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Pain Management

James R Miner, Timothy I Melson, David Leiman, Harold S Minkowitz, Yu-Kun Chiang, Karen P DiDonato, Pamela P Palmer
AIM: To evaluate the pooled safety of sufentanil sublingual tablets (SSTs) administered at 30-mcg dose equivalents over ≤72 h for moderate-to-severe acute pain management in medically supervised settings. PATIENTS & METHODS: Safety data from SST 30 mcg Phase III studies were pooled with an additional patient subset from studies in which two SST 15 mcg were self-administered within 20-25 min (30-mcg dose-equivalent). RESULTS: Analyses included 804 patients...
January 7, 2019: Pain Management
Alessia Gallucci, Pedro H Lucena, Géraldine Martens, Aurore Thibaut, Felipe Fregni
Opioid misuse leading to dependence is a major health issue. Recent studies explored valid alternatives to treat pain in postsurgical settings. This systematic review aims to discuss the role of transcranial direct current stimulation (tDCS) in preventing and treating postoperative pain and opioid dependence. PubMed and Embase databases were screened, considering studies testing tDCS effects on pain and opioid consumption in surgical settings and opioid addiction. Eight studies met our inclusion criteria...
December 5, 2018: Pain Management
John D Loeser
No abstract text is available yet for this article.
December 5, 2018: Pain Management
David Magee, Sabina Bachtold, Matthew Brown, Paul Farquhar-Smith
Increasing numbers of those living with and beyond cancer presents a clinical challenge for pain specialists. A large proportion of these patients experience pain secondary to their disease or its treatment, impeding rehabilitation and significantly impacting upon their quality of life. The successful management of this pain presents a considerable challenge. This review aims to outline current concepts and treatment options, while considering nuances within pain assessment and the use of large-scale data to help guide further advances...
December 5, 2018: Pain Management
Rena Gatzounis, Geert Crombez, Martien G S Schrooten, Johan W S Vlaeyen
Activity interruptions, namely temporary suspensions of an ongoing task with the intention to resume it later, are common in pain. First, pain is a threat signal that urges us to interrupt ongoing activities in order to manage the pain and its cause. Second, activity interruptions are used in chronic pain management. However, activity interruptions by pain may carry costs for activity performance. These costs have recently started to be systematically investigated. We review the evidence on the consequences of activity interruptions by pain for the performance of the interrupted activity...
December 5, 2018: Pain Management
(no author information available yet)
No abstract text is available yet for this article.
December 3, 2018: Pain Management
Krishnan V Chakravarthy, Thomas M Kinfe, Paul J Christo
No abstract text is available yet for this article.
December 3, 2018: Pain Management
Rubén Nieto, Beatriz Sora, Gemma Ruiz
Giving less importance to pain and focusing on achieving objectives in accordance with values can help people to live their lives in spite of the pain. We present a rationale for this orientation and several techniques that can help people achieve this. Specifically, we present the importance of starting the intervention by educating people about pain and setting objectives in line with each person's personal values. After that, we present some techniques that can help people deal with triggers and barriers that can make it difficult to stay on track when it comes to giving less importance to pain and more to achieving objectives...
December 3, 2018: Pain Management
Standiford Helm, Nebojsa Nick Knezevic
Degeneration, whether from age or postsurgical, in the ventral and lateral epidural space can lead to irritation of both the nerve roots and of the nerves present in the epidural space, the peridural membrane and the posterior longitudinal ligament. This irritation is often accompanied by mild scarring. Neuroplasty is a specific procedure designed to relieve this irritation. The effectiveness of neuroplasty is not affected by the extent of spinal stenosis. Neuroplasty can be performed in the lumbar, thoracic and cervical spine, and using caudal, transforaminal and interlaminar approaches...
December 3, 2018: Pain Management
Helen Laycock, Vanessa Crawford, Andrew Sc Rice, Sarah Cox
People living with HIV represent a unique aging population, living with a chronic condition associated with significant pain. A number take high dose, long-term opioids to manage moderate to severe chronic pain, presenting specific risks. This article highlights the size and impact of this problem and outlines the service objectives and set up of a specialist clinic to manage people living with HIV on high dose opioids, alongside its successes and learning points.
December 3, 2018: Pain Management
Parisa Gazerani, Brian Edwin Cairns, Hanim Yassin, Jasmin Tannaz Yousefi, Asiah Rahi Sherzaman, Bettina Storgaard Nedergaard, Søren Kjærgaard Boldsen
AIM: Glyceryl trinitrate (GTN) provokes an immediate migraine-like headache, followed by a delayed migraine attack in migraineurs. In healthy volunteers, only an immediate, less severe and shorter headache occurs. The presence of an already sensitized nervous system in migraineurs may underlie the more intense and prolonged GTN-evoked headaches. We tested if in healthy humans, application of noxious cutaneous and/or mechanical stimulation within craniofacial region would enhance or prolong GTN-evoked headache...
December 3, 2018: Pain Management
M Povedano, Y Martínez, A Tejado, P Arroyo, C Tebe, J L Lorenzo, J Montero
AIM: Carpal tunnel syndrome (CTS) is a very common entrapment neuropathy characterized by pain and paresthesia in the territory of the median nerve. Although this syndrome has a considerable impact on the patient's quality of life, its medical treatment is far from optimal. MATERIAL & METHODS: We performed an observational study to evaluate Nucleo CMP ForteTM  in patients with electromyography-confirmed, mild-moderate CTS. Pain was assessed using a visual analog scale, electromyogram and the SF-36...
November 19, 2018: Pain Management
Aliza T Ehrlich, Emmanuel Darcq
No abstract text is available yet for this article.
January 1, 2019: 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 1, 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 1, 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 1, 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 1, 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 1, 2018: Pain Management
Joseph V Pergolizzi, Melanie Rosenblatt, Dean J Mariano, John Bisney
No abstract text is available yet for this article.
November 1, 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 1, 2018: Pain Management
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