Pain medicine : the official journal of the American Academy of Pain Medicine
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This systematic review aims to examine the available literature and to synthesize published data concerning the treatment of Complex Regional Pain Syndrome (CRPS) with ketamine. ⋯ There is no high quality evidence available evaluating the efficacy of ketamine for CRPS and all manuscripts examined in this review were of moderate to low quality. Therefore, we conclude there is currently only weak evidence supporting the efficacy of ketamine for CRPS, yet there is clearly a rationale for definitive study.
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Randomized Controlled Trial
Aerobic exercise and cold pressor test induce hypoalgesia in active and inactive men and women.
Physical inactivity is a risk factor for chronic pain. Several mechanisms play a role in pain chronification including impairment of pain inhibition. ⋯ Cold pressor stimulation and aerobic exercise caused comparable multisegmental increases in PPT in active and inactive men and women. The CPM and EIH responses were correlated, but they have different temporal manifestation of hypoalgesia.
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To determine whether the thermal energy associated with lumbar spine radiofrequency neurotomy (RFN) performed near titanium and stainless steel pedicle screws is conducted to the pedicle screws or adjacent tissues, or both, thus introducing potential for thermal damage to those tissues. ⋯ Titanium and stainless steel pedicle screws are capable of sustaining large increases in temperature when the radiofrequency probe comes in contact with the screw. These results are suggestive that pedicle screws could serve as a possible source of tissue heating and thermal injury during RFN.
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Chronic pain remains a serious public health problem worldwide. A spinal cord stimulation (SCS) therapy called HF10 SCS uses 10-kHz high-frequency stimulation to provide pain relief without paresthesia. In this article, we describe the therapy, device, and the methods of implant and then review the safety and effectiveness data for this therapy. ⋯ The clinical experience reported in this article supports the efficacy and pain relief provided by HF10 SCS therapy. Clinical studies have also concluded that HF10 SCS does not generate paresthesia nor was it necessary to provide adequate coverage for pain relief. As clinical evidence accumulates and technological innovation improves patient outcomes, neuromodulatory techniques will be sought earlier in the treatment continuum to reduce the suffering for the many with otherwise intractable chronic pain.
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While the safety and efficacy of peripheral nerve blocks for postoperative pain management has been established in several well controlled prospective trials, the local anesthetic (LA) concentration and volume used in these studies was associated with a significant increase muscle weakness due to motor nerve block. The purpose of the present retrospective study of patients undergoing total knee arthroplasty was to assess the relative analgesic efficacy and functional outcomes of the low concentration, low volume of LA used in peripheral nerve blocks for postoperative pain management. ⋯ This analysis supports the use of low concentration, low volume of LA based peripheral nerve blocks for postoperative pain management.