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Clinical Journal of Pain

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https://www.readbyqxmd.com/read/28617716/hybrid-blocks-for-total-knee-arthroplasty-a-technical-description
#1
David F Johnston, Rakesh V Sondekoppam, Vishal Uppal, James L Howard, Sugantha Ganapathy
This narrative review article aims to examine current evidence of knee innervation in order to develop a technique of targeting pure sensory innervation of the knee joint without compromising motor function. A literature review of knee innervation was performed to gain an anatomic understanding of terminal sensory branches of the relevant target nerves (femoral, obturator, sciatic, and lateral femoral cutaneous). Pure sensory block of the knee joint is challenging due to important contributions from the muscular innervation close to the joint and the variability of nerves afferents contained within and around the adductor canal...
June 14, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28609308/evaluation-of-a-clinical-protocol-to-assess-and-diagnose-neuropathic-pain-during-acute-hospital-admission-results-from-traumatic-spinal-cord-injury
#2
Lise M A Bélanger, Hamed S Umedaly, Vanessa K Noonan, So Eyun Park, Jennifer Prince, Nancy P Thorogood, Tian Shen, Andrea F Townson, John T Street, Marcel F Dvorak, Michael Negraeff
OBJECTIVES: A clinical protocol was developed for clinicians to routinely assess and initiate treatment for patients with neuropathic pain (NP) in an acute care setting. The objectives of this study were to: (1) determine the incidence and onset of NP in patients with traumatic SCI during acute care and (2) describe how the implementation of a clinical protocol impacts the assessment and diagnosis of NP. METHODS: The study was a cohort analysis with a pre-post-test utilizing a historical control...
June 12, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591086/dexamethasone-injected-perineurally-is-more-effective-than-administered-intravenously-for-peripheral-nerve-blocks-a-meta-analysis-of-randomized-controlled-trials
#3
Andres Zorrilla-Vaca, Jinlei Li
INTRODUCTION: Peripheral nerve blocks (PNBs) are widely and increasingly used for better acute perioperative pain control for a variety of procedures. Clinically preservative-free dexamethasone is arguably the most commonly used adjuvant and offers the most optimization effects on PNBs yet with the least side-effects noted. Our aim was to compare the effectiveness of intravenous versus perineural dexamethasone on the effectiveness and safety of PNBs. METHODS: Major databases (PubMed, EMBASE, Cochrane library, ISI Web of Science, Google Scholar) were systematically searched for randomized controlled trials (RCTs) comparing the effectiveness of intravenous versus perineural dexamethasone on peripheral nerve blocks...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591085/influence-of-oprm1-polymorphism-on-post-operative-pain-after-intrathecal-morphine-administration-in-italian-patients-undergoing-elective-cesarean-section
#4
Eleonora Pettini, Massimo Micaglio, Ubaldo Bitossi, Angelo Raffaele De Gaudio, Duccio Rossi Degl'Innocenti, Lorenzo Tofani, Vittorio Limatola, Chiara Adembri, Alessandro Di Filippo
OBJECTIVES: the aim of this prospective observational study was to evaluate the influence of OPRM1 polymorphism on the analgesic efficacy (including VAS scores and requirement for rescue analgesia) of a standard dose of intrathecal morphine METHODS:: an Italian cohort of 63 parturients, scheduled for elective cesarean section at a tertiary University Hospital, received a spinal anesthesia with hyperbaric bupivacaine and morphine 100 mcg. For the first 48 hours in the post-operative period the patients received acetaminophen 1 g IV q6hr...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591084/efficacy-of-postoperative-analgesia-of-local-ketamine-wound-instillation-following-total-thyroidectomy-a-randomized-double-blind-controlled-clinical-trial
#5
Ahmad M Abd El-Rahman, Fatma A El Sherif
BACKGROUND: Total thyroidectomy is recommended as a line of management of thyroid cancer in a lot of cases. Our aim was to compare postoperative analgesic effect of local ketamine 1 mg/kg instilled in the wound to I.M ketamine and to placebo after total thyroidectomy. METHODS: Ninety patients aged 18 - 60 years, American Society of Anesthesiologists (ASA) class I-II, with a body weight of 50-90 kg, scheduled for total thyroidectomy were enrolled after ethics committee approval in this prospective, randomized, double-blind, controlled study and divided randomly into three groups to receive after hemostasis: Group (I): 1 mg/kg ketamine in a total volume of 10 mL normal saline instilled in the wound...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591083/investigating-the-fear-avoidance-model-in-people-with-whiplash-the-association-between-fear-of-movement-and-in-vivo-activity
#6
Ashley Pedler, Steven J Kamper, Annick Maujean, Michele Sterling
OBJECTIVES: The aims of this study were to examine the relationship between fear of movement and activity levels in people with WAD over the first 3 months post injury, to determine the mediating effect of: fear of movement on the relationship between catastrophising and activity levels, and activity levels on the relationship between fear of movement and disability in patients with WAD. METHODS: Ambulatory monitoring of physical activity was conducted for a minimum of 8 waking hours on 2 consecutive days within 4 weeks post injury and at 12 weeks post injury for 103 (74 female) people with WAD...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591082/opioid-sparing-effects-of-solumatrix-indomethacin-in-a-phase-3-study-in-patients-with-acute-postoperative-pain
#7
Christopher Gharibo, Charles Argoff, Joseph A Markenson, Lynn Webster, Jennifer Nezzer, Daniel Solorio, Melanie Lauterio, Clarence Young
OBJECTIVES: To report the opioid-sparing effects of SoluMatrix indomethacin, developed using SoluMatrix Fine Particle Technology, in a phase 3 study in patients with acute pain following bunionectomy. METHODS: This phase 3, placebo-controlled study randomized 462 patients with moderate-to-severe pain following bunionectomy surgery to receive SoluMatrix indomethacin 40 mg three times daily, SoluMatrix indomethacin 40 mg twice daily, SoluMatrix indomethacin 20 mg three times daily, celecoxib 400-mg loading dose followed by 200 mg twice daily, or placebo...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591081/pain-related-activity-management-patterns-and-function-in-patients-with-fibromyalgia-syndrome
#8
Mélanie Racine, Santiago Galán, Rocío de la Vega, Catarina Tomé Pires, Ester Solé, Warren R Nielson, Jordi Miró, Dwight E Moulin, Mark P Jensen
OBJECTIVES: To clarify the importance of avoidance, pacing and overdoing pain-related activity management patterns as predictors of adjustment in patients with Fibromyalgia Syndrome (FMS). METHODS: A total of 119 tertiary care patients with FMS who agreed to be part of an activity management pain program completed a survey, which requested information about demographics, pain intensity and pain interference, psychological and physical function, and pain-related activity management patterns...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28591080/muscle-pain-induces-a-shift-of-the-spatial-distribution-of-upper-trapezius-muscle-activity-during-a-repetitive-task-a-mechanism-for-perpetuation-of-pain-with-repetitive-activity
#9
Deborah Falla, Corrado Cescon, Rene Lindstroem, Marco Barbero
OBJECTIVE: An association exists between repetitive movements and neck-shoulder muscle pain. The mechanisms underlying this association remain unclear. This observational study investigated the effect of upper trapezius muscle pain on the distribution of upper trapezius activity during repetitive lifting. It was hypothesized that nociception would change the distribution of activity resulting in activation of muscle regions which would not normally be active during the task. MATERIALS AND METHODS: Healthy men repeatedly lifted a box with a cycle time of 3 seconds for 50 cycles, at baseline, following injection of isotonic and hypertonic saline into the upper trapezius muscle and 15 minutes after the last injection...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28542026/combination-drug-therapy-of-pioglitazone-and-d-cycloserine-attenuates-chronic-orofacial-neuropathic-pain-and-anxiety-by-improving-mitochondrial-function-following-trigeminal-nerve-injury
#10
Danielle N Lyons, Liping Zhang, Jignesh D Pandya, Robert J Danaher, Fei Ma, Craig S Miller, Patrick G Sullivan, Cristian Sirbu, Karin N Westlund
OBJECTIVES: The study aim was to determine how peripheral trigeminal nerve injury affects mitochondrial respiration and to test efficacy of combined treatment with two FDA approved drugs with potential for improving mitochondrial bioenergetics, pain and anxiety related behaviors in a chronic orofacial neuropathic pain mouse model. METHODS: Efficacy of (R)-(+)-4-amino-3-isoxazolidinone (D-cycloserine, DCS), an NMDA antagonist/agonist, and Pioglitazone (PIO), a selective agonist of nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ) was investigate in the trigeminal inflammatory compression (TIC) neuropathic nerve injury mouse model...
May 24, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28542025/brief-psychological-screening-questions-can-be-useful-for-ruling-out-psychological-conditions-in-patients-with-chronic-pain
#11
Henrik Bjarke Vaegter, Gitte Handberg, Peter Kent
OBJECTIVES: Psychological symptoms are highly prevalent in chronic pain patients. Timely and accurate identification may enable individualized treatment and improve outcomes. The aims of this study were to (i) investigate the concurrent validity of brief psychological screening questions assessing anxiety, fear of movement, stress, pain catastrophization, and depression in chronic pain patients, and (ii) to determine screening question cut-points at which the likely probability of having these psychological states was less than 10%...
May 24, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28542024/omega-6-omega-3-pufa-ratio-pain-functioning-and-distress-in-adults-with-knee-pain
#12
Kimberly T Sibille, Christopher King, Timothy J Garrett, Toni L Glover, Hang Zhang, Huaihou Chen, Divya Reddy, Burel R Goodin, Adriana Sotolongo, Megan E Petrov, Yenisel Cruz-Almeida, Matthew Herbert, Emily J Bartley, Jeffrey C Edberg, Roland Staud, David T Redden, Laurence A Bradley, Roger B Fillingim
OBJECTIVES: Osteoarthritis (OA) is associated with inflammation, chronic pain, functional limitations, and psychosocial distress. High Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are associated with lower levels of inflammatory mediators, anti-nociception, and adaptive cognitive/emotional functioning. High Omega-6 (n-6) PUFAs are associated with inflammation, nociception, and psychological distress. While findings related to n-3 supplementation in knee OA are mixed, consideration of the n-6:n-3 ratio and additional outcome measures may provide improved understanding of the potential relevance of these fatty acids in OA...
May 24, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28514232/ppar%C3%AE-agonists-attenuate-trigeminal-neuropathic-pain
#13
Danielle N Lyons, Liping Zhang, Robert J Danaher, Craig S Miller, Karin N Westlund
The aim of this study is to investigate the role of peroxisome proliferator-activated receptor-gamma isoform (PPARγ), in trigeminal neuropathic pain utilizing a novel mouse trigeminal inflammatory compression (TIC) injury model. The study determined that the PPARγ nuclear receptor plays a significant role in trigeminal nociception transmission, evidenced by: (1) Intense PPARγ immunoreactivity is expressed 3 weeks after TIC nerve injury in the spinal trigeminal caudalis, the termination site of trigeminal nociceptive nerve fibers...
May 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28514231/preoperative-pain-neuroscience-education-combined-with-knee-joint-mobilization-for-knee-osteoarthritis-a-randomized-controlled-trial
#14
Enrique Lluch, Lirios Dueñas, Deborah Falla, Isabel Baert, Mira Meeus, Jose Sánchez-Frutos, Jo Nijs
OBJECTIVES: This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions on knee pain, disability, and psychosocial variables. MATERIALS AND METHODS: Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery...
May 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28481838/contribution-of-endocannabinoid-gene-expression-and-genotype-on-low-back-pain-susceptibility-and-chronicity
#15
Divya Ramesh, Amy D'Agata, Angela Starkweather, Erin Young
A major research emphasis has been focused on defining the molecular changes that occur from acute to chronic pain in order to identify potential therapeutic targets for chronic pain. As the endocannabinoid system is dynamically involved in pain signaling, a plausible mechanism that may contribute to chronic pain vulnerability involves alterations in the amount of circulating endocannabinoids. Therefore, this study sought to examine cannabinoid type-1 (CNR1), type-2 (CNR2) receptors, fatty acid amide hydrolase (FAAH) and the vanilloid receptor (TRPV1) gene expression profiles among individuals with acute and chronic LBP at their baseline visit...
May 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28481837/mindfulness-based-cognitive-therapy-and-persistent-pain-in-women-treated-for-primary-breast-cancer-exploring-possible-statistical-mediators-results-from-a-randomized-controlled-trial
#16
Maja Johannsen, Maja O'Connor, Mia Skytte O'Toole, Anders Bonde Jensen, Robert Zachariae
OBJECTIVES: To investigate possible statistical mediators in a randomized controlled trial of Mindfulness-Based Cognitive Therapy (MBCT) on pain intensity in women treated for primary breast cancer. METHODS: The sample consisted of 129 women treated for breast cancer, presenting with persistent pain, who were randomly assigned to MBCT or a wait-list control. We previously reported a statistically significant and robust effect of MBCT on pain intensity (11-point Numeric Rating Scale), which was included as the primary outcome...
May 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28481836/sensitivity-of-the-dn4-in-screening-for-neuropathic-pain-syndromes
#17
Elizabeth G VanDenKerkhof, Larry Stitt, Alexander J Clark, Allan Gordon, Mary Lynch, Patricia K Morley-Forster, Howard J Nathan, Catherine Smyth, Cory Toth, Mark A Ware, Dwight E Moulin
OBJECTIVES: Several tools have been developed to screen for neuropathic pain. This study examined the sensitivity of the Douleur Neuropathique en 4 Questions (DN4) in screening for various neuropathic pain syndromes. METHODS: This prospective observational study was conducted in 7 Canadian academic pain centers between April 2008 and December 2011. All newly admitted patients (n=2199) were approached and 789 eligible participants form the sample for this analysis...
May 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28448426/orexin-receptor-antagonism-in-painful-diabetic-neuropathy-a-phase-2-trial-with-filorexant
#18
W Joseph Herring, Joy Y Ge, Saheeda Jackson, Christopher Assaid, Kathryn M Connor, David Michelson
OBJECTIVES: To evaluate whether orexin receptor antagonism with filorexant provides pain relief in patients with painful diabetic neuropathy (PDN). METHODS: In this double-blind, placebo-controlled, enriched-enrollment, randomized-withdrawal proof-of-concept study, patients with PDN (aged 18-75 y) entered a 2-week, single-blind active run-in period with filorexant 10 mg nightly, before randomization 1:1 to placebo or filorexant in a 2-week, double-blind treatment period...
April 26, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28448425/vulnerability-to-psychopathology-and-dimensions-of-personality-in-patients-with-fibromyalgia
#19
Alba Garcia-Fontanals, Mariona Portell, Susanna García-Blanco, Violant Poca-Dias, Ferran García-Fructuoso, Marina López-Ruiz, Teresa Gutiérrez-Rosado, Montserrat Gomà-I-Freixanet, Joan Deus
OBJECTIVE: Fibromyalgia (FM) patients may present psychopathology and some characteristic personality traits that may affect their adaptation to the disease. This paper aims to study the relationship between personality dimensions according to the psychobiological model of Cloninger and the presence of psychopathology. METHOD: The study sample consisted of 42 patients with FM and 38 healthy controls. The assessment instruments administered were the Temperament and Character Inventory (TCI-R) and the Millon Clinical Multiaxial Inventory (MCMI-III)...
April 26, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28430671/elevated-production-of-nociceptive-cc-chemokines-and-se-selectin-in-patients-with-low-back-pain-and-the-effects-of-spinal-manipulation-a-non-randomized-clinical-trial
#20
Julita A Teodorczyk-Injeyan, Marion McGregor, John J Triano, H Stephen Injeyan
BACKGROUND: The involvement of inflammatory components in the pathophysiology of low back pain is poorly understood. It has been suggested that spinal manipulative therapy (SMT) may exert anti-inflammatory effects. PURPOSE: To determine the involvement of inflammation-associated chemokines (CC series) in the pathogenesis of non-specific low back pain and to evaluate the effect of SMT on that process. METHODS: Patients presenting with non-radicular, non-specific low back pain (minimum pain score 3 on 10 point visual analogue scale, VAS) were recruited according to stringent inclusion criteria...
April 19, 2017: Clinical Journal of Pain
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