Cancer-related pain is a pervasive symptom affecting the quality of life in patients with malignant tumors. For those with refractory pain, palliative sedation combined with pain management is recommended. Dexmedetomidine (DEX), known for its unique "awake sedation" effect, remains relatively unexplored when used in conjunction with patient-controlled analgesia (PCA) for terminal-stage cancer patients. This study aimed to assess the safety and efficacy of DEX for palliative sedation with PCA in patients experiencing refractory pain. A retrospective analysis was conducted on terminal-stage cancer patients who received DEX for palliative sedation combined with PCA in a hospice ward between January 2020 and June 2023. Data collection included general patient information, laboratory tests, rating scales, pain and analgesia conditions, sedation details, palliative sedative effects, and changes in vital signs before and after sedation. Nine patients with terminal-stage cancer received DEX palliative sedation at doses ranging from 0.2 to 1.0 g/kg·h combined with PCA for refractory pain. After 1 h of sedation and at the maximum sedation dose, the Richmond Agitation-Sedation Scale scores significantly decreased (all < 0.001). While heart rate, blood oxygen saturation, and respiratory rate remained stable, systolic blood pressure and diastolic blood pressure after 1 h of sedation were significantly lower than presedation levels ( = 0.040 and = 0.044, respectively). DEX emerges as a promising option for palliative sedation in terminal-stage cancer patients. When used in conjunction with PCA, DEX has been shown to effectively, safely, and stably control refractory pain without inducing adverse effects such as respiratory/circulatory depression.

This study aims to investigate the impact of postgraduate education on the comprehension of Temporomandibular Disorders (TMDs) among dental professionals. A cross-sectional observational study was conducted, involving 348 dental professionals, including students and practicing dentists, categorized based on their educational background into two groups: bachelor's degree or lower (Group B) and master's degree or higher (Group M). Questionnaires were utilized to assess attitudes and knowledge across four TMDs-related domains. Statistical analysis was performed to compare responses between groups and identify differences in TMDs comprehension. Among the 348 respondents, who participated in the study, 183 were students and 165 were practicing dentists, yielding a response rate of 79% (348/440). In the dentist group, 11 statements across every TMDs-related domain exhibited statistically significant differences in responses between Group B and Group M ( < 0.05). Only 2 responses from Group M conflicted with the standard answers, whereas Group B had 9 conflicting responses. In the student group, 11 statements also showed statistically significant differences between Group B and Group M ( < 0.05). Group M had no conflicting responses with the standard answers, while Group B had 7 conflicting responses. Postgraduate education deepened dental professionals' understanding of TMDs. Students improved more in the domains of "diagnosis" and "treatment and prognosis," whereas practicing dentists enhanced more in the "etiology" domain. To further advance postgraduate education, there is a need for more systematic course designs for TMDs, emphasizing the enhancement of knowledge related to examination methods and treatment options.

The aim of this investigation was to assess bleaching sensitivity following bleaching using either 38% HO only or 38% HO followed by ozone application. In this randomized controlled clinical investigation, 80 participants (40 females and 40 males) were randomly assigned to two groups ( = 40 each; 20 females and 20 males). The upper anterior teeth were bleached by 38% HO for 20 min followed by ozone application for 60 s (healOzone X4, KaVo Dental, Biberach, Germany) in Group 1 (test group). Meanwhile, the bleaching protocol in Group 2 (controls) included the application of just 38% HO for 20 min. Tooth sensitivity before and after bleaching was reported by the participants using a visual analog scale (VAS) from 0 to 10. Mann-Whitney test, Wilcoxon signed-rank test, and regression analysis were used to analyze the data. Significant statistical outcomes were identified at < 0.05. Bleaching sensitivity was reported following both tested bleaching protocols ( < 0.001). However, less bleaching sensitivity was reported when ozone was applied for 60 s after bleaching with 38% HO ( < 0.001). Female participants reported more bleaching sensitivity regardless the applied bleaching protocol ( < 0.05). Bleaching protocols with 38% hydrogen peroxide were associated with less bleaching sensitivity when followed by ozone application on the teeth.

Current evidence indicates that some phenotypic characteristics, such as eye or hair color, might be associated with the experience of pain. We, therefore, compared the anesthetic success rate of inferior alveolar nerve block (IANB) and postoperative pain scores between light eyes and dark eyes in female patients who experienced symptomatic irreversible pulpitis (SIP) in a mandibular molar. This prospective, parallel-group, observational study was registered with ClinicalTrials.gov (NCT06206304). A total of 110 adult female patients who experienced moderate or severe pain with SIP participated in this study. All patients received IANB with 4% articaine with 1:100.000 epinephrine. Endodontic access cavity preparation was initiated after confirmation of IANB. Pain during treatment was recorded by using a Visual Analog Scale. Anesthetic success was recorded as "none" or "mild" pain. Root canal treatment was performed, with standardized protocols. Postoperative pain scores were also recorded at 24, 48, and 72 h and 7 days after treatment. Statistical analyses of the data were performed using the independent -test, repeated measures ANOVA test, and Pearson's chi-square test. The statistical significance level was set at 0.05. No significant differences were found in the success rate of IANB and postoperative pain scores between light- and dark-eyed patients at any time point ( > 0.05). The success rate of IANB was 72.73% and 67.27% for light- and dark-eyed patients, respectively. Pain scores decreased significantly after RCT in both groups on all days ( < 0.05). No significant differences were found in the success rate of IANB and postop pain scores between light- and dark-eyed female patients who experienced SIP in a mandibular molar. ClinicalTrials.gov identifier: NCT06206304.

Complex regional pain syndrome (CRPS) represents a rare complication following injury to a limb. The DASH questionnaire (disability of arm, shoulder, and hand) evaluates everyday arm function. We assessed the DASH and its subitems in comparison to patients with brachial plexus lesions or fracture controls, analysed it over time, and in relation to active range of motion (ROM), to determine patients' impairment and trajectory.

A child's concept of pain comprises their understanding of what pain is, the purpose of pain, and biological processes underpinning pain. The concept of pain can influence pain experiences, pain beliefs, and pain-related behaviour. This study aimed to assess the concept of pain among children attending primary schools in Gqeberha in the Eastern Cape of South Africa. A secondary aim was to explore demographic and pain-related information that may contribute to a child's concept of pain. A cross-sectional study with an analytic component was used. The cross-culturally adapted Concept of Pain Inventory (COPI) was used to assess the concept of pain amongst 12-year-old school-attending children. Children from seven primary schools that were selected via stratified random sampling participated. Participants completed the adapted COPI and a sociodemographic questionnaire. Descriptive statistics and inferential analysis were used to analyse the data. There were 119 participants. Participants' concept of pain partially aligned with contemporary pain science (mean = 34.39 out of 56; standard deviation = 6.49), indicating a partial understanding of the factors influencing pain. Demographic factors and pain-related information investigated did not influence participants' concept of pain. However, differences in the concept of pain were observed amongst participants from different schools. Participants had a developing concept of pain that was partially aligned with contemporary pain science. Participants had pain knowledge strengths and gaps that can be used to develop a tailored school-based pain education intervention for them. There were indications that contextual factors may have influenced the participants' concept of pain. Further studies to explore socioenvironmental factors that influence pain knowledge in children are recommended.

The objective of this study was to systematically evaluate the safety and efficacy of local anesthesia, general anesthesia, and epidural anesthesia in percutaneous endoscopic lumbar discectomy (PELD). We searched PubMed, EMBASE, and OVID databases for all relevant studies. All statistical analysis was performed using STATA 17.0. Fourteen studies were finally included, comprising 7 randomized controlled trials and 7 retrospective studies. The total number of subjects across these studies was 1655, with 316 undergoing general anesthesia, 789 undergoing local anesthesia, and 550 undergoing epidural anesthesia. The meta-analysis of pairwise comparisons suggests that there are no differences among epidural, general anesthesia, and local anesthesia in terms of postoperative VAS, ODI, and surgery time. Regarding complications, general anesthesia has a higher complication rate compared with local anesthesia, but there are no differences between epidural and general anesthesia or between epidural and local anesthesia. In terms of anesthesia satisfaction, both general and epidural anesthesia have higher satisfaction rates compared with local anesthesia, with no significant difference between general and epidural anesthesia. The ranking of the best probabilities shows that epidural anesthesia has the lowest postoperative VAS and highest anesthesia satisfaction. General anesthesia has the lowest ODI scores. Local anesthesia has the fewest complications and operative time. Local anesthesia, general anesthesia, and epidural anesthesia are all safe and effective methods for PELD. Local anesthesia has advantages in complications and operation time. Epidural anesthesia is most advantageous in anesthesia satisfaction and postoperative VAS scores. General anesthesia is most advantageous in postoperative ODI. In the future, more multicenter RCTs are needed to further compare the safety and effectiveness of different anesthesia methods in PELD.

Herpes zoster (HZ) is typically characterized by a burning, stabbing pain, hyperalgesia, and allodynia. In some patients, despite the lesions resolving, the pain persists and becomes chronic. If the pain continues for more than 6 months after the onset of the pain phase, this condition is called postherpetic neuralgia (PHN). The frequency and severity of PHN increase with advancing age. The pain in PHN can be severe, sometimes resistant to medications, significantly impacting the patients' quality of life. The elderly patient population cannot tolerate the medications due to their side effects. In this situation, interventional pain treatment should be applied in the elderly patient group who have a high risk of developing PHN compared to other age groups. We included patients over 65 years of age with HZ-related pain who underwent dorsal root ganglion (DRG) pulsed radiofrequency (PRF) within the first 6 months from the onset of pain. We divided these patients into 2 groups: patients who underwent intervention within the first 1 month from the onset of pain and patients who underwent intervention between 1 and 6 months. We recorded medication doses and Numeric Rating Scale (NRS) scores before the procedure and at 1 week, 1 month, 3 months, and 6 months after the procedure. After the DRG PRF treatment, NRS scores improved significantly in both groups ( < 0.05). The mean NRS score in the early DRG PRF group was significantly lower than that in the late DRG PRF group ( < 0.05). The medication doses in the early DRG PRF group were significantly lower than those in the other group ( < 0.05). : Interventional pain treatment should be applied as soon as possible in the elderly patient group who do not respond to first-line medical treatment or cannot tolerate medical treatment due to its side effects and who have a high risk of developing PHN compared to other age groups. DRG PRF, applied in the early period of medical treatment-resistant acute HZ, is safe and effective, preventing the progression to PHN.

Lumbar facet joints are the source of pain in 15%-41% of individuals experiencing low back pain (LBP). Conventional lumbar facet radiofrequency ablation (RFA) has Level II evidence for improving pain and function. The best proven technique, the parallel technique, is technically challenging, time-consuming, and often uncomfortable for the patient. A novel RFA technique using a 3-tined cannula offers a potentially less complex and shorter procedure. To describe the novel lumbar facet joint RFA technique with the 3-tined cannula and to evaluate its efficacy in treating chronic lumbar facet joint pain. Eligible adult patients with chronic lumbar facet joint pain, confirmed by positive medial branch blocks (MBBs), refractory to conservative treatment, received the novel RFA treatment with the 3-tined cannula. The change in pain intensity at 2 months follow-up compared to baseline, percentage of patients reporting a ≥ 30% and ≥ 50% reduction of pain intensity, patient global impression of change (PGIC), need for pain medication, walking ability, sleep quality, and patient satisfaction were evaluated. A total of 44 patients were included. Patients experienced a clinically meaningful and significant pain relief at follow-up and 41% of the patients reported ≥ 50% reduction of pain. Forty-eight percent experienced at least a score of "much improved" on the PGIC. No severe side effects or complications were observed. Our observational study suggests that lumbar facet joint RFA using the novel technique achieves significant pain relief. The larger lesions decrease the likelihood of missing the target nerve while obviating the need to conduct numerous lesions. Limiting is the single-center set-up with a relatively short-term follow-up duration. Randomized controlled clinical trials are warranted to confirm the efficacy of the novel RFA technique to treat lumbar facet joint pain.

Hypoxia is not uncommon in elderly patients during painless gastrointestinal endoscopy. This study aimed to determine the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) in reducing the occurrence of hypoxia symptoms in elderly patients. Patients were randomly and equally grouped into sham control ( = 109) or TEAS group ( = 109) by using the random number table method. Patients in the TEAS group received electrical stimulation at the bilateral ST36 points 30 min before the examination until the end of the painless gastrointestinal endoscopy. Patients in the control group only had electrodes attached to bilateral nonacupoints in a similar pattern as the TEAS group without electrical stimulation. The primary endpoints measured were the incidence of hypoxia and severe hypoxia. The secondary endpoints included propofol dosage, sedation-related adverse events, hemodynamic parameters, surgical duration, patient recovery time, pain score, patient satisfaction, anesthesiologist satisfaction, and endoscopist satisfaction. Of the 251 patients who participated in this study, 218 patients ended up completing the final study. The primary outcome was that, compared with group control, the incidence of hypoxia in group TEAS was reduced by 11% (19.3% vs. 8.3%, =0.018) and the incidence of severe hypoxia did not show a significant change (7.3% vs. 2.8%, =0.122). And there was a significant decrease in the occurrence of patients requiring emergency airway assistance (increased oxygen flow: 16.5% vs. 6.4%, =0.019, jaw thrust: 11.0% vs. 3.7%, =0.038, mask-assisted ventilation: 5.5% vs. 1.8%, =0.015). TEAS can reduce the incidence of hypoxia in elderly patients undergoing painless gastrointestinal endoscopy. ClinicalTrials.gov identifier: ChiCTR2200059465.

The global rise in work-related musculoskeletal ailments has led to issues like neck discomfort, scapular muscle dysfunction, reduced neck mobility, and functional limitations. This study aimed to evaluate the effectiveness of scapular functional exercises (SFE) and cervical isometric exercises (CIE) on pain, cervical range of motion (CROM), and functional limitations in individuals with chronic mechanical neck pain (CMNP). A two-arm, parallel group pretest-post-test randomized comparative trial was conducted. Thirty participants (21 females, 9 males; average age 28.94 ± 3.77 years) were randomly divided into two groups, 1 and 2 ( = 15/group). Both groups received common treatments of CIE and hot packs, while Group 1 was given SFE additionally. To assess the outcomes, which included pain, cervical range of motion (CROM), and functional limitations, measurements were taken using a numeric pain rating scale (NPRS), a standard universal goniometer, and a neck disability index (NDI) questionnaire at the beginning of the study and 4 weeks after the interventions. A one-way multivariate followed by univariate analysis of covariance (MANCOVA and ANCOVA) was applied to examine the outcomes disparities within-group and between-group, with a significance level at 95% (i.e., < 0.05). MANCOVA analysis revealed a significant impact of interventions on CROM in all directions, NPRS, and NDI scores, even after adjusting for initial scores ( (8, 13) = 90.1; =0.001). Univariate ANCOVA showed significant improvements in outcomes for Group 1 compared to Group 2. Adding SFE to CIE and conventional physiotherapy was more effective than just using CIE and conventional physiotherapy alone. This approach better alleviated neck pain, improved CROM (particularly in forward and left-side flexion), and reduced functional limitations in individuals with CMNP. ClinicalTrials.gov Identifier: NCT05624021.

The neuropathic characteristics of pain occurring after an osteoporosis (OP)-related fracture are often under-recognized. The aim of this pilot study is to identify, in patients suffering from pain localized on the site of a previous osteoporotic fracture, the presence of neuropathic characteristics, their medical management, and their impact on quality of life. This pilot cross-sectional study on consecutive patients in University Hospital, Rheumatology Department, Clermont-Ferrand, France, was approved by the Ethics Committee (IRB number 2023-CF34). Pain was evaluated with the Numeric Pain Rating Scale (NPRS), Neuropathic Component of Chronic pain (NCCP) was screened with the DN4 questionnaire, and sleep was assessed with the Pittsburg questionnaire. Depression, anxiety, quality of life, and concomitant treatment were also evaluated. Results were expressed using effect sizes (ESs) and 95% confidence intervals. Fifty new patients with a history of at least one fully documented fragility vertebral fracture (VF) or nonvertebral fracture (NVF) due to osteoporosis, in the last 2 years minus the previous 6 months, were included. Findings show that 21% patients with VF and 28% patients with NVF reported NCCP (DN ≥ 4). NCCP patients had more intense pain (NPRS = 5.1 ± 2.9 vs. 2.9 ± 2.7, ES = 0.82 [0.18; 1.44], =0.019) and impaired sleep compared to patients without NCCP (ES = 0.71 [0.08; 1.33], =0.043). A remarkable point was that patients had no specific oral or topical treatment for NCCP and were only taking on demand paracetamol and nonsteroidal anti-inflammatory drugs. Future research should focus on the neuropathic characteristics of pain patients with OP, in order to better manage OP-related pain.

Neuropathic pain (NP) is a chronic condition caused by abnormal neuronal excitability in the nervous system. Current treatments for NP are often ineffective or poorly tolerated. Hence, we reviewed the efficacy and safety of novel drugs or devices that target neuronal excitability in NP patients compared with placebo, sham, or usual care interventions. Six databases were searched for parallel randomized controlled trials (RCTs) reporting novel devices (rTMS, SCS, and TENS) or drugs (EMA401, capsaicin 8% patch, and Sativex) for NP. Data were extracted and quality was assessed using the ROB2 tool. The random-effects inverse variance method was used for analysis. In our review of 30 RCTs with 4251 participants, device-based interventions were found to be more effective in reducing pain scores than control interventions (SMD = -1.27, 95% CI: -1.92 to -0.62). However, high heterogeneity was seen ( < 0.01,  = 91%), attributable to the etiology of NP (  = 58.84%) and year of publication (  = 49.49%). Funding source and type of control comparator were ruled out as cause of heterogeneity. Although drug interventions did not differ from placebo interventions in absolute pain reduction (SMD = -1.21, 95% CI: -3.55 to 1.13), when comparing relative change in pain intensity from baseline, drug interventions were found to be effective (SMD = 0.29, 95% CI: 0.04-0.55). Asymmetry in the funnel plot was visualized, suggesting publication bias. Certainty of evidence was very low according to GRADE assessment. Our review indicates that device-based interventions are more effective than control interventions in reducing pain intensity in NP. Nevertheless, available evidence is limited due to heterogeneity and publication bias, prompting the need for more high-quality RCTs to confirm the efficacy and safety of these interventions.

Although previous studies suggest that Piezo2 regulates chronic pain in the orofacial area, few studies have reported the direct evidence of Piezo2's involvement in inflammatory and neuropathic pain in the orofacial region. In this study, we used male Sprague Dawley rats to investigate the role of the Piezo2 pathway in the development of inflammatory and neuropathic pain. The present study used interleukin (IL)-1-induced pronociception as an inflammatory pain model. Subcutaneous injection of IL-1 produced significant mechanical allodynia and thermal hyperalgesia. Subcutaneous injection of a Piezo2 inhibitor significantly blocked mechanical allodynia and thermal hyperalgesia induced by subcutaneously injected IL-1. Furthermore, the present study also used a neuropathic pain model caused by the misplacement of a dental implant, leading to notable mechanical allodynia as a consequence of inferior alveolar nerve injury. Western blot analysis revealed increased levels of Piezo2 in the trigeminal ganglion and the trigeminal subnucleus caudalis after inferior alveolar nerve injury. Furthermore, subcutaneous and intracisternal injections of a Piezo2 inhibitor blocked neuropathic mechanical allodynia. These results suggest that the Piezo2 pathway plays a critical role in the development of inflammatory and neuropathic pain in the orofacial area. Therefore, blocking the Piezo2 pathway could be the foundation for developing new therapeutic strategies to treat orofacial pain conditions.

Strong associations have been demonstrated between chronic musculoskeletal pain, pain-related fear-avoidance (FA) of activities of daily living, and functional disability. The Fear Avoidance Components Scale (FACS) is a patient-reported outcome (PRO) measure, which was designed to evaluate cognitive, emotional, and behavioural dimensions of FA. The study aims were to translate the English version of the FACS into Simplified Chinese and then to examine its psychometric properties. The translation and cross-cultural adaptation of the FACS from English to Chinese was performed with standard methodology. A group of 330 subjects with chronic musculoskeletal pain completed the FACS-Chi and additional FA-related PRO measures. The FACS-Chi was then completed a second time, 1 week later. The FACS-Chi showed excellent internal consistency (Cronbach's alpha = 0.920) and test-retest reliability (ICC = 0.918). A confirmatory factor analysis of the 2-factor model determined in the original English version of FACS revealed an acceptable fit. Strong correlations were found between FACS-Chi scores and other PRO measures of perceived level of disability, pain catastrophizing, and pain-related anxiety ( < 0.001 for all analyses). The FACS-Chi demonstrated good psychometric properties, including excellent test-retest reliability and internal consistency and satisfactory construct validity. The FACS-Chi may be a useful measure of pain-related FA in Chinese-speaking patients with chronic musculoskeletal pain.

Trigeminal postherpetic neuralgia (TPHN) is a severe chronic pain that can lead to various socioeconomic consequences. Therefore, it is necessary to explore optimal treatment options for acute/subacute herpes zoster (HZ)-related trigeminal neuralgia and prevent the further development of TPHN. High-voltage, long-duration pulsed radiofrequency (HL-PRF) of the Gasserian ganglion is a new surgical intervention used to treat PHN. A ganglion block has been reported to possess anti-inflammatory effects and potential analgesic benefits. We included 83 patients with HZ-related acute/subacute trigeminal neuralgia admitted from January 1, 2021, to June 1, 2023, and received Gasserian ganglion HL-PRF combined with block. A 6-month follow-up was conducted, including Numerical Rating Scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), the incidence of TPHN, the dosage of anticonvulsants and analgesics, efficacy, and adverse events. All patients showed a significant decrease in postoperative NRS scores ( < 0.05). The NRS scores of the acute HZ group were consistently lower than those of the subacute HZ group at different time points ( < 0.01). The overall incidence of TPHN from the onset of HZ to 12 weeks is 21.68%. The incidence of TPHN in the acute phase group was 12.77%, significantly lower than the 33.33% in the subacute phase group (=0.024). The effective rate was 74.7% in all patients, at 3 months after the treatment. The effective rate was 82.98% in the acute phase group and 63.89% in the subacute phase group, showing a statistically significant difference (=0.047). The PSQI score of the acute group was consistently lower than that of the subacute group ( < 0.01). The dosage of analgesics and anticonvulsants used in the acute HZ group was lower than that in the subacute group ( < 0.01). All patients did not experience serious adverse reactions. Gasserian ganglion HL-PRF combined with block can be an effective and safe technique to relieve the pain of acute/subacute zoster-related trigeminal neuralgia and prevent the incidence of TPHN.

Several adjuvant drugs have been tried to prolong spinal anesthesia block. Currently, dexamethasone appears to be effective in extending the duration of sensory block and enhancing analgesia during surgery. It is unclear, however, whether administering dexamethasone at a dose of 8 mg offers any advantages over administering it at a dose of 4 mg. To compare the effect of adding 4 and 8 mg dexamethasone to intrathecal bupivacaine on perioperative analgesia among adult orthopedic patients at Sodo Christian Hospital from June 1 to October 31, 2021. A total of 178 adult patients undergoing elective orthopedic surgery were randomly assigned to one of the two groups through a prospective cohort research design. A systematic random sampling method was used. For analysis, data were imported into EpiData v.4.6 and exported to SPSS v.25. Levene's test was used to verify homogeneity of variance, whereas the Shapiro-Wilk test was used to assess data distribution. The Mann-Whitney test and the independent sample -test were employed to compare numerical variables between study groups. Category variables were determined using the chi-square test. values were deemed statistically significant if they were less than 0.05. Between groups, the perioperative and demographic features were similar. The mean durations of sensory block (347.42 ± 91.06 versus 341.46 ± 68.84), motor block (308.36 ± 80.91 versus 310.84 ± 75.50), and overall analgesia (421.51 ± 121.62 versus 412.40 ± 107.0) minutes did not show a statistically significant difference between the groups. In addition, there was no significant difference ( > 0.05) in postoperative analgesic use, initial analgesia rescue time, or pain severity, as measured by the Numerical Rating Scale (NRS). The addition of dexamethasone did not result in any issues, nor was there a statistically significant difference in the onset time between the two groups. Dexamethasone at a dose of 4 mg extends the duration of sensory, motor, and overall analgesia in a manner similar to that of 8 mg dexamethasone with comparable durations for both the initial analgesic request and overall analgesic use.

The global increase in the elderly population has led to a higher prevalence of degenerative lumbar spinal diseases. Epidural steroid injection (ESI) is a widely used procedure for managing lower back pain. This study investigated the association of preprocedural frailty status with the efficacy of ESI in elderly patients diagnosed with degenerative lumbar spinal diseases. This retrospective observational study included patients aged 65 years and older who underwent lumbar ESI. Frailty status (robust, prefrail, and frail) assessed via the Frailty Phenotype Questionnaire was collected along with demographic and clinical parameters. Good analgesia was defined as a ≥ 50% reduction in pain score at 4-week follow-up evaluation. Multivariable logistic regression analyses were performed to identify factors associated with poor analgesia. We included 289 patients in this study. Frailty status correlated with analgesic outcomes, with worsening frailty status correlating with increasingly poor analgesia after the injection (robust = 34.5%, prefrail = 40.8%, and frail = 60.0%, =0.003), predominantly in female patients. After adjusting for demographic and clinical factors, frail patients demonstrated much higher odds of poor analgesia than robust individuals (adjusted odds ratio [aOR] = 2.673, 95% confidence interval [CI] = 1.338-5.342, =0.005). Conversely, prefrail patients did not show a significant association with analgesic outcome (aOR = 1.293, 95% CI = 0.736-2.272, =0.372). Frailty, but not prefrailty, appeared to be an independent factor associated with poor analgesic efficacy of ESI in elderly patients with symptomatic degenerative lumbar spinal disease receiving conservative care.

The incidence of peripheral nerve injury (PNI) in China is continuously increasing. With an inability to function due to sensory and motor abnormalities, patients with PNI suffer from neuropathic pain and subsequent lesions. Presently, effective treatments for PNI are limited. To determine the role of neuroprotectin D1 (NPD1) in PNI, a sciatic nerve crush injury model was developed to investigate the impact of NPD1 on sensory and motor function recovery following nerve injury. The results demonstrated that NPD1 administered at different time points might reduce mechanical allodynia and thermal hyperalgesia caused by PNI, and its analgesic effect was not tolerated. Immunohistochemistry analyses revealed that administering NPD1 to PNI mice decreased the spinal microglia and astrocyte activation and decreased the inflammatory factor expression in the spinal dorsal horn. Furthermore, NPD1 can inhibit the invasion of IBA-1 macrophages in dorsal root ganglions generated by nerve injury. Meanwhile, it can help rehabilitate motor and neuromuscular functions following PNI. The results indicate that NPD1 may be involved in the sensory and motor function recovery following PNI.

Rheumatoid arthritis (RA) is one of the most common forms of arthritis. Extracorporeal shockwave therapy (ESWT) has been identified as a viable alternative therapeutic approach in light of the present protracted clinical course of pharmacological treatment, and changes in levels of marker proteins in the blood samples of RA patients can be utilized to assess treatment outcomes.

General anaesthesia (GA) as a pharmacological behaviour management strategy may be indicated for dental extractions in children unable to cooperate in the dental chair. Pain is the most common postoperative complication in children following dental GA. There is conflicting evidence available on the efficacy of local anaesthetic (LA) agents for postoperative pain management following dental extraction. Therefore, this review aimed to evaluate the efficacy of different pharmacological analgesic techniques on postoperative pain following dental extractions under GA in children. A search of PubMed, Embase, Scopus and CINAHL was conducted on 17/10/2023 to identify studies eligible for inclusion in this review. Two independent reviewers performed search screening, data extraction and critical appraisal. Results were narratively described due to heterogeneity of pain assessment tools and management strategies. The search yielded 8742 results, of which 15 studies were included. Methods of pain assessment varied greatly across included studies, with 14 different pain scales used across the 15 studies. Included studies suggest preoperative oral paracetamol and oral ibuprofen as well as postoperative topical bupivacaine lowered pain scores. This review underscores the challenges in reliably assessing pain in children and highlights the necessity for age-specific validated pain assessment tools.