Monthly Archives: October 2014

Number of Patients Experiencing Postsurgical Pain Reduced by 24% in Last Decade

Anesthesiology

 

The number of patients reporting moderate to severe pain two weeks after surgery has decreased by 24% in the last decade, a new study found.

Researchers surveyed 441 patients before they were discharged from the hospital, and then at one, two and three weeks after surgery. Patients were asked to rate their pain intensity and satisfaction with the pain medicine they were given. The results were then compared to a similar study conducted from 1998 to 2002.

The investigators found that 39% of patients experienced moderate to severe pain two weeks after surgery compared with 63% in the previous study.

“During the last 10 years there have been significant changes in hospitals to support better pain management post-surgery,” said lead study author Asokumar Buvanendran, MD, director of orthopedic anesthesia at Rush University Medical Center in Chicago, in a press release. “Our study shows that health care providers are implementing better pain protocols and heading in the right direction.”

The number of patients who reported no pain remained at 22%. And patients continued to be satisfied with their pain management.

Increased measures put in place by hospitals and the involvement of physician anesthesiologists have also contributed to this decrease, according to Dr. Buvanendran.

“Greater awareness among health care providers and the implementation of advanced pain measures have led to great improvements. We are moving forward, but there is still plenty to be done to improve pain management and the quality of health care,” he said.

The findings were presented at American Society of Anesthesiologists’ (ASA) annual meeting in New Orleans.

Based on a press release from the ASA.

http://www.anesthesiologynews.com/ViewArticle.aspx?d=Web%2bExclusives&d_id=175&i=October+2014&i_id=1107&a_id=28573

 

 

Fibromyalgia linked to decreased brain connectivity

Anesthesiology

New study from Sweden finds fibromyalgia is linked to abnormal activity in parts of the brain that process pain signals and link them to other regions.

Dr. Pär Flodin and colleagues, from the Karolinska Institute in Stockholm, report their findings in the journal Brain Connectivity.

Fibromyalgia syndrome is a common and chronic condition of unknown cause that mostly strikes in middle age, although symptoms can often present earlier. Sufferers typically experience fatigue with long-term pain in several areas of the body, plus tenderness in soft tissues such as the muscles, joints and tendons.

We don’t know why, but while men and children can also have it, the vast majority of those diagnosed with fibromyalgia are women.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, scientists estimate that fibromyalgia affects 5 million adult Americans.

Decreased brain connectivity in fibromyalgia patients

For their study, the Karolinska researchers compared brain activity in women with and without fibromyalgia. In fibromyalgia patients, they found decreased connectivity between brain areas that process pain and sensorimotor signals.

 

They suggest their findings show reduced brain connectivity may contribute to deficient pain regulation in people with fibromyalgia.

The results build on previous studies that have linked abnormal brain activity to poor pain inhibition.

For the study, 22 healthy women and 16 with fibromyalgia underwent functional magnetic resonance imaging (fMRI) brain scans while experiencing different levels of pain by having pressure applied to the thumb.

The day before the scans, the women completed tests to calibrate their pain sensitivity. A computer-controlled pressure stimulator applied pressure to their left thumb, while they rated the sensitivity. Pressure intensities derived from these ratings were then delivered in a random order as the women underwent the brain scans.

The participants had to refrain from taking pain medication and sedatives 48 hours before the assessment of pain and 72 hours before the fMRI scans. Altogether, each received 15 stimuli lasting 2.5 seconds each, at half-minute intervals.

Reduction in brain connectivity could impair pain perception

The results showed that the fibromyalgia participants had significantly increased pain sensitivity compared with the control group.

When they analyzed the brain scans, the team found differences in brain patterns between the healthy participants and those with fibromyalgia. The fibromyalgia participants showed “functional decoupling” between areas of the brain that process pain signals and other parts, including those that control sensorimotor activity.

The authors suggest this reduction in brain connectivity could impair pain perception.

The co-editor-in-chief of the journal, Dr. Christopher Pawela, an assistant professor at the Medical College of Wisconsin in the US, describes the study as “an important first step” in understanding how the brain affects widespread pain perception, which is a known characteristic of fibromyalgia.

In February 2014, Medical News Today learned of a UK study that found poor sleep is tied to widespread pain and fibromyalgia.

Written by Catharine Paddock PhD

http://www.medicalnewstoday.com/articles/283346.php