Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Intranasal ketorolac for postoperative pain: a phase 3, double-blind, randomized study.
Analgesic efficacy and tolerability of intranasal (IN) ketorolac was evaluated in postoperative patients in a randomized, double-blind, placebo-controlled study. ⋯ IN ketorolac was well tolerated and effective in treating moderate-to-severe postoperative pain in inpatients; the convenience of IN dosing suggests that its usefulness in the ambulatory care setting should be evaluated.
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Review Historical Article
A narrative review of lumbar medial branch neurotomy for the treatment of back pain.
Confusion persists concerning the nature and efficacy of procedures variously known as facet denervation, lumbar medial branch radiofrequency neurotomy, and radiofrequency neurotomy or denervation for the treatment of back pain. Systematic reviews have not recognized the importance of patient selection and correct surgical technique when appraising the literature. As a result, negative conclusions about procedures have been drawn because lack of efficacy of one procedure has been misattributed to other, cognate, but different procedures. ⋯ Negative results have been reported only in studies that selected inappropriate patients or used surgically inaccurate techniques. All valid studies showed positive outcomes that cannot be attributed to placebo. Inappropriate conclusions have been drawn by systematic reviews that misrepresent invalid studies as providing evidence against the efficacy of lumbar medial branch neurotomy.
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Case Reports
Radiofrequency neurotomy for a patient with deep brain stimulators: proposed safety guidelines.
To discuss the potential risks inherent to performing radiofrequency procedures in patients with deep brain neurostimulators, and to propose safety guidelines. ⋯ Radiofrequency medial branch neurotomy was performed on a patient with two deep brain stimulators with a satisfactory clinical outcome, and no adverse sequelae. Additional study is warranted regarding the safety and compatibility of brain neurostimulators and radiofrequency interventions.