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Pain Physician

Lu Chen, Ling Ye
No abstract text is available yet for this article.
September 2018: Pain Physician
Adam Romman, Joseph Salama-Hanna, Samvid Dwivedi
BACKGROUND: Intravenous lidocaine has multiple applications in the management of acute and chronic pain. Mexiletine, an oral lidocaine analogue, has been used in a number of chronic pain conditions although its use is not well characterized. OBJECTIVES: To report our experience using mexiletine in a chronic pain population, specifically looking at tolerability, side effects, and EKG changes. STUDY DESIGN: Retrospective, cohort study. SETTING: Three chronic pain clinics within a hospital system in Detroit, MI...
September 2018: Pain Physician
Dong Ah Shin, Chunwoo Kim, Farid Yudoyono, Yeomin Yun, Yoon Ha, Sungchul Kang
BACKGROUND: Endoscopy has replaced open surgery, especially in spinal surgery. Among them, image-guided epiduroscopy allows pain generators to be identified, including epidural adhesion, fibrotic tissues, root compression, and spinal stenosis. However, the heavy lead apron worn by pain physicians to avoid exposure to radiation can induce occupational hazards, such as orthopedic complications and radiation-induced cancer. Hence, we developed a robotic system to address these problems. OBJECTIVE: The aim of the study was to evaluate the feasibility of a robot-controlled epiduroscopic system...
September 2018: Pain Physician
Ya-Qun Zhao, Jun-Bin Yin, Huang-Hui Wu, Tan Ding, Yong Wang, Jin-Chuan Liang, Xiao-Ju Guo, Ke Tang, Dong-Sheng Chen, Guo-Zhong Chen
BACKGROUND: Over-expression of spinal protein kinase Cγ(PKCγ) contributes to the induction of persistent bilateral hyperalgesia following inflammatory injury, yet the role of spinal PKCγ in short- and long-lasting pain behavior is poorly understood. OBJECTIVE: This study aimed to characterize the contribution of spinal PKCγ to spontaneous pain and long-lasting bilateral hyperalgesia in formalin-induced inflamed mice using pharmacological inhibition. STUDY DESIGN: Laboratory animal study...
September 2018: Pain Physician
Yuanyuan Ding, Hongxi Li, Tao Hong, Yongqiang Zhu, Peng Yao, Guangyu Zhou
BACKGROUND: Primary trigeminal neuralgia (TN) is a common clinical refractory neuralgia. Severe pain is experienced during episodes, severely impacting the patient's quality of life. Long-term suffering from the disease can lead to anxiety, depression, and even suicide. The pathological processes involved in TN are complex, the mechanisms of pathogenesis are unknown, and effective treatment is lacking. OBJECTIVE: This study aimed to assess the efficacy and safety of computed tomography (CT)-guided pulsed radiofrequency (PRF) combined with low-temperature continuous radiofrequency (CRF) thermocoagulation in V2/V3 primary trigeminal neuralgia...
September 2018: Pain Physician
Chrysanthi Batistaki, Philippe Mavrocordatos, Maria-Eleni Smyrnioti, George Lyrakos, Maria-Chrysanthi Kitsou, Georgia Stamatiou, Georgia Kostopanagiotou
BACKGROUND: Chronic pain is well known to be influenced by various social factors; however, the impact of financial issues on pain has not been extensively studied. OBJECTIVE: The aim of this study was to investigate the impact of the economic crisis on pain and quality of life in Greek patients suffering from chronic pain. STUDY DESIGN: The study employed a prospective, open-label design. SETTING: The study setting was the Pain Unit of Attikon University Hospital in Athens, Greece...
September 2018: Pain Physician
Raymond Kelly, Aisling McMahon, Dominic Hegarty
BACKGROUND: The growth of interventional pain medicine in recent years has resulted in more procedures being carried out under fluoroscopic guidance. The proximity of the pain physician (PP) to ionization radiation (IR) potentially increases the risk of radiation exposure to the ocular region. A European directive has reduced the limits of occupational ocular dose 7.5-fold. OBJECTIVES: The objectives of this study are to quantify the typical IR exposure in the ocular region of PP and to compare it to recommended international guidelines...
September 2018: Pain Physician
Guo-Fang Lu, Jun-Ming Zhang, Jian-Xiong An, Xiao-Yan Oian, Yong Wang, Si-Yu Lin, John P Williams
BACKGROUND: Electroacupuncture (EA) has been proved to be effective in treating certain neuropathic pain conditions. The mechanisms of pain relief by EA are not fully understood. There have been sporadic reports of damage in the peripheral nervous system (PNS) and regions of the central nervous system (CNS) at the ultrastructural level following peripheral nerve injury. However, information about possible systemic changes in the PNS and CNS after nerve injury is scarce. OBJECTIVES: The goal of this study was to examine the ultrastructural changes of the nervous system induced by a local injection of cobra venom into the sciatic nerve and to compare the ultrastructural changes in rats with or without treatment with EA or pregabalin...
September 2018: Pain Physician
Mert Akbas, Abdel Reheem Elawamy, Haitham Hamby Salem, Ahmed Zaghloul Fouad, Nisreen Adel Abbas, Gozde Dagistan
BACKGROUND: Percutaneous epidural adhesiolysis and neuroplasty (PEAN) has been proven to be safe and effective in treating different spine pathologies, in particular post lumbar surgery syndrome (PLSS). OBJECTIVES: The purpose of this study was to compare the efficacy and complication rates of the 3 different PEAN anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) used to treat PLSS. STUDY DESIGN: This study used a case control, blind study...
September 2018: Pain Physician
Lisa Doan, Hersh Patel, Yeseniya Aronova, Christopher Gharibo
BACKGROUND: Previous surveys have identified variations in practice patterns related to epidural steroid injections. Since then, the United States Food and Drug Administration (FDA) has required the addition of drug warning labels for injectable corticosteroids. Updated evidence, as well as scrutiny from regulatory agencies, may affect practice patterns. OBJECTIVE: To provide an update on interlaminar epidural steroid injection (ILESI) practice patterns, we surveyed interventional pain management (IPM) physicians in the United States...
September 2018: Pain Physician
Chang-Chen Yang, Jui-Teng Chien, Tzung-Yi Tsai, Kuang-Ting Yeh, Ru-Ping Lee, Wen-Tien Wu
BACKGROUND: Percutaneous vertebroplasty (PVP) is widely used to treat osteoporotic vertebral compression fractures (OVCFs). The influence of timing (early vs. late) of PVP on the development of adjacent vertebral fractures (AVF) has rarely been discussed. OBJECTIVE: This study aimed to compare the incidence of AVF among patients who received early PVP (= 30 days after symptom onset, EPVP) or late PVP (> 30 days after symptom onset, LPVP) in the thoracolumbar region (T10 to L2) after a 1-year follow up...
September 2018: Pain Physician
Stephen Ellwood, Peter Shupper, Andrew Kaufman
BACKGROUND: Recent studies have shown that medial branch radiofrequency neurotomy (RFN) procedures done at the level of a pedicle screw can increase pedicle screw temperature, and it has been speculated that pedicle screw heating may cause thermal injury. There has been a limited amount of investigation into the real-world safety profile of RFN procedures in patients with pedicle screws. OBJECTIVES: We aim to demonstrate that the occurrence of serious adverse events is rare for a medial branch RFN procedure completed at a level with metallic spinal hardware when performed according to the Spine Intervention Society practice standards...
September 2018: Pain Physician
Abed Rahman, Raed Rahman, George Macrinici, Sam Li
BACKGROUND: Abdominal pain from primary cancer or metastatic disease is a significant cause of pain for patients undergoing treatment for the disease. Patient's pain may be resistant to conventional analgesics. The need for timely pain relief in order to facilitate further care in the cancer treatment plan should be a priority. OBJECTIVES: The aim of this retrospective observational review was to assess the relief given with a low volume neurolytic retrocrural celiac plexus nerve block, the duration of the procedure, the duration of relief, the reduction in daily opioid consumption, and the improvement of quality of life in a patient suffering from incapacitating abdominal pain due to primary abdominal malignancy or abdominal metastatic disease...
September 2018: Pain Physician
Kaustuv Dutta, Samarjit Dey, Prithwis Bhattacharyya, Sharat Agarwal, Priyanka Dev
BACKGROUND: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach...
September 2018: Pain Physician
Hui-Ming Peng, Long-Chao Wang, Wei Wang, Qi-Heng Tang, Wen-Wei Qian, Jin Lin, Jin Jin, Bin Feng, Xing-Hua Yin, Xi-Sheng Weng, Yi-Xin Zhou
BACKGROUND: Total hip arthroplasty (THA) is a well-accepted surgical treatment for terminal hip diseases. OBJECTIVE: To evaluate the effect of preemptive analgesia with parecoxib in patients undergoing primary unilateral THA. STUDY DESIGN: A randomized, double-blind, placebo-controlled study. SETTING: This study was conducted at Peking Union Medical College Hospital and Beijing Jishuitan Hospital in Beijing, China. METHODS: A total of 94 patients scheduled for primary unilateral THA in 2 centers (Peking Union Medical College Hospital and Beijing Jishuitan Hospital) were randomly assigned to receive 40 mg parecoxib (n = 48) or 0...
September 2018: Pain Physician
Yitong Jia, Yuesong Pan, Hao Ren, Nan Ji, Fang Luo
BACKGROUND: Trigeminal neuralgia (TN) is a neurological syndrome characterized by paroxysmal, lightning-like, severe pain in the facial area innervated by the trigeminal nerve. Patients who do not respond well to drug treatment can undergo a nerve block, a traditional conservative treatment. Pulsed radiofrequency (PRF) is a nondestructive pain intervention technique. However, its treatment effectiveness for TN has rarely been reported and remains controversial among scholars. A recent single-center preliminary clinical study showed that high-voltage PRF was significantly effective in the treatment of TN...
September 2018: Pain Physician
Jung Hwan Lee, Dong Hwan Kim, Du Hwan Kim, Kyoung-Ho Shin, Sung Jin Park, Goo Joo Lee, Chang-Hyung Lee, Hee Seung Yang
BACKGROUND: Epidural injection is performed for treatment of back and radicular pain in patients with lumbosacral disc herniation (LDH). Steroids are usually administered to effectively remove inflammatory mediators, and local anesthetics or saline also contribute to pain reduction by washing out chemical mediators or blocking the nociceptor activity. Controversy exists regarding whether steroids produce superior clinical effects compared with local anesthetics or saline. OBJECTIVES: This study investigated whether epidural injection of steroids produces better clinical effects than local anesthetics or saline in the treatment of LDH...
September 2018: Pain Physician
Jung Hwan Lee, Kyoung-Ho Shin, Sung Jin Park, Goo Joo Lee, Chang-Hyung Lee, Dong Hwan Kim, Du Hwan Kim, Hee Seung Yang
BACKGROUND: Epidural injection (EI) is used to treat back or radicular pain from lumbosacral disc herniation (LDH). Although several reports have stated that the transforaminal approach in EI (TFEI) has an advantage in target specificity and yields better clinical efficacy than the interlaminar approach in EI (ILEI), other studies have indicated that the clinical efficacy of ILEI was not inferior to that of TFEI and that ILEI also has the ability to spread medication into the ventral space to a degree similar to that of TFEI...
September 2018: Pain Physician
Katharina Rosian, Katharina Hawlik, Brigitte Piso
BACKGROUND: Metastatic spinal lesions are difficult-to-treat entities that are most commonly associated with pain and severely reduced health-related quality of life (HRQoL). Within the last 5 to 10 years, radiofrequency ablation (RFA) has emerged as an option in the palliative treatment of vertebral metastases. OBJECTIVES: Our review aims to evaluate the clinical effectiveness and safety of RFA, mostly in combination with vertebroplasty, in patients with painful vertebral metastases...
September 2018: Pain Physician
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