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American Society of Anesthesiologists Annual Meeting, Oct. 13-17, 2007

American Society of Anesthesiologists Annual Meeting

The annual meeting of the American Society of Anesthesiologists took place Oct. 13-17 in San Francisco, Calif. The meeting attracted more than 18,000 attendees from around the world, presented about 1,900 abstracts, and highlighted developments in pain management.

"That was the hot topic this year," said Dawn Glossa, the society's director of communications. "Although hundreds of topics were addressed, there's been a large focus on pain management."

"It's important to realize that anesthesiologists are involved in trying to understand the mechanisms involved in post-operative pain. If we can figure out the mechanisms, maybe future pharmacological agents could be utilized to treat pain more aggressively," said Asokumar Buvanendran, M.D., of Rush Medical College in Chicago, a member of the society's Committee of Regional Anesthesia and Acute Post-Operative Pain and the sub-committees of Acute Post-Operative Pain and Chronic Post-Operative Pain.

Buvanendran was either the lead researcher or a secondary researcher on nine studies presented at the meeting. In one of those studies, he and his colleagues studied the effects of perioperative and post-operative pregabalin -- an anticonvulsant drug approved for treating seizures -- in patients who underwent total knee replacement surgery. "We showed that the patients who received pregabalin not only walked better and had lower pain scores in the immediate post-operative period but also had decreased chronic pain at six months compared to patients who received placebo," Buvanendran said.

"Although we only studied pregabalin in this selected group of patients, it probably could help reduce chronic pain associated with other types of surgeries that cause nerve damage and retraction," Buvandendran said. Because the drug has already been approved by the U.S. Food and Drug Administration, studies showing its benefits in managing post-operative pain could quickly lead to changes in clinical practice, he added.

Although much of the research presented at the conference focused on novel ways to reduce pain and opioid requirements in surgical patients -- including the use of a nicotine patch in men who underwent radical prostatectomy -- at least one study suggested that administration of chronic moderate-dose opioids does not impair patients' driving ability.

In that study, Buvanendran and colleagues used a computerized driving simulator to compare driving skills in 51 pain patients who were treated with oral morphine and 49 pain patients who did not take opioids. "We found that there were no group differences in the number of 'crashes,'" Buvanendran said. "We also found no differences in reaction times and weaving from the center line."

Buvanendran and colleagues are expanding their study to include a larger group of patients. "We'd like to try other combinations of pharmaceutical agents," he said.

Many states treat driving under the influence of doctor-prescribed opioids the same way they treat driving under the influence of alcohol and other drugs. If the new study shows that chronic, moderate-dose opioids don't impair driving skills, Buvanendran said he couldn't predict how state legislatures would respond. "But at the very least it should improve the quality of life of chronic pain patients for whom driving is an integral part of daily activity," he added.

ASA: Acupuncture Helps Manage Post-Operative Pain

MONDAY, Oct. 22 (HealthDay News) -- Acupuncture and related techniques such as acupressure or moxibustion are effective adjunct treatments in the management of post-operative pain, according to research presented this month at the annual meeting of the American Society of Anesthesiologists in San Francisco.

Abstract #1746

ASA: Pregabalin Benefits Knee Replacement Patients

FRIDAY, Oct. 19 (HealthDay News) -- In patients scheduled to undergo total knee arthroplasty, perioperative administration of the anticonvulsant drug pregabalin reduces the need for postoperative epidural analgesia and improves active and passive range of motion, according to research presented this week at the annual meeting of the American Society of Anesthesiologists in San Francisco.

Abstract #493

ASA: Pain Patients Often Deficient in Vitamin D

THURSDAY, Oct. 18 (HealthDay News) -- Vitamin D deficiency is common in patients who are treated for chronic pain and may be associated with an increased need for opioids and a poorer prognosis, according to research presented this week at the annual meeting of the American Society of Anesthesiologists in San Francisco.

Abstract #1380

ASA: Nicotine Patch May Reduce Post-Surgical Pain

THURSDAY, Oct. 18 (HealthDay News) -- In men who undergo radical retropubic prostatectomy under general anesthesia, the use of a transdermal nicotine patch may help reduce pain and the subsequent need for post-operative opioids, according to research presented this week at the annual meeting of the American Society of Anesthesiologists in San Francisco.

Abstract #494

ASA: Capsaicin Reduces Post Herniotomy Pain

MONDAY, Oct. 15 (HealthDay News) -- In men who undergo open mesh groin hernia repair, the use of a novel purified capsaicin formulation may help reduce short-term postoperative pain, according to research presented this week at the annual meeting of the American Society of Anesthesiologists in San Francisco.

Abstract #459

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