European Resuscitation Council Guidelines for Resuscitation.

ESPEN Guidelines on Parenteral Nutrition: intensive care.

Here we provide the updated version of the guidelines of the European Association for Palliative Care (EAPC) on the use of opioids for the treatment of cancer pain. The update was undertaken by the European Palliative Care Research Collaborative. Previous EAPC guidelines were reviewed and compared with other currently available guidelines, and consensus recommendations were created by formal international expert panel. The content of the guidelines was defined according to several topics, each of which was assigned to collaborators who developed systematic literature reviews with a common methodology. The recommendations were developed by a writing committee that combined the evidence derived from the systematic reviews with the panellists' evaluations in a co-authored process, and were endorsed by the EAPC Board of Directors. The guidelines are presented as a list of 16 evidence-based recommendations developed according to the Grading of Recommendations Assessment, Development and Evaluation system.

Use of Opioid Analgesics in the Treatment of Cancer Pain: Evidence-Based Recommendations From the EAPC

The assessment of pain.

Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis

The association of erector spinae plane block and ultrasound guided dry needling could be a winning strategy for long-term relief of chronic musculoskeletal pain.

Abstract We retrospectively analyzed the data from patients admitted to the intensive care unit (ICU) of the Hospital of L’Aquila during the first and second waves of pandemic to identify pain related to COVID-19. Pain was evaluated by using the Numerical Rating Scale, and the assessment for neuropathic disturbances of pain was performed with von Frey’s hair and Lindblom tests. Pain increased significantly during hospitalization (from 48% at hospital admission to 94.3% at ICU discharge). Female patients were affected by somatic pain in 32.8% of the cases and by somatic pain and pain with neuropathic features (NFs) in 23.5% of the cases, during the ICU stay. Somatic pain and pain with NFs affected more frequently patients with cardiological and respiratory comorbidities. Patients treated with continuous positive airway pressure via helmet had a higher frequency of somatic pain and pain with neuropathic disturbances (84 and 74%, respectively). The frequency of somatic pain and pain with neuropathic disturbances was lower in patients sedated with propofol combined with ketamine. Females have been associated with a higher risk of somatic pain and pain with NFs. Patients with cardiological and respiratory comorbidities undergoing noninvasive ventilation had higher levels of pain. As conclusion, ketamine may reduce the promotion or the worsening of pain in COVID-19 patients.

https://www.degruyter.com/document/doi/10.1515/med-2022-0600/pdf

Pain in critically ill COVID-19 patients: An Italian retrospective study

Multiple Chemical Sensitivity (MCS) is characterised by the appearance of numerous and sometimes severe symptoms, when subjects are in contact with various chemicals and medicinal substances. Currently there are no useful guidelines for managing clinical issues and, specifically, anaesthesia for patients with MCS. This case report describes anaesthesia management in a patient affected by clinically documented MCS and a latex allergy, a candidate for a laparoscopic cholecystectomy operation.

https://journals.sagepub.com/doi/pdf/10.1177/039463201302600415

Anaesthesia management in patients with multiple chemical sensitivity syndrome.

friction; 16, any pain, and 6, disabling pain. There were 11 (6.5%) questionnaires with four positive responses. Pain was reported without neuropathic signs in three (1.8%) questionnaires. In 32 cases there were two [1 to 3] neuropathic signs [range: 1 to 6] but without pain at the surgical site. Surgery was orthopaedic equipment removal, epiphysiodesis, ligamentoplasty, cryptorchidism, circumcision, inguinal or umbilical hernia, hypospadias, and plastic surgery. Multivariate analysis identified two independent risk factors for PPP: age at least 72 months at the time of surgery [odds ratio (OR), 2.6 95%CI 1.29 to 5.33) P1⁄4 0.008] and the need for morphine titration in the recovery room [OR, 3.5 (95% CI 1.34 to 9.28) P1⁄4 0.01] with an area under the curve1⁄4 0.64 (x Hosmer and Lemeshow1⁄4 0.22, Pearson coefficient1⁄4 0.96). At the 35.3% threshold, sensitivity was 71.4%, specificity 51.7%, positive predictive value 38.0%, negative predictive value 81.3%. The positive and negative likelihood ratios were 1.53 and 0.55, respectively. Statistical analysis failed to identify the independent factors associated with four positive responses to the questionnaire except, again, for age.

The anaesthetic and analgesic effects of pectoral nerve and parasternal block combination for patients undergoing breast cancer surgery: A phase II study.

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