Pain medicine : the official journal of the American Academy of Pain Medicine
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Current treatments for cancer pain are often inadequate, particularly when metastasis to bone is involved. The addition to the treatment regimen of another drug that has a complementary analgesic effect may increase the overall analgesia without the necessity to increase doses, thus avoiding dose-related side effects. This project investigated the synergistic effect of the addition of the potassium channel (KCNQ2-3) modulator flupirtine to morphine treatment in a rat model of prostate cancer-induced bone pain. ⋯ These results suggest that flupirtine in combination with morphine may be useful clinically to provide better analgesia at lower morphine doses in the management of pain caused by tumors growing in bone.
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Compared with the blind technique, ultrasound-guided stellate ganglion block (SGB) reduces the amount of local anesthetic needed for a successful block. The purpose of this study is to determine the minimal, optimal volume of local anesthetic required for successful ultrasound-guided SGB and to reduce its adverse effects. ⋯ In conclusion, when performing an ultrasound-guided SGB, 2 mL dosage was sufficient for a successful block as the previous, conventional volume. Therefore, when performing an ultrasound-guided SGB, we recommend the 2 mL dosage of local anesthetics for a successful block.
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To describe the value and utility in using a contralateral oblique (CLO) view when performing cervical, thoracic, and lumbar interlaminar procedures including epidural steroid injections and spinal cord stimulation percutaneous lead placement. ⋯ We recommend that the CLO view for thoracic and lumbar interlaminar procedures, in addition to cervical cases. Thus, when confirming proper needle placement for interlaminar procedures, the CLO view combined with anterior-posterior view yields safe multi-planar imaging and should be considered when a lateral view is unable to demonstrate target landmarks clearly.
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Comparative Study
Clinical outcomes of multidisciplinary pain rehabilitation among african american compared with caucasian patients with chronic pain.
The primary aim of this study was to determine if the immediate outcomes of multidisciplinary pain rehabilitation were different for African Americans compared with Caucasians. ⋯ The results of this study highlight an under-recognized health disparity which provides the basis for developing targeted interventions aimed at improving the clinical outcomes of African Americans with chronic pain.
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To describe a technique for and assess accuracy of ultrasound-guided supraorbital, infraorbital, and mental nerve injections in a cadaveric model. Prior studies have shown that peripheral trigeminal nerve injections can be beneficial for a subgroup of patients for whom surgical treatment is not appropriate. Accurate injection is necessary to limit side effects and improve its efficacy. Ultrasound guidance may improve the accuracy of an injection that is typically performed using a blind technique. ⋯ This cadaveric investigation suggests that ultrasound guidance can be used to inject the peripheral trigeminal nerve with a high degree of accuracy. Clinicians should consider using ultrasound guidance to inject the trigeminal nerve for diagnostic or therapeutic purposes.