Innovative Applications of Telemedicine and Other Digital Health Solutions in Pain Management: A Literature Review.

Since the COVID-19 pandemic, healthcare systems are facing extraordinary challenges. Our approaches to medicine have changed and created a whole new generation of people who have chronic pain. Various medical services were postponed. The pandemic significantly impacted the bio-psychosocial model of pain and the management of chronic pain. These new challenges affected millions of patients worldwide, with more burden on patients with chronic pain. Telemedicine and digital health rather than traditional office visits have become essential tools for communications, resulting in an unmatched surge in telehealth adoption. This new approach facilitated the remote treatment and follow-up of patients who have difficulty to access the healthcare services, particularly patients with chronic pain and those who were receiving regular controlled medications. An extensive computer search was conducted, during the period (from January 2014 to March 2024), and included literature from PubMed, Scopus, MEDLINE, and Google scholar. According to preset inclusion and exclusion criteria, a total of 38 articles have been included in this review article. This literature review focuses on the innovation of telemedicine and digital health in pain management, especially in the context of the challenges posed by the COVID-19 pandemic. The manuscript provides a comprehensive overview of telemedicine and digital communications, their evolution, and their significance in healthcare. It also emphasizes the benefits, challenges, limitations, and the ethical concerns of telemedicine in pain management after the COVID-19 pandemic. Furthermore, the document explores the different modes of the telecommunications and discusses the future directions of the digital health technology.

Efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block versus periarticular local infiltration analgesia after unilateral total knee arthroplasty: Prospective randomized control trial.

OBJECTIVES: To compare the efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block with periarticular local infiltration analgesia (LIA) to assess postoperative pain control and enhanced recovery after total knee arthroplasty (TKA). METHODS: This research was carried out at King Saud University Medical City, Riyadh, Saudi Arabia, from September 2020 to March 2021. Eighty Patients scheduled for elective unilateral TKA were randomized to receive either iPACK or periarticular LIA along with adductor canal block under spinal anesthesia. The primary outcome was postoperative pain score, and secondary outcomes included physical rehabilitation, duration of surgery, length of post-anesthesia care unit stay, hemodynamics, and length of hospital stay. RESULTS: The pain score during activity in iPACK group was significantly lower compared to LIA group at 4 hours postoperatively, but no significant difference was observed at 24 or 48 hours. The timed up and go test took significantly longer for patients in LIA group at 4, 24, and 48 hours compared to those in iPACK group. No significant differences in knee range of motion were observed between the 2 groups at any point. CONCLUSION: Based on our findings, iPACK block is an effective technique in reducing pain in the immediate postoperative period without affecting motor function, resulting in enhanced recovery following primary TKA.

Mentorship in anesthesia: A perspective survey among anesthesia residents in Riyadh, Saudi Arabia.

CONTEXT: Mentorship is an integral part of the professional and academic growth; however, the position of mentorships in anesthesia is still yet to be understood. As an attempt to understand this phenomenon, we targeted Riyadh Anesthesiology residents and program directors to explore their perception of mentorship relationships. AIMS: The aims of this study were to assess the prevalence of mentorship in anesthesiology training and to assess the perspective of mentorship from anesthesiology residents. SETTINGS AND DESIGN: This was a cross-sectional study. METHODS AND MATERIAL: We administered a 20-item validated cross-sectional survey to program directors and anesthesia residents to all Riyadh SCFHS anesthesiology departments. Residents were asked about their perceptions of barriers and benefits to effective mentoring. STATISTICAL ANALYSIS USED: IBM SPSS version 23 and Microsoft Office Excel version 2010. RESULTS: Fifty anesthesiology residents and three program directors responded to our survey. The majority of residents agreed that mentorship was beneficial to the overall success as an anesthesiologist (36 of 50, 72%). Although all three program directors reported that a formal mentorship program is part of their residency program (3 of 3, 100%), only (25 of 50, 50%) responded with access to a mentor. Difficulties reported included lack of formalized meeting times, insufficient times with mentors, and mentor-mentee incompatibility. CONCLUSIONS: In conclusion, the study indicated the positive perspective and high principles to mentorship held by anesthesiology residents in Riyadh, Saudi Arabia. It evidenced the beneficial, professional, and social impact that mentoring hails to the development of future anesthesiologists, and despite all that, it remains underutilized.