence of US adults is as high as 65–80%. Recent Findings Patient history, physical exam, and diagnostic testing are important components to accurate diagnosis and identification of patient pathophysiology. Etiologies of low back pain include myofascial pain, facet joint pain, sacroiliac joint pain, discogenic pain, spinal stenosis, and failed back surgery. In chronic back pain patients, a multidisciplinary, logical approach to treatment is most effective and can include multimodal medical, psychological, physical, and interventional approaches. Summary Low back pain is a difficult condition to effectively treat and continues to affect millions of Americans every year. In the current investigation, we present a comprehensive review of low back pain and discuss associated pathophysiology, diagnosis, and treatment.
      PubDate: 2019-03-11
       
  • Pavlov’s Pain: the Effect of Classical Conditioning on Pain Perception
           and its Clinical Implications
    • Abstract: Purpose of Review It has been known for decades that classical conditioning influences pain perception. However, the precise relationship between conditioning and pain remains unclear. In addition, the clinical implications of their relationship are vastly underappreciated. Thus, we aim to (a) examine how conditioning increases or decreases pain sensitivity, (b) assess how conditioning contributes to the development and maintenance of chronic pain, and (c) explore strategies to utilize conditioning to optimize pain treatment. Recent Findings We first review studies regarding how classical conditioning alters pain perception with an emphasis on two phenomena where conditioning increases pain sensitivity (i.e., conditioned hyperalgesia) or decreases it (i.e., conditioned hypoalgesia). Specifically, we critically examine empirical studies about conditioned hyperalgesia and conditioned hypoalgesia, explore reasons why conditioning leads to these two seemingly opposite phenomena, and discuss the neural mechanisms behind them. We then highlight how conditioning contributes to the development and maintenance of chronic pain, and present neuroscientific evidence for maladaptive aversive conditioning in chronic pain patients. Moreover, we propose a framework for understanding how to exploit conditioning to optimize pain treatment, including minimizing conditioned hyperalgesia, maximizing conditioned hypoalgesia, and eliminating excessive fear and overgeneralization in chronic pain. Summary Classical conditioning profoundly modulates the experience of pain and affects the development and maintenance of chronic pain. The relationship between them has far-reaching clinical implications in pain treatment. Further investigations should tackle crucial issues in previous studies, including the complex relationship between conditioning and explicit expectation, and a lack of relevant clinical studies. Resolving these issues, future research would advance our understanding of the nature of pain, help relieve the suffering of patients, and thus contribute to promoting human flourishing.
      PubDate: 2019-03-05
       
  • Radiofrequency Ablation for Treating Headache
    • Abstract: Purpose of Review Examining the efficacy of radiofrequency ablation in treating headache conditions. Recent Findings The efficacy of radiofrequency ablation in treating headache conditions is not well studied. Summary Chronic headache conditions can be difficult to treat with little consensus on management of headaches associated with pericranial neuralgias. In this retrospective study, we found that radiofrequency ablation is an effective and safe treatment for resistant headache conditions. This study is important as it describes a novel treatment for chronic headache which can benefit a large number of patients.
      PubDate: 2019-03-04
       
  • Is There Support for the Paradigm ‘Spinal Posture as a Trigger for
           Episodic Headache’' A Comprehensive Review
    • Abstract: Purpose of Review The International Classification of Headache Disorders provides an extensive framework to classify headaches. Physiotherapy is indicated if neuromusculoskeletal dysfunctions are involved in the pathophysiology. Maladaptive postures seem a dominant trigger in tension-type and cervicogenic headache. Yet, outcomes following physiotherapy vary. The absence of protocol studies to identify determinants concerning the role of spinal posture in headache might explain such variability. Hence, multi-dimensional profiling of patients with headache based on interactions between spinal posture, psychosocial and lifestyle factors might be essential. Therefore, the aim of this paper was to perform a comprehensive review to find support for the paradigm of spinal posture triggering episodic headache based on a multi-dimensional view on tension-type and cervicogenic headache including modern pain neuroscience. Recent Findings A review was conducted to support spinal posture-induced episodic headache. Pubmed, Web of Science, Pedro and the Cochrane database were explored based on the following ‘Mesh’ or ‘Topics’: ‘Headache’, ‘Posture’, ‘Spine’, ‘Psychosocial’, ‘Lifestyle’. The contemporary review of neuroanatomical, biomechanical and non-nociceptive pathways, with integration of modern pain neuroscience in tension-type and cervicogenic headache, supports spinal posture as a trigger for episodic headache. Maladaptive postures can activate C1-C3 nociceptors. Convergence with trigeminal afferents at the trigeminocervical nucleus could explain spinal headache. Interactions with psychosocial and lifestyle factors might contribute to peripheral and central sensitisation. Summary Neuroanatomical, biomechanical and non-nociceptive pathways seem to justify profiling patients based on a postural trigger. Further research is needed to determine the contribution of postural dysfunctions in headache and the effect of specific interventions.
      PubDate: 2019-03-04
       
  • Current Therapeutic Interventions in Lower Extremity Venous Insufficiency:
           a Comprehensive Review
    • Abstract: Purpose of Review Chronic venous disease (CVD), although affecting up to 40% of the US population, is often underdiagnosed by healthcare professionals due to an incomplete understanding of the presenting symptoms. CVD is a common cause of lower extremity pain and discomfort, including aching, cramping, tingling, burning, swelling, heaviness, restlessness, and fatigue, and may lead to significant morbidity if left untreated. The negative impact of CVD on quality of life is well established and the optimization of management strategies is an important area of evolving research. Recent Findings Management of CVD has rapidly evolved over the last two decades with the development of minimally invasive endovenous ablative techniques, now the mainstay of treatment. We discuss the data supporting various methods of CVD treatment with an emphasis on the impact on patient comfort and quality of life. Summary Both radiofrequency ablation (RFA) and endovenous laser therapy (EVLA) are excellent options for treatment of lower extremity venous disease, but RFA is associated with less post-procedure discomfort. Ultrasound-guided foam therapy is best reserved for the adjuvant setting or for patients ineligible for RFA or EVLA.
      PubDate: 2019-03-04
       
  • Oxycodone’s Unparalleled Addictive Potential: Is it Time for a
           Moratorium'
    • Abstract: Purpose of Review This study and literature review were carried out to investigate whether oxycodone is the most addictive prescription opioid. Recent Findings This was a cross-sectional survey from a pain management practice in south-central Alaska and review of the literature involving 86 patients diagnosed with opioid dependence/opioid use disorder from 2013 to 2018. Patients were given a list of prescription opioids and asked to identify the one (1) most desirable to themselves, (2) most desirable among drug-using associates or community, and (3) they deemed most addictive. Patients with a history of heroin use were asked which, if any, served as their gateway drug to heroin. The literature was reviewed using a PubMed search for articles containing the words “oxycodone” and “abuse,” “addiction,” “dependence,” “disorder,” and “euphoria.” Oxycodone was ranked most highly in all four questions (n = 50, 60.2%; n = 46, 75.4%; n = 38, 60.2%; n = 14, 77.8%, respectively) by a wide margin. Summary Numerous observational studies performed over the past few decades have demonstrated the supreme “likability” and abuse and dependence liability/addictiveness of oxycodone, with more recent mechanistic studies illuminating biological underpinnings including markedly increased active transport across the blood-brain barrier, increased phasic dopaminergism in the ventral tegmental area, nucleus accumbens and related striatal reward centers, and possibly increased kappa opioid receptor-mediated withdrawal dysphoria. Oxycodone possesses pharmacologic qualities that render it disproportionately liable to abuse and addiction and the risks of any long-term prescription outweigh the benefits.
      PubDate: 2019-02-28
       
  • Perioperative Considerations in the Management of Anticoagulation Therapy
           for Patients Undergoing Surgery
    • Abstract: Purpose of Review As ambulatory surgery has become increasingly more common, the appropriate management of anticoagulation therapy in patients undergoing invasive procedures has become progressively more relevant to healthcare professionals. The purpose of this literature review is to provide an overview of current common anaticoagulants and their pharmacological properties and to evaluate recent relevant literature and bridging therapy and provide recommendations on risk-guided therapy. Recent Findings With the development of new drugs and the advancing study and practice of anticoagulation use, clinicians must keep up-to-date on the optimal management of patients requiring anticoagulation. NOACs and warfarin continue to be the mainstays of treatment, with varying timelines regarding when to hold administration of the different agents within the perioperative period. Summary There are numerous factors that are considered in patients with multiple comorbidities including the risk for stroke on long-term anticoagulation and risk for thromboembolism, particularly in the perioperative setting when certain medication regimens may be altered and/or briefly held. There is ongoing investigation whether certain NOACs have more efficacy or greater safety profiles, depending on the degree of surgical intervention.
      PubDate: 2019-02-22
       
  • Functional Improvements Utilizing the Short Physical Performance Battery
           (SPPB) in the Elderly after Epidural Steroid Injections
    • Abstract: Purpose of Review The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB). Our study was IRB-approved and included 16 patients, 68 to 83 years old, with symptomatic back and radicular leg pain secondary to lumbar stenosis. Patients could elect to undergo a lumbar ESI (n = 11) or be treated via medication management (n = 5). Numeric pain score, SPPB score, and adverse events were measured and compared at baseline and a 1-month follow-up visit. Recent Findings Statistically significant improvements were observed from baseline compared to the 1-month follow-up for total SPPB score in the injection group. Similar improvements in the injection group were observed for pain scores and the SPPB subcomponents such as the 4-m walk test, chair stand time, and balance score. Comparatively, no statistically significant improvements were observed in the medication group. Summary Lumbar ESIs improved objective physical capacity parameters and pain scores in elderly patients with symptomatic lumbar stenosis compared to medication management. In addition, the SPPB is an easy-to-use tool to measure changes in physical function in older adults and could easily be integrated into an outpatient pain clinic.
      PubDate: 2019-02-22
       
 
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