The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Safety and Efficacy of Needle-Free Powder Lidocaine Delivery System in Adult Patients Undergoing Venipuncture or Peripheral Venous Cannulation: Randomized, Double-blind, Placebo-controlled Trial.
The purpose of this study was to evaluate the efficacy, safety, and tolerability of a needle-free powder lidocaine delivery system compared with sham placebo in adults. ⋯ This clinical trial demonstrated that use of a needle-free powder lidocaine delivery system resulted in a significant reduction of pain during venipuncture and peripheral intravenous cannulation in adults. Both the predefined primary endpoint and all 3 secondary endpoints were met. The needle-free powder lidocaine delivery system may be an option for analgesia during venous access procedures in adults.
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Randomized Controlled Trial Multicenter Study
Pregabalin in Subjects With Painful Diabetic Peripheral Neuropathy Using an NSAID for Other Pain Conditions: A Double-Blind Crossover Study.
To evaluate pregabalin's efficacy and safety versus placebo to reduce pain in patients with diabetic peripheral neuropathy (DPN) using a concomitant nonsteroidal anti-inflammatory drug. ⋯ Pregabalin (vs. placebo) showed overall improvements in sleep, pain reduction in 1 sensitivity analysis, and was well tolerated. Potential factors that may have confounded the ability to detect a treatment difference in DPN pain reduction (high placebo response, carryover effect, short washout period, or pregabalin dose) are discussed in the context of future studies.
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Multicenter Study
Chronic Pain and Heart Rate Variability in a Cross-Sectional Occupational Sample: Evidence for Impaired Vagal Control.
The vagus nerve influences the modulation of pain. Chronic pain is associated with disturbance of the descendent inhibitory pathway (DIP). Heart rate variability (HRV) is a proxy measure for vagal activity and may reflect dysfunction of the DIP. We aimed to investigate the association of HRV and pain in individuals with and without chronic pain. ⋯ Our results suggest that the DIP indexed by vagal activity operationalized as RMSSD is disturbed in persons with chronic pain. Furthermore, the correlations between RMSSD and pain are different between those without and those with chronic pain. The findings are discussed, emphasizing changes in brain activity and the comorbid dysregulation of emotion in patients with chronic pain, to provide implications for the treatment of chronic pain.
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Randomized Controlled Trial Comparative Study
Sympathetic Dysfunction in Patients with Chronic Low Back Pain and Failed Back Surgery Syndrome.
Chronic low back pain (CLBP) is defined as pain that persists longer than 12 weeks and is often attributed to degenerative or traumatic conditions of the spine. Failed back surgery syndrome is a condition in which chronic pain persists after spinal surgery. Electrodiagnostic studies can be used to confirm the diagnosis of lumbosacral radiculopathy, but other diagnostic methods are often needed to assess sympathetic nervous system dysfunction. ⋯ It was concluded that the sympathetic nervous system is affected in CLBP and FBSS patients with abnormalities in SSR and that the dysfunction of sympathetic nervous system may contribute to the intensity and chronicity of pain in these groups of patients. Moreover, a strong association was found between SSR and functional disabilities in these patients.
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To determine the effectiveness and cost-effectiveness of noninvasive interventions for temporomandibular disorders (TMD). ⋯ The available evidence suggests that cognitive-behavioral therapy, intraoral myofascial therapy, and self-care management are therapeutic options for persistent TMD.