The Clinical journal of pain
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Randomized Controlled Trial
Evaluation of Analgesic Efficacy and Opioid-sparing Effect of Duloxetine After Arthroscopic Rotator Cuff Repair: A Randomized Clinical Trial.
This study aimed to evaluate the analgesic efficacy and opioid-sparing effect of duloxetine in adults having arthroscopic rotator cuff repair, as well as its clinical safety. ⋯ For patients undergoing arthroscopic rotator cuff repairs, duloxetine resulted in a significant reduction in pain within postoperative 2 days, but the reduction was not clinically meaningful. Duloxetine did not decrease the opioid consumption within postoperative 2 days and did not increase the risk of bleeding within postoperative 2 days. The incidence of nausea and vomiting in the duloxetine group was significantly greater than that in the placebo group.
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Success rates of spinal surgeries to treat chronic back pain are highly variable and useable prognostic indicators are lacking. We aimed to identify and evaluate preoperative predictors of pain and disability after spinal surgery for chronic low back/leg pain. ⋯ In conclusion, absence of spinal stenosis potentially predicts greater pain relief and preoperative sensory loss likely predicts reduction in disability. Overall, QoE for most identified associations was low/very low.
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Functional improvement is a critical outcome for individuals living with chronic pain. Graded exposure treatment (GET) has been associated with statistically significant improvements in functional outcomes for youth with chronic pain by targeting pain-related fear and avoidance. ⋯ Examining reliable and clinically meaningful change (vs. statistical significance alone) provides a way to examine treatment response to an intervention and to enhance the interpretability of findings, helping to bridge the gap between clinical trials and clinical practice by providing guidelines for interpretation.
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The aim was to investigate whether pretreatment pain characteristics, psychological variables, and pelvic floor muscle (PFM) function predict the response to physical therapy (PT) in women with provoked vestibulodynia (PVD). ⋯ This study identified PVD secondary subtype, lower PFM tone, and higher fear of pain as significant predictors of better treatment response to PT in women with PVD.