The Clinical journal of pain
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Pain is the cardinal feature in fibromyalgia syndrome (FM) and increases the risk of anxiety and depression. Patients with FM frequently report sleep disturbances as well. Sleep may mediate the association between pain and emotional symptoms, an idea which has been scarcely studied. The objective of this study was to uncover the role of subjective and objective sleep characteristics as mediators of the relationship between pain and anxiety and depression in FM. ⋯ These findings show a high prevalence of sleep problems in individuals with FM and suggest that they play a role in the relationship between pain and anxiety and depression. In fact, the impact of chronic pain on the later emotional variables was mediated not only by self-efficacy but also by subjective sleep quality and, especially, by objective sleep efficiency.
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Randomized Controlled Trial Observational Study
Pain and Recovery After Total Knee Arthroplasty: A Twelve Months Follow-up After a Prospective Randomized Study Evaluating Nefopam and Ketamine for Early Rehabilitation.
Ketamine and nefopam has been documented to decrease pain intensity and improve rehabilitation after total knee arthroplasty (TKA). We conducted a follow-up study of a previously randomized clinical trial to determine the prevalence and risk factors of chronic pain 1 year after TKA and to assess the role of perioperative administration of ketamine and nefopam. ⋯ After TKA, the intensity of postoperative pain is a risk factor of chronic pain on movement. Intraoperative ketamine seems to improve long-term results of rehabilitation in this setting.
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Randomized Controlled Trial
Evidence-Based Development and Initial Validation of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (Pacslac-II).
Our goal was to develop and validate, based on theoretical and empirical knowledge, the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-II), a shorter tool that would improve on the PACSLAC, while addressing limitations of the original version. ⋯ Findings indicate that the empirical and theoretically driven revisions to the PACSLAC led to improved ability to differentiate between pain and nonpain states, while retaining its clinical utility.
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Randomized Controlled Trial
Effects of tDCS Induced Motor Cortex Modulation on Pain in HTLV-1: A Blind Randomized Clinical Trial.
We aimed to evaluate the effects of transcranial direct current stimulation (tDCS) on chronic pain in human T-lymphotropic virus type I-infected patients. ⋯ The analysis of the main outcomes in this study did not demonstrate a significant advantage of anodal tDCS applied to M1 in patients with human T-lymphotropic virus type I and chronic pain in comparison with sham tDCS, although secondary analysis suggests some superiority of active tDCS over sham. The large placebo effect observed in this study may explain the small differences between sham versus active tDCS.