The Clinical journal of pain
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Randomized Controlled Trial
Effect of modulated-frequency and modulated-intensity transcutaneous electrical nerve stimulation after abdominal surgery: a randomized controlled trial.
This study aimed to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) for treatment of postoperative pain and pulmonary functions (vital capacity [VC]; cough peak flow, [CPF]) in patients who underwent abdominal surgery. ⋯ TENS is a valuable treatment to alleviate postoperative pain and improve pulmonary functions (ie, VC, CPF) in patients following abdominal surgery.
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Gabapentin (GBP), originally an antiepileptic drug, is more commonly used in the treatment of neuropathic pain. In recent years, GBP has been used as an adjunct or primary therapy in non-neuropathic pain, most commonly for the treatment of perioperative and cancer pain. ⋯ Although efficacy varies, multiple well-designed clinical trials have demonstrated reduced pain and analgesic use with otolaryngology, orthopedic, mastectomy, and abdominal/pelvic surgical perioperative use of GBP, whereas there is limited or no efficacy for cardiothoracic surgery. Cancer pain studies have had greater design variability, often nonblinded, with pain benefit being mild to moderate, and more efficacious with partial neuropathic pain quality. Overall, GBP seems to have significant benefit in neuropathic and non-neuropathic pain associated with the perioperative period and cancer. Considering its favorable side effect profile, GBP represents a beneficial pain adjunctive therapy, beyond neuropathic symptoms.
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Randomized Controlled Trial
Efficacy of Postoperative Continuous Wound Infiltration With Local Anesthesia After Open Hepatectomy.
Local anesthetic wound infiltration is widely used as an effective adjunct during multimodal postoperative pain management. The aim of this study was to evaluate the effectiveness of continuous wound infusion of ropivacaine in postoperative pain relief, opioid sparing, incidence of nausea and vomiting, and bowel and liver function improvement in patients undergoing open hepatectomy. ⋯ Surgical wound infusion with ropivacaine after hepatectomy can improve pain relief at rest and accelerate recovery and discharge.
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Randomized Controlled Trial
Short-Term Effects of a Manual Therapy Protocol on Pain, Physical Function, Quality of Sleep, Depressive symptoms and Pressure Sensitivity in Women and Men with Fibromyalgia Syndrome: A Randomized Controlled Trial.
To investigate the therapeutic effects of a manual therapy protocol for improving pain, function, pressure pain thresholds (PPT), quality of sleep, and depressive symptoms in women and men with fibromyalgia syndrome (FMS). ⋯ Manual therapy protocol was effective for improving pain intensity, widespread pressure pain sensitivity, impact of FMS symptoms, sleep quality, and depressive symptoms. In addition, sex differences were observed in response to treatment: women and men get similar improvements in quality of sleep and tender point count, whereas women showed a greater reduction in pain and impact of FMS symptoms than men, but men reported higher decreases in depressive symptoms and pressure hypersensitivity than women.
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Increasing rates of opioid use disorders (OUDs) (abuse and dependence) among patients prescribed opioids are a significant public health concern. We investigated the association between exposure to prescription opioids and incident OUDs among individuals with a new episode of a chronic noncancer pain (CNCP) condition. ⋯ Among individuals with a new CNCP episode, prescription opioid exposure was a strong risk factor for incident OUDs; magnitudes of effects were large. Duration of opioid therapy was more important than daily dose in determining OUD risk.