Peripheral Nerve Blocks Pain control is crucial when a patient undergoes surgery. Individuals often become hesitant when agreeing to an operation in fear of the pain that follows. With the advancement of minimally invasive procedures being done in outpatient settings, analgesic tools must keep up (Chang et al., 2023). Studies have been done on the use of peripheral nerve blocks to provide pain relief, including following surgical procedures. Peripheral nerve blocks are used to stop impulses from transmitting to a distal nerve terminal, which also stops the pain signal (Wiederhold et al., 2023).

Response to each discussion post below by providing further suggestions on how their database search might be improved. 200 words. APA format 2 references and 2 intext citation. ( all article use should be 2019-present)

Brittany

Peripheral Nerve Blocks

            Pain control is crucial when a patient undergoes surgery. Individuals often become hesitant when agreeing to an operation in fear of the pain that follows. With the advancement of minimally invasive procedures being done in outpatient settings, analgesic tools must keep up (Chang et al., 2023). Studies have been done on the use of peripheral nerve blocks to provide pain relief, including following surgical procedures. Peripheral nerve blocks are used to stop impulses from transmitting to a distal nerve terminal, which also stops the pain signal (Wiederhold et al., 2023). Following orthopedic surgical procedures, pain often stops patients from willingly use their limbs or attempt daily activities. During this period of recovery, ambulation or movement is crucial to heal. Proper analgesic techniques ease the minds of patients. 

            I attempted utilizing multiple search terms and databases to locate the best articles for my clinical interest. My first search attempt was “peripheral nerve blocks after orthopedic surgeries”, but this mostly provided systematic reviews as the results. I needed to be more aware of Boolean terms, which creates more precise and powerful searches with more relevant results (Walden University Library, n.d.). I tried searching for “peripheral nerve blocks”, “orthopedic surgeries and pain control”, and “peripheral nerve blocks and orthopedic surgeries”. When using PubMed, I received over 2,000 results. When using MEDLINE, I received less than 200 results with the more specific Boolean terms. The results were minimal, but they were more specific to my potential PICOT question. 

            According to Stillwell et al. (2010), it is important to combine search terms when looking for research. When looking for articles, I did not look for just peripheral nerve blocks or orthopedic surgeries because I wanted to find information on how they relate to each other specifically. When using PubMed, I removed systematic reviews from the available searches to only provide original research results. The next step was to limit the results to only the last 5 years to improve relevancy. 

PICOT Question:

P- Pain control following orthopedic surgeries

I-Utilizing peripheral nerve blocks for analgesia

C-Peripheral nerve blocks compared to standard opioid-based analgesia 

O-Improved pain control and patient satisfaction during recovery

T- Within the week after surgery

Does a peripheral nerve block provide better pain control and improved patient satisfaction compared to only using opioid-based analgesic regimens within the week following orthopedic surgery? 

Nicole

According to Chu et al., (2023) intimate partner violence is common, one in three women have experienced or will experience intimate partner violence (IPV) in their lifetime. There are several poor mental health effects of IPV; anxiety, depression, PTSD, with most women experiencing some form of PTSD as the primary issue (Chu et al., 2023). The clinical issue of interest that I am choosing to research is how trauma and IPV affect both the psychological and physical health and wellbeing of women over time and what treatment interventions are effective. This is more of a background question (Stillwell et al., 2010). I utilized several databases to search for relevant articles, CINAHL, APAPscyInfo, PubMed, and Medline (Walden University, 2023).   

When searching for research, utilizing Boolean operators, and nesting can really aid in condensing and finding specific research by way of word combinations of phrases in a certain order (Library of Congress, n.d.). According to the Library of Congress (n.d.)., the Keyword searches, Advanced, and EXPERT options all support the Boolean operators.  The database APAPsycInfo offers three search field options using AND format for the Boolean operators (Library of Congress, n.d.). Both basic and advanced searches can be conducted, and under search modes, Boolean, find all, and find any are all options to assist in narrowing or broadening a search.  

For my Boolean operators I chose to use intimate partner violence AND trauma and mental health, AND effective interventions. For that search, only 20 articles appeared. The broader searches had more articles to look through to check for relatability to the subject of interest. CINAHL with full text, and Medline were similar. For CINAHL my original search was intimate partner violence, women’s mental health, and interventions. This search resulted in 119 articles, using the same Boolean operators for Medline resulted in 214. PubMed was much broader, and your own phrase is typed into the advanced search, this initially resulted in 1402 results. 

According to Melnyk and Fineout-Overholt (2023), there are several strategies to increase the rigor and effectiveness of a database search for PICOT questions. Using keywords, and identifying synonyms, utilizing subject headings from initial research articles found from each database, applying limiting factors can be useful, these factors could be information such as age and language (Melnyk & Fineout-Overholt, 2023). 

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