The Clinical journal of pain
-
Randomized Controlled Trial
Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery.
Perioperative lidocaine (1.5 mg/kg bolus then 1.5 mg/kg/h until 1 h after skin closure) reduces the incidence of persistent post-surgical pain after breast cancer surgery at 3 months.
summary -
To perform a topical review of the published literature on painful neuromas. ⋯ Neuromas develop as part of a normal reparative process following peripheral nerve injury. Painful neuromas can induce intense pain resulting in immense suffering and disability. MRI aids the diagnosis, but, ultrasound imaging allows cost effective accurate diagnosis and localization of neuromas by demonstrating their direct contiguity with the nerve of origin. Management options for painful neuromas include pharmacotherapy, prosthetic adjustments, steroid injection, chemical neurolysis, cryoablation, and radiofrequency ablation. Ultrasound imaging guidance has improved the success in localizing and targeting the neuromas. This review discusses the patho-physiology and accumulated evidence for various therapies and the current percutaneous interventional management options for painful neuromas.
-
Loin pain hematuria syndrome (LPHS) is a rare pain syndrome, which is somewhat poorly characterized and challenging to treat. The condition of LPHS is still controversial and there is no consensus of validated diagnostic criteria or optimal treatment strategies. ⋯ Curiously, for such a controversial pain syndrome there is substantially more written in the literature regarding surgical-type treatments than conservative treatments. A brief review of LPHS potential pathophysiology and potential treatment approaches is presented.
-
Randomized Controlled Trial
A double-blind, placebo-controlled study on the effect of buprenorphine and fentanyl on descending pain modulation: a human experimental study.
The descending pain inhibitory system is impaired in chronic pain and it is important to know how analgesics interact with this system. The aim of this human experimental pain, double-blind, randomized, placebo-controlled, 3 way cross-over study was to investigate the effect of 2 different opioids on descending pain inhibition using conditioning pain modulation (CPM) as a screening tool. ⋯ The opioids buprenorphine and fentanyl significantly potentiate the effect of descending pain inhibition in healthy volunteers.
-
Randomized Controlled Trial Multicenter Study
Long-term maintenance of response across multiple fibromyalgia symptom domains in a randomized withdrawal study of pregabalin.
To determine the incidence and duration of response of clinically meaningful improvements with pregabalin across several key symptoms of fibromyalgia (FM). ⋯ The results from this post hoc analysis indicate that pregabalin provides long-term effects across multiple domains of FM (ClinicalTrials.gov registry ID: NCT00151489).