The Clinical journal of pain
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Clinical Trial
Computerized tomographic localization of clinically-guided sacroiliac joint injections.
The goal of this study was to use computed tomographic (CT) scanning to localize clinically guided sacroiliac (SI) joint injections and identify other structures affected by this procedure. ⋯ The low rate of intra-articular injection seen with this clinically-guided technique suggests restraint in its use for injection therapy. Some image guidance (e.g., fluoroscopy, CT) is probably necessary to reliably inject the SI joint. Perhaps in clinical settings, where image guidance is not readily available, a clinically-guided technique could initially be tried in patients at low risk for complications from such injections. This study also provides an anatomic explanation for the occasional weakness observed after SI joint injection.
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The purpose of this study was to assess the analgesic potential of sustained-release (SR) bupropion for neuropathic pain. ⋯ This uncontrolled pilot study suggests that bupropion may be an effective and tolerated treatment for some patients with neuropathic pain. Blockade of norepinephrine reuptake may mediate this effect. The role of dopamine reuptake blockade is uncertain. A larger randomized, double-blind, placebo-controlled study is currently underway to confirm these preliminary results.
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Comparative Study
Comorbid fibromyalgia accounts for reduced fecundity in women with myofascial face pain.
This study examined factors related to reduced fecundity among women with myofascial face pain (MFP) arising from hypotheses concerning the role of neurohormonal factors in MFP and associated conditions. ⋯ Reduced fecundity in women with MFP is restricted to those who self-report a history of fibromyalgia. Possible mechanisms for reduced fecundity in fibromyalgia are discussed. These findings highlight the need to screen for widespread pain among women with regional myofascial pain syndromes.
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Randomized Controlled Trial Clinical Trial
Effects of presurgical local infiltration of bupivacaine in the surgical field on postsurgical wound pain in laparoscopic gynecologic examinations: a possible preemptive analgesic effect.
A randomized, double-blind, controlled study was designed to evaluate the effect of presurgical local infiltration of bupivacaine in the surgical field on postsurgical wound pain relief and analgesic requirements in 28 healthy patients scheduled for laparoscopic gynecologic examinations. ⋯ It is concluded that presurgical infiltration of 0.25% bupivacaine in the surgical field is a useful method for decreasing postsurgical wound pain for up to 10 hours and analgesic consumption for up to 24 hours after laparoscopic gynecologic examination.
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The goal of this study was to assess clinical consensus regarding whether myofascial pain syndrome (MPS) is a legitimate and distinct diagnosis as well as the signs and symptoms characterizing MPS. ⋯ There was general agreement across specialties that MPS is a legitimate diagnosis distinct from fibromyalgia. There was a high level of agreement regarding the signs and symptoms essential or associated with a diagnosis of MPS. Differences across specialties are discussed. This survey provides a first step toward the development of consensus-based diagnostic criteria for MPS, which can then be validated empirically.