The Clinical journal of pain
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Disability in patients with chronic neck pain: heart rate variability analysis and cluster analysis.
Adequately addressing the scope of disability in patients with chronic neck pain is crucial in a clinical setting. The aim of this study was to determine the disease profile of patients with chronic neck pain and to analyze the factors related to the level of disability. ⋯ We suggest that 3 distinct subgroups of patients with chronic neck pain exhibit particular features. Furthermore, reduced heart rate variability was associated with subjective disability in these patients. Further study is advised to establish the pathologic mechanism and clinical applications of our findings.
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Natural variation in the μ-opioid gene OPRM1 predicts increased pain on third day after thoracotomy.
The mechanism whereby acute postsurgical pain can persist and become chronic remains unknown. Thoracotomy is a common procedure with a high incidence of long-term pain for which acute postsurgical pain is an established risk factor. Therefore, the genetic basis of elevations in acute postsurgical pain after thoracotomy was investigated. ⋯ We identified previously unpublished haplotypes of the OPRM1 receptor that predicted increases in self-reported pain on the third postoperative day after thoracotomy. These findings require replication and further refinement before their impact on patient care can be determined.
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Randomized Controlled Trial
Modification of experimental, lower limb ischemic pain with transcutaneous electrical nerve stimulation.
Transcutaneous electrical nerve stimulation (TENS) has been shown to be effective for the reduction of experimentally induced ischemic pain in the upper limb. No studies have been published on the effects of TENS for lower limb ischemic pain. ⋯ HF-TENS had stronger modifying effects on several aspects of laboratory-induced ischemic pain than did P-TENS. HF-TENS delayed the onset of pain, reduced pain levels, and delayed the onset of extreme pain over a period of several minutes.
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Review Case Reports
Use of buprenorphine in children with chronic pseudoobstruction syndrome: case series and review of literature.
Abdominal pain is the most challenging symptom in chronic intestinal pseudoobstruction (CIPO) syndrome, because of its severity and the limited availability of suitable opioid formulations, especially in pediatric patients with digestive problems. Most of the children with CIPO cannot tolerate oral formulations. ⋯ CIPO and the unique pharmacological profile of buprenorphine are reviewed briefly.
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Randomized Controlled Trial
The pain quality response profile of pregabalin in the treatment of neuropathic pain.
To identify and describe the response profile of pregabalin on the qualities of pain associated with peripheral neuropathy. ⋯ Pregabalin had a greater effect on PQAS-assessed paroxysmal pain than on surface or deep pain in patients with peripheral neuropathy. The findings corroborate previous research demonstrating differential effects of analgesic drugs across pain qualities, further emphasizing the need to assess individual pain qualities in addition to overall pain intensity.