Complex regional pain syndrome (CRPS) is a rare but debilitating chronic pain condition with a complex and poorly understood pathophysiology, making diagnosis and treatment challenging. Diagnosis is by exclusion, and the Budapest diagnostic criteria have helped standardize definitions, but the underlying pathways remain unclear. Two types exist: CRPS type 1 (no neuronal injury) and type 2 (with neuronal injury). Management ranges from non-invasive therapies like physical and psychological therapy to invasive options such as dorsal root ganglion stimulation and amputation. Multimodal treatment is ideal, but more research is needed to understand CRPS development and to conduct robust clinical trials for therapies.
Opioid-free anaesthesia (OFA) reduces postoperative nausea and vomiting (PONV) compared with opioid-inclusive anaesthesia in adults undergoing lower extremity wound surgery. In a randomized double-blind crossover trial, 66 patients each received both OFA (lidocaine, esketamine, dexmedetomidine, propofol) and opioid-inclusive anaesthesia (sufentanil, propofol) for two separate surgeries. OFA lowered the incidence of PONV during the first 48 hours after surgery (5% vs. 23%), and also reduced the severity of PONV and rate of hypotension, though time to extubation was longer. Postoperative pain and need for rescue analgesia did not differ between the two techniques.
A pilot study tested whether short, digitally delivered meditation videos could reduce stress and increase mindfulness in pregnant and parenting women recovering from opioid use disorder. Twenty women from three rural New England treatment programs watched four of sixteen co-designed videos over two weeks. Perceived stress scores dropped from 21.49 to 19.85, and mindfulness scores rose from 3.47 to 3.76, both statistically significant changes. Participants rated the videos as highly acceptable and useful; 80% intended to use them in the future. The low-dose digital intervention shows promise for supporting recovery in this population, warranting larger studies.