Nociception

Could restless sleep cause widespread pain in older folks?
Researchers in the U.K. report that non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50. According to the study published in Arthritis & Rheumatology (formerly Arthritis & Rheumatism), a journal of the American College of Rheumatology (ACR), anxiety, memory impairment, and poor physical health among older adults may also increase the risk of developing widespread pain. Eurekalert!

Sedation before nerve block increases risk, not pain relief
Nerve blocks, performed by injecting anesthetics and/or steroids into any number of areas of the body, from the spinal column to the hip joint, are often performed ahead of surgery and in addition to other invasive procedures, such as the ablation of nerves to treat arthritis in the back, to more accurately pin down the source of pain. If the nerve block fails to numb pain, surgery or the nerve ablation may not help. Increasingly, physicians have used light or even deep sedation in a bid to ease anxiety and pain while the injection is given.

However, results of the new study, reported online Feb. 13 in the journal Pain Medicine, show that sedation before a nerve block significantly increases false-positive results, which means patients are more likely to be sent in for surgeries and other procedures that won't cure the underlying pain. Another worry, Cohen says, is the health risk when someone is sedated. Eurekalert!

Prolonged Opioid Use Uncommon After Major Surgery in Older Adults
Only about 1 in 30 older patients undergoing major elective surgery continued to use opioids more than 90 days post-surgery, according to a BMJ study.

Using Canadian databases, researchers studied nearly 40,000 patients (aged 66 years and older) without preexisting pain disorders who underwent coronary artery bypass graft surgery, lung or colon resection, prostatectomy, or hysterectomy. Both open and minimally invasive procedures were considered. Half the patients were prescribed opioids within 90 days after surgery. After 90 days, 3% were still taking opioids. Journal Watch