Pain physician
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The scarcity of an effective and safe therapy to relieve acute zoster-related trigeminal neuralgia (TN) and preventing it from developing into trigeminal postherpetic neuralgia is well known. Pulsed radiofrequency (PRF) is a novel and safe, minimally neuro-destructive technique for the treatment of acute zoster-related TN, which attains satisfactory pain relief. However, this result is only reported by a few single-center researches. In addition, no study has reported the predictive factors of the analgesic effect for PRF treatment on acute zoster-related TN patients. ⋯ CT-guided PRF is an effective and safe treatment for acute zoster-related TN patients. Compared to peripheral nerve PRF, gasserian ganglion treatment may be more effective for patients with acute zoster-related TN.
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Randomized Controlled Trial Multicenter Study
Comparison Between Two Volumes of 70% Alcohol in Single Injection Ultrasound-Guided Celiac Plexus Neurolysis: A Randomized Controlled Trial.
Pain due to inoperable upper abdominal malignancies is a challenging condition that needs a multimodal analgesic regimen to be managed properly. Celiac plexus alcohol neurolysis was proved to be effective in relieving such type of pain; however, there is no consistent data about the optimal volume to be used to maintain the balance between the neurolytic effect and the destructive effect of alcohol. ⋯ During ultrasound-guided CPN for patients with inoperable upper abdominal cancers who failed medical management, a volume of 20 mL is as effective as 40 mL of 70% alcohol regarding pain control, opioid consumption, quality of life, and procedure-related complications.
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Multicenter Study
Bi-Needle PELD with Intra-Discal Irrigation Technique for the Management of Lumbar Disc Herniation.
Lumbar disc herniation (LDH) is the most common cause of sciatica. Percutaneous endoscopic discectomy (PELD) is indicated when conservative treatments fail, which has been proved effective. During conventional PELD, ruptured discs and loose fragments inside discs are removed as much as possible to guarantee a lower reherniation rate, but it inevitably would lead to deterioration of disc degeneration and loss of disc height after PELD. Ensuring sufficient decompression while alleviating the post-operation disc degeneration process is still a clinical problem. ⋯ Bi-needle technique with saline irrigation maneuver showed a significant advantage of restoration of disc height and amelioration of disc degeneration compared to conventional PELD surgery.
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Randomized Controlled Trial Multicenter Study
Safety and Efficacy of Platelet Rich Plasma for Treatment of Lumbar Discogenic Pain: A Prospective, Multicenter, Randomized, Double-blind Study.
Interventions for chronic discogenic spine pain are currently insufficient in lowering individual patient suffering and global disease burden. A 2016 study of platelet rich plasma (PRP) for chronic discogenic pain previously demonstrated clinically significant response among active group patients compared with controls. ⋯ These findings are markedly different than the highly promising results of the 2016 PRP study. This study posits necessary caution for researchers who wish to administer PRP for therapeutic benefit and may ultimately point to necessary redirection of interventional research for discogenic pain populations.
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Multicenter Study Observational Study
Radiation Doses for Different Approaches of Fluoroscopy-Guided Epidural Injections: An Observational Clinical Study.
Although fluoroscopy-guided interventional therapies have declined in recent years, radiation exposure remains a critical issue for both patients and medical staff. Radiation exposure varies according to the physicians' experience, procedure time, patients' body mass index (BMI), imaging techniques, and the type of procedure performed. ⋯ Radiation dose levels and procedure times of 4 approaches of epidural injections were obtained from 3,711 procedures performed in a university hospital pain medicine clinic. BMI of patients was taken into account with the dose levels of injections given per BMI. Multicenter research with standardized techniques will assure more reliable reference levels, which will guide pain physicians to self-assess their own levels of radiation exposure.