The Clinical journal of pain
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Neuromodulation, particularly intrathecal drug delivery systems and spinal cord stimulators (SCSs), can be a valuable tool when treating chronic pain in adults. However, there is a paucity of literature with regard to its use in pediatrics. ⋯ Neuromodulation can offer important options in treating some pediatric chronic pain patients. In-depth knowledge of primary disease and strict patient selection in the context of the patient's social situation is vital to successful treatment.
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In the context of the current opioid epidemic, there has been a renewed interest in the use of ketamine as an analgesic agent. ⋯ In this review, we examined basic mechanisms of ketamine and its current clinical use and potential novel use in pain management.
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To evaluate the difference between combination pharmacotherapy and monotherapy on low back pain (LBP). ⋯ Combination pharmacotherapy is more effective than placebo or monotherapy in the management of pain and disability in chronic LBP, but not in acute LBP. Further, combination pharmacotherapy has a higher risk of adverse effects than placebo and monotherapy.
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Randomized Controlled Trial
Acute Procedural Pain in Children: Intervention With the Hospital Clown.
Hospitalized children often describe needle-related procedures as the worst pain possible and such procedures may be emotionally traumatic. The use of hospital clowns (HCs) related to painful medical procedures in children may offer pain relief, but this has not been systematically evaluated. The objective of this study was to assess the effect of a therapeutic clown in comparison with standard care on the experience of pain in children receiving venipuncture. ⋯ Assessing the pain experience of children receiving venipuncture with the presence of an HC indicates a pain relieving effect for children older than 6 years. However, future studies should carefully study the effects on younger children where mixed effects may be present.
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This review aimed to explore the processes that underlie the main and the buffering effect of social support on decreased pain experience. ⋯ This review presents evidence that the stress-buffering effect is more often able to account for the relationship between social support and pain experience. Moreover, findings suggest the critical significance of stress appraisal and attenuated stress systems in linking social support to aspects of reduced pain experience. Findings implicate the role of integrating perceived support and intimacy in support-oriented interventional trials for chronic pain.