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Palliative care involves patients with a high incidence of chronic pain and inadequate treatment related to opioid abuse. In terminal patients, the side effects of opioids may result in lower quality of life due to their deleterious immunosuppression and gastrointestinal effects. In our routine clinical practice, we consider the ultrasound-guided PENG block as a palliative analgesic technique to improve end-of-life care to terminal patients.

This manuscript aims to report the successful treatment of a patient with fibromyalgia using a novel approach to vagus nerve (VN) stimulation. The patient reported significant pain relief and improved performance after almost 3 months of follow-up. VN stimulation has been Food and Drug Administration approved for epilepsy and depression, but recent studies have shown its usefulness for pain management. Our novel approach is minimally-invasive compared to surgical techniques; it provides long-lasting analgesia within a single session and is cheaper than current methods. This technique should be evaluated in clinical trials to clarify the optimal parameters and treatment intervals. [ABSTRACT FROM AUTHOR]

To evaluate superficial serratus anterior plane block's efficacy and side effects in preventing postoperative pain after breast cancer surgery. A prospective cohort study was conducted on 195 adult patients undergoing breast oncological surgery under general anesthesia (Group G, n = 96) or combined general anesthesia with superficial serratus anterior plane block (Group L, n = 99). Validated preoperative data, which are predictors of chronic postoperative pain of patients, were recorded (type of surgery, age, pain in the area of the intervention and the other regions; anesthetic-surgical data, analgesic doses used, duration of surgery; pain intensity (EVN scale) at immediate postoperative period, 24 h, seven days and one month after the surgery, and complications. Pain intensity, measured by the EVN scale, had a mean of 1.02 +/− 1.656 in the Postoperative Unit; 1.20 +/− 1.448 at 24 h; 0.76 +/− 1208 seven days; and 0.34 +/− 0.757 one month after surgery. Patients were operated under general anesthesia (n = 96) or general anesthesia combined with the interfascial block (n = 99). Significant differences (p < 0.05) were found in age, height, and VAS scale in PACU. Ten complications were recorded, six in Group L and four in Group G. There were no differences between groups in complications. Superficial serratus anterior plane blocks are effective and safe in pain control in the immediate postoperative period for breast cancer surgery as a part of the multimodal approach. No significant differences were found one week and one month after surgery. • Serratus anterior block is used in clinical practice. The efficacy and side effects remain understudied. • Analgesic interfascial blockades provide significative analgesia in the immediate postoperative period • No complications associated with the analgesic technique were recorded. [ABSTRACT FROM AUTHOR]