The Clinical journal of pain
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Heterogeneity of outcome domains, used in interventional trials and systematic reviews (SRs) for neuropathic pain (NeuP), makes decisions on the comparative effectiveness of available treatments difficult. This study analyzed outcome domains and measures used in SRs of randomized controlled trials on efficacy and safety of interventions for NeuP and compared them with the core outcome set (COS) and core outcome measures (COMs) for chronic pain recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). ⋯ Authors of SRs in the field of NeuP insufficiently use relevant recommended COS and COMs for chronic pain. More effort should be put into the implementation of COS to ensure that the study results can be compared and combined. There is a need for defining core outcome domains and measures specific for NeuP.
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Since approval of intravenous acetaminophen (IV APAP), its use has become quite common without strong positive evidence. Our goal was to determine the effect of IV APAP on length of hospital stay (LOS) via mediation of opioid-related side effects in pediatric patients. ⋯ IV APAP hastens oral intake and is associated with decreased LOS in an adolescent surgery population likely through decreased opioid consumption. Through addition of IV APAP in this population, LOS may be decreased, an important implication in the setting of escalating health care costs.
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Review Meta Analysis
Efficacy of 8 Different Drug Treatments for Patients With Trigeminal Neuralgia: A Network Meta-analysis.
Trigeminal neuralgia (TN) is commonly seen in older persons and negatively influences their daily life. Although some research on the efficacy of TN drugs has been conducted, the optimal choice still remains uncertain. Therefore, this network meta-analysis (NMA) evaluated the efficacy and performance of 8 drugs with respect to TN. ⋯ Among the 8 drugs investigated, all exhibited a capacity to alleviate TN more than the placebo except for pimozide and proparacaine. Moreover, LDC, BTX-A, and CBZ stood out for their high efficacy and could be recommended as the primary choice of treatment for TN.
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Multicenter Study
Does Self-compassion Benefit Couples Coping With Vulvodynia? Associations With Psychological, Sexual, and Relationship Adjustment.
Vulvodynia, a chronic vulvovaginal pain condition, has deleterious consequences for the psychological, relational, and sexual well-being of affected women and their partners. Protective factors, which can reduce these negative effects, are increasingly studied in the field of chronic pain. One of these, self-compassion, entails qualities such as kindness toward oneself, and has been associated with better adjustment in individuals with chronic pain. Because many women with vulvodynia have a negative image of themselves in the context of sexuality, self-compassion may be especially relevant for this population. This study aimed to investigate self-compassion among couples coping with vulvodynia and its associations with psychological, sexual, and relationship adjustment, as well as pain during sexual intercourse. ⋯ Findings suggest that self-compassion is a promising protective factor in the experience of vulvodynia and associated distress. Interventions aimed at increasing self-compassion could enhance the efficacy of psychological treatments for these women and their partners. Further studies are needed to better understand the correlates of self-compassion among this population.
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Randomized Controlled Trial Comparative Study
Cortical Pain Response of Newborn Infants to Venepuncture: A Randomized Controlled Trial Comparing Analgesic Effects of Sucrose Versus Breastfeeding.
Sucrose administration and breastfeeding decrease behavioral expressions of pain in neonates. However, recent studies indicated that there is a persistent cortical response with sucrose. This study compared the efficacy of sucrose administration versus breastfeeding to decrease cortical responses to pain during venepuncture. ⋯ There was no difference in the cortical responses to pain during venepuncture in newborn infants who were administered sucrose versus those who were breastfed.