Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Do cardiorespiratory variables predict the antinociceptive effects of deep and slow breathing?
Deep and slow breathing (DSB) is a central part of behavioral exercises used for acute and chronic pain management. Its mechanisms of action are incompletely understood. ⋯ The present study could not confirm hypotheses that the antinociceptive effects of DSB are related to changes in breathing frequency, heart rate variability, or hypoventilation/hyperventilation when applied as a short-term intervention. It could confirm the notion that increased cardiac parasympathetic activity is associated with reduced pain perception.
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Recent surveys suggest more than one third of patients utilize the Internet to seek information about chronic pain (CP) and that 60% of patients feel more confident in the information provided online than provided by their physician. Unfortunately, the quality of online information is questionable. For example, some Websites make unsubstantiated claims while others may have covert motives (i.e., product advertisement). This article presents two studies that utilized a well-validated tool to evaluate the quality of online CP-related information. ⋯ Overall, these findings speak to the risks associated with clients making CP-related treatment choices based on information obtained online without first evaluating the Website.
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This manuscript reviews how patient-reported outcomes data can be used to guide efforts to improve patient outcomes. ⋯ Patient outcomes can be improved with standardization of the process of patient care, as well as through other quality improvement efforts. The cornerstone to any effort to improve patient outcomes starts with the integration of valid outcomes data collection into ongoing patient care. Outcome measurement tools should provide information on several key domains, yet the process of data collection should not pose a significant burden on either the patient or health care team. Efforts to improve patient outcomes are ongoing, and should be a high priority for every health care team.
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Case Reports Randomized Controlled Trial
Treating intractable phantom limb pain with ambulatory continuous peripheral nerve blocks: a pilot study.
There is currently no reliable treatment for phantom limb pain (PLP). Chronic PLP and associated cortical abnormalities may be maintained from abnormal peripheral input, raising the possibility that a continuous peripheral nerve block (CPNB) of extended duration may permanently reorganize cortical pain mapping, thus providing lasting relief. ⋯ A prolonged ambulatory CPNB may be a reliable treatment for intractable PLP. The results of this pilot study suggest that a large, randomized clinical trial is warranted.