The Clinical journal of pain
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In view of the paucity of studies on central poststroke pain (CPSP), in this hospital-based prospective study, we evaluated the frequency, the spectrum, imaging, and quantitative sensory testing in a cohort of stroke patients with CPSP. ⋯ CPSP was present in 20.7% of the stroke patients. Spinothalamic tract dysfunction may not be necessary for the development of CPSP, and it can also be seen with normal spinothalamic sensation. The location of the stroke, its type and quality, and the severity of CPSP were not related.
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Review Meta Analysis
Does Evidence Support the Use of Neural Tissue Management to Reduce Pain and Disability in Nerve-related Chronic Musculoskeletal Pain? A Systematic Review with Meta-analysis.
In nerve-related chronic musculoskeletal (MS) disorders, neural tissue management is used to relieve pain by balancing the relative movement of neural tissues and their surrounding tissues. To date, there has not been any review evaluating the magnitude of this treatment effect in nerve-related chronic MS pain. The aim of this review was to compare pain and disability in individuals with nerve-related chronic MS pain who were treated with neural tissue management with those who received minimal or other treatment approaches. ⋯ Neural tissue management is superior to minimal intervention for pain relief and reduction of disability in nerve-related chronic MS pain. Existing evidence does not establish superiority of neural mobilization over other forms of intervention in reducing pain and disability in individuals with nerve-related chronic MS pain.
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To systematically review the evidence for duloxetine in the management of painful diabetic neuropathy (PDN). ⋯ Duloxetine has a beneficial effect over placebo. Nevertheless, the evidence of superiority of duloxetine over pregabalin and amitriptyline should be explored further as there was only 1 trial for each category. Provided majority of the PDN patients share cardiovascular complications, use of duloxetine will be a good option for treating pain associated with PDN over amitriptyline. Future randomized controlled trials should be designed keeping this in mind.
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Randomized Controlled Trial
Does Topical Lidocaine Reduce the Pain associated with the Insertion of Nasal Continuous Positive Airway Pressure Prongs in Preterm Infants? A Randomized, Controlled Pilot Trial.
To evaluate the efficacy of topical lidocaine 2% gel in reducing the pain associated with the insertion of nasal continuous positive airway pressure (nCPAP) prongs in preterm infants. ⋯ Our data suggest that topical lidocaine did not reduce the pain associated with the insertion of nCPAP prongs in preterm infants. However, the trends for lower PIPP scores in the lidocaine group and the effect sizes for lidocaine on PIPP scores and salivary cortisol were large enough so that a large-scale randomized clinical trial is warranted to confirm or refute our results. Such a study should compare 2 or more active pain interventions during nCPAP application, rather than evaluating a single intervention versus placebo or no treatment.
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Review
A Systematic Review of Knowledge Translation (KT) in Pediatric Pain: Focus on Health Care Providers.
Pain is inadequately managed in pediatric populations across health care settings. Although training programs to improve health care provider knowledge and skills have been developed and evaluated, clinical practices have not always kept pace with advancing knowledge. Consequently, the goal of this review was to systematically examine the pediatric pain literature of knowledge translation (KT) programs targeting health care providers. ⋯ KT programs vary in quality and impact. Although several successful programs have been developed, many studies include a high risk of bias due to study quality. Evidence-based KT program implementation and a focus on sustainability of outcomes must be given greater consideration in the field of pediatric pain.