The Clinical journal of pain
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Randomized Controlled Trial Pragmatic Clinical Trial
Acupuncture Reduces Pain and Autonomic Distress During Injection of Local Anesthetic in Children - A Pragmatic Crossover Investigation.
Stimulation of acupoint LI4 has been shown to result in analgesic effects in patients experiencing acute pain. We aimed to study the effectiveness of LI4 stimulation for pain relief in children receiving an injection of a local anesthetic (LA). ⋯ Stimulation of acupoint LI4 reduces pain and autonomic distress in children during LA injection in dental procedures.
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Opioid-induced pruritus is a common side effect of opioid treatment in patients with acute pain associated with surgery or childbirth. There are several options available to treat opioid-induced pruritus, including nalbuphine. However, it is not known whether nalbuphine offers greater efficacy in treating pruritus without attenuation of analgesia and an increase in the incidence of adverse outcomes. ⋯ Nalbuphine is superior in treating opioid-induced pruritus when compared with placebo, control, diphenhydramine, naloxone, or propofol in patients receiving neuraxial opioids for acute pain related to surgery or childbirth. Therefore, it is recommended that nalbuphine should be used as a first-line treatment of opioid-induced pruritus.
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Adolescents with juvenile fibromyalgia (JFM) are typically sedentary despite recommendations for physical exercise, a key component of pain management. Interventions such as cognitive-behavior therapy (CBT) are beneficial but do not improve exercise participation. The objective of this study was to obtain preliminary information about the feasibility, safety, and acceptability of a new intervention--Fibromyalgia Integrative Training for Teens (FIT Teens), which combines CBT with specialized neuromuscular exercise training modified from evidence-based injury prevention protocols. ⋯ Results of this study provided initial support for the new FIT Teens program. An integrative strategy of combining pain coping skills via CBT enhanced with tailored exercise specifically designed to improve confidence in movement and improving activity participation holds promise in the management of JFM.
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The scope of this literature review was to assess the safety and the efficacy of spinal cord stimulation (SCS) for the treatment of chronic pain syndromes originating from refractory angina pectoris and peripheral vascular disease compared with conservative management. ⋯ SCS is a minimally invasive and reversible pain intervention. On the basis of the current literature, SCS may be an alternative treatment strategy in refractory angina pectoris and peripheral vascular disease patients, presenting a low surgical risk profile. However, further clinical trials with larger sample sizes and extended follow-up are required to confirm this finding.
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To examine: (1) the relationships between habitual approach to activity engagement and specific aspects of physical functioning in chronic pain; and (2) whether or not these relationships differ according to pain duration. ⋯ The results of this study do not support the commonly held notion that avoidance and/or overactivity behavior leads to deconditioning and reduced physical capacity over time. Findings do, however, suggest that a relationship exists between avoidance and/or overactivity behavior and reduced participation in activities. Implications for the clinical management of chronic pain and directions for further research are discussed.