Interventional Pain Management in Trauma: Bridging Acute Injury, Critical Care and Chronic Pain | Chapter 7 | An Overview of Disease and Health Research Vol. 9

Interventional Pain Management (IPM) has emerged as an integral component of modern trauma anaesthesia, particularly in the care of patients with neurotrauma. Traumatic injuries to the nervous system are frequently associated with complex pain syndromes that extend beyond the acute phase and may progress to chronic, function-limiting pain. Reliance on systemic pharmacological therapy alone is often insufficient and may adversely affect neurological assessment, haemodynamic stability, and long-term functional outcomes. This chapter examines the role of IPM across the continuum of neurotrauma and trauma care, including the acute perioperative period, intensive care management, rehabilitation, and chronic pain treatment. Emphasis is placed on the neurobiological mechanisms of trauma-related pain, rational selection of interventional techniques, and safety considerations unique to neurologically vulnerable and critically injured patients. Integration of IPM within a multidisciplinary trauma care framework is presented as a key strategy to enhance patient outcomes and quality of life.

 

 

Author(s) Details

Sony Sony
All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

 

Shivam Shekhar
All India Institute of Medical Sciences, Deoghar, Jharkhand, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7033

Rooting Out Pain: PIPS and SWEEPS in the Battle against Postoperative Discomfort | Chapter 1 | Medical Science: Recent Advances and Applications Vol. 11

 

Background: A successful root canal isn’t just about shaping the canals—it’s about making sure they are completely clean and free from bacteria. Traditional syringe irrigation often struggles to reach the tiny, hidden spaces inside a tooth, which can leave bacteria behind and cause pain after treatment.

 

Aim: This article looks at how two modern laser-based techniques—Photon-Induced Photoacoustic Streaming (PIPS) and Shockwave-Enhanced Emission Photoacoustic Streaming (SWEEPS)—help improve cleaning and reduce post-treatment discomfort, comparing them with ultrasonic, sonic, and conventional irrigation methods.

 

Methods: We reviewed recent research, including laboratory and clinical studies, that evaluated how well PIPS and SWEEPS remove debris and bacteria, and how they affect patient comfort after treatment.

 

Results: Both PIPS and SWEEPS use bursts of Er:YAG laser energy to create shockwaves in the cleaning solution like EDTA, NaOCl and saline, pushing it deep into complex canal spaces without inserting tips into the canal. SWEEPS, with its well-timed dual pulses, produces stronger waves that are especially effective in curved or narrow canals. Studies consistently show these techniques clean better and cause less discomfort afterwards than older methods. Still, the cost, need for training, and equipment care can limit their use.

 

Conclusion: PIPS and SWEEPS are changing how dentists clean root canals, offering better results and a smoother recovery for patients. As the technology becomes more advanced and accessible, it’s likely to play a bigger role in everyday dental care.

 

Author(s) Details

Malhaan Khan K
SRM Kattankulathur Dental College and Hospital, India.

 

Tripuravaram Vinay Kumar Reddy
Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, India.

 

Vijay Venkatesh
Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, India.

 

Seetha Kunhikannan
ICON, CRO Chennai, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msraa/v11/6207

Role of Parasternal Bupivacaine Injection for Pain Management and Early Extubation in Coronary Artery Bypass Grafting: A Prospective Randomized Placebo-Controlled Study | Chapter 4 | Medicine and Medical Research: New Perspectives Vol. 12

Background: After cardiac surgery, patients often experience significant pain, primarily due to the median sternotomy or thoracotomy. This pain is usually severe during the first 48 hours, which is the typical duration of their stay in the ICU. Managing this pain effectively is important because it plays a key role in enabling early extubation—usually within 6 to 8 hours after surgery. This approach has become a major advancement in the postoperative ventilatory care of open-heart surgery patients. By optimizing pain control, we can help facilitate early extubation, leading to faster recovery times, decreased length of ICU stay, and better overall outcomes.

Objectives: This study was designed to determine the efficacy of the parasternal injection of Bupivacaine on postoperative pain for early extubation in patients undergoing coronary artery bypass grafting (CABG).

Materials and Methods: Patients admitted for elective primary coronary artery bypass surgery were enrolled in the study. A total of 35 patients were randomized into two groups: Group 1 (Bupivacaine) with 13 patients (37.14%) and Group 2 (Placebo) with 15 patients (42.85%). Standard anesthetic protocols were followed. Bupivacaine 0.5% at 2 mg per kg was diluted in a 50 ml syringe with normal saline, and 50 ml of normal saline was used as a placebo. Identical syringes marked with patient study numbers were delivered to the operating theaters. Both the surgeon and the anesthetist were blinded to the content of the solution. The injection was infiltrated into the parasternal wound at the end of the procedure before placing the sternal wires. The anesthetist assessed patients in the intensive care unit (ICU) for early extubation. Pain intensity was measured using a Visual Analogue Scale (VAS) at the time of extubation.

Results: A total of 35 patients were selected for the study, but only 28 completed it. Seven patients were dropped out due to prolonged ventilation (5 patients) and reopening (2 patients). The mean VAS was 1.38±1.19 in the Bupivacaine group and 6.13±2.92 in the Placebo group, with a significant difference (P<0.001). No rescue pain medication was required in the Bupivacaine group, while 8 patients (53.3%) in the Placebo group required it. The mean ventilation time was significantly shorter in the Bupivacaine group (5.8±1.3 hours) compared to the Placebo group (122±2.8 hours) (P=0.002). Mean partial oxygen pressure was significantly higher in the Bupivacaine group (208.23±42.57) compared to the Placebo group (126.40±23.15) (P<0.001).

Conclusion: Parasternal wound infiltration of long-acting local anesthetic Bupivacaine is an effective method of pain control after sternotomy. It facilitates early extubation with significant improvements in oxygenation and VAS scores.

Larger trials including all categories of open-heart surgery, with more variables such as partial pressure oxygen and carbon dioxide levels and their mean differences, would lead to yield improved and more reliable results.

 

Author (s) Details

 

Salman Ur Rahman Khan
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Tariq Azam Siddiqi
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Akhtar Husain
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Riffat Tanveer
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Saad Badar
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Rafiq Khan
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Iqbal Pathan
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi,
Saudi Arabia.

 

Munir Afridi
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

Ayesha Khan
Department of Cardiac Surgery and Anaesthesia, National Institute of Cardiovascular Diseases Karachi, Saudi Arabia.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v12/2675

 

Modern Analgesic Techniques for Hip and Knee Arthroplasty: An Approach to Evidence-Based Medicine| Chapter 10 | Perspective of Recent Advances in Medical Research Vol. 4

In big orthopedic medical procedure, contemporary and patella arthroplasty plays an main part. Statistics from past years show united states of america decrease in the age of subjects bearing this type of enucleation.Effective examination pain administration endure admit accelerated patient group accompanying the possibility of discharge even in inferior two days. Therefore skilled is likewise a increasing bias to shift smart and patella arthroplasty from in-patient to person being treated for medical problem section. The combining several branches of learning approach of the fast-path program also depends on the administrative methodical conveniences of each organization.Our renovate aims to review the main models of classic and new pharmacological or non-pharmacological methods and analgesics secondhand contemporary in the postoperative ending. Their approximate study explains the benefits and aftereffects of each and guides us on by means of what to command evidence-located cure in our regularly practice.

Author(s) Details:

Denisa Madalina Anastase,
Department of Anesthesiology, Orthopedic Clinical Hospital Foisor, Bulevardul Ferdinand, No. 35-37, 021382 Bucharest, Romania.

Simona Cionac Florescu,
Department of Anesthesiology, Orthopedic Clinical Hospital Foisor, Bulevardul Ferdinand, No. 35-37, 021382 Bucharest, Romania.

Please see the link here: https://stm.bookpi.org/PRAMR-V4/article/view/9134

Transdermal Fentanyl Patch as a Component of Multimodal Analgesic Regimen for Acute Postoperative Pain | Chapter 09 | New Horizons in Medicine and Medical Research Vol. 2

 Background: Acute pain in the postoperative phase affects around 80% of patients, with nearly 86 percent experiencing moderate to severe pain [1]. To reduce postoperative pain and improve results, enhanced recovery after surgery (ERAS) proposes a multimodal analgesic regimen [2]. The multimodal analgesic regimen prioritises the decrease of opioid analgesia reliance, and pain is handled at different levels using different mechanisms of action, thereby treating pain and reducing complications associated with any specific medicine. Various methods (regional anaesthesia, nerve blocks, local infiltration) and medications, including non-opiate nonsteroidal anti-inflammatory drugs, paracetamol, Cyclooxygenase2 inhibitors, NMDA receptor antagonists, gabapentins, pregabalins, and alpha 2 receptor agonists, and opioids, are incorporated into the treatment regimen as needed. After 12-24 hours of administration, the transdermal fentanyl patch provides steady-state plasma levels, and the plasma levels remain stable for the remaining 72 hours, providing effective analgesia [3].

The primary goal of this study was to evaluate pain treatment in the postoperative period using a transdermal fentanyl patch in opioid-naive patients, and the secondary goal was to evaluate any associated side effects.

Material and Methods: A total of 44 patients were randomly assigned to one of two groups. The groups were labelled as FP (Fentanyl patch) and P (Paracetamol patch) ( Placebo). The Patch was applied 10-12 hours before surgery, and the patient was monitored for pain by NRS for 72 hours after surgery (Numeric Rating Scale). All of the patients were regularly given Paracetamol and Diclofenac Sodium. Tramadol was given as a rescue analgesic if the NRS scale was more than 5. The data was analysed using the Windows stat version 9.2 of Indostat services.

Results: There was a statistically significant difference in Tramadol intake over 72 hours between patients in the FP group (19.44mg) and the P group (72.22mg). The FP group also had significantly lower Numerical Rating scale scores of 8, 16, 24, 32, 40, 48, 56, 64, and 72 hours. The FP group had the greatest difference in pain score at 24 hours. Sedation, pruritus, respiratory depression, nausea, and vomiting scores did not differ between the two groups.

Conclusion: As part of multimodal analgesia, a 25g/hr transdermal Fentanyl patch administered 10-12 hours before surgery provides good postoperative pain management after major abdominal surgery.

Author(S) Details

S. Kalyani Surya Dhana Lakshmi
Department of Anaesthesiology, AIIMS Bibinagar Hyderabad, Telangana, India.

C. N. Chandrasekhar
Department of Anaesthesiology, AIIMS Bibinagar Hyderabad, Telangana, India.

View Book:- https://stm.bookpi.org/NHMMR-V2/article/view/6129

Study on the Outcome of Preoperative Administration of Single-Dose Ketorolac, Ibuprofen 400mg and Placebo on Postoperative Pain in Teeth with Irreversible Pulpitis and Apical Periodontitis | Chapter 8 | Recent Developments in Medicine and Medical Research Vol. 2

 

The goal of this study was to see how single-dose ketorolac, 400mg ibuprofen, and placebo affected postoperative pain in teeth with irreversible pulpitis and apical periodontitis.

Introduction: It is widely acknowledged that preoperative pain is the most important factor in determining postoperative pain severity. Even when endodontic treatment is performed to the highest standards, modest postoperative pain is not uncommon. Methodology: A total of 54 patients (29 women and 25 men) ranging in age from 18 to 60 years old with 54 eligible teeth agreed to participate in the study and were separated into three groups (n = 18) based on the type of preoperative medicine used: Ketorolac 10mg, Ibuprofen 400mg, and a placebo were given to Group A, B, and C, respectively (capsule filled with sugar). A chi-square test and one-way ANOVA were used to examine the data. To compare the incidence of postoperative discomfort, the Kruskal-Wallis nonparametric test was used. The threshold for significance was set at 5% (p = 0.05). Preoperative analgesic medication resulted in lower pain levels than the placebo on Days 1 and 3. However, while preoperative analgesic administration resulted in less pain than the placebo on Days 5 and 7, there was no significant difference between the analgesic and placebo on Days 5 and 7 (p= 0.05). In comparison to the placebo, ketorolac plus Ibuprofen 400 mg provided clinically substantial pain reduction for the next three days. Furthermore, no significant differences between ketorolac and ibuprofen 400 mg were found (Table 3). Conclusion: A single dosage of ketorolac was equally effective and safe as an NSAID in relieving pain after procedures in teeth with symptomatic apical periodontitis.

Author (S) Details

Jorge Paredes Vieyra
Facultad de Odontología Tijuana, Universidad Autónoma de Baja California, México.

Fabian Ocampo Acosta
Facultad de Odontología Tijuana, Universidad Autónoma de Baja California, México.

Mario I. Manriquez Quintana
Facultad de Odontología Tijuana, Universidad Autónoma de Baja California, México.

View Book :- https://stm.bookpi.org/RDMMR-V2/article/view/4279