Nerve stimulation reduces pain and opioid use after orthopedic surgery
Benefits 'much greater than anticipated' in initial randomized trial
2021-04-15
(Press-News.org) A technique called percutaneous peripheral nerve stimulation yields "impressive" reductions in pain scores and opioid use during the first week after common orthopedic surgery procedures, concludes a randomized clinical trial published Online First in Anesthesiology, the official peer-reviewed journal of the American Society of Anesthesiologists (ASA), today.
The benefits of postoperative nerve stimulation were "much greater than what we had anticipated, concurrently reducing pain scores by more than 50 percent and opioid consumption by 80 percent," according to the randomized trial report by Brian M. Ilfeld, M.D., MS, and colleagues. With further study, they believe that peripheral nerve stimulation could be a safe, effective, opioid reducing, non-drug adjunct for pain management after surgery.
In percutaneous peripheral nerve stimulation, a tiny electrical lead (insulated wire) is placed alongside a nerve and connected to a battery-powered pulse generator. The generator delivers mild electrical stimulation to the nerve, interrupting pain transmission. Although this "neuromodulation" technique has been widely used for patients with chronic pain, the new study is the first randomized, controlled trial to evaluate its use for acute pain after surgery.
The study enrolled 65 patients undergoing common outpatient joint surgery, such as bunion surgery in the foot or rotator cuff repair in the shoulder. All patients underwent lead placement near the nerve(s) serving the surgical joint. Half of the patients were randomly assigned to active electrical stimulation, adjusted to achieve the desired sensory change - sometimes described as feeling like a "pleasant massage." The remaining patients received an inactive "sham" treatment, with a pulse generator that appeared to function normally, but did not deliver any electrical current. After one week, pain scores and opioid use were compared between groups. Evaluations were performed in "double-masked" fashion: neither the researchers nor the patients knew which treatment the patient was receiving.
The results showed significantly lower pain ratings in the active nerve stimulation group. Mean pain score (on a 0 to 10 scale) was 1.1 in patients receiving active treatment, compared to 3.1 in the sham group.
Active nerve stimulation was also associated with a much lower use of opioids to control postoperative pain. Median opioid dose (oral morphine equivalents) for the entire first week after surgery was 5 milligrams in the active treatment group, compared to 48 milligrams in the sham group. That's an important benefit due to the possible adverse effects of postoperative opioids, such as nausea, constipation, sedation, and respiratory depression.
Although the trial was designed as a pilot study, the results "stand on their own and indicate that percutaneous peripheral nerve stimulation is highly effective for acute pain," Dr. Ilfeld and coauthors wrote. They outlined plans for a subsequent study that is currently enrolling a far larger number of patients and will include a more complete assessment of the treatment effect across patient subgroups.
INFORMATION:
ELSE PRESS RELEASES FROM THIS DATE:
2021-04-15
OAK BROOK, Ill. - A deep learning algorithm accurately predicts the risk of death from cardiovascular disease using information from low-dose CT exams performed for lung cancer screening, according to a study published in Radiology: Cardiothoracic Imaging.
Cardiovascular disease is the leading cause of mortality worldwide. It even outpaces lung cancer as the leading cause of death in heavy smokers.
Low-dose CT lung scans are used to screen for lung cancer in high-risk people such as heavy smokers. These CT scans also provide an opportunity to screen for cardiovascular disease by extracting information about calcification ...
2021-04-15
Key takeaways
Pancreatic, liver, bile duct, and stomach cancer operations are inherently complex and initially often take place at large cancer centers where surgical teams perform a large volume of procedures.
Readmission to a different hospital from where patients had these operations initially performed markedly increases death risk.
There are ways to address care fragmentation with newly identified risk factors for readmission; cancer hospitals should seek to determine safe sites of care for readmissions after these types of operations.
CHICAGO: New research reveals that 28 percent of patients who are readmitted ...
2021-04-15
Patients who are overweight or obese have more severe COVID-19 and are highly likely to require invasive respiratory support, according to a new international study.
The research, led by the Murdoch Children's Research Institute (MCRI) and The University of Queensland and published in Diabetes Care, found obese or overweight patients are at high risk for having worse COVID-19 outcomes. They are also more likely to require oxygen and invasive mechanical ventilation compared to those with a healthy weight.
MCRI researcher Dr Danielle Longmore said the findings, which highlighted the relationship between obesity and increased COVID-19 disease burden, showed the need to urgently introduce strategies to address ...
2021-04-15
https://www.sciencedirect.com/journal/acta-pharmaceutica-sinica-b/vol/11/issue/3
The Journal of the Institute of Materia Medica, the Chinese Academy of Medical Sciences and the Chinese Pharmaceutical Association, Acta Pharmaceutica Sinica B (APSB) is a monthly journal, in English, which publishes significant original research articles, rapid communications and high quality reviews of recent advances in all areas of pharmaceutical sciences -- including pharmacology, pharmaceutics, medicinal chemistry, natural products, pharmacognosy, pharmaceutical analysis and pharmacokinetics.
Featured papers in this issue are:
Isorhapontigenin protects against doxorubicin-induced ...
2021-04-15
Guangzhou, April 8, 2021: New journal BIO Integration (BIOI) publishes its fifth issue, volume 2, issue 1. BIOI is a peer-reviewed, open access, international journal, which is dedicated to spreading multidisciplinary views driving the advancement of modern medicine. Aimed at bridging the gap between the laboratory, clinic, and biotechnology industries, it will offer a cross-disciplinary platform devoted to communicating advances in the biomedical research field and offering insights into different areas of life science, to encourage cooperation and exchange among scientists, clinical researchers, and health care providers.
The issue contains an editorial, two mini review articles, two opinion articles and an interview offering ...
2021-04-15
The inner surface of blood vessels is lined by a wafer-thin layer of cells known as the endothelium, which forms a crucial barrier between blood and the surrounding tissue. The single-layered cell structure promotes the exchange of oxygen and nutrients, while simultaneously preventing the uncontrolled leakage of blood components. Only when the metabolic needs of the surrounding tissue increase, e.g., during growth, wound healing or tumor development, do endothelial cells abandon this stable cell association in order to divide and form new blood vessels. The signals that trigger this activation have been ...
2021-04-15
Detecting hidden genetic defects by applying an existing method to an existing datasets. Researchers at Radboud university medical center have succeeded: they showed that the 'Expansion Hunter' method can detect errors in the DNA that lead to repeat expansion diseases, such as the movement disorder ataxia. This result provides guidance to fellow researchers worldwide on how to use this method to diagnose patients with genetic disorders.
With current diagnostic technology for genetic disorders, it is possible to map all 20,000 genes in our DNA at once. Doctors are increasingly opting for this so-called exome technique: it is widely applicable and increasingly provides molecular diagnoses. ...
2021-04-15
High intensity interval training has become increasingly popular as it's a quick and effective way to improve health. This is all the more important as countries around the world emerge from lockdowns due to coronavirus and are looking for quick and easy way to exercise again.
Recently, researchers have been studying whether shorter variations of HIIT, involving as little as 4-min of high intensity exercise per session (excluding a warm up and cool down), also improve health.
A new review paper published in the Journal of Physiology collates a decade's worth of research ...
2021-04-15
Words categorize the semantic fields they refer to in ways that maximize communication accuracy while minimizing complexity. Recent studies have shown that human languages are optimally balanced between accuracy and complexity. For example, many languages have a word that denotes the colour red, but no language has individual words to distinguish ten different shades of the colour. These additional words would complicate the vocabulary and rarely would they be useful to achieve precise communication.
A study published on 23 March in the journal Proceedings of the ...
2021-04-15
The corona pandemic has had a major impact on the Nordic news media. At the same time as advertising revenues have fallen drastically, interest among the audience for professional news coverage has increased, according to a new report from Nordicom at the University of Gothenburg. Several Nordic media companies have also reported record sales of digital subscriptions as a result of the pandemic.
Covid-19 swept over the Nordic region and the rest of the world with full force in the spring of 2020. A year later, the pandemic still has the world in a strong grip. However, both the health-related ...
LAST 30 PRESS RELEASES:
[Press-News.org] Nerve stimulation reduces pain and opioid use after orthopedic surgery
Benefits 'much greater than anticipated' in initial randomized trial
