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Guillermo Ceniza-Bordallo,1,* Eric Zimmermann,2,* Marie Vigouroux,2 Kacper Niburski,3 Maryse Fortin,4 Jean Ouellet,5– 7 Juan Pablo Cata,8,9 Pablo M Ingelmo2,7,10,11 1Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain; 2Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada; 3Department of Anesthesia, University of British Columbia, Vancouver, BC, Canada; 4Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada; 5Department of Paediatric Surgery & Surgery, McGill University Health Centre, Montreal, QC, Canada; 6Department of Scoliosis & Spine Surgery, Shriner’s Hospital for Children, Montreal, QC, Canada; 7Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; 8Department of Anesthesia and Perioperative Medicine, the University of Texas – MD Anderson Cancer Center, Houston, TX, USA; 9Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA; 10Department of Anesthesia. McGill University, Montreal, Canada; 11Research Institute, McGill University Health Center, Montreal, Canada*These authors contributed equally to this workCorrespondence: Guillermo Ceniza-Bordallo, Email gceniza@ucm.esAbstract: Space flights can produce physiological changes in the spine, leading to the development of acute and chronic pain in passengers. However, there is a lack of comprehensive literature exploring physiological spine changes and acute and chronic pain in space passengers (astronauts and animals). The first aim of this study was to identify the physiological changes experienced by passengers (humans and animals) after space flight. The second aim was to identify the incidence of low back pain during and after space flight. This systematic review was conducted following PRISMA guidelines and was pre-regi

Lisa M Einhorn,1 Padmaja Krishnan,2 Cassandra Poirier,3 Pablo Ingelmo4– 7 1Department of Anesthesiology, Division of Pediatrics, Duke University School of Medicine, Durham, NC, USA; 2Campbell University School of Osteopathic Medicine, Lillington, NC, USA; 3Department of Anesthesiology, University of British Columbia, Kelowna, BC, Canada; 4Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, McGill University Health Center, Montreal, QC, Canada; 5Research Institute, McGill University Health Center, Montreal, QC, Canada; 6Department of Anesthesia, McGill University, Montreal, QC, Canada; 7Alan Edwards Center for Research in Pain, Montreal, QC, CanadaCorrespondence: Lisa M Einhorn, Department of Anesthesiology, Division of Pediatrics, DUMC 3094, Durham, NC, 27710, USA, Tel +1 919 681-4487, Email Lisa.einhorn@duke.eduAbstract: Chronic postsurgical pain (CPSP) affects a significant proportion of children and adolescents after major surgery and is a detriment to both short- and long-term recovery outcomes. While clinical characteristics and psychosocial risk factors for developing CPSP in children and adults are well established in the literature, there has been little progress on the prevention and management of CPSP after pediatric surgery. Limited evidence to support current pharmacologic approaches suggests a fundamentally new paradigm must be considered by clinicians to both conceptualize and address this adverse complication. This narrative review provides a comprehensive evaluation of both the known and emerging mechanisms that support our current understanding of CPSP. Additionally, we discuss the importance of optimizing perioperative analgesic strategies to mitigate CPSP based on individual patient risks. We highlight the importance of postoperative pain trajectories to identify those most at risk for developing CPSP, the early referral to multi-disciplinary pain clinics for comprehensive evaluation and treatment of CPSP, a

Madalina Patron,1,2,* Mattias Neset,1,2,* Mariia Mielkozorova,2,* Daniel G Bisson,1,3,* Marie Vigouroux,4 Juan Pablo Cata,5,6 Pablo M Ingelmo,4,7,8 Jean A Ouellet,1,3 Lisbet Haglund,1,3,* Svetlana V Komarova1,2,* 1Shriners Hospital for Children, Montreal, Canada; 2Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada; 3Orthopaedic Research Laboratory, Department of Surgery, McGill University, Montreal, Canada; 4Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada; 5Department of Anesthesia and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA; 6Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA; 7Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; 8Research Institute, McGill University Health Center, Montreal, Canada*These authors contributed equally to this workCorrespondence: Svetlana V Komarova, Shriners Hospital for Children, 1003 Decarie Boulevard, Montreal, Quebec, H4A 0A9, Canada, Tel +1 514 282-7153, Email svetlana.komarova@mcgill.caPurpose: Pain is an understudied physiological effect of spaceflight. Changes in inflammatory and tissue degradation markers are often associated with painful conditions. Our aim was to evaluate the changes in markers associated with tissue deterioration after a short-term spaceflight.Patients and Methods: Plasma levels of markers for systemic inflammation and tissue degeneration markers were assessed in two astronauts before and within 24 h after the 17-day Axiom Space AX-1 mission.Results: After the spaceflight, C-reactive protein (CRP) was reduced in both astronauts, while INFγ, GM-CSF, TNFα, BDNF, and all measured interleukins were consistently increased. Chemokines demonstrated variable changes, with consistent positive changes in CCL3, 4, 8, 22 and CXCL8, 9, 10, and consistent nega

Andrea K Sauer,1,* Marie Vigouroux,2,3,* Patrick M Dougherty,4 Juan Pablo Cata,5,6,* Pablo M Ingelmo2,3,7,8,* 1Department of Anesthesia, University of Bonn, Bonn, Germany; 2Department of Anesthesia, McGill University, Montreal, QC, Canada; 3Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada; 4Department of Pain Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA; 5Department of Anesthesia and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA; 6Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA; 7Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; 8Research Institute, McGill University Health Center, Montreal, QC, Canada*These authors contributed equally to this workCorrespondence: Pablo M Ingelmo, Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Room A02.3525, Glen Site, 1001 Boul, Décarie, Montreal, QC, H4A 3J1, Canada, Tel +1 514 412-4448, Fax +1 514 412-4341, Email pablo.ingelmo@mcgill.caAbstract: Space travel has been associated with musculoskeletal pain, yet little is known about the nociceptive changes and pain experience during spaceflight. This preliminary study aims to investigate the pain experience and sensory alterations in astronauts following a 17-day mission to the International Space Station (ISS) on Axiom Space’s AX-1 commercial space flight. Two participants were enrolled, and data were collected pre-flight, in-flight, post-flight, and three-month post-flight. Validated pain questionnaires assessed anxiety, catastrophizing, impact on physical and mental health, disability, and overall pain experience. Qualitative interviews were conducted post-landing and conditioned pain modulation (CPM) and quantitative sensory testing (QST) were performed. Both astronauts reported musculoskeletal

Uri Hochberg,1 Pablo Ingelmo,2– 4 Ester Solé,5 Jordi Miró,5,6 Gonzalo Rivera,7,8 Jordi Perez2,3,9 1Pain Institute of the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 2Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada; 3Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children’s Hospital McGill University Health Centre, Montreal, Quebec, Canada; 4Research Institute, McGill University Health Center, Montreal, Quebec, Canada; 5Universitat Rovira i Virgili, Tarragona, Spain; 6Chair in Pediatric Pain, Center for Behavior Assessment (CRAMC), Department of Psychology, Institut d’Investigació Sanità ria Pere Virgili, Tarragona, Spain; 7Hospital de Niños Luis Calvo Mackenna, Santiago de Chile, Chile; 8Clínica las Condes, Santiago de Chile, Chile; 9Cancer Pain Clinic, Cedars Cancer Center, McGill University Health Centre, Montreal, Quebec, CanadaCorrespondence: Jordi Perez, Cancer Pain Clinic, Cedars Cancer Centre, Royal Victoria Hospital, McGill University Health Centre, D2-1995, 1001 Boul, Decarie, Montreal, H4A 3J1, Canada, Tel +1 514 934 4502, Fax +1 514 934 8415, Email Jordi.perez@mcgill.caAbstract: Between 10% and 20% of patients with cancer-related pain cannot achieve adequate control following the three-step ladder guidelines by the World Health Organization. Therefore, a “fourth step”, including interventional approaches, has been suggested for those cases. Systematic reviews support the early use of interventional procedures to treat refractory cancer pain, control symptoms and prevent opioid dose escalation. There is strong evidence of the efficacy of celiac plexus or splanchnic neurolysis, vertebroplasty, kyphoplasty and intrathecal drug delivery. Those procedures have been found to be associated with a decrease in the symptom burden and opioid consumption, improved quality of life, and suggested as having a potentially positive impact on survival. Several studies have recommended using sp

Don Daniel Ocay,1– 3 Brendan D Ross,4 Lorenzo Moscaritolo,3 Nabeel Ahmed,4 Jean A Ouellet,2,5– 7 Catherine E Ferland,1– 3,6– 8,* Pablo M Ingelmo3,6– 8,* 1Department of Experimental Surgery, McGill University, Montreal, QC, Canada; 2Department of Clinical Research, Shriners Hospitals for Children Canada, Montreal, QC, Canada; 3Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada; 4Faculty of Medicine, McGill University, Montreal, QC, Canada; 5Department of Pediatric Surgery, McGill University, Montreal, QC, Canada; 6Department of Anesthesia, McGill University, Montreal, QC, Canada; 7Research Institute-McGill University Health Centre, Montreal, QC, Canada; 8Alan Edwards Research Center for Pain, McGill University, Montreal, QC, Canada*These authors contributed equally to this workCorrespondence: Pablo M Ingelmo, Edwards Family Interdisciplinary Centre for Complex Pain, Montreal Children’s Hospital, B02-3525-1001 Boulevard Décarie, Montreal, H4A 13J, Canada, Tel +1 514 412-4448, Fax +1 514 412-4341, Email pablo.ingelmo@mcgill.caPurpose: Nociplastic pain distinguishes individuals with pain and hypersensitivity in body regions with apparently normal tissues, without any signs of neuropathy, but with contribution of central and/or peripheral sensitization. There is a lack of literature describing nociplastic pain in the pediatric population. The objective of this study was to investigate the differences between pediatric patients with nociplastic pain compared with patients with non-nociplastic pain.Patients and Methods: This study included 414 pediatric patients followed at an interdisciplinary centre for complex pain. All patients underwent an exhaustive pain assessment consisting of face-to-face interviews, validated self-report questionnaires and quantitative sensory testing. Recently established criteria for chronic nociplastic pain, and quantitative sensory testing was use