Pain physician
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Randomized Controlled Trial
Iliocostalis Thoracis-Lumborum Myofascial Pain: Reviewing a Subgroup of a Prospective, Randomized, Blinded Trial. A Challenging Diagnosis with Clinical Implications.
Pain of myofascial origin is a well-recognized pathology characterized by the presence of two components: referred pain; which is often distant from its source and specific to each muscle, and the trigger point, a localized hyperirritable band present in the affected muscle and able to reproduce the referred pain when stimulated. Myofascial pain (MP) commonly coexists in patients with acute or chronic pain of other etiologies. The uniqueness of the clinical presentation of some MPs and the lack of training of most specialties represent a clinical challenge. Thus, many patients with MPS receive less than optimal management of this condition. ⋯ Anterior torso pain often resulted in extensive workups before ITL myofascial pain was diagnosed. TP injections were diagnostic and therapeutic of ITL myofascial pain.
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Review Meta Analysis
Particulate vs Non-Particulate Steroids for Transforaminal Epidural Steroid Injections: Systematic Review and Meta-analysis of the Current Literature.
The efficacy of particulate and non-particulate steroids in patients receiving epidural steroid injections remains unclear. ⋯ As the use of particulate steroids seems to be associated with slightly better VAS scores only, clinicians need to weigh their clinical relevance in the light of complications and recent FDA recommendations on the use of particulate steroids.
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Randomized Controlled Trial
Synergistic Effect of Intravenous Ibuprofen and Hydromorphone for Postoperative Pain: Prospective Randomized Controlled Trial.
An intravenous form of ibuprofen has recently been approved by the Food and Drug Administration (FDA) and reports are rare on its co-administration with opioids. ⋯ The combination of intravenous ibuprofen and hydromorphone produces a strong synergistic analgesia on postoperative pain.
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Randomized Controlled Trial
A New Look on Adding Dexamethasone as an Adjuvant to Caudal Bupivacaine; Efficacy on Postoperative Pain and Vomiting in Pediatric Patients.
Controlling postoperative pain and vomiting in children remains a great challenge. ⋯ Analgesic and antiemetic effects of dexamethasone as an adjunct to caudal block with bupivacaine (0.25%) 0.5 mL/kg is similar whether administered intravenously 0.5 mg/kg or caudally 0.1 mg/kg.