After massage therapy, patients reported highly significant improvement in their levels of distress, pain, tension, discomfort, and mood compared with their premassage ratings (all t-values >6.1, ****P < 1 x 10(-8). To control for the possible effects of patients reporting improvements simply as a result of rating their symptoms, we collected control ratings before and after a comparable 'no intervention' time period in a subset of 25 patients. The 'no intervention' time period typically took place in the treatment room with the therapist present. Approximately 60% of the control ratings were obtained before the intervention and 40% were obtained after the massage therapy. None of the differences between the pre- and postratings associated with the 'no intervention' control time period were significant. In these same patients, the difference between the pre- and postmassage ratings were significant, all t-values >3.8, **P < 0.001.
We examined the efficacy of serial ilioinguinal nerve blocks using ultrasound guidance for management of chronic inguinal pain secondary to persistent ilioinguinal neuralgia in adolescents. This case series consists of two adolescents who had persistent inguinal pain secondary to ilioinguinal neuralgia who were treated with conventional pain medications that did not relieve the pain. One patient had pain immediately following surgery while the other had pain several months after an injury. Serial ilioinguinal nerve blocks were performed with local anesthetic solution using ultrasound guidance in an outpatient setting. Both the adolescents had complete relief of pain symptoms and were able to resume normal activities. There were no adverse effects associated with the blocks. Performance of serial ilioinguinal nerve blocks using ultrasonography in an outpatient setting in adolescents and adolescents with ilioinguinal neuralgia may reduce pain and allow these adolescents to resume their normal activities.
Parent-assisted or nurse-assisted epidural analgesia can be safely administered to children undergoing surgery who are physically or cognitively unable or unwilling to self-activate a demand dose. Additional studies are needed to compare the efficacy of PNEA with other modalities for postoperative pain control in children.
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