Pain physician
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Review Meta Analysis
Efficacy of Palmitoylethanolamide for Pain: A Meta-Analysis.
Palmitoylethanolamide (PEA) is a cannabimimetic compound that has been investigated as an analgesic agent in animal models and clinical trials. ⋯ PEA, palmidrol, palmitoylethanolamide, efficacy, pain, pain management, meta-analysis.
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Refractive surgery is a common procedure, but may be associated with severe post-operative pain. ⋯ Photorefractive keratectomy, in situ keratomileusis, pain, analgesia, opioid, codeine, review.
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Research into interventional techniques in managing chronic spinal pain continues to be challenging, mystifying, confusing, and biased. Insight, or lack thereof, into placebo and nocebo phenomena contributes mightily to these difficulties. Unfortunately, placebo-nocebo responses are the subject of numerous controversies and challenges from not only a research perspective, but also clinical perspective. ⋯ This review focuses on a multitude of controversies surrounding placebo and nocebo phenomena in research and clinical applications. The discussion includes a focus on unsolved, forgotten, and ignored features of placebo responses in medicine, and provides an appropriate understanding of placebo and nocebo phenomena in interventional pain management. To that effect, this review also describes therapeutic placebos, research with open placebos, and improvements in understanding clinical applications of present interventional pain management research.
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Our intent is to report a case of intercostal neuralgia occuring as a complication of splanchnic radiofreqency ablation (RFA), due to a breach in the integrity of the insulating sheath of the RFA needle. A 48-year-old man presented to our pain clinic with upper abdominal pain due to chronic pancreatitis, recalcitrant to medical management. We decided to perform bilateral splanchnic nerve RFA in this patient. ⋯ Convinced of correct needle placement, we examined the RFA needles which had been used for ablation in this patient. One of the needles was discovered to have a fine breach in its insulating sheath, at a distance of approximately 30 mm from the active tip. It is of utmost importance for all interventional pain physicians to perform a thorough pre-use check of the equipment prior to any RFA procedure, with special emphasis on ensuring the integrity of the insulating sheath of the needles which are to be used, in order to prevent injury of non target nerves.