European journal of pain : EJP
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Clinical Trial Controlled Clinical Trial
The assessment of radiating low back pain by thermal sensory testing.
Low back pain radiating into the legs is a common pain syndrome. However, neurological examination, imaging and electromyographic studies are of limited value for prognosis or therapy. The origin of the pain remains unknown. ⋯ We propose that these findings indicate selective damage to the Adelta fibres which are involved in transmission of cold sensation and pain, presumably by root compression. We found no evidence of involvement of C fibres, which transmit warm sensation and pain. Thermal testing should be considered among the testing modalities that are capable of demonstrating objective findings in patients with radiating low back pain.
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Randomized Controlled Trial Clinical Trial
Pregabalin in patients with postoperative dental pain.
Pregabalin is an analogue of the inhibitory neurotransmitter gamma-aminobutyric acid. In preclinical models, it has shown activity as an analgesic agent. A randomized, double-blind, placebo-controlled, parallel-group trial was undertaken to compare pregabalin to placebo and 400 mg of ibuprofen using a dental pain model. ⋯ Adverse events were reported more frequently in the pregabalin 300-mg group. Pregabalin appears to have significant analgesic properties in the third molar extraction model. Further research is needed to confirm these findings.
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The present study was undertaken to assess the health-related quality of life (HRQoL) and burden of illness due to pain and its treatment for patients with peripheral neuropathic pain (PNP). It is the first step in finding reliable instruments/targets to evaluate treatment outcome in this patient population. Study population consisted of 126 patients suffering from neuropathic pain due to a peripheral nerve or root lesion, recruited from two multidisciplinary pain clinics. ⋯ Besides pain, patients were most bothered by difficulty in sleeping, lack of energy, drowsiness, difficulty in concentrating and dry mouth. Employment status was reduced owing to pain in 52% of the patients. The intense pain, other troublesome symptoms, limited efficacy and tolerability of available treatments, together with the impaired health and reduced work status, amount to a substantial burden for patients with PNP.
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Case Reports
Inefficacy of high-dose transdermal fentanyl in a patient with neuropathic pain, a case report.
Pain partially responsive to opioids can lead to rapid escalating dosages due to tolerance development. In this report the case of a 58-year-old female with neuropathic pain using increasing transdermal (TTS) fentanyl dosages to a maximum dose of 3400 microg/h resulting in fentanyl plasma levels of 173 ng/ml is described. For pain relief an epidural infusion at the level T1-2 with bupivacaine was started. Immediate pain relief was accompanied by short lasting respiratory depression and drowsiness.
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Clinical Trial
Reliability and sensitivity measures of the Greek version of the short form of the McGill Pain Questionnaire.
The translation of existing healthcare measurement scales is considered a feasible, efficient and popular approach to produce internationally comparable measures. The short form of the McGill Pain Questionnaire is one of the most widely used and translated instruments to measure the pain experience. The Greek version of the short form of the McGill Pain Questionnaire (GR-SFMPQ) has recently been developed and demonstrated satisfactory levels of internal consistency. ⋯ All indexes of the GR-SFMPQ (total score, sensory and affective scores, total count of used words, visual analogue score, present pain index) managed consistently to detect the changes in pain experienced (p<0.05), after a therapeutic intervention, when assessing for the sensitivity of the questionnaire. An explorative discriminant analysis of the GR-SFMPQ indexes managed to correctly classify up to 85% of the patients; a classification rate comparable to the full version MPQ rating capacity. It can be argued from the results of this study that the Greek version of the SFMPQ fulfils the criteria of reliability and sensitivity to fluctuations of pain and can be utilized with confidence in cross-cultural comparative research trials.