Pain practice : the official journal of World Institute of Pain
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Randomized Controlled Trial Comparative Study
Percutaneous Cervical Nucleoplasty Versus Pulsed Radio Frequency of the Dorsal Root Ganglion in Patients with Contained Cervical Disc Herniation; A Prospective, Randomized Controlled Trial.
Cervical neck pain is often caused by cervical disk pathology and may cause severe symptoms and disability. Surgeons and patients are increasingly aware of postsurgery-related complications. This stimulated the clinical usage of minimally invasive treatments such as percutaneous nucleoplasty (PCN) and pulsed radio frequency (PRF). However, scientific evidence on both treatments is limited. ⋯ Within 3 months, both PCN and PRF show significant pain improvement in patients with contained cervical disk herniation, but none is superior to the other. Both treatment options appear to be effective and safe in regular clinical practice.
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Randomized Controlled Trial Multicenter Study
Randomized, Double-Blind Trial of Oral Methylnaltrexone for the Treatment of Opioid-Induced Constipation in Patients with Chronic Noncancer Pain.
Subcutaneous methylnaltrexone, a peripherally acting μ-opioid receptor antagonist, improves opioid-induced constipation (OIC) in patients with chronic noncancer pain. An oral methylnaltrexone formulation has been developed. ⋯ Oral methylnaltrexone was efficacious and well tolerated for OIC in patients with chronic noncancer pain, particularly the 450-mg dose.
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Percutaneous neurostimulation of the peripheral nervous system involves the insertion of a wire "lead" through an introducing needle to target a nerve/plexus or a motor point within a muscle. Electrical current may then be passed from an external generator through the skin via the lead for various therapeutic goals, including providing analgesia. With extended use of percutaneous leads sometimes greater than a month, infection is a concern. It was hypothesized that the infection rate of leads with a coiled design is lower than for leads with a noncoiled cylindrical design. ⋯ Percutaneous leads used for neurostimulation of the peripheral nervous system have a much lower risk of infection with a coiled design compared with noncoiled leads: approximately 1 infection for every 30,000 vs. 1,200 indwelling days, respectively.
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Patients with thoracic neuropathic pain often do not respond to medication and physical therapy. Coblation technology has been demonstrated to have potential for pain management. ⋯ Percutaneous thoracic paravertebral nerve coblation guided by computed tomography is a potential method for the treatment of thoracic neuropathic pain.
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Herpes zoster (HZ) and postherpetic neuralgia are known to have a profound effect on the patient's quality of life, but the incidence and severity of itch and its relation with pain and quality of life in the long term are still relatively unknown. ⋯ Pain and itch are highly prevalent months after HZ. Pain caused by HZ has a large impact on quality of life, burden of illness, impact on daily life, and health care costs for these patients. The impact of itch on quality of life is relatively small.