Comparing the efficacy of Pregabalin with Duloxetine in perioperative pain management in knee fractures surgery: A randomized, double-blind, clinical trial

开始日期2023-06-22

申办/合作机构

Tehran University of Medical Sciences

100 项与骨折痛相关的临床结果

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100 项与骨折痛相关的转化医学

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0 项与骨折痛相关的专利（医药）

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项与骨折痛相关的文献（医药）

2024-08-02·Medicine

Association between pain intensity and depressive status in patients with hip fracture: An observational study

Article

作者: Chen, Jun ; Li, Jing ; Sheng, Yawen ; Kong, Qingyue ; Xue, Kun ; Jiang, Limei

Identifying depression symptoms in patients with hip fractures and studying the relationship between depression and pain intensity and pain location in hip fracture patients is of great significance for disease recovery in hip fracture patients. This cohort study analyzed 5 wave data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, 2018, and 2020, focusing on 1222 patients with hip fractures. The study utilized the CESD-10 Depression Scale to assess depressive symptoms in hip fracture patients and conducted analyses to explore the relationship between depression symptoms, pain, and pain intensity, including binary logistic regression and examination of interaction terms between pain variables and pain intensity in key body parts. Depression symptoms are strongly associated with pain intensity in hip fracture patients, particularly in key body areas. Severe pain significantly increases the risk of depressive symptoms. Moreover, absence of pain in other key body parts is linked to depressive symptoms. Multivariate analysis reveals that higher education levels, marriage, urban residence, and self-rated good health serve as protective factors against depression, while diabetes and heart disease pose significant risks for depressive symptoms in hip fracture patients. Hip fracture pain can induce discomfort and trigger depressive symptoms, showing varied trajectories among patients. Pain intensity predicts the course of depressive symptoms, emphasizing the importance of tailored pain management strategies including medication, physical therapy, and nonpharmacological interventions. Personalized rehabilitation and mental health plans should be designed based on individual patient needs and differences.

2024-08-01·Journal of Anesthesia

Anatomic evaluation to compare the dye spread with ultrasound-guided pericapsular nerve group (PENG) injection with or without an additional suprainguinal fascia iliaca (SIFI) injection in soft embalmed cadavers

Article

作者: Timane, Rasika ; Shivamallappa, Shivprakash ; Pai, Pallavi ; Diwan, Sandeep ; Gupta, Anju

BACKGROUNDNovel interfascial plane blocks like PEricapsular Nerve Group (PENG) and SupraInguinal Fascia Iliaca (SIFI) blocks are effective for management of hip fracture pain. We compared the difference in the distribution of the dye injected and nerves stained by the addition of the SIFI block to the PENG block.METHODSA total of 24 designated dye injections were performed in eight soft-embalmed cadavers. Under ultrasound guidance 20 ml green ink injected bilaterally in PENG block and 30 ml methylene blue dye was injected in the SIFI block on the right side. The cadavers were dissected 24 h later to assess the extent of dye spread.RESULTSExtensive spread of dyes was seen on both side of iliacus muscle on the right side, but blue dye was not visible medial to the psoas tendon. The subcostal and iliohypogastric nerves were stained green in the infra-inguinal region. On the left side (PENG alone), the anterior division of the obturator, femoral and saphenous nerve (7/8) and iliohypogastric nerves (3/8) were stained in the infrainguinal region. In the suprainguinal region, the femoral nerve (5/8), accessory obturator nerve (3/8), lateral femoral cutaneous (1/8) and nerve to rectus femoris (4/8) were stained. The main obturator nerve trunk was spared with both injections while its anterior branch and accessory obturator nerve were stained with the PENG injection.CONCLUSIONThe study findings indicate that combined PENG + SIFI injections lead to an extensive craniocaudal and longitudinal spread along the iliacus muscle. We perceive that the combination of these two injections will have a superior clinical outcome.

2024-07-02·Journal of Back and Musculoskeletal Rehabilitation

Dynamic spinal orthoses self-reported effects in patients with back pain due to vertebral fragility fractures: A multi-center prospective cohort study

Article

作者: Cisari, Carlo ; Lippi, Lorenzo ; Mezian, Kamal ; Ammendolia, Antonio ; Invernizzi, Marco ; de Sire, Alessandro ; Calafiore, Dario ; Vecchio, Michele ; Chiaramonte, Rita ; Marotta, Nicola

BACKGROUND: Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated. OBJECTIVE: This survey aimed to investigate the patients-reported outcomes of a dynamic spinal orthosis prescribed in the routine clinical practice of VFFs management. METHODS: This multi-center national-wide prospective cohort study assessed older patients (aged > 60 years) diagnosed with acute VFFs and prescribed with a dynamic spinal orthosis (Spinfast®). A survey questionnaire was realized and included sections on patient characterization, osteoporosis characterization, spinal orthosis, clinical outcomes, pain medications, and osteoporosis medications. The questionnaire was administered at baseline and after three months. A total of 68 patients completed the questionnaire at three months. Most patients had one or two VFFs and were treated with pain medications and osteoporosis medications. Compliance and tolerability of the spinal orthosis were assessed, and clinical outcomes such as pain intensity, physical functioning, and QoL were measured. RESULTS: The results showed no significant differences in outcomes between age subgroups. Italian physical medicine and rehabilitation physicians were commonly involved in the management of VFFs patients. Sixty-six patients completed the questionnaire. The results showed that pain intensity, physical functioning and QoL improved after three months of spinal orthosis wearing (p< 0.0001). CONCLUSION: The correct management of VFFs is mandatory to improve pain and reduce disability, and our findings suggested a positive role of dynamic spinal orthosis to improve the comprehensive management of VFFs patients. However, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF.

项与骨折痛相关的新闻（医药）

2023-11-02

·PRNewswire

RIVANNA Awarded $2.9 Million NIH Grant for Expansion of Accuro 3S Indications to Regional Anesthesia in Emergency Medicine

CHARLOTTESVILLE, Va., Nov. 2, 2023 /PRNewswire/ -- RIVANNA®, developers of world-first, imaging-based medical solutions, announced they received a $2.9 million grant from the National Institutes of Health (NIH). The grant will further the development of Accuro® 3S, designed for image-guided regional anesthesia, to broaden access to opioid-sparing analgesia for hip fracture pain. Each year, over 330,000 Americans face hospitalization due to hip fractures, requiring immediate pain management and surgery for mobility restoration and mortality risk reduction. Conventional treatment involves parenteral opioids, which increase adverse events, including recurrent opioid use. Ultrasound-guided regional anesthesia (UGRA), like the pericapsular nerve group (PENG) block, provides an effective opioid-free alternative for 300,000 patients annually. However, barriers to UGRA adoption persist due to provider experience and specialized training limitations. Accuro 3S represents a technological advancement designed to address UGRA barriers by equipping healthcare providers with workflow intelligence for hip regional anesthesia; this will effectively reduce training requirements, streamline workflow and enhance the utilization of hip regional anesthesia for hip fracture pain. Notable innovations within the Accuro 3S system include AI-based reconstructions of hip anatomy, real-time needle guidance with automated identification of essential anatomical landmarks and a novel ultrasound probe. "Considering that more than one million PENG blocks are performed annually across 5,000 U.S. emergency departments, there is a pressing need to expand opioid-sparing UGRA for hip fracture pain, enhancing accessibility to safer medical procedures and improving patient outcomes," commented Will Mauldin, PhD, co-founder and CEO of RIVANNA. "Our technology is well-positioned to bridge a crucial gap in healthcare delivery and expand the range of Accuro 3S clinical applications, unlocking a significant U.S. market opportunity estimated at $295 million annually." This funding opportunity is part of the NIH HEAL (Helping to End Addiction Long-term) Initiative and is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases under Award Number R44AR083337. About RIVANNA RIVANNA® is a commercial-stage medical device innovator and manufacturer in Charlottesville, VA. RIVANNA's mission is to develop and commercialize world-first imaging-based medical technologies that elevate global standards of care. A patented ultrasound-based bone imaging technology powers RIVANNA's unique value proposition: enhancing patient safety through radiation-free alternatives to X-ray-based imaging and increasing provider precision and efficiency with AI-enabled software. RIVANNA is privately held and operates an FDA-registered and ISO 13485:2016 certified manufacturing facility where it produces the Accuro® product line and related medical equipment and components. For more information, visit RIVANNA. SOURCE Rivanna Medical