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Article ; Online: Cyclooxygenase-2 Selective Nonsteroidal Anti-Inflammatory Drugs in the Chronic Kidney Disease Population: Are They Rational or Reckless?

Karri, Jay / D'Souza, Ryan S / Wang, Eric J

2024

Language	English
Publishing date	2024-02-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006574
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Finding diamonds in the rough: evaluating the quality of meta-analyses in chronic pain - an infographic.

Hussain, Nasir / D'Souza, Ryan S

Regional anesthesia and pain medicine

2024

Language	English
Publishing date	2024-03-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1425299-5
ISSN	1532-8651 ; 1098-7339 ; 0146-521X
ISSN (online)	1532-8651
ISSN	1098-7339 ; 0146-521X
DOI	10.1136/rapm-2024-105447
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Article ; Online: In Response.

D'Souza, Ryan S / Dunn, Lauren

Anesthesia and analgesia

2023 Volume 138, Issue 1, Page(s) e4–e5

Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006771
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Treatment Disparities in Hispanic Patients with Chronic Pain: An Evidence-Based Narrative Review.

Crimmel, Stephanie / Hu, Lizbeth / D'Souza, Ryan S / Wang, Eric J

Current pain and headache reports

2024 Volume 28, Issue 4, Page(s) 271–278

Abstract: Purpose of review: The purpose of this narrative review is to summarize healthcare disparities experienced by Hispanic and Latino/Latinx patients with chronic pain, evaluate the existing literature exploring the specific therapeutic inequities affecting ...

Abstract	Purpose of review: The purpose of this narrative review is to summarize healthcare disparities experienced by Hispanic and Latino/Latinx patients with chronic pain, evaluate the existing literature exploring the specific therapeutic inequities affecting this patient population, and identify gaps in the literature requiring future study. Recent findings: Hispanic and Latino/Latinx patients experience disparities in chronic pain management. They are less likely to be prescribed pharmacologic therapies, including non-steroidal anti-inflammatory drugs and opioids. Hispanic and Latino/Latinx patients are also less likely to receive spinal cord stimulators and may be charged higher costs for them. There are no published studies specifically assessing Hispanic and Latino/Latinx patients' utilization and outcomes from other common interventional pain procedures (e.g., epidural steroid injections, radiofrequency ablation). Limited data suggest non-pharmacologic treatments, such as cognitive behavioral therapy and complementary/integrative health modalities, might have more benefit for this population, potentially because of greater utilization. Hispanic and Latino/Latinx patients experience disparities in chronic pain management. There is a paucity of data available pertaining specifically to pain-related outcomes and the utilization of pain treatment modalities, especially in regard to interventional procedures. Additional research is urgently needed in order to understand the full extent of these disparities and develop solutions to provide more equitable care.
MeSH term(s)	Humans ; Chronic Pain/therapy ; Hispanic or Latino ; Healthcare Disparities ; Pain Management ; Analgesics, Opioid
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055062-5
ISSN	1534-3081 ; 1531-3433
ISSN (online)	1534-3081
ISSN	1531-3433
DOI	10.1007/s11916-024-01220-y
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Article ; Online: How Real Are the Effects of Virtual Reality in Decreasing Acute Pain?

Shanthanna, Harsha / D'Souza, Ryan S / Johnson, Rebecca L / YaDeau, Jacques T

Anesthesia and analgesia

2024 Volume 138, Issue 4, Page(s) 746–750

MeSH term(s)	Humans ; Acute Pain/diagnosis ; Acute Pain/therapy ; Pain Management ; Virtual Reality
Language	English
Publishing date	2024-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006698
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Efficacy of Low-Dose Naltrexone and Predictors of Treatment Success or Discontinuation in Fibromyalgia and Other Chronic Pain Conditions: A Fourteen-Year, Enterprise-Wide Retrospective Analysis.

Driver, C Noelle / D'Souza, Ryan S

Biomedicines

2023 Volume 11, Issue 4

Abstract: Current pharmacologic treatments may provide limited analgesia in fibromyalgia and other chronic pain disorders. Low-dose naltrexone (LDN) has emerged as a potential analgesic option that has been minimally explored. This study aims to describe current ... ...

Abstract	Current pharmacologic treatments may provide limited analgesia in fibromyalgia and other chronic pain disorders. Low-dose naltrexone (LDN) has emerged as a potential analgesic option that has been minimally explored. This study aims to describe current real-world prescribing practices of LDN, to investigate if patients have a perceived benefit of LDN in treating pain symptoms and to identify predictors associated with a perceived benefit or discontinuation of LDN. We evaluated all outpatient prescriptions for LDN prescribed for any pain indication in the Mayo Clinic Enterprise from 1 January 2009 to 10 September 2022. A total of 115 patients were included in the final analysis. The patients were 86% female, had a mean age of 48 ± 16 years, and 61% of prescriptions were for fibromyalgia-related pain. The final daily dose of oral LDN ranged from 0.8 to 9.0 mg, while the most common dose was 4.5 mg once daily. Of patients who reported follow-up data, 65% reported benefit in their pain symptoms while taking LDN. Adverse effects were reported in 11 (11%) patients and 36% discontinued taking LDN by the most recent follow-up. Concomitant analgesic medications were used by 60% of patients and were not associated with perceived benefit nor discontinuation of LDN, including concomitant opioids. LDN is a relatively safe pharmacologic option that may benefit patients with chronic pain conditions and warrants further investigation in a prospective, controlled, and well-powered randomized clinical trial.
Language	English
Publishing date	2023-04-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11041087
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Pro-Con Debate: Role of Methadone in Enhanced Recovery After Surgery Protocols-Superior Analgesic or Harmful Drug?

D'Souza, Ryan S / Esfahani, Kamilla / Dunn, Lauren K

Anesthesia and analgesia

2023 Volume 137, Issue 1, Page(s) 76–82

Abstract: ... possesses a multimodal profile consisting of µ-opioid agonism, N-methyl-d-aspartate (NMDA) receptor ...

Abstract	Enhanced recovery after surgery (ERAS) protocols are standardized and designed to provide superior analgesia, reduce opioid consumption, improve patient recovery, and reduce hospital length of stay. Yet, moderate-to-severe postsurgical pain continues to afflict over 40% of patients and remains a major priority for anesthesia research. Methadone administration in the perioperative setting may reduce postoperative pain scores and have opioid-sparing effects, which may be beneficial for enhanced recovery. Methadone possesses a multimodal profile consisting of µ-opioid agonism, N-methyl-d-aspartate (NMDA) receptor antagonism, and reuptake inhibition of serotonin and norepinephrine. Furthermore, it may attenuate the development of chronic postsurgical pain. However, caution is advised with perioperative use of methadone in specific high-risk patient populations and surgical settings. Methadone's wide pharmacokinetic variability, opioid-related adverse effects, and potential negative impact on cost-effectiveness may also limit its use in the perioperative setting. In this PRO-CON commentary article, the authors debate whether methadone should be incorporated in ERAS protocols to provide superior analgesia with no increased risks.
MeSH term(s)	Humans ; Methadone/adverse effects ; Analgesics, Opioid/adverse effects ; Pharmaceutical Preparations ; Enhanced Recovery After Surgery ; Analgesics ; Pain, Postoperative/diagnosis ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control
Chemical Substances	Methadone (UC6VBE7V1Z) ; Analgesics, Opioid ; Pharmaceutical Preparations ; Analgesics
Language	English
Publishing date	2023-06-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006331
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Systematic Reviews and Meta-analyses in Regional Anesthesia and Pain Medicine (Part II): Guidelines for Performing the Systematic Review.

D'Souza, Ryan S / Barrington, Michael J / Sen, Ananda / Mascha, Edward J / Kelley, George A

Anesthesia and analgesia

2024 Volume 138, Issue 2, Page(s) 395–419

Abstract: In Part I of this series, we provide guidance for preparing a systematic review protocol. In this article, we highlight important steps and supplement with exemplars on conducting and reporting the results of a systematic review. We suggest how authors ... ...

Abstract	In Part I of this series, we provide guidance for preparing a systematic review protocol. In this article, we highlight important steps and supplement with exemplars on conducting and reporting the results of a systematic review. We suggest how authors can manage protocol violations, multiplicity of outcomes and analyses, and heterogeneity. The quality (certainty) of the evidence and strength of recommendations should follow the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. It is our goal that Part II of this series provides valid guidance to authors and peer reviewers who conduct systematic reviews to adhere to important constructs of transparency, structure, reproducibility, and accountability. This will likely result in more rigorous systematic reviews being submitted for publication to the journals like Regional Anesthesia & Pain Medicine and Anesthesia & Analgesia .
MeSH term(s)	Humans ; Analgesics ; Anesthesia, Conduction ; Pain ; Reproducibility of Results ; Systematic Reviews as Topic/methods
Chemical Substances	Analgesics
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006607
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Systematic Reviews and Meta-analyses in Regional Anesthesia and Pain Medicine (Part I): Guidelines for Preparing the Review Protocol.

Barrington, Michael J / D'Souza, Ryan S / Mascha, Edward J / Narouze, Samer / Kelley, George A

Anesthesia and analgesia

2024 Volume 138, Issue 2, Page(s) 379–394

Abstract: Comprehensive resources exist on how to plan a systematic review and meta-analysis. The objective of this article is to provide guidance to authors preparing their systematic review protocol in the fields of regional anesthesia and pain medicine. The ... ...

Abstract	Comprehensive resources exist on how to plan a systematic review and meta-analysis. The objective of this article is to provide guidance to authors preparing their systematic review protocol in the fields of regional anesthesia and pain medicine. The focus is on systematic reviews of health care interventions, with or without an aggregate data meta-analysis. We describe and discuss elements of the systematic review methodology that review authors should prespecify, plan, and document in their protocol before commencing the review. Importantly, authors should explain their rationale for planning their systematic review and describe the PICO framework-participants (P), interventions (I), comparators (C), outcomes (O)-and related elements central to constructing their clinical question, framing an informative review title, determining the scope of the review, designing the search strategy, specifying the eligibility criteria, and identifying potential sources of heterogeneity. We highlight the importance of authors defining and prioritizing the primary outcome, defining eligibility criteria for selecting studies, and documenting sources of information and search strategies. The review protocol should also document methods used to evaluate risk of bias, quality (certainty) of the evidence, and heterogeneity of results. Furthermore, the authors should describe their plans for managing key data elements, the statistical construct used to estimate the intervention effect, methods of evidence synthesis and meta-analysis, and conditions when meta-analysis may not be possible, including the provision of practical solutions. Authors should provide enough detail in their protocol so that the readers could conduct the study themselves.
MeSH term(s)	Humans ; Anesthesia, Conduction ; Bias ; Meta-Analysis as Topic ; Pain ; Systematic Reviews as Topic/methods
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006573
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Methodological and statistical characteristics of meta-analyses on spinal cord stimulation for chronic pain: a systematic review.

Kleppel, Donald J / Copeland, Royce / Hussain, Nasir / Karri, Jay / Wang, Eric / D'Souza, Ryan S

Regional anesthesia and pain medicine

2024

Abstract: Background: A growing number of meta-analyses (MA) have investigated the use of spinal cord stimulation (SCS) as a treatment modality for chronic pain. The quality of these MAs has not been assessed by validated appraisal tools.: Objective: To ... ...

Abstract	Background: A growing number of meta-analyses (MA) have investigated the use of spinal cord stimulation (SCS) as a treatment modality for chronic pain. The quality of these MAs has not been assessed by validated appraisal tools. Objective: To examine the methodological characteristics and quality of MAs related to the use of SCS for chronic pain syndromes. Evidence review: An online literature search was conducted in Ovid MEDLINE(R), Ovid EMBASE, Ovid Cochrane Database of Systematic Reviews, and Scopus databases (January 1, 2000 through June 30, 2023) to identify MAs that investigated changes in pain intensity, opioid consumption, and/or physical function after SCS for the treatment of chronic pain. MA quality was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) critical appraisal tool. Findings: Twenty-five MAs were appraised in the final analysis. Three were considered "high" quality, three "low" quality, and 19 "critically low" quality, per the AMSTAR-2 criteria. There was no association between the publication year and AMSTAR-2 overall quality (β 0.043; 95% CI -0.008 to 0.095; p=0.097). There was an association between the impact factor and AMSTAR-2 overall quality (β 0.108; 95% CI 0.044 to 0.172; p=0.002), such that studies published in journals with higher impact factors were associated with higher overall quality. There was no association between the effect size and AMSTAR-2 overall quality (β -0.168; 95% CI -0.518 to 0.183; p=0.320).According to our power analysis, three studies were adequately powered (>80%) to reject the null hypothesis, while the remaining studies were underpowered (<80%). Conclusions: The study demonstrates a critically low AMSTAR-2 quality for most MAs published on the use of SCS for treating chronic pain. Future MAs should improve study quality by implementing the AMSTAR-2 checklist items. Prospero registration number: CRD42023431155.
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1425299-5
ISSN	1532-8651 ; 1098-7339 ; 0146-521X
ISSN (online)	1532-8651
ISSN	1098-7339 ; 0146-521X
DOI	10.1136/rapm-2023-105249
Database	MEDical Literature Analysis and Retrieval System OnLINE

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