Post C-Section Pain Relief: Noninvasive Bioelectronic Device Reduced Need for Opioids

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PainRelief.com Interview with:
Jennifer Grasch, MD
Fellow, Maternal-Fetal Medicine
Department of Obstetrics and Gynecology
The Ohio State University Wexner Medical Center

PainRelief.com: What is the background for this study? What are the main findings?

Response: Cesarean delivery is the most commonly performed major surgery in the US. Almost all patients who have a cesarean delivery take opioid pain medications for postoperative pain, but we know that opioids have many short- and long-term side effects.

We conducted a triple-blind sham-controlled randomized clinical trial testing the efficacy of adding transcutaneous treatment with a high-frequency (20,000 Hz) electrical stimulation device to a multimodal analgesic protocol after cesarean delivery. 

Participants who were randomly assigned to the functional device used 47% less opioid medication postoperatively in the hospital and were prescribed fewer opioids at discharge than those who received treatment with a sham device.  

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PainRelief Through Optogenetics: Scientists Make Flexible Gel to Deliver Light to Peripheral Nerves

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PainRelief.com Interview with:
Xinyue Liu, Ph.D.
Assistant Professor
Department of Chemical Engineering and Materials Science
Michigan State University
Siyuan Rao, Ph.D.
Assistant Professor
Biomedical Engineering Department
Binghamton University, SUNY

Dr. Liu

PainRelief.com: What is the background for this study?

Response: The background lies in the field of optogenetics and its application to the study and modulation of pain perception. Optogenetics is a powerful tool that allows precise control of neural cell populations using light. It has been widely used in neuroscience to investigate how different cells in the brain and nervous system function and how their activity can be modulated. Specifically, in the context of pain research, optogenetics offers the potential to explore the neural mechanisms underlying pain perception and to develop new therapeutic interventions for pain management.

However, one of the challenges in applying optogenetics to the study of pain and nociceptive circuits is the delivery of light to peripheral nerves that experience mechanical strain during locomotion. Traditional light-delivery devices made from rigid materials, such as glass fibers, are not well-suited for this purpose. They can impede the natural behaviors of animals and may cause tissue damage when used in dynamic conditions.

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Buprenorphine Initiation and Retention Through Telehealth for Opioid Use Disorder

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PainRelief.com Interview with:
Lindsey Hammerslag, Ph.D.
Assistant Research Professor
Division of Biomedical Informatics
University of Kentucky
Lexington, KY 40536

PainRelief.com: What is the background for this study? What are the main findings?

Response: This study was designed to examine whether COVID-related changes to buprenorphine prescribing policies, which allowed the use of telehealth during treatment initiation, were associated with benefits for people with opioid use disorder. There’s a push to return to normalcy, with some COVID-related policies being rolled back during the unwinding, and we felt that it was important to make sure that we could provide the evidence policy makers need to make good decisions for patients.

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Study Finds Modest Decrease in Opioid Prescriptions after Insurer Opioid Prescribing Limit

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PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109

Dr. Kao-Ping Chua
Dr. Kao-Ping Chua

PainRelief.com: What is the background for this study?

Response: Almost every state has implemented a policy to restrict the duration of opioid prescriptions for acute pain, as have many major insurers. Prior studies have evaluated the effects of these limits on opioid prescribing, but there are no large-scale studies that have evaluated the effects of limits on patient-reported outcomes, such as pain control.

In this study, we evaluated the effect of a major Michigan insurer’s
5-day opioid prescribing limit in February 2018 on both opioid prescribing and patient-reported outcomes after surgery.

To do so, we leveraged our access to a statewide surgical registry in Michigan that has been collecting data on opioid prescribing and patient-reported outcomes from adult patients undergoing common general surgical procedures since 2017.

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Cannabis-Related Hospitalizations Following Legalization in Canada

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PainRelief.com Interview with:
Daniel Myran, MD, MPH, CCFP, FRCPC
Canada Research Chair, Social Accountability, University of Ottawa
Investigator, Bruyère Research Institute 
Assistant Professor, Department of Family Medicine
Lecturer, School of Epidemiology and Public Health
Adjunct Scientist, ICES
University of Ottawa

PainRelief.com: What is the background for this study?

Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Legalization in Canada took a phased approach initially, only the sale of flower-based cannabis products and oils was permitted and there were very few legal cannabis stores and legal sales. Starting in early 2020, Canada allowed the sale of expanded products (e.g. cannabis edibles, vape pens, concentrates), and the number of retail stores began expanding. In this study, we took advantage of this evolution of the legal cannabis market to understand how different phases of legalization were associated with hospitalizations due to cannabis.  

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Columbia Model Predicts Return-to-Use Risk After Treatment for Opioid Use Disorder

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PainRelief.com Interview with:
SEAN X. LUO, M.D., PH.D.
Assistant Professor of Clinical Psychiatry
Data Science Research Group
Division on Substance Use Disorders
Department of Psychiatry
Columbia University

PainRelief.com: What is the background for this study?

Response: Opioid use disorder presents a major public health crisis, with increasing overdose death through the last 5 years. Treatment delivery continues to be difficult, with a large number of patients not stably maintained on Medication for Opioid Use Disorder (MOUD) after the initial treatment engagement.

In this study we applied novel statistical methods to a newly harmonized dataset incorporating 3 large clinical trials from the National Drug Treatment Clinical Trials Network (CTN) to develop individual level risk prediction models for opioid use disorder. We showed that urine toxicology data in the first 3 weeks after initiation of treatment can predict return-to-use at the end of 3 months with surprising accuracy.

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Miami Thoracic Surgeons Achieve Pain Control With Minimal or No Opioids

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PainRelief.com Interview with:
Dao Minh Nguyen, MD, MSc FRCSC FACS
Thoracic Cancers Group Go-Lead
Sylvester Comprehensive Cancer Center
University of Miami Miller School of Medicine

PainRelief.com: What is the background for this study?

Response: Patients undergoing thoracic surgery operations experience significant acute incisional pain as well as chronic pain many months after.

The mainstay of treatment is based on frequent use of potent and addictive-prone opioids such as hydromorphone, oxycodone at high dosages and long duration.
There is a high incidence of persistent opioid users and chronic opioids users in surgical patient population. This certainly contributes to the opioid epidemic in the USA and worldwide.

We implemented a peri-operative care protocol for patients undergoing thoracic surgery operations called Enhanced Recovery after Thoracic Surgery (ERATS). The overarching goal of ERATS is to streamline care for thoracic surgery patients particularly in the postoperative period to mitigate pain with opioid-free strategy, to minimize postoperative complications, rapid return to baseline states and safe, early discharge home. This protocol follows guidelines of the ERAS principles and is developed for thoracic patients to address their unique needs.

Once pain is adequately addressed with opioid-free strategy with elimination of opioid-associated side effects, rapid recovery after surgery can be achieved.

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Canadian Study Finds Cannabis Use Disorder Associated with Higher Risk of Heart Disease

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PainRelief.com Interview with:
Anees Bahji, BSc(H), MD, CISAM, CCSAM, DABPN, FRCPC (pronouns: he/him/his)
Clinical Assistant Professor, Department of Psychiatry, University of Calgary
Ph.D. Student, Department of Community Health Sciences, University of Calgary
Addiction, Concurrent Disorder, and General Psychiatry
Opioid Dependency Program, Sheldon M. Chumir Centre
Rapid Access to Addiction Medicine Service, Calgary
Adult Addiction Centre, 6th Floor, Foothills Medical Centre

PainRelief.com: What is the background for this study?

Response: The background for this study is rooted in the need to understand the potential health implications of cannabis use disorder (CUD), especially in relation to cardiovascular health.

Cannabis has become increasingly popular for both recreational and medicinal purposes, and it is essential to assess its impact on various health outcomes.

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Newly Studied Pain Pathway May Provide Pain Relief Without Opioid Side Effects

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PainRelief.com Interview with:
Daniel McGehee, PhD
Professor
Chair, Committee on Neurobiology
Department of Anesthesia & Critical Care
University of Chicago

PainRelief.com: What is the background for this study?

Response: Chronic pain conditions are major challenges for those suffering with pain and the clinicians who struggle to find effective treatments. Identifying novel strategies for relieving pain will help limit availability of opioid drugs, as they offer alternatives to replace or reduce opioids in the clinic. 

Along with overdose and addiction issues, there are other complications and side effects of opioids, including tolerance, where the pain relieving properties diminish with repeated use, hypersensitivity to pain when patients stop taking the drug, constipation, and other peripheral side effects. 

Pain relief without those side effects would certainly be valuable for individuals struggling to treat painful conditions. 

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Fibromyalgia: Imaging Studies Find Cognitive Behavioral Therapy Reduces Pain Catastrophizing

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PainRelief.com Interview with:
Jeungchan Lee, Ph.D.,
Instructor
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

Jeungchan Lee, Ph.D., Postdoctoral Research Fellow MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital Harvard Medical School Charlestown, MA 024129

PainRelief.com: What is the background for this study?

Response: Cognitive behavioral therapy (CBT) has shown promise in alleviating fibromyalgia (FM) symptoms by targeting pain-related catastrophizing, which comprises negative cognitive and emotional processes amplifying pain perception.

However, the neurological mechanisms underlying CBT’s impact on pain catastrophizing in FM patients have remained unclear.

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