A virtual 8-week mindfulness-based program (MORE) reduced daily pain intensity in people with lumbosacral radiculopathy (sciatica) compared with usual care, but did not improve disability, depression, or quality of life. Participants in the mindfulness group also reported greater increases in mindful reinterpretation of pain and trait mindfulness. The authors suggest that fear-avoidance behaviors may explain why pain relief did not translate into reduced disability in this long-duration chronic pain sample.
Ketamine given during general anesthesia reduces pain intensity by 3 points and increases dissociation scores by 17.8 points, but these two effects are independent: the pain reduction does not depend on dissociation. This suggests that ketamine's analgesic and dissociative properties involve separate brain circuits, even under general anesthesia, and that ketamine might be developed into a more targeted pain treatment without causing dissociation.
Adding ketamine to a thoracic paravertebral block (TPVB) improves immediate pain control after thoracotomy. In a randomized controlled trial of 60 patients, those receiving ketamine plus levobupivacaine requested pain relief significantly later, required less morphine in the first 24 and 48 hours, and reported lower pain scores at rest and during deep breathing compared to those receiving levobupivacaine alone. However, the addition of ketamine did not reduce the incidence of chronic post-thoracotomy pain syndrome or complications at 2 and 3 months.