Dolor crónico postamputación / Chronic post-amputation pain

Noviembre 17, 2017. No. 2905 Estimad@ Dr@ Víctor Valdés:

Dolor crónico post-aputación. Manejo perioperataorio. Revisión Chronic post-amputation pain: peri-operative management - Review. Srivastava D1. Author information Br J Pain. 2017 Nov;11(4):192-202. doi: 10.1177/2049463717736492. Epub 2017 Oct 9. Abstract STUDY DESIGN: Narrative review. METHOD: Eight bibliographic databases were searched for studies published in the (last five years up until Feb 2017). For the two database searches (Cochrane and DARE), the time frame was unlimited. The review involved keyword searches of the term 'Amputation' AND 'chronic pain'. Studies selected were interrogated for any association between peri-operative factors and the occurrence of chronic post amputation pain (CPAP). RESULTS: Heterogeneity of study populations and outcome measures prevented a systematic review and hence a narrative synthesis of results was undertaken. The presence of variation in two gene alleles (GCH1 and KCNS1) may be relevant for development of CPAP. There was little evidence to draw conclusions on the association between age, gender and CPAP. Pre-operative anxiety and depression influenced pain intensity post operatively and long-term post amputation pain (CPAP). The presence of pre-amputation pain is correlated to the development of acute and chronic post amputation pain while evidence for the association of post-operative pain with CPAP is modest. Regional anaesthesia and peri-neural catheters improve acute postoperative pain relief but evidence on their efficacy to prevent CPAP is limited. A suggested whole system pathway based on current evidence to optimize peri-operative amputation pain is described. CONCLUSION: The current evidence suggests that optimized peri-operative analgesia reduces the incidence of acute peri-operative pain but no firm conclusion can be drawn on reducing risk for CPAP. KEYWORDS: Amputation; chronic pain; persistent post-surgical pain; phantom limb pain; stump pain PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information International Anesthesia Research Society Annuals Meetings USA Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Dolor cronico / Chronic pain

Agosto 2, 2017. No. 2768

Dolor y psicología- Una relación recíproca. Pain and Psychology-A Reciprocal Relationship. Vadivelu N, Kai AM, Kodumudi G, Babayan K, Fontes M, Burg MM. Ochsner J. 2017 Summer;17(2):173-180. Abstract BACKGROUND: Depression typically affects 5% of the general population, but among patients with chronic pain, 30%-45% experience depression. Studies have shown that the relationship between depression and pain is bidirectional: depression is a positive predictor of the development of chronic pain, and chronic pain increases the risk of developing depression. METHODS: This literature review focuses on the relationship between psychology and pain, covering studies that have investigated the association between depression, pain sensitivity, opioid abuse, and gender differences in pain perception. We conducted a PubMed search pairing the word pain with depression, opioid use, and gender differences. RESULTS: The relationship between depression and pain is complex, as suggested by numerous studies that propose depression to be a moderator of the relationship between pain severity, physical functioning, and opioid use. Neuroimaging also suggests an anatomic overlap in the pathway of chronic pain and depression. Positive psychological factors, namely hope, pain acceptance, and optimism, affect the adjustment to persistent pain. CONCLUSION: The intricate relationship between pain and psychology is evidenced by the clinical overlap in their presentations and the overlap between the anatomic regions in the brain associated with the emotional and sensory features of pain and the areas affected by depression. Studies are beginning to improve our understanding of these two systems, but more studies are needed to elucidate the relationship. KEYWORDS: Analgesics-opioid; chronic pain; depression; pain; pain perception; psychology PDF Dolor crónico postoperatorio: hallazgos recientes en la comprensión y el manejo. Chronic postoperative pain: recent findings in understanding and management. Correll D. F1000Res. 2017 Jul 4;6:1054. doi: 10.12688/f1000research.11101.1. eCollection 2017. Abstract Chronic postoperative pain is a poorly recognized potential outcome from surgery. It affects millions of patients every year, with pain lasting for months to years, resulting in patient suffering and ensuing economic consequences. The operations with the highest incidence of chronicpostoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery. Other risk factors include preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain. Attempts to prevent chronic postoperative pain have often led to debatable results. This article presents data from recently published studies examining the incidence, risk factors, mechanisms, treatment options, and preventive strategies for chronic postoperative pain in adults. In summary, many of the previously identified risk factors for chronic postoperative pain have been confirmed and some novel ones discovered, such as the importance of the trajectory of acute painand the fact that catastrophizing may not always be predictive. The incidence of chronic postoperative pain hasn't changed over time, and there is limited new information regarding an effective preventive therapy. For example, pregabalin may actually cause more harm in certain surgeries. Further research is needed to demonstrate whether multimodal analgesic techniques have the best chance of significantly reducing the incidence of chronic postoperative pain and to determine which combination of agents is best for given surgical types and different patient populations. KEYWORDS: multimodal analgesia; persistent postoperative pain; surgery PDF El Comité Ejecutivo de la IASP insta a Venezuela a centrarse en el acceso a medicamentos para el dolor a la luz de escasez crítica IASP Executive Committee Urges Venezuela to Focus on Access to Pain Medications in Light of Critical Shortages As the leading global organization that brings together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain with the goal of improved pain relief worldwide, the International Association for the Study of Pain (IASP) has been made aware that difficult conditions in Venezuela have resulted in inadequate access to pain treatment. Declaración / Statement

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org