The Clinical journal of pain
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The intensity of post-egg retrieval pain is underestimated, with few studies examining post-procedural pain and predictors to identify women at risk for severe pain. We evaluated the influence of pre-procedural hormonal levels, ovarian factors, as well as mechanical temporal summation (mTS) as predictors for post-egg retrieval pain in women undergoing in vitro fertilization (IVF). ⋯ Peak post-egg retrieval pain intensity was higher than anticipated. Our results suggest that post-egg retrieval pain can be predicted by baseline AMH, high peak estradiol, and OHSS. Further studies to evaluate intra- and post-procedural pain in this population are needed, as well as clinical trials to assess post-procedural analgesia in women presenting with high hormonal levels.
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Opioid prescription for non-malignant pain is increasing in Europe and the US. Research and guidance have focused on the potential for dependency and medical side effects with high doses. In contrast, benzodiazepines have received little attention in the chronic pain literature, despite evidence for dependency and cognitive impairment in long term use. We aimed to examine the relationship between these classes of medication use, mood and functioning. ⋯ This study is the first to examine both opioid and benzodiazepine use together in chronic pain. We found the anticipated negative effects of opioid medication, and particularly consistent associations between benzodiazepine use and poor wellbeing. Future guidance on chronic pain prescription should focus on restricting benzodiazepine use.
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To study the relationship between expected pain and future outcomes along with the moderating effects of expected pain in neuropathic pain patients. ⋯ In neuropathic pain patients whose pain does not respond to therapy, high levels of expected pain may relate to relatively lower catastrophizing scores by shifting focus away from futile attempts at "curing" pain toward focusing on achievement of more realistic personal goals.
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Randomized Controlled Trial
Effect of Spinal Cord Stimulation on Sensory Characteristics: A Randomized, Blinded Crossover Study.
Spinal cord stimulation (SCS) is increasingly used to treat various chronic pain conditions. One undetermined issue is to what extent SCS alters the processing of sensory information from the periphery, including those stimuli that are mediated by small-fiber populations. We aimed to investigate these possible changes using quantitative sensory testing (QST). ⋯ The results support existing evidence suggesting that SCS does not change sensory characteristics, which is important information for both patients and clinicians. Changes in pain intensity after deactivation of SCS may be different in short-term and long-term SCS treatment.
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Randomized Controlled Trial
Mediators and Moderators of Chronic Pain Outcomes in an Online Self-Management Program.
Little is known about the moderators and mediators of change in online pain interventions based on cognitive-behavior therapy (CBT). We hypothesized that the effects of painACTION.com, an online pain self-management program, on pain-related outcomes would be mediated by changes in depression, anxiety, and stress, as well as the use of coping strategies. We also examined potential moderators of change. ⋯ This study supports the effectiveness of online interventions when CBT and self-management targets pain levels, emotional factors, and wellness-focused coping. The importance of stress as a mediator of pain severity is discussed. The absence of moderators may indicate that the intervention is effective for a wide variety of patients with chronic pain.