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Chronic Pain: The Role of Regional Anesthesia
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Chronic Pain: The Role of Regional Anesthesia

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: closed (20 April 2024) | Viewed by 6691

Special Issue Editors

Dr. Alessandro De Cassai

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Guest Editor
Anesthesia and Intensive Care Unit, Padua University Hospital, 35128 Padua, Italy
Interests: chronic pain; regional anesthesia; fascial block
Dr. Federico Geraldini

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Guest Editor
Anesthesia and Intensive Care Unit, Padua University Hospital, 35128 Padua, Italy
Interests: chronic pain; regional anesthesia; fascial block; neurocritical care

Special Issue Information

Dear Colleagues,

Chronic pain poses a major challenge for physicians. It leads to a lower quality of life, with patients requiring prolonged hospitalization and medical attention; moreover, the available medical treatment may not effectively treat the pain.

However, in recent years, regional anesthesia has made considerable progress thanks to factors such as improved technology, better anatomical knowledge, and high research interest leading to multiple scientific publications on the topic.

The role of regional anesthesia in chronic pain is fascinating, owing to its ability to mitigate or resolve such pain with focused therapy in addition to the usual multimodal strategy.

However, research is still lacking, especially on newly described techniques such as interfascial plane blocks, when considering the role of regional anesthesia in chronic pain.

The aim of this Special Issue is to highlight recent advances in the context of treatment and the prediction of prognoses in regional anesthesia for the treatment of chronic pain in gastrointestinal disorders.

We welcome all submissions, and are especially interested in receiving original randomized or observational trials and reviews (with or without meta-analysis).

Dr. Alessandro De Cassai
Dr. Federico Geraldini
Guest Editors

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. Journal of Clinical Medicine 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 2600 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
  • chronic pain
  • regional anesthesia
  • local anesthetics
  • fascial block

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Published Papers (3 papers)

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Editorial

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3 pages, 164 KiB  
Editorial
Chronic Pain and Regional Anesthesia: A Call to Action!
by Alessandro De Cassai and Federico Geraldini
J. Clin. Med. 2023, 12(5), 1955; https://doi.org/10.3390/jcm12051955 - 1 Mar 2023
Cited by 3 | Viewed by 2197
Abstract
Chronic pain is an unwanted companion in the lives of millions of people worldwide, and findings show that more than one in fiveadults in America experience chronic pain [...] Full article
(This article belongs to the Special Issue Chronic Pain: The Role of Regional Anesthesia)

Other

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7 pages, 373 KiB  
Brief Report
Long-Term Outcome and Predictors of Transversus Abdominis Plane Block for Chronic Post-Hernioplasty Pain
by Ulderico Freo and Maurizio Furnari
J. Clin. Med. 2024, 13(14), 4039; https://doi.org/10.3390/jcm13144039 - 10 Jul 2024
Viewed by 1370
Abstract
Background/Objectives: Different analgesic techniques have been used in the clinical management of chronic post-hernioplasty pain (CPHP), with variable results. This study aimed to investigate clinical factors associated with long-term outcome of the transversus abdominal plane (TAP) block for CPHP. Methods: We [...] Read more.
Background/Objectives: Different analgesic techniques have been used in the clinical management of chronic post-hernioplasty pain (CPHP), with variable results. This study aimed to investigate clinical factors associated with long-term outcome of the transversus abdominal plane (TAP) block for CPHP. Methods: We retrospectively analyzed 26 patients with CPHP who were treated with single or multiple TAP blocks with local anesthetic and steroid. Patients were evaluated for pain and neuropathic pain intensity by a Numerical Rating Scale (NRS) and the painDETECT questionnaire (PDQ), for anxiety and depression by the Hospital Anxiety and Depression Scale, and for quality of life by the 12-item Short Form Health Survey (SF12). Results: At 6 months post-treatment, 20 patients (77%) presented substantial (>50%) or moderate (30–50%) CPHP relief and were considered responders. In responders, the 24-h average and maximum NRS pain significantly declined (p < 0.01) from 7.3 ± 1.3 to 2.6 ± 2.1 and from 8.8 ± 1.5 to 5.1 ± 2.0, and the neuropathic PDQ score from 9.1 ± 3.2 to 6.1 ± 1.3; the physical SF12 score improved from 36.5 ± 5.8 to 44.3 ± 7.5 (p < 0.01). Six patients failed to achieve a significant CPHP improvement and were considered non-responders. Non-responders presented a significantly (p < 0.05) longer CPHP, higher body mass index and neuropathic symptoms, and more frequent anxiety, depression, diabetes, and fibromyalgia. Conclusions: The TAP block with local anesthetic and steroid should be considered as a therapeutic option for CPHP. However, medical and psychiatric comorbidities negatively impact the TAP block effectiveness for CPHP. Full article
(This article belongs to the Special Issue Chronic Pain: The Role of Regional Anesthesia)
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19 pages, 1589 KiB  
Systematic Review
Non-Opioid Analgesics and Adjuvants after Surgery in Adults with Obesity: Systematic Review with Network Meta-Analysis of Randomized Controlled Trials
by Michele Carron, Enrico Tamburini, Federico Linassi, Tommaso Pettenuzzo, Annalisa Boscolo and Paolo Navalesi
J. Clin. Med. 2024, 13(7), 2100; https://doi.org/10.3390/jcm13072100 - 3 Apr 2024
Cited by 3 | Viewed by 2499
Abstract
Background/Objectives: Managing postoperative pain in patients with obesity is challenging. Although using a combination of pain relief methods is recommended for these patients, the true effectiveness of various intravenous non-opioid analgesics and adjuvants in multimodal anesthesia needs to be better defined. Methods: A [...] Read more.
Background/Objectives: Managing postoperative pain in patients with obesity is challenging. Although using a combination of pain relief methods is recommended for these patients, the true effectiveness of various intravenous non-opioid analgesics and adjuvants in multimodal anesthesia needs to be better defined. Methods: A systematic review and network meta-analysis was performed to evaluate the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, ketamine, α-2 agonists, lidocaine, magnesium, and oral gabapentinoids in adult surgical patients with obesity. The analysis aimed to compare these treatments to a placebo/no treatment or alternative analgesics, with a primary focus on postoperative pain and secondary endpoints including rescue analgesia, postoperative nausea and vomiting (PONV), and recovery quality. English-language randomized controlled trials across PubMed, Scopus, Web of Science, CINAHL, and EMBASE were considered. Quality and evidence certainty were assessed with the RoB 2 tool and GRADE, and data was analyzed with R software. Results: NSAIDs, along with acetaminophen, lidocaine, α-2 agonists, ketamine, and oral gabapentinoids, effectively reduce early postoperative pain. NSAIDs, particularly ibuprofen, as well as acetaminophen, ketamine, and lidocaine, also show benefits in later postoperative stages. Intravenous non-opioid analgesics and adjuvants show some degree of benefit in reducing PONV and the need for rescue analgesic therapy when using α-2 agonists alone or combined with oral gabapentinoids, notably decreasing the likelihood of PONV. Ketamine, lidocaine, and α-2 agonists are shown to enhance postoperative recovery and care quality. Conclusions: Intravenous non-opioid analgesics and adjuvants are valuable in multimodal anesthesia for pain management in adult surgical patients suffering from obesity. Full article
(This article belongs to the Special Issue Chronic Pain: The Role of Regional Anesthesia)
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