Pain medicine : the official journal of the American Academy of Pain Medicine
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Pre-outpatient interventions in chronic pain have the potential to improve patient self-management earlier in primary or secondary care, which may minimize pain chronicity and negative health outcomes. The literature for this is sparse, and there are no existing systematic reviews on this topic. ⋯ Group interventions before individual appointments have the potential to provide important improvements in service delivery, including improvements in waiting times and cost per patient. Benefits for patient outcome measures are less clear. Clinical heterogeneity and high levels of bias existed in the included studies. Further research is required so that meaningful conclusions can be made about these interventions.
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Meta Analysis
Percutaneous Interventional Strategies for Migraine Prevention: A Systematic Review and Practice Guideline.
To systematically evaluate the efficacy and effectiveness of percutaneous interventional treatments for prevention of migraine through a qualitative and (when possible) quantitative analysis. ⋯ As informed by evidence related to the preselected outcomes, adverse event profile, cost, and values and preferences of patients, onabotulinumtoxinA received a strong recommendation for its use for chronic migraine prevention and a weak recommendation against its use for episodic migraine prevention. Greater occipital nerve blocks received a weak recommendation for their use for chronic migraine prevention. For greater occipital nerve block, steroid received a weak recommendation against its use vs the use of local anesthetic alone. Occipital nerve with supraorbital nerve blocks, sphenopalatine ganglion blocks, cervical spine percutaneous interventions, and implantable stimulation all received weak recommendations for their use for chronic migraine prevention. The committee found insufficient evidence to assess trigger point injections in migraine prevention and highly discouraged the use of intrathecal medication.
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We conducted a systematic review and meta-analysis to examine the impact of perioperative intravenous lidocaine infusion on pain management scores, opioid consumption, adverse events, and hospital length of stay in patients undergoing spinal surgery. ⋯ Perioperative intravenous lidocaine infusion consistently improves analgesic measures in adult and pediatric populations in the first 24 hours, with an effective decrease in opioid consumption noted to 48 hours. These results are most generalizable in the adult population in the first 4-6 to 24 postoperative hours.
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Randomized Controlled Trial
The effect of the model's social status on placebo analgesia induced by social observational learning.
Placebo analgesia can be induced by social observational learning. The aim of this study was to determine whether this effect can be influenced by the social status of a model. ⋯ This is the first study to show that the perception of a model's social status is related to the magnitude of placebo analgesia induced by observational learning.
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To verify the articular branch contributions in the human knee, delineate their anatomical variance, and outline the limitations of currently applied procedure protocols for denervation of the knee joint. ⋯ Genicular denervation using classical anatomical landmarks may not be sufficient to treat the anterior knee joint pain. Our findings illustrate more accurate anatomic landmarks for the three-target paradigm and support additional targets for more complete genicular denervation. This cadaveric study provides robust anatomical findings that can provide a foundation for new anatomical landmarks and targets to improve genicular denervation outcomes.