Analgesia for the Bayesian Brain: How Predictive Coding Offers Insights Into the Subjectivity of Pain

Transitional Pain Service: An Update

PURPOSE OF REVIEW

Chronic Postsurgical Pain (CPSP) and the risk for long-term opioid dependency are known complications following major surgery. The idea of Transitional Pain Service (TPS) has been introduced as an interdisciplinary setting to manage pain in the perioperative continuum. We expand on the basic framework and principles of TPS and summarize the current evidence of the TPS and possible interventions to adress postoperative pain. Areas of future work in TPS-related research are discussed.

RECENT FINDINGS

Several studies support the effectiveness of TPS in reducing opioid consumption in the perioperative period and following discharge. Some studies also show an improvement in functional outcome with TPS with patients reporting lower pain severity and pain interference. The TPS aims to halt the progress of acute postoperative pain to CPSP by providing longitudinal support with patient-centered care. While some studies suggest a positive impact of TPS implementation in terms of reduction in postoperative opioid consumption and improvement of some functional outcomes, direct evidence in terms of reduction in the incidence of CPSP is still missing. The cost-effectiveness of TPS and the expansion of TPS through e-health services and digital applications also need to be evaluated.

Contemporary neurocognitive models of memory: A descriptive comparative analysis

The great complexity involved in the study of memory has given rise to numerous hypotheses and models associated with various phenomena at different levels of analysis. This has allowed us to delve deeper in our knowledge about memory but has also made it difficult to synthesize and integrate data from different lines of research. In this context, this work presents a descriptive comparative analysis of contemporary models that address the structure and function of multiple memory systems. The main goal is to outline a panoramic view of the key elements that constitute these models in order to visualize both the current state of research and possible future directions. The elements that stand out from different levels of analysis are distributed neural networks, hierarchical organization, predictive coding, homeostasis, and evolutionary perspective.

Perioperative Evaluation of Brain Health

As the global population is aging and surgical needs rise, the occurrence of perioperative neurocognitive disorders (PND) is becoming a significant concern. PND refers to cognitive changes that occur before or after surgery, including neurocognitive disorders, postoperative delirium, and delayed neurocognitive recovery. To address this issue, a brain health assessment initiative within a multidisciplinary team is an emerging concept. Assessing cognitive function, comorbidities, severity of neurocognitive disorders, medications, nutritional status, sleep quality, and other factors can help mitigate the risk of PND and improve patient outcomes.