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Pain Management

Carlos J Roldan, Thomas Chai, Jennifer Erian, John Welker
Cancer therapy-induced oral mucositis (CTIOM) can cause intolerable oral pain resulting in difficulty in chewing, swallowing and speaking. Thus, leading to patients requiring aggressive measures, such as parenteral feeding, the placement of gastric feeding tubes and discontinuation of oncologic treatments. Although, pain is the debilitating symptom, current efforts seem to focus independently in the histological damage, not in pain and symptom care. Current strategies for managing pain from CTIOM entail maintaining oral hygiene and the use of oral rinses, topical anesthetics, prophylactic antimicrobials and systemic analgesics such as opioids...
November 9, 2018: Pain Management
Brad Brown, Jeremy W Naber, Leonardo Kapural
AIM: To describe two consecutive cases of Postural Orthostatic Tachycardia Syndrome (POTS)-related chronic abdominal pain control in children after bilateral splanchnic block. PATIENTS & METHODS: Two pediatric patients with chronic abdominal pain related to POTS received celiac and T11 splanchnic plexus block for pain control. RESULTS: While celiac plexus block did not provide any substantial relief of their pain, splanchnic block provided a long-term improvement in pain scores, nausea and vomiting cessation...
November 9, 2018: Pain Management
Yuri Rs Franco, Katherinne Fm Franco, Letícia A Silva, Macilene O Silva, Michele N Rodrigues, Richard E Liebano, Cristina Mn Cabral
AIM: To evaluate whether active interferential current (AIC) before pilates exercises improves pain faster than placebo interferential current (PIC) in patients with chronic nonspecific low back pain (CNLBP). METHODS: A total of 142 patients with CNLBP were treated with AIC or PIC before pilates exercises. Pain intensity was measured daily before and after treatment by Pain Numerical Rating Scale. Statistical analysis was performed using survival analysis for Kaplan-Meier method...
November 5, 2018: Pain Management
Seshadri C Mudumbai, David B Auyong, Stavros G Memtsoudis, Edward R Mariano
Anesthesiologists set up regional anesthesia and acute pain medicine programs in order to improve the patient outcomes and experience. Given the increasing frequency and volume of newly described techniques, applying a pragmatic framework can guide clinicians on how to critically review and consider implementing the new techniques into clinical practice. A proposed framework should consider how a technique: increases access; enhances efficiency; decreases disparities and improves outcomes. Quantifying the relative contribution of these four factors using a point system, which will be specific to each practice, can generate an overall scorecard to help clinicians make decisions on whether or not to incorporate a new technique into clinical practice or replace an incumbent technique within a clinical pathway...
November 5, 2018: Pain Management
Naveen Poonai, Kyle Canton, Samina Ali, Shawn Hendrikx, Amit Shah, Michael Miller, Gary Joubert, Lisa Hartling
AIM: In children, intravenous anesthetic premedication can be distressing. Intranasal (IN) ketamine offers a less invasive approach. MATERIALS AND METHODS: We included randomized trials of IN ketamine in anesthetic premedication in children 0-19 years. We performed electronic searches of MEDLINE, EMBASE, Google Scholar, CINAHL, Cochrane Library, Web of Science, Scopus, clinical trial registries and conference proceedings. RESULTS: Among the 23 trials (n = 1680) included, IN ketamine adequately sedated 220/311 (70%) for face mask application, 217/308 (70%) for caregiver separation, 200/371 (54%) for iv...
November 5, 2018: Pain Management
Joseph V Pergolizzi, Melanie Rosenblatt, Dean J Mariano, John Bisney
No abstract text is available yet for this article.
November 5, 2018: Pain Management
Christian Maihöfner, Sabine Schneider, Patric Bialas, Helmut Gockel, Katrin-Grit Beer, Max Bartels, Kai-Uwe Kern
AIM: The secretolytic drug ambroxol may be useful for the treatment of neuropathic pain due to its multiple modes of action. We hypothesized that ambroxol may be a treatment option for complex regional pain syndrome (CRPS). METHODS: Additional to standard therapy, eight CRPS-patients with symptoms of less than 12 months were treated with topical 20% ambroxol cream. Clinical courses were assessed using detailed anamnesis and clinical examination. RESULTS: Following treatment we found a reduction of spontaneous pain (6 patients), pain on movement (6 patients), edema (seven patients), allodynia (six patients), hyperalgesia (seven patients), reduction of skin reddening (four patients), improvement of motor dysfunction (six patients) and improvement of skin temperature (four patients)...
November 5, 2018: Pain Management
Ángel Oteo-Álvaro, María Teresa Marín
AIM: To determine the predictive factors of the neuropathic pain in patients with carpal tunnel syndrome (CTS), and the impact of such neuropathic pain on patient's activity. METHODS: Douleur Neuropathique 4 questionnaire, Short Form-Brief Pain Inventory test and Boston Carpal Tunnel Syndrome Questionnaire were completed and results were stratified according neuropathic pain and work activity of the patients. RESULTS: 69 of 90 patients with CTS had neuropathic pain (76...
November 5, 2018: Pain Management
Serdar Kesikburun, Berke Aras, Bayram Kelle, Ferdi Yavuz, Evren Yaşar, Mehmet A Taşkaynatan
AIM: To investigate the long-term effect of fluoroscopy guided cervical transforaminal epidural steroid injection on neck pain radiating to the arm due to cervical disc herniation. MATERIALS & METHODS: 64 patients (26 women [40.6%], 38 men [59.4%]; mean age, 44.9 ± 12.1 years) who had received fluoroscopy guided cervical transforaminal epidural steroid injection for neck pain due to cervical disc herniation at least 1 year before were included in the study...
October 3, 2018: Pain Management
Anuradha Setlur, Howard Friedland
AIM: The primary objective of this review is to provide an updated, comprehensive overview on the efficacy of intranasal fentanyl (INF) for acute pain relief in the pediatric population. METHODS: Utilizing the Preferred Reporting Instructions for Systematic Reviews and Meta-Analyses (PRISMA), we were able to screen articles based on key words to reach a final number of 10 studies. RESULTS: All but one study showed that INF was efficacious for pain relief in this select pediatric population...
October 3, 2018: Pain Management
Sameer Jain, Hsiangkuo Yuan, Nicole Spare, Stephen D Silberstein
Migraine is a highly prevalent neurological pain syndrome, and its management is limited due to side effects posed by current preventive therapies. Calcitonin gene-related peptide (CGRP) plays a crucial role in the pathogenesis of migraine. In recent years, research has been dedicated to the development of monoclonal antibodies against CGRP and CGRP receptors for the treatment of migraine. This review will focus on the first US FDA-approved CGRP-receptor monoclonal antibody developed for the prevention of migraine: erenumab...
September 21, 2018: Pain Management
Jessica A Boyette-Davis, Saiyun Hou, Salahadin Abdi, Patrick M Dougherty
The burdensome condition of chemotherapy-induced peripheral neuropathy occurs with various chemotherapeutics, including bortezomib, oxaliplatin, paclitaxel and vincristine. The symptoms, which include pain, numbness, tingling and loss of motor function, can result in therapy titrations that compromise therapy efficacy. Understanding the mechanisms of chemotherapy-induced peripheral neuropathy is therefore essential, yet incompletely understood. The literature presented here will address a multitude of molecular and cellular mechanisms, beginning with the most well-understood cellular and molecular-level changes...
September 13, 2018: Pain Management
Oscar Diaz-Cambronero, Guido Mazzinari, Juan P Cata
AIM: To summarize the literature on the long-term impact of perioperative opioids in colorectal cancer. MATERIALS & METHODS: Combined results from two searching strategies in PubMed/MEDLINE (1950-2018), based on a PICO approach; P: Opioid influence on cancer-related long-term outcome in patient undergoing colorectal surgery; I: Opioid drugs administered in the perioperative period; C: Correlation between dose and/or type of opioid with long-term oncologic outcome; O: Disease-free survival and/or overall survival (OS)...
September 13, 2018: Pain Management
Marjorie Flahaut, Nicolas L Laurent, Murielle Michetti, Nathalie Hirt-Burri, Winnie Jensen, Romulus Lontis, Lee A Applegate, Wassim Raffoul
AIM: Limb amputation traumatically alters body image. Sensations rapidly prevail that the limb is still present and 85% of patients portray phantom limb pain. Throughout the testimonies of amputated patients with intense phantom limb pain, we show the difficulty in treating this chronic pain with current pharmacological and nonpharmacological therapies. PATIENTS & METHODS: We qualitatively analyzed the therapeutic choices of five amputees, the effectiveness of the treatments chosen and the impact on patients' quality-of-life...
September 3, 2018: Pain Management
Jonathan E Silverman, Amitabh Gulati
Pain is a ubiquitous part of the cancer experience. Often the presenting symptom of malignancy, pain becomes more prevalent in advanced or metastatic disease and often persists despite curative treatment. Although management of cancer pain improved following publication of the WHO's analgesic ladder, when used in isolation, conservative approaches often fail to control pain and are limited by intolerable side effects. Interventional strategies provide an option for managing cancer pain that remains refractory to pharmacologic therapy...
September 2018: Pain Management
Kathleen Cullion, Daniel S Kohane
No abstract text is available yet for this article.
September 1, 2018: Pain Management
Alexander Schnabel
No abstract text is available yet for this article.
September 1, 2018: Pain Management
Christina Wh Cheng, Clara Sm Wong, Grace Km Hui, Edmond Kn Chung, Steven Hs Wong
Fibromyalgia is a chronic pain syndrome of unclear pathophysiology. It is believed to be a dysfunction of the CNS, but no definite structural lesion has been identified so far. Despite a number of changes in the diagnostic criteria, diagnosis remains a clinical one. Since the 2011 revision of the IASP definition of neuropathic pain, fibromyalgia has been excluded from the diagnosis of neuropathic pain. More recent studies however found newer evidences of pathophysiology including small fiber neuropathy in patients with fibromyalgia...
September 1, 2018: Pain Management
Tejus Anantharamu, Mathur A Govind
No abstract text is available yet for this article.
September 1, 2018: Pain Management
Jessie S Channell, Stephan Schug
BACKGROUND: Tapentadol is a novel atypical opioid. Anecdotal evidence suggests that tapentadol has a lower toxicity than conventional opioids. OBJECTIVES: To evaluate all single-drug mortality due to tapentadol and assess serious adverse events caused by tapentadol. METHODS: The Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) reporting guidelines, an evidence-based minimum set of items for reporting in systematic reviews, were followed in this systematic review...
August 6, 2018: Pain Management
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