Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Does intrathecal morphine sulfate provide preemptive analgesia for patients undergoing stapled hemorrhoidopexy?
Surgical excision of hemorrhoids is characterized by a prolonged and painful postoperative course. This double-blind, randomized, prospective, controlled trial was conducted to determine if morphine sulfate provides additional pain relief after stapled hemorrhoidopexy when added to a standard lidocaine spinal anesthetic. It was hypothesized that the addition of morphine sulfate to a spinal anesthetic would decrease postoperative pain. ⋯ This study provides evidence that intrathecal morphine sulfate does not significantly alter postoperative pain, narcotic use, or well-being when used as preemptive analgesia for patients undergoing stapled hemorrhoidopexy.
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To describe the prevalence of hysterectomy for women aged 18-45 seeking treatment at a chronic pain clinic, to describe patient characteristics (pain intensity, age, smoking status, hormone replacement status, and psychosocial factors) based on opioid and hysterectomy status, and to determine whether hysterectomy status predicted receipt of opioid prescription. ⋯ Hysterectomy may confer risk for pain-related dysfunction and opioid prescription in women 45 and younger. More research is needed to understand 1) how patient characteristics influence prescribing patterns and 2) the specific medical risks and consequences of chronic opioid therapy in this population.
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Investigate whether percutaneous spinal cord stimulator (SCS) leads migrate significantly during a 3-day trial, and determine whether the skin anchoring method influences lead migration. ⋯ Percutaneous SCS trial electrodes migrate significantly, inferiorly, during a 3-day trial. Anchoring the trial electrodes to the skin with a suture and tape results in significantly greater inferior migration when compared with anchoring the lead with tape only.
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Phantom limb pain is often resistant to treatment. Techniques based on visual-kinesthetic feedback could help reduce it. ⋯ Persons with phantom limb pain may benefit from this novel intervention combining observation and motor imagery. Additional studies are needed to confirm our findings, elucidate mechanisms, and identify patients likely to respond.
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It is generally well established that catastrophizing exerts a potent influence on individuals' experience of pain and accompanying emotional distress. Further, preliminary evidence has shown that meaningful differences among various pain relevant outcomes (e.g., pain ratings, endogenous pain inhibitory processes) can be attributed to individuals' ethnic background. The mechanisms that might explain ethnic differences in pain outcomes are unclear, and it remains to be fully established whether the relation between ethnicity and pain response may be indirectly affected by pain catastrophizing. ⋯ To better explicate our findings, we described the context in which these findings occurred following a "who, what, where, when, and why" approach. This approach provides an efficient description of how our findings align with previous research, while identifying future research that should clarify the theoretical underpinnings of catastrophizing and pain and also inform clinical intervention.