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Neuropathic Pain OR Refractory Pain

Yijin Yu, Nan Liu, Qingxin Zeng, Jing Duan, Qi Bao, Min Lei, Jinning Zhao, Junran Xie
Purpose: Pregabalin is commonly used as an analgesic for neuropathic pain. But pregabalin as an adjunct to a multimodal analgesic regimen - although standard clinical protocol in some settings - has remained controversial. This meta-analysis was conducted to identify the efficacy of pregabalin for management of postoperative pain in thoracotomy. Materials and methods: Pubmed, Embase, Cochrane, Web of Science, Springer, and Clinical Trial Register database were searched for randomized controlled trials (RCTs) of pregabalin in preventing postoperative pain in thoracotomy...
2019: Journal of Pain Research
Andrew I Yang, Brendan J McShane, Frederick L Hitti, Sukhmeet K Sandhu, H Isaac Chen, John Y K Lee
OBJECTIVEFirst-line treatment for trigeminal neuralgia (TN) is pharmacological management using antiepileptic drugs (AEDs), e.g., carbamazepine (CBZ) and oxcarbazepine (OCBZ). Surgical intervention has been shown to be an effective and durable treatment for TN that is refractory to medical therapy. Despite the lack of evidence for efficacy in patients with TN, the authors hypothesized that patients with neuropathic facial pain are prescribed opioids at high rates, and that neurosurgical intervention may lead to a reduction in opioid use...
January 11, 2019: Journal of Neurosurgery
Salwa Seddik Hosny, Merhan Samy Nasr, Rana Hashem Ibrahim, Zainb YousryHelal
BACKGROUND: Peripheral neuropathy is one of the most common complications of both type 1 and type 2 diabetes, Long standing peripheral neuropathic pain associated with peripheral neuropathy occurs in one of six diabetic subjects, Apelin is a peptide secreted from adipocytes that seems to be beneficial in early detection of diabetic neuropathy, Itisnotedthatitincreasesindiabeticpatients and more in those with neuropathy. AIM: We aimed to study the relation between plasma apelin levels and peripheral neuropathy in a sample of type 2 egyptian diabetic patients METHODS: The current study included 60 subjects with type 2 diabetes divided into 30 with diabetic neuropathy (group I) and 30 without diabetic neuropathy (group II) and 20 healthy subjects as a control group (group III)...
January 2019: Diabetes & Metabolic Syndrome
Teresa Martins Rocha, Sofia Pimenta, Alexandra Bernardo, Miguel Bernardes, Margarida Barbosa, Raquel Lucas, Jan Vollert, Lúcia Costa, Christoph Maier
INTRODUCTION: Features suggestive of neuropathic pain (NP) have been described in RA in addition to nociceptive pain. We aimed to determine the clinical predictors of NP in RA patients and study its association with radiographic structural damage. METHODS: Cross-sectional study was performed with RA patients followed at our Rheumatology department. Patients with diagnosed neuropathy of other origin, non-RA related risk factors for NP (e.g. diabetes mellitus) or fibromyalgia according to expert opinion were excluded...
October 2018: Acta Reumatológica Portuguesa
Jeffrey S Kroin, Vaskar Das, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Ketamine has been shown to reduce chronic pain; however, the adverse events associated with ketamine makes it challenging for use outside of the perioperative setting. The ketamine metabolite (2R,6R)-hydroxynorketamine ((2R,6R)-HNK) has a therapeutic effect in mice models of depression, with minimal side effects. The objective of this study is to determine if (2R,6R)-HNK has efficacy in both acute and chronic mouse pain models. METHODS: Mice were tested in three pain models: nerve-injury neuropathic pain, tibia fracture complex regional pain syndrome type-1 (CRPS1) pain, and plantar incision postoperative pain...
January 2019: Regional Anesthesia and Pain Medicine
Isaac O Pérez-Martínez, Casandra R Acevedo-Roque, Claudia D Montes-Angeles, Mariana Martínez, Florencio Miranda
OBJECTIVE: Dental treatment and orofacial surgeries may induce chronic neuropathic orofacial pain (CNOP). This kind of pain affects adaptability to environmental changes in both model animals and humans. Part of the adaptation process depends on the ability to distinguish between familiar and novel stimuli. CNOP induces novelty seeking behaviour as a deficit in environmental adaptation. Alternatively, novelty seeking is a sign for susceptibility to the development of substance abuse. Evidence shows that CNOP leads to alcoholism in animal models...
January 7, 2019: Archives of Oral Biology
S Vincenzetti, S Pucciarelli, Y Huang, M Ricciutelli, C Lambertucci, R Volpini, G Scuppa, L Soverchia, M Ubaldi, V Polzonetti
Neuropathic pain is caused by a lesion or disease of the somatosensory nervous system and has a considerable impact on the quality of life. Neuropathic pain has a dynamic and complex aetiology and gives heterogeneous symptoms across patients; therefore, it represents an important clinical challenge. Current pharmacological treatment includes tricyclic antidepressant serotonin-noradrenaline uptake inhibitors such as duloxetine, pregabalin, and gabapentin. However, these drugs do not show efficacy in all patients suffering from neuropathic pain...
January 10, 2019: Biochimie
Xiangyu Fang, Xueru Xu, Xingwu Lin, Rongguo Liu
Pulsed radiofrequency (PRF) on the dorsal root ganglion (DRG), which produces remarkable analgesia through high-frequency electromagnetic energy, has become a main therapy for chronic neuropathic pain. The chronic neuropathic pain in patients is frequently accompanied by depression. However, the underlying neurophysiological mechanisms of the treatment of PRF on DRG for the neuropathic pain-induced depression remain unclear. This study was designed to explore the effect of PRF on DRG on the neuropathic pain-induced depression in rats with spared nerve injury (SNI)...
January 9, 2019: Brain Research Bulletin
Natalia Ruiz-Negrón, Jyothi Menon, Jordan B King, Junjie Ma, Brandon K Bellows
BACKGROUND: Neuropathic pain significantly reduces an individual's quality of life and places a significant economic burden on society. As such, many cost-effectiveness analyses (CEAs) have been published for treatments available for neuropathic pain. OBJECTIVES: The primary objective of this systematic review was to provide a detailed summary of the estimates of cost-effectiveness from published CEAs comparing available treatments for neuropathic pain. The secondary objectives were to identify the key drivers of cost-effectiveness and to assess the quality of published CEAs in neuropathic pain...
January 14, 2019: PharmacoEconomics
Hari Prasad Joshi, Sung Bum Kim, Seungki Kim, Hemant Kumar, Min-Jae Jo, Hyemin Choi, Juri Kim, Kyungjae Won, Seil Sohn, Kyoung-Tae Kim, Jin-Ki Kim, In-Bo Han
Neuropathic pain is a devastating chronic condition and effective treatments are still lacking. Carbon monoxide-releasing molecule-2 (CORM-2) as a carbon monoxide (CO) carrier, exerts potent anti-neuropathic pain effects; however, its poor water solubility and short half-life hinder its clinical utility. Therefore, the aim of this study was to investigate whether CORM-2-loaded solid lipid nanoparticles (CORM-2-SLNs) enhance the anti-allodynic and anti-hyperalgesic effects of CORM-2 in a rat chronic constriction injury (CCI) model...
January 12, 2019: Molecular Neurobiology
Ratnadip Bose, Anirban Deep Banerjee
BACKGROUND: Complex regional pain syndrome (CRPS) is a chronic neuropathic painful condition, sometimes associated with spinal myoclonus. For intractable cases spinal cord stimulation is an important modality of treatment but the response of specifically myoclonus to this treatment is not well described. CASE DESCRIPTION: A 40-year old male, had a history of trauma 12 years back since when he had intractable neuropathic pain in his both upper limbs with superimposed severely disabling myoclonic jerks...
January 12, 2019: British Journal of Neurosurgery
Marie Joseph
'Opioid induced hyper-algesia' is a paradoxical phenomenon known to occur with high-dose opioid therapy when attempting to control severe pain. The high opioid load leads to exacerbation of existing 'central sensitization' process in the spinal cord dorsal horn and parts of the brain. This situation usually occurs in the clinical context of uncontrolled complex pain with a predominant neuropathic pain component. There is resistance to the analgesic effect of the opioid which worsens with increasing doses. It was not commonly known that in this situation there is often a resistance to the respiratory depression effect of the opioid too caused by similar mechanisms...
January 12, 2019: BMJ Supportive & Palliative Care
Etiane Micheli Meyer Callai, Vanessa Leal Scarabelot, Liciane Fernandes Medeiros, Carla de Oliveira, Andressa de Souza, Isabel Cristina Macedo, Stefania Giotti Cioato, Fabrício Finamor, Wolnei Caumo, Alexandre da Silva Quevedo, Iraci Ls Torres
OBJECTIVE: Our objective was to evaluate the tDCS effect on facial allodynia induced by chronic constriction of the infraorbital nerve (CCI-ION) and on the brainstem levels of TNF-α, NGF, IL-10 and, serum LDH in rats. METHODS: Rats were exposed to the CCI-ION model. Facial allodynia was assessed by Von Frey filaments test at baseline, 3, 7, 10 and 14 days post-surgery and24h and 7 days after the bimodal tDCS sessions for 20 min/day/8 days. RESULTS: CCI-ION induced a significant decrease in the mechanical threshold 14 days after surgery...
January 12, 2019: Oral Diseases
Robbert C Maatman, Mads U Werner, Marc R M Scheltinga, Rudi M H Roumen
BACKGROUND AND OBJECTIVES: Mirror-image pain may occur in the presence of a one-sided peripheral nerve lesion leading to a similar distribution of pain on the contralateral side of the body ("mirrored"). Anterior cutaneous nerve entrapment syndrome (ACNES) is a neuropathic pain syndrome due to entrapment of terminal branches of intercostal nerves T7-12 in the abdominal wall and sometimes presents bilaterally. This study aims to address specifics of bilateral ACNES and to determine potential differences in clinical presentation and treatment outcomes when compared with the unilateral form of ACNES...
January 11, 2019: Regional Anesthesia and Pain Medicine
Fitri Octaviana, Ahmad Yanuar Safri, Denise Dewanto Setiawan, Riwanti Estiasari, Darma Imran, Teguh Ranakusuma, Patricia Price
Lower limb neuropathic pain in HIV patients is a common manifestation of sensory neuropathy (HIV-SN), but can be seen in patients who do not meet standard definitions of HIV-SN. The drug stavudine is a risk factor for HIV-SN, but some patients treated without stavudine experience HIV-SN, and the prevalence and risk factors influencing neuropathic pain in this setting are unknown. A cross sectional study at Cipto Mangunkusumo Hospital Jakarta tested 197 HIV patients treated for >12 months without stavudine...
January 2, 2019: Journal of the Neurological Sciences
D Vasović, B Divović, M Treven, D E Knutson, F Steudle, P Scholze, A Obradović, J Fabjan, B Brković, W Sieghart, M Ernst, J M Cook, M M Savić
GABAA receptors containing the α6 subunit are located in trigeminal ganglia, and their reduction by small interfering RNA increases inflammatory temporomandibular and myofascial pain in rats. We thus hypothesized that enhancing their activity may help in neuropathic syndromes originating from the trigeminal system. Here, we performed a detailed electrophysiological and pharmacokinetic analysis of two recently developed deuterated structurally similar pyrazoloquinolinone compounds. DK-I-56-1 at concentrations below 1 μM enhanced GABA currents at recombinant rat α6β3γ2, α6β3δ and α6β3 receptors whereas it was inactive at most GABAA receptor subtypes containing other α subunits...
January 11, 2019: European Journal of Pain: EJP
Joyce T da Silva, Bianca G Evangelista, Rafael A G Venega, David A Seminowicz, Marucia Chacur
Neuropathic pain is driven by abnormal peripheral and central processing, and treatments are insufficiently effective. Antibodies against nerve growth factor (anti-NGF) have been investigated as a potent analgesic treatment for numerous conditions. However, the peripheral and brain effects of anti-NGF in neuropathic pain remain unknown. We examined the effectiveness of anti-NGF in reducing chronic pain by local administration in a rat model of sciatic constriction injury (CCI). NGF and substance P in the dorsal root ganglion (DRG) and spinal cord were evaluated...
February 2019: Behavioural Pharmacology
Hatice Evren Eker, Oya Yalçın Çok, Nesrin Bozdoğan Özyılkan, Anış Arıboğan
In some situations, the cause of the supposed neuropathic pain might be related to abnormal tissue recovery such as scar formation due to wound retraction that might create mechanical compression on the nerve tissue. In this report we describe infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue to reduce mechanical stress in 3 patients. The infiltration technique might resolve the tension of the contracted scar tissue by tearing the adhesions and the eliminated mechanical compression would reduce the pressure on nerve tissue and hence neuropathic pain symptoms...
January 2019: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Ferda Ilgen Uslu, Nazan Şimşek Erdem
Neurological complications of cardiac surgery is known for almost a century. Brachial plexus injury after coronary artery bypass grafting is not a rare complication, but the frequency of reporting is less because these are temporary and often symptoms requiring treatment. in a few cases peripheral neuropathy findings are permanent and causes of disability. Diagnosis is based on symptoms, imaging and electrophysiological studies and it is important that both treatments for both medical and legal liability. Here in 63-year-old male patient was diagnosed brachial plexus injury lasting neuropathic pain the left upper limb after uneventful coronary artery bypass surgery presented and causes and consequences were discussed with literature...
January 2019: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Eivind Hasvik, Anne Julsrud Haugen, Stacey Haukeland-Parker, Stein Arne Rimehaug, Johannes Gjerstad, Lars Grøvle
STUDY DESIGN: A prospective observational study with translation and psychometric analyses of a questionnaire. OBJECTIVE: Cross-cultural adaptation of the Short-Form McGill Pain Questionnaire-2 into Norwegian. SUMMARY OF BACKGROUND DATA: The different versions of the McGill Pain Questionnaire (MPQ) have been important and influential tools for pain assessment. To more reliably assess qualities of both neuropathic and non-neuropathic pain, the Short-Form MPQ was revised in 2009 (SF-MPQ-2), including seven additional descriptors...
January 7, 2019: Spine
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