Peripheral Nerve Blocks for Surgery About the Knee.

Peripheral nerve blocks are an often-utilized and efficacious method of analgesia for orthopaedic surgery about the knee. Benefits include decreased pain and narcotic use, increased participation in postoperative physical therapy, and decreased length of hospital stay. Adductor canal blocks have the advantage of preserving quadriceps function for early postoperative range of motion and walking. The risk of serious complications resulting from a peripheral nerve block is relatively low, ranging from 0% to 3%.

Improvement in chronic low back pain in an obese patient with topiramate use.

The objective of this study was to demonstrate efficacy, benefit, and potential use of topiramate in treating obese patients with chronic low back pain. This is a case report from an outpatient academic pain multidisciplinary clinical center. The patient was a 30-year-old morbidly obese (body mass index [BMI]: 61.4 kg/m(2)) female suffering from chronic low back pain. With a known association between obesity and chronic low back pain, and a possible role of topiramate in treating both simultaneously, the patient was started on a therapeutic trial of topiramate. Over a period of a 12-week topiramate therapy, the patient experienced clinically meaningful and significant weight loss as well as improvement in her chronic low back pain and functionality. With more substantial evidence, pain physicians may start considering using topiramate in the multimodal management of obesity-related chronic low back pain based on their thoughtful consideration of the drug's efficacy and side effects and the patient's comorbidities and preferences.