{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:55:22Z","timestamp":1777964122368,"version":"3.51.4"},"reference-count":28,"publisher":"BMJ","funder":[{"name":"Eleanor and Miles Shore Faculty Development Award, Brigham and Women\u2019s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2025,5,22]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Preoperative peripheral nerve block placement can involve both procedural pain and psychological distress, which practitioners treat using both sedation and education\/reassurance. The experience of pain may be potently modulated by baseline pain catastrophizing (presence of rumination, magnification, and helplessness). This randomized clinical trial assessed whether the treatment effect of sedation vs education\/reassurance on procedural nerve block pain and satisfaction varied for patients with different baseline pain catastrophizing scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>At baseline, patients completed the Pain Catastrophizing Scale (PCS), were stratified into low-PCS (&lt;10) or high-PCS (\u226510) groups, and then randomized to receive sedation or education\/reassurance during nerve block placement. Patients reported maximum and average procedural pain and satisfaction, immediately after the procedure and recalled in the postanesthesia care unit (PACU). Generalized estimating equations examined main effects of treatment and baseline PCS group on maximum procedural pain and the interaction between them.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Maximal procedural pain immediately after the procedure was similar between treatment groups (n=72), but a significant treatment\u00d7PCS group interaction (B=0.8, 95% CI (0.04, 1.5), p=0.04) indicated that among patients with high PCS, sedation was associated with less pain (2.3\u00b12.2 vs 4.3\u00b12.5, p=0.01). Exploratory findings indicate sedation being associated with lower recalled procedural pain in PACU than education\/reassurance (0.3\u00b10.7 vs 2.2\u00b12.4, p&lt;0.001), and education being associated with higher satisfaction among those with lower PCS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our findings suggest that patients with high PCS may disproportionately benefit from sedation during nerve block, reporting less pain, whereas patients with low PCS may have a slight preference for education\/reassurance, reporting higher satisfaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05579509\">NCT05579509<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2025-106644","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T05:30:19Z","timestamp":1749101419000},"page":"rapm-2025-106644","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Education or sedation? A randomized clinical trial of impact on procedural pain and satisfaction during regional block placement, and the moderating effect of pain catastrophizing"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct05579509","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3770-2749","authenticated-orcid":false,"given":"Yun-Yun Kathy","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna M","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila R","family":"Gokul","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick W","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Kiik","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7704-3709","authenticated-orcid":false,"given":"Kamen","family":"Vlassakov","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-2214","authenticated-orcid":false,"given":"Kristin L","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"2025101112425522000_rapm-2025-106644v1.1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000038"},{"key":"2025101112425522000_rapm-2025-106644v1.2","doi-asserted-by":"crossref","unstructured":"Graff V , Cai L , Badiola I , et al . Music versus midazolam during preoperative nerve block placements: a prospective randomized controlled study. Reg Anesth Pain Med 2019:rapm-2018-100251. doi:10.1136\/rapm-2018-100251","DOI":"10.1136\/rapm-2018-100251"},{"key":"2025101112425522000_rapm-2025-106644v1.3","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aem342"},{"key":"2025101112425522000_rapm-2025-106644v1.4","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-00115550-200809000-00008"},{"key":"2025101112425522000_rapm-2025-106644v1.5","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.jfma.2013.07.018","article-title":"Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy","volume":"114","author":"Hsu","year":"2015","journal-title":"J Formos Med Assoc"},{"key":"2025101112425522000_rapm-2025-106644v1.6","doi-asserted-by":"publisher","DOI":"10.1592\/phco.24.13.1177.38089"},{"key":"2025101112425522000_rapm-2025-106644v1.7","doi-asserted-by":"publisher","DOI":"10.1007\/BF03005624"},{"key":"2025101112425522000_rapm-2025-106644v1.8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2147\/LRA.S11271","article-title":"Anesthesiologists\u2019 perception of patients\u2019 anxiety under regional anesthesia","volume":"3","author":"Jlala","year":"2010","journal-title":"Local Reg Anesth"},{"key":"2025101112425522000_rapm-2025-106644v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2018.01.017"},{"key":"2025101112425522000_rapm-2025-106644v1.10","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199403000-00008"},{"key":"2025101112425522000_rapm-2025-106644v1.11","doi-asserted-by":"publisher","DOI":"10.1037\/\/1040-3590.7.4.524"},{"key":"2025101112425522000_rapm-2025-106644v1.12","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1093\/pm\/pnaa192","article-title":"Reliability and Validity of the Boston Bedside Quantitative Sensory Testing Battery for Neuropathic Pain","volume":"21","author":"Koulouris","year":"2020","journal-title":"Pain Med"},{"key":"2025101112425522000_rapm-2025-106644v1.13","doi-asserted-by":"publisher","DOI":"10.1586\/ern.09.34"},{"key":"2025101112425522000_rapm-2025-106644v1.14","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2024-105602"},{"key":"2025101112425522000_rapm-2025-106644v1.15","doi-asserted-by":"crossref","first-page":"e293","DOI":"10.1016\/j.bja.2019.01.041","article-title":"Benefit of regional anaesthesia on postoperative pain following mastectomy: the influence of catastrophising","volume":"123","author":"Zinboonyahgoon","year":"2019","journal-title":"Br J Anaesth"},{"key":"2025101112425522000_rapm-2025-106644v1.16","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1093\/pm\/pnab039","article-title":"Persistent Post-Mastectomy Pain: The Impact of Regional Anesthesia Among Patients with High vs Low Baseline Catastrophizing","volume":"22","author":"Zinboonyahgoon","year":"2021","journal-title":"Pain Med"},{"key":"2025101112425522000_rapm-2025-106644v1.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2003.12.005"},{"key":"2025101112425522000_rapm-2025-106644v1.18","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000258615.42478.55"},{"key":"2025101112425522000_rapm-2025-106644v1.19","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700048017"},{"key":"2025101112425522000_rapm-2025-106644v1.20","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182a8eb1f"},{"key":"2025101112425522000_rapm-2025-106644v1.21","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.54.6.1063"},{"key":"2025101112425522000_rapm-2025-106644v1.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00076-9"},{"key":"2025101112425522000_rapm-2025-106644v1.23","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181cc5727"},{"key":"2025101112425522000_rapm-2025-106644v1.24","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1093\/pm\/pnae072","article-title":"A mixed-methods study of the impact of sex and situational pain catastrophizing on pain sensitivity","volume":"25","author":"Chen","year":"2024","journal-title":"Pain Med"},{"key":"2025101112425522000_rapm-2025-106644v1.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2012.03.010"},{"key":"2025101112425522000_rapm-2025-106644v1.26","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000465"},{"key":"2025101112425522000_rapm-2025-106644v1.27","doi-asserted-by":"crossref","DOI":"10.2196\/18537","article-title":"A Brief Music App to Address Pain in the Emergency Department: Prospective Study","volume":"22","author":"Chai","year":"2020","journal-title":"J Med Internet Res"},{"key":"2025101112425522000_rapm-2025-106644v1.28","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/pm\/pnac183","article-title":"Brief Mindfulness-Based Cognitive Behavioral Therapy is Associated with Faster Recovery in Patients Undergoing Total Knee Arthroplasty: A Pilot Clinical Trial","volume":"24","author":"Pester","year":"2023","journal-title":"Pain Med"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2025-106644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:43:05Z","timestamp":1760211785000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2025-106644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,5]]},"references-count":28,"alternative-id":["10.1136\/rapm-2025-106644"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2025-106644","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,5]]}}}