s u m m a r y p o i n t s • Mood disorders, especially depression and anxiety, play an important role in the exacerbation of pain perception in all clinical settings.• Depression commonly occurs as a result of chronic pain and needs treating to improve outcome measures and quality of life.• Anxiety negatively affects thoughts and behaviours which hinders rehabilitation.• Anxiety and depression in acute hospital settings also negatively affect pain experience and should be considered in both adults and children.• Poor pain control and significant mood disorders perioperatively contribute to the development of chronic postoperative pain.

There is a complex interplay between sleep disturbance and patients in pain. There is an increasing appreciation of the direct effects of analgesic drugs and sleep quality. This review provides an overview of the effects of different analgesic drugs and their effects on phases of sleep. The effects of different pain conditions and their direct effects on sleep physiology are also discussed. A structured search of the scientific literature using MEDLINE and PubMed databases. Original human and animal studies were included. A multi-search term strategy was employed. An appreciation of the physiological effects of these drugs will allow a more considered prescription of them to better manage sleep disturbance.

Most hospital inpatients will need intravenous fluid therapy as a result of altered intake, extra losses and dynamic shifts within the body. This simple and basic therapy is often overlooked but can cause significant morbidity if neglected as organ perfusion, electrolyte balance and acid base equilibrium may be compromised.

Stellate ganglion block is an established intervention used in pain management settings. Its use in the treatment of congenital venous malformations (VM) of the upper limb has never been described. We present a case of ultrasound-guided stellate ganglion block for a patient who derived excellent relief from pain uncontrolled with conservative and pharmacological methods.

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