The journal of pain : official journal of the American Pain Society
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Randomized Controlled Trial Multicenter Study
Capsaicin 8% Patch in Painful Diabetic Peripheral Neuropathy: A Randomized, Double-Blind, Placebo-Controlled Study.
This 12-week study evaluated the efficacy and safety of capsaicin 8% patch versus placebo patch in painful diabetic peripheral neuropathy (PDPN). Patients aged 18 years or older with PDPN were randomized (1:1) to one 30-minute treatment (capsaicin 8% patch or placebo patch) to painful areas of the feet. Overall, 369 patients were randomized (capsaicin 8% patch, n = 186; placebo patch, n = 183). Percentage reduction in average daily pain score from baseline to between weeks 2 through 8 (the primary end point) was statistically significant for capsaicin 8% patch versus placebo (-27.4% vs -20.9%; P = .025); improvements in pain were observed from week 2 onward. Versus placebo, patients treated with capsaicin 8% patch had a shorter median time to treatment response (19 vs 72 days) and modest improvements in sleep interference scores from baseline to between weeks 2 through 8 (P = .030) and weeks 2 through 12 (P = .020). Apart from application site reactions, treatment-emergent adverse events were similar between groups. No indications of deterioration in sensory perception of sharp, cold, warm, or vibration stimuli were observed. In patients with PDPN, capsaicin 8% patch treatment provided modest pain relief and sleep quality improvements versus a placebo patch, similar in magnitude to other treatments with known efficacy, but without systemic side effects or sensory deterioration. ⋯ To our knowledge, this is the first study of the capsaicin 8% patch versus placebo in patients with PDPN to show that one 30-minute capsaicin treatment provides modest improvements in pain and sleep quality. Results confirm the clinical utility of the capsaicin 8% patch in the diabetic population.
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Randomized Controlled Trial Multicenter Study
Headache impairs attentional performance: a conceptual replication and extension.
Pain is thought to capture our attention. A consequence is that our performance on other tasks may suffer. Research has supported this, showing that pain disrupts our ability to perform various attention tasks. ⋯ Headache slowed reaction times to 4 of the 5 complex tasks, and this could be attributed to a slower basic processing speed measured using the choice reaction time task. Our findings differ from those of Moore et al in their headache study, suggesting that the effect of pain on attention is dynamic, even within a given type of pain. Whereas there is growing evidence that pain does disrupt attention, we cannot yet predict the specific nature of disruption in any given case.