Pain medicine : the official journal of the American Academy of Pain Medicine
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To examine the evolution of pain and the duration of numbness after neural blockade of the pudendal nerve in women with pudendal neuralgia and correlate with clinical and historical data. ⋯ In patients with pudendal neuralgia, the pudendal nerve block has a variable response, but may have a beneficial effect in a subset of women. Surgical and obstetrical trauma are common historical antecedents.
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An increasing number of deaths have been inferred to be associated with current opioid rotation practices and evidence is mounting that the use of widely accepted protocols for opioid rotation is an important contributing factor. Based on the findings of a literature review published in conjunction with this article, we propose a new paradigm for a potentially safer method of opioid rotation and present a case study illustrating the paradigm. This new paradigm suggests three easy-to-remember steps in opioid rotation and obviates the need to use a conversion table. ⋯ A safer new paradigm for opioid rotation may provide an important incremental step forward in reducing adverse public health consequences of inappropriate opioid dosing.
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Review Comparative Study
A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter?
Pain is a subjectively complex and universal experience. We examine research investigating ethnic group differences in experimental pain response and factors contributing to group differences. ⋯ There are potentially important ethnic/racial group differences in experimental pain perception. Elucidating ethnic group differences has translational merit for culturally competent clinical care and for addressing and reducing pain treatment disparities among ethnically/racially diverse groups.
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Review
Age-related changes in the structure and function of brain regions involved in pain processing.
This review summarizes the scientific literature addressing the effects of aging on pain processing in the brain. ⋯ The network of brain regions involved in pain processing are subject to age-related changes in structure, but that the functional implications of these changes are yet to be determined.
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This article has the following two primary objectives: 1) to provide a discussion of the self-management of pain for older adults in relation to therapist-assisted cognitive behavioral procedures; and 2) to review the main features of a recently developed manualized pain self-management program for older adults. ⋯ Self-management outcomes may be inconsistent across studies partly because there is very limited standardization and manualization of self-management approaches. A manualized self-management program is described as an example of an approach that could easily be standardized and facilitate future investigations. It would be important for subsequent research to focus on the identification of subgroups of older patients who are most likely to benefit from self-management, and to determine whether self-management improves outcomes of future professionally administered treatments.