The Clinical journal of pain
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The review article was designed to assess the effectiveness of regional anesthesia (RA), specifically peripheral nerve blocks, in the treatment of burn pain; with noting of clinical indications and contraindications for peripheral nerve block application, along with discussion of evidence-based analgesic strategies for providing improved, comprehensive burn pain management. ⋯ RA techniques are an adjunct therapy currently used worldwide to improve patient pain outcomes and reduce the adverse effects associated with general anesthetic. RA presents a safe and effective intervention for acute pain resulting from burn-acquired injury. This review of current literature supports the use of RA as a treatment to manage pain associated with burn-related care procedures as an addition to multimodal pain treatment. To date there is limited evidence showing the use of RA in the burns' patient population. In addition, there appear to be no particular risks to using the technique of RA in this group. Further prospective studies are required to provide information about the benefits and limitations of RA.
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Meta Analysis Comparative Study
Effect of Local Anesthetic versus Botulinum Toxin-A Injections on Subjective for Myofascial Pain Disorders: A Systematic Review and Meta-analysis.
Myofascial pain is a chronic pain disorder characterized by the presence of painful localized regions of stiff muscle and/or myofascial trigger points. Intramuscular myofascial trigger point injections are considered first-line treatments for myofascial pain. Common injectates include local anesthetics and botulinum toxin-A (BTX-A). The objective of this systematic review was to compare the effectiveness of local anesthetics and BTX-A on pain intensity in patients with myofascial pain. ⋯ Additional studies are needed to determine sources of heterogeneity mediating the observed differences in effectiveness of local anesthetic and BTX-A injections among the studies. Additional replicative studies are also needed to delineate the relative efficacy and effectiveness of local anesthetic and BTX-A injection. The quantitative results of this study suggest that patients overall experience more pain relief with local anesthetic injections.
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Multicenter Study Observational Study
Precollision Medical Diagnoses Predict Chronic Neck Pain Following Acute Whiplash Trauma.
The reason why some individuals develop chronic symptoms, whiplash-associated disorder, following whiplash trauma is poorly understood. We explored whether precollision pain-related diagnoses, medically unexplained symptoms, and psychiatric diagnoses are related to whiplash-associated disorder. ⋯ Precollision pain and medically unexplained symptoms predict chronic neck pain following whiplash trauma. This may indicate that a sensitization process was initiated before the collision or that individuals with precollision low threshold for contacting health care services maintain this behavior postcollision. The collision may trigger existing individual vulnerabilities that constitute to be a risk factor for chronic whiplash.
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The aims of this study were: (1) to investigate the association between the rs4680 Val158Met polymorphism in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH); and (2) to analyze the association between the rs4680 Val158Met polymorphism with clinical, psychological, or psychophysical variables. ⋯ The Val158Met polymorphism (rs4680) does not appear to be involved in predisposition to tension-type headache; however, this genetic factor may be involved in the pathogenesis expression of CTTH, as greater pressure pain sensitivity and higher depressive levels were found in CTTH carrying the Met/Met genotype.
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Review Meta Analysis
Dexmedetomidine as an Adjuvant to Local Anesthetics in Transversus Abdominis Plane Block: A Systematic Review and Meta-analysis.
The objective of this meta-analysis was to evaluate the analgesic effects of dexmedetomidine (DEX) in transversus abdominis plane (TAP) blocks for abdominal surgery. ⋯ DEX is a potential anesthetic adjuvant that can facilitate better postoperative analgesia, reduce postoperative analgesic requirements, and prolong the local anesthetic effect when administered in TAP blocks.