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Life
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A Paradigm Shift in Airway and Pain Management
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A Paradigm Shift in Airway and Pain Management

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 10911

Special Issue Editor

Dr. Jui An Lin

E-Mail Website
Guest Editor
Department of Anesthesiology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Interests: anesthesiology; pain managemen; pain medicine; conduction anesthesia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last several decades, notable advances have been made in the field of anesthesiology, particularly the means and devices in airway management and widespread ultrasound applications in pain management. Airway management is central to anesthesiologists, with significant challenges posed by the uncertain COVID era, and needs to be adjusted over time in accordance with the trend. As for pain management, there is still an unmet need despite the recent progress in ultrasound-guided procedures. A motor-sparing goal will remain the mainstay in both acute and chronic pain scenarios due to its key role in enhancing recovery after surgery and clinic-based practice, respectively. Acute pain management is inherently an extension of regional anesthesia, which can be viewed as an advanced modality of perioperative analgesia starting in the pre-surgical period. The concept of motor-sparing should also be rooted in peripheral nerve block-based regional anesthesia to facilitate motor recovery as early as possible. As regenerative medicine advances in this expanded ultrasound era, future research in chronic pain management should focus on transitioning from fluoroscopy guidance (with or without ultrasound assistance) to exclusively ultrasound guidance for most pain management procedures as well as the extensive application of regenerative therapies in pain medicine.

The aim of this Special Issue is to present a paradigm shift in airway and pain management using new data. We welcome submissions of Original Research, Brief Research Reports, and Reviews that will stimulate continuing efforts to develop better choices for optimal patient care.

Dr. Jui An Lin
Guest Editor

Manuscript Submission Information

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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. Life is an international peer-reviewed open access monthly 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

  • airway management
  • pain management
  • ultrasonography
  • motor activity
  • nerve block
  • anesthesia, conduction
  • regenerative medicine
  • multidisciplinary/comprehensive care program

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Published Papers (5 papers)

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17 pages, 624 KiB  
Article
Oxytocin Modulation in Mindfulness-Based Pain Management for Chronic Pain
by Oytun Aygün, Emily Mohr, Colin Duff, Sophie Matthew and Poppy Schoenberg
Life 2024, 14(2), 253; https://doi.org/10.3390/life14020253 - 15 Feb 2024
Cited by 1 | Viewed by 3654
Abstract
In the context of chronic pain management, opioid-based treatments have been heavily relied upon, raising concerns related to addiction and misuse. Non-pharmacological approaches, such as Mindfulness-Based Pain Management, offer alternative strategies. We conducted a mechanistic clinical study to investigate the impact of an [...] Read more.
In the context of chronic pain management, opioid-based treatments have been heavily relied upon, raising concerns related to addiction and misuse. Non-pharmacological approaches, such as Mindfulness-Based Pain Management, offer alternative strategies. We conducted a mechanistic clinical study to investigate the impact of an 8-week Mindfulness-Based Pain Management intervention on chronic pain, the modulation of inflammatory markers, stress physiology, and oxytocin, and their interplay with clinical pain symptoms and perception, in comparison to a patient wait-list active control. A total of 65 participants, including 50 chronic pain patients and 15 healthy controls, underwent salivary assays to assess endocrine markers, oxytocin, interleukin (IL)-1b, IL-6, IL-8, tumor necrosis factor (TNF)-a, and dehydroepiandrosterone sulphate (DHEA-S). Psychological assessments were also conducted to evaluate aspects of pain perception, mindfulness, mood, and well-being. Findings revealed significant differences between chronic pain patients and healthy controls in various clinical metrics, highlighting the psychological distress experienced by patients. Following Mindfulness-Based Pain Management, oxytocin levels significantly increased in chronic pain patients, that was not observed in the patient wait-list control group. In contrast, cytokine and DHEA-S levels decreased (not to statistically significant margins) supporting anti-inflammatory effects of Mindfulness-Based Pain Management. The fact DHEA-S levels, a marker of stress, did attenuate but not to statistically meaningful levels, suggests that pain reduction was not solely related to stress reduction, and that oxytocin pathways may be more salient than previously considered. Psychological assessments demonstrated substantial improvements in pain perception and mood in the intervention group. These results contribute to the growing body of evidence regarding the effectiveness of mindfulness-based interventions in chronic pain management and underscore oxytocin’s potential role as a therapeutic target. Full article
(This article belongs to the Special Issue A Paradigm Shift in Airway and Pain Management)
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14 pages, 761 KiB  
Article
Individual Factors Modifying Postoperative Pain Management in Elective Total Hip and Total Knee Replacement Surgery
by Alina Jurewicz, Agata Gasiorowska, Katarzyna Leźnicka, Maciej Pawlak, Magdalena Sochacka, Anna Machoy-Mokrzyńska, Andrzej Bohatyrewicz, Agnieszka Maciejewska-Skrendo and Grzegorz Pawlus
Life 2024, 14(2), 211; https://doi.org/10.3390/life14020211 - 31 Jan 2024
Cited by 4 | Viewed by 1821
Abstract
Total hip and knee replacements are the most common orthopedic procedures performed due to osteoarthritis. Pain is an intrinsic symptom accompanying osteoarthritis, persisting long before surgery, and continuing during the preoperative and postoperative periods. Appropriate pain management after surgery determines the comfort, duration, [...] Read more.
Total hip and knee replacements are the most common orthopedic procedures performed due to osteoarthritis. Pain is an intrinsic symptom accompanying osteoarthritis, persisting long before surgery, and continuing during the preoperative and postoperative periods. Appropriate pain management after surgery determines the comfort, duration, and cost of hospitalization, as well as the effectiveness of postoperative rehabilitation. Individual differences in pain perception and tolerance in orthopedic patients remain an important research topic. Therefore, the aim of this study was to investigate the predictors of analgesic requirements (morphine, acetaminophen, and ketoprofen), including individual pain threshold and tolerance, body mass index (BMI), diabetes, and beliefs about pain control in patients undergoing elective hip or knee arthroplasty using a multilevel regression model (N = 147, 85 women, 62 men, 107 after hip replacement, and 40 after knee replacement). Results: Higher pain tolerance was associated with a lower dose of morphine per kg after surgery. Patients undergoing hip surgery received a lower dose of ketoprofen than patients undergoing knee surgery. The more the patient believed in personal pain control, the stronger the negative relationship between pain tolerance and morphine requirement. The lowest doses were given to patients with the highest pain tolerance and the greatest belief in personal control. Factors such as belief in pain control and pain tolerance should be considered in comprehensive postoperative pain management in orthopedic patients to reduce opioid doses and, thus, side effects. Full article
(This article belongs to the Special Issue A Paradigm Shift in Airway and Pain Management)
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11 pages, 989 KiB  
Article
Comparative Study of Post-Surgical Outcomes in Pain, Disability, and Health-Related Quality of Life for Adult Spinal Deformity in Patients Aged above and below 75 Years
by Yeonsu Park, Jiyoon Kim, Ho-Joong Kim, Seungtak Oh, Joon-Hee Park, Daechul Shim and Jin-Ho Park
Life 2023, 13(12), 2329; https://doi.org/10.3390/life13122329 - 12 Dec 2023
Viewed by 1061
Abstract
(1) Background: Adult spinal deformity (ASD) surgery is known to improve clinical and radiological parameters; however, it may also cause more complications in elderly patients. The purpose of this study was to compare the outcomes of ASD surgery, specifically regarding pain, disability, and [...] Read more.
(1) Background: Adult spinal deformity (ASD) surgery is known to improve clinical and radiological parameters; however, it may also cause more complications in elderly patients. The purpose of this study was to compare the outcomes of ASD surgery, specifically regarding pain, disability, and health-related quality of life (HRQOL) in patients aged 75 years and over and patients aged under 75 years; (2) Methods: A total of 151 patients who underwent ASD surgery between August 2014 and September 2020 were included. Patients were divided into two groups based on whether they are 75 years and over or under. Radiological parameters measured included sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence (PI)- lumbar lordosis (LL). Data were collected 3, 6, and 12 months after surgery; (3) Results: At 12 months postoperatively, visual analog scale (VAS) for low back pain (p = 0.342), Oswestry disability index (ODI) (p = 0.087), and EuroQol 5-Dimensions (EQ-5D) (p = 0.125) did not differ between patients under 75 years and those 75 and above 75 group. PT (p = 0.675), PI-LL (p = 0.948), and SVA (p = 0.108) did not differ significantly 12 months after surgery in the two groups. In the entire patient group, compared to preoperative data, significant improvements were demonstrated for clinical and radiological parameters 12 months after surgery (all p < 0.001). The rate of medical complications did not correlate with age, but the rates of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) did (p = 0.638, p < 0.001, and p = 0.001, respectively); (4) Conclusions: In terms of clinical and radiological improvements, ASD surgery should be considered for patients regardless of whether they are younger than or older than 75 years. The clinical and radiological improvements and the risk of complications and revision surgeries must be considered in ASD patients who are 75 years or older. Full article
(This article belongs to the Special Issue A Paradigm Shift in Airway and Pain Management)
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17 pages, 732 KiB  
Article
Automated Electrodermal Activity and Facial Expression Analysis for Continuous Pain Intensity Monitoring on the X-ITE Pain Database
by Ehsan Othman, Philipp Werner, Frerk Saxen, Ayoub Al-Hamadi, Sascha Gruss and Steffen Walter
Life 2023, 13(9), 1828; https://doi.org/10.3390/life13091828 - 29 Aug 2023
Cited by 3 | Viewed by 1308
Abstract
This study focuses on improving healthcare quality by introducing an automated system that continuously monitors patient pain intensity. The system analyzes the Electrodermal Activity (EDA) sensor modality modality, compares the results obtained from both EDA and facial expressions modalities, and late fuses EDA [...] Read more.
This study focuses on improving healthcare quality by introducing an automated system that continuously monitors patient pain intensity. The system analyzes the Electrodermal Activity (EDA) sensor modality modality, compares the results obtained from both EDA and facial expressions modalities, and late fuses EDA and facial expressions modalities. This work extends our previous studies of pain intensity monitoring via an expanded analysis of the two informative methods. The EDA sensor modality and facial expression analysis play a prominent role in pain recognition; the extracted features reflect the patient’s responses to different pain levels. Three different approaches were applied: Random Forest (RF) baseline methods, Long-Short Term Memory Network (LSTM), and LSTM with the sample-weighting method (LSTM-SW). Evaluation metrics included Micro average F1-score for classification and Mean Squared Error (MSE) and intraclass correlation coefficient (ICC [3, 1]) for both classification and regression. The results highlight the effectiveness of late fusion for EDA and facial expressions, particularly in almost balanced datasets (Micro average F1-score around 61%, ICC about 0.35). EDA regression models, particularly LSTM and LSTM-SW, showed superiority in imbalanced datasets and outperformed guessing (where the majority of votes indicate no pain) and baseline methods (RF indicates Random Forest classifier (RFc) and Random Forest regression (RFr)). In conclusion, by integrating both modalities or utilizing EDA, they can provide medical centers with reliable and valuable insights into patients’ pain experiences and responses. Full article
(This article belongs to the Special Issue A Paradigm Shift in Airway and Pain Management)
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Other

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18 pages, 2280 KiB  
Systematic Review
Effectiveness of Virtual Reality on Postoperative Pain, Disability and Range of Movement after Knee Replacement: A Systematic Review and Meta-Analysis
by Jara Esteban-Sopeña, Hector Beltran-Alacreu, Marc Terradas-Monllor, Juan Avendaño-Coy and Nuria García-Magro
Life 2024, 14(3), 289; https://doi.org/10.3390/life14030289 - 21 Feb 2024
Cited by 4 | Viewed by 1938
Abstract
Postoperative pain after knee arthroplasty (TKA) is a reality that continues to be experienced today. Recently, virtual reality (VR) has demonstrated effectiveness in the management of pain. Our aim was to review the original controlled trials evaluating the effectiveness of VR for pain [...] Read more.
Postoperative pain after knee arthroplasty (TKA) is a reality that continues to be experienced today. Recently, virtual reality (VR) has demonstrated effectiveness in the management of pain. Our aim was to review the original controlled trials evaluating the effectiveness of VR for pain management and quality of life after TKA. Six databases were searched for articles published from inception to September 2023, following (PRISMA) guidelines. The methodological quality was assessed using the Risk of Bias tool for Randomized Trials (ROB2). Five RCTs were included in the systematic review, and four of them in the meta-analysis. The effectiveness of VR for short term pain relief was superior compared to the control (MD = −0.8 cm; CI 95%: −1.3 to −0.4; p < 0.001). VR showed a greater effect on the secondary outcomes of WOMAC (MD = −4.6 points; CI 95%: −6.5 to −2.6, p < 0.001) and the HSS scale (MD = 6.5 points; CI 95%: 0.04 to 13.0, p = 0.049). However, no differences were found in the effect on the ROM between groups (MD = 3.4 grades; CI 95%: −6.0 to 12.8, p = 0.48). Our findings suggest that the use of virtual reality during the postoperative period could be an effective non-pharmacological therapy in relieving acute pain, compared to a control intervention, with a very low degree of certainty according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). However, the low methodological quality of the articles limits our findings. Full article
(This article belongs to the Special Issue A Paradigm Shift in Airway and Pain Management)
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