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Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain
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Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Pain Management".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 6012

Special Issue Editors

Dr. Dariusz Kosson

E-Mail Website
Guest Editor
Department of Anaesthesiology and Intensive Care Education, Medical University of Warsaw, 4 Oczki str, 02-007 Warsaw, Poland
Interests: anesthesiology; intensive therapy; nursing; intensive care; acute and chronic pain treatment
Dr. Marcin Kołacz

E-Mail Website
Guest Editor
1st Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, 4 Lindleya str, 02-005 Warsaw, Poland
Interests: acute and chronic pain treatment; regional anesthesia; interventional methods in pain treatment; anesthesia in organ transplantation; anesthesia in facial and maxillary surgery
Dr. Robert Hadzik

E-Mail
Guest Editor Assistant
I Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, 02-005 Warsaw, Poland
Interests: anaesthesiology

Special Issue Information

Dear Colleagues,

This Special Issue of Healthcare, entitled “Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain”, was envisaged to touch upon a wide range of topics from the fields of anesthesia and pain medicine related to the matter in question.

There is an increasing demand for the effective management of both postsurgical and posttraumatic pain, as well as that related to chronic disease. Nevertheless, in real life, many patients are not receiving satisfactory therapy. The role of primary pain related to central sensitization as well as chronification of acute pain conditions is also of vital importance.

It is necessary to present research results on effective and safe therapies to manage certain diseases where severe acute and chronic pain persists and is not well controlled by existing and even recommended therapeutic methods.

Moreover, many interventional therapeutic methods and devices that are well known and already used, as well as new ones, require additional studies to support their indications, contraindications, safety, and effectiveness in pain therapy.

This issue will provide evidence regarding interventional acute and chronic pain management. 

In view of the above, it is my pleasure to announce this Special Issue entitled “Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain”. I welcome papers on any subject that is appropriate for this Special Issue. Meta-analyses, reviews, and original articles are welcome.

Dr. Dariusz Kosson
Dr. Marcin Kołacz
Guest Editors

Dr. Robert Hadzik
Guest Editor Assistant 

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pain treatment
  • interventional pain management
  • regional anesthesia

Published Papers (4 papers)

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Research

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10 pages, 1210 KiB  
Article
Effect of Intramuscular Tramadol on the Duration of Clinically Relevant Sciatic Nerve Blockade in Patients Undergoing Calcaneal Fracture Fixation: A Randomized Controlled Trial
by Marek Janiak, Grzegorz Gorniewski, Rafal Kowalczyk, Piotr Wasilewski, Piotr Nowakowski and Janusz Trzebicki
Healthcare 2023, 11(4), 498; https://doi.org/10.3390/healthcare11040498 - 08 Feb 2023
Cited by 2 | Viewed by 1319
Abstract
Background: Calcaneal fracture fixation can generate severe postoperative pain and analgesia can be supported by a sciatic nerve block. However, following resolution of the sensory blockade, rebound pain may ensue. The aim of this study was to assess whether an incidental finding of [...] Read more.
Background: Calcaneal fracture fixation can generate severe postoperative pain and analgesia can be supported by a sciatic nerve block. However, following resolution of the sensory blockade, rebound pain may ensue. The aim of this study was to assess whether an incidental finding of two patients with an extension of the sciatic nerve block beyond 24 h following 100 mg of intramuscular tramadol administration could be confirmed. Methods: Thirty-seven patients scheduled for a calcaneal intramedullary fixation (Calcanail®) were randomly divided into two groups. The tramadol group (n = 19) received a sciatic nerve block with 20 mL of 0.25% bupivacaine and a concomitant dose of 100 mg of intramuscular tramadol, while the control group (n = 18) received an identical sciatic nerve block with concomitant injection of normal saline (placebo). All patients had a spinal anesthesia with light sedation for the procedure. The time to first analgesic request defined as appearance of any pain (NRS > 0) was assessed as the primary endpoint with a clinically relevant expected result of at least 50% elongation in sensory blockade. Results: The median time to first analgesic request from time of blockade in the tramadol group was 670 min compared with 578 min in the control group. The result was clinically not relevant and statistically not significant (p = 0.17). No statistical difference could be demonstrated in the time to first opioid request, although a trend for opioid sparing in the tramadol group could be seen. Total morphine consumption in the first 24 h was also statistically insignificant (the tramadol group 0.066 mg kg−1 compared with 0.125 mg kg−1 in the control group). In conclusion, intramuscular tramadol does not extend the duration of analgesia of a sciatic nerve block following a calcaneal fracture fixation beyond 2 h and an opioid sparing effect could not be demonstrated in this trial. Full article
(This article belongs to the Special Issue Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain)
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Review

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12 pages, 2837 KiB  
Review
The Safety of Peripheral Nerve Blocks: The Role of Triple Monitoring in Regional Anaesthesia, a Comprehensive Review
by Marek Paśnicki, Andrzej Król, Dariusz Kosson and Marcin Kołacz
Healthcare 2024, 12(7), 769; https://doi.org/10.3390/healthcare12070769 - 01 Apr 2024
Viewed by 433
Abstract
Regional anaesthesia, referred to as regional blocks, is one of the most frequently used methods of anaesthesia for surgery and for pain management. Local anaesthetic drug should be administered as close to the nerve as possible. If administered too far away, this may [...] Read more.
Regional anaesthesia, referred to as regional blocks, is one of the most frequently used methods of anaesthesia for surgery and for pain management. Local anaesthetic drug should be administered as close to the nerve as possible. If administered too far away, this may result in insufficient block. If it is administrated too close, severe nerve damage can occur. Neurostimulation techniques and ultrasound imaging have improved the effectiveness and safety of blockade, but the risk of nerve injury with permanent nerve disfunction has not been eliminated. Intraneural administration of a local anaesthetic damages the nerve mechanically by the needle and the high pressure generated by the drug inside the nerve. In many studies, injection pressure is described as significantly higher for unintended intraneural injections than for perineural ones. In recent years, the concept of combining techniques (neurostimulation + USG imaging + injection pressure monitoring) has emerged as a method increasing safety and efficiency in regional anaesthesia. This study focuses on the contribution of nerve identification methods to improve the safety of peripheral nerve blocks by reducing the risk of neural damage. Full article
(This article belongs to the Special Issue Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain)
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17 pages, 591 KiB  
Review
Postoperative Pain Management in Children Undergoing Laparoscopic Appendectomy: A Scoping Review
by Abdalkarem Fedgash Alsharari, Farhan Faleh Alshammari, Dauda Salihu and Majed Mowanes Alruwaili
Healthcare 2023, 11(6), 870; https://doi.org/10.3390/healthcare11060870 - 16 Mar 2023
Cited by 1 | Viewed by 2108
Abstract
Laparoscopic appendectomy (LA) is one of the most commonly performed surgical procedures in children and is associated with extreme postoperative discomfort due to peritoneal inflammation and infection. The main objective of this study was to investigate the effects of postoperative pain (POP) in [...] Read more.
Laparoscopic appendectomy (LA) is one of the most commonly performed surgical procedures in children and is associated with extreme postoperative discomfort due to peritoneal inflammation and infection. The main objective of this study was to investigate the effects of postoperative pain (POP) in children after laparoscopic appendectomy. Articles describing or evaluating the control of POP in children with LA were considered eligible. All available literature such as randomized controls, prospective controls, retrospective as well as clinical studies were considered. A comprehensive search was performed in PubMed, Medline, Embase, Cochrane Library, Clinical trials.gov, and Google scholar. The initial search took place on 23 April 2021, and was updated on 24 August 2021. There were no language or date restrictions. Each of the included articles was evaluated separately by two independent reviewers. Additional papers were found by searching the reference lists of eligible studies. Eighteen papers were considered. All papers, and many of them used different methods to treat POP in children undergoing LA, such as lidocaine infusion, different analgesic approaches, ultrasound-guided transverse abdominis blockade (UGTAP), ultrasound-guided quadratus lumborum blockade (UGQLB), and comparison of open appendectomy (OA) with local anesthetics in relation to POP management in children. Laparoscopic appendectomy is the surgical procedure preferred by clinicians compared with open appendectomy in children. A multimodal analgesic approach is optimal and efficient surgical techniques such as UGBRSB, UGQLB, and UGTAP block might significantly impact POP in children except that there are contraindications. Dexmedetomidine proved to be an effective adjuvant that can enhance the effect of local anesthetics. The lack of a sufficient number of studies may be a factor affecting our confidence in the results of this study. Therefore, further evidence-based randomized control trials with a large sample size are needed to provide clarity. Full article
(This article belongs to the Special Issue Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain)
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11 pages, 1351 KiB  
Review
Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis
by Eduardo Gómez-Sánchez, Lorenzo Franco-de la Torre, Ronell Eduardo Bologna-Molina, Nelly Molina-Frechero, Nicolás Addiel Serafín-Higuera, Adriana Hernández-Gómez, Ángel Josabad Alonso-Castro, Daniel Sat-Muñoz and Mario Alberto Isiordia-Espinoza
Healthcare 2022, 10(10), 1867; https://doi.org/10.3390/healthcare10101867 - 25 Sep 2022
Viewed by 1512
Abstract
Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine [...] Read more.
Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine the effect of pre-treatment with tramadol in patients with symptomatic irreversible pulpitis, as well as for pain control and adverse effects. This study was registered in PROSPERO (ID: CRD42021279262). PubMed was consulted to identify clinical investigations comparing tramadol and placebo/local anesthetics in patients with symptomatic irreversible pulpitis. Data about the anesthesia, pain control, and adverse effects were extracted. Both the anesthetic success index and the adverse effects of local tramadol and placebo were compared with the Mantel–Haenszel test and odds ratio. Data analysis showed that the local administration of tramadol increased the anesthetic success rate when compared to placebo in patients with symptomatic irreversible pulpitis (n = 228; I2 = 0; OR = 2.2; 95% CIs: 1.30 to 3.79; p < 0.004). However, local administration of tramadol increased the risk of adverse effects when compared to placebo/local anesthetics (n = 288; I2 = 0; OR = 7.72; 95% CIs: 1.37 to 43.46; p < 0.02). In conclusion, this study shows that the local administration of tramadol increases the anesthetic success index when compared to placebo in patients with symptomatic irreversible pulpitis. Full article
(This article belongs to the Special Issue Regional Anesthesia and Interventional Treatment of Acute and Chronic Pain)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Injection Pressure Monitoring in Regional Anaeshesia
Authors: Marek Paśnicki; Andrzej Król; Dariusz Kosson; Marcin Kołacz
Affiliation: Department of Anaesthesia and Chronic Pain Service, St George's University Hospital, Blackshaw Road SW170QT, Tooting, London
Abstract: Regional anesthesia, referred to as regional blocks, is one of the most frequently used methods of anesthesia for surgery and for pain management. Local anesthetic drug should be administered as close to the nerve as possible. If it is administered too far - may result in insufficient block. If it is administrated too close or even into the nerve – severe nerve damage can occur. Neurostimulation techniques and ultrasound imaging have improved effectiveness and safety of blokade, but risk of nerve injury with permanent nerve disfunction is not eleminated Intraneural administration of a local anesthetic damages the nerve mechanically by the needle and high pressure generated by the drug inside the nerve. In many studies injection pressure is described as significantly higher for unintendent intraneural injections than for perineural ones. In recent years, the concept of combining techniques (neurostimulation + USG imaging + injection pressure monitoring) has emerged as a methode increasing safety and efficiency in regional anaesthesia

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