Pain physician
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Randomized Controlled Trial Multicenter Study
The Safety and Effectiveness of Orthobiologic Injections for Discogenic Chronic Low Back Pain: A Multicenter Prospective, Crossover, Randomized Controlled Trial with 12 Months Follow-up.
Chronic low back pain is one of the most common causes of disability, affecting more than 600 million people worldwide with major social and economic costs. Current treatment options include conservative, surgical, and minimally invasive interventional treatment approaches. Novel therapeutic treatment options continue to develop, targeting the biological cascades involved in the degenerative processes to prevent invasive spinal surgical procedures. Both intradiscal platelet-rich plasma (PRP) and bone marrow concentrate (BMC) applications have been introduced as promising regenerative treatment procedures. ⋯ This is the only human lumbar disc study that evaluates both PRP and BMC in the same study and compares it to placebo. PRP and BMC were found to be superior to placebo in improving pain and function; however, larger randomized clinical trials are needed to answer further questions on the comparative effectiveness of various biologics as well as to identify outcome differences specific to disc pathology.
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Randomized Controlled Trial
Dexmedetomidine in Fluoroscopic Guided Splanchnic Nerve Neurolysis for Pain Control: A Randomized, Controlled Trial.
Splanchnic nerve neurolysis (SNN) shows beneficial effects in reducing malignancy-associated refractory abdominal pain. Using adjuvants, such as dexmedetomidine to improve the pain was studied. ⋯ This study revealed that using dexmedetomidine in the chemical SNN process improves the pain results from injection of alcohol and refractory cancer related pain with reduction in the consumption of morphine in patients with upper-abdominal malignancy.
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Randomized Controlled Trial
Co-treatment with Oral Duloxetine and Intraarticular Injection of Corticosteroid plus Hyaluronic Acid Reduces Pain in the Treatment of Knee Osteoarthritis.
Knee osteoarthritis (OA) is a common form of arthritis in elders which can lead to reduced daily activity and quality of life. It is important to administer a proper treatment with high efficacy and low side effects. In this study, we evaluated the efficacy of co-treatment with oral duloxetine and intraarticular (IA) injection of hyaluronic acid (HA) and corticosteroid (CS) in patients with knee OA. ⋯ Patients receiving co-treatment with oral duloxetine and IA (HA+CS) injections experienced considerable improvement in pain and knee function compared to those who received an IA injection alone.
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Randomized Controlled Trial
A Randomized Controlled Trial Comparing the Effect of Two-Time Durations of Balloon Compression During Percutaneous Balloon Compression in Resistant Trigeminal Neuralgia.
Percutaneous balloon compression of the trigeminal nerve's gasserian ganglion for the treatment of trigeminal neuralgia is an interventional pain procedure with results comparable to microvascular decompression surgery. The procedure is safe in experienced hands and has less morbidity associated with it. However, there is a lack of clear-cut guidelines about the details of the technique like balloon shape, inflation pressure, and duration of inflation. So, keeping the inflation pressure and shape of the balloon constant, we studied the effect of the duration of inflation of the balloon and its effect on pain relief in refractory trigeminal neuralgia cases. ⋯ There is no difference in the pain relief obtained by the 2 different durations of compressions. A longer duration of compression, however, has more incidence of side effects.
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Randomized Controlled Trial
Erector Spinae Plane Block versus Transversus Abdominis Plane Block for Robotic Inguinal Hernia Repair: A Blinded, Active-Controlled, Randomized Trial.
Regional anesthetic nerve blocks are widely used in the treatment of pain after outpatient surgery to reduce opioid consumption. Erector spinae plane (ESP) block is a recently described technique with promising results in different scenarios. ⋯ ESP block was not superior to TAP block in the treatment of post-operative pain among patients undergoing robotic inguinal hernia repair.