Pain medicine : the official journal of the American Academy of Pain Medicine
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This preliminary and retrospective pilot case series examines a treatment concept consisting of ultrasound-guided stellate ganglion blocks (SGBs) combined with pharmacological and occupational therapy in patients with complex regional pain syndrome (CRPS) of the hand. Efficacy of combined treatment concepts and safety of ultrasound-guided SGB have not been sufficiently investigated yet. ⋯ The combination of ultrasound-guided SGB and simultaneous pharmacological and occupational therapy showed encouraging treatment results under conditions of this pilot case series. Assessment of efficacy of this combined treatment concept and safety of ultrasound-guided SGB require further prospective clinical studies with larger number of participants.
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To investigate the role of preoperative pain sensitivity and preoperative symptom severity for prediction of postoperative pain intensity after lumbar spine surgery. ⋯ The study highlights that each preoperative back pain and individual pain sensitivity could predict the different aspects of postoperative pain after lumbar surgery.
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This study aims to compare radiofrequency (RF) heat lesion size across electrodes and generator settings available for interventional pain management. ⋯ Tip gauge, tip length, temperature, and time substantially affect RF lesion size.
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Observational Study
Conversion from high-dose full-opioid agonists to sublingual buprenorphine reduces pain scores and improves quality of life for chronic pain patients.
This study aims to determine the effectiveness of converting patients from high doses of full-opioid agonists to sublingual (SL) buprenorphine. ⋯ Average pain scores decreased from 7.2 to 3.5, and quality of life scores increased from 6.1 to 7.1 for 35 patients converted from high-dose full-opioid agonists to SL buprenorphine therapy for more than 60 days. Clinicians should consider buprenorphine SL conversion for all patients on high-dose opioids, particularly patients with severe pain (7-10) unrelieved by their current opioid regimen or patients for whom the clinician does not feel comfortable prescribing high-dose opioids.
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A migraine is a common neurological disorder that often coexists with other illnesses including heart abnormalities, such as patent foramen ovale (PFO), atrial septal aneurysm (ASA), and mitral valve prolapse (MVP). ⋯ The results of our study raise the question of the heart's role in the mechanism of migraine attacks. If the occurrence of migraine with aura had been related to some heart abnormalities, the pathophysiology of migraine attacks may have some connection to some heart dysfunction. Resolving the association between migraine and comorbid cardiac conditions might shed light on the underlying mechanisms of migraines and even result in a different treatment strategy. However, we do not find any clear connection between PFP, ASA, and MVP, and migraine occurrence.