The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparative study between 2 protocols for management of severe pain in patients with unresectable pancreatic cancer: one-year follow-up.
The efficacy of a celiac plexus block for the treatment of upper abdominal cancer-related pain has been documented. However, the effect of preprocedural pharmacological control of pain on its efficacy remains unknown. The researchers investigated the effect of first controlling severe pain with medications and then performing the celiac plexus block and compared the results with those obtained when the celiac block was performed first followed by pharmacotherapy for controlling severe pain; the impact on and duration of pain relief, effect on the quality of life, and analgesic requirements were analyzed. ⋯ Controlling severe pain with medication and then performing the celiac block seems to be more effective in controlling pain, reducing opioid consumption, and improving the quality of life of patients with pancreatic cancer compared with performing the celiac block at the beginning followed by pharmacotherapy for pain relief.
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Randomized Controlled Trial
Long-term Safety of Gastroretentive Gabapentin in Postherpetic Neuralgia Patients.
This study evaluated the long-term safety and tolerability of a gastroretentive formulation of gabapentin (G-GR) and its effect on weight gain in postherpetic neuralgia (PHN) patients participating in a 14-week, open-label extension to a 10-week double-blind study. ⋯ Long-term treatment (up to 24 wk) with G-GR of 1800 mg was well tolerated and associated with little weight gain (< 1 kg) in patients with PHN. No new safety issues emerged with G-GR long-term treatment.
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Randomized Controlled Trial
Effects of pain and prescription opioid use on outcomes in a collaborative care intervention for anxiety.
To determine the effects of pain and opioid pain medication use on clinical and functional outcomes in 1004 primary care patients with an anxiety disorder randomized to receive the Coordinated Anxiety Learning and Management (CALM) collaborative care intervention (cognitive-behavioral therapy and/or medication) versus usual care. ⋯ Anxious patients with pain benefit as much as those without pain from cognitive-behavioral therapy and medication treatment. Among patients with pain, however, there is some evidence of a reduced anxiety treatment response in those taking opioid medication, which should be further studied.
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Randomized Controlled Trial
Combining Cognitive-Behavioral Therapy and Milnacipran for Fibromyalgia: A Feasibility Randomized-controlled Trial.
To evaluate the feasibility of a randomized-controlled trial and to obtain estimates of the effects of combined cognitive-behavioral therapy (CBT) and milnacipran for the treatment of fibromyalgia. ⋯ In this pilot study, a therapeutic approach that combines phone-based CBT and milnacipran was feasible and acceptable. Moreover, the preliminary data supports conducting a fully powered randomized-controlled trial.
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Randomized Controlled Trial
Peripheral neurostimulation and specific motor training of deep abdominal muscles improve posturomotor control in chronic low back pain.
Chronic low back pain (CLBP) is associated with an impaired control of transversus abdominis/internal oblique muscle (TrA/IO), volitionally and during anticipatory postural adjustment (delay) along with maladaptive reorganization of primary motor cortex (M1). Specific training of deep trunk muscles and repetitive peripheral magnetic stimulation (RPMS) improve motor control. We thus tested whether RPMS over TrA/IO combined with training could promote TrA/IO motor control and decrease pain beyond the gains already reached in CLBP. ⋯ This study supports that peripheral neurostimulation (adjuvant to training) could improve TrA/IO motor learning and pain in CLBP associated with motor impairment. Testing of enlarged samples over several sessions should question the long-term influence of this new approach in CLBP.