The Clinical journal of pain
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Randomized Controlled Trial Comparative Study
Topical amitriptyline versus lidocaine in the treatment of neuropathic pain.
Oral amitriptyline, a tricyclic antidepressant, is effective for treating neuropathic pain. We conducted a double-blind, randomized, placebo-controlled crossover study to evaluate the efficacy of topical 5% amitriptyline and 5% lidocaine in treating patients with neuropathic pain. ⋯ This randomized, placebo-controlled crossover study examining topical 5% amitriptyline and 5% lidocaine in the treatment of neuropathic pain showed that topical lidocaine reduced pain intensity but the clinical improvement is minimal and that topical 5% amitriptyline was not effective.
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Randomized Controlled Trial
The analgesic effect of botulinum-toxin A on postwhiplash neck pain.
The effectiveness of botulinum neurotoxin type A (BTXA) injections in relieving the neck pain and reduced motion that evolve after whiplash injury (WI) has been controversial. ⋯ Study results suggest that BTXA treatment has some efficacy when administered within 1 year of the WI. However, a large, well-designed clinical trial is needed to draw final conclusions.
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Randomized Controlled Trial Comparative Study
Gabapentin supplemented with ropivacain block of trigger points improves pain control and quality of life in trigeminal neuralgia patients when compared with gabapentin alone.
Pain control in trigeminal neuralgia (TN) is achieved using anticonvulsivants, mainly carbamazepine. When this drug cannot be used, other drugs like gabapentin (GBP) have been used to provide adequate pain control. To improve the therapeutic effect of GBP, we evaluated the clinical efficacy of associating GBP with ropivacain (ROP) analgesic block of facial trigger points in TN patients. ⋯ The association of GBP and ROP is safe, without side effects and results in an important clinical benefit associated to an improvement of the functional health status of TN patients when compared with GBP alone. This may constitute a therapeutic alternative for pain control in TN patients who cannot be treated with carbamazepine.
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Randomized Controlled Trial
Is it painful or not? Discriminant validity of the Behavioral Indicators of Infant Pain (BIIP) scale.
To evaluate the ability of the Behavioral Indicators of Infant Pain (BIIP) scale to discriminate between skin-breaking and nonskin breaking procedures, and to identify sensitized pain responses in preterm infants in the neonatal intensive care unit (NICU). ⋯ The BIIP scale is reliable, accurate, and valid assessment for measuring acute pain in preterm infants in the NICU. This assessment combines the relatively most specific, anatomically based, theoretically derived indicators; and it allows evaluation of behavioral and physiologic pain responses separately.
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In complex regional pain syndrome type 1 (CRPS1) vascular changes occur from the initial, inflammatory event onto the trophic signs during chronicity of the disease, resulting in blood flow disturbances and marked temperature changes. Pharmacotherapeutic treatment is generally inadequate. ⋯ In this pilot study, topical application of ISDN seems to be beneficial to improve symptoms for patients with cold type CRPS1, but further study is needed.