Pain practice : the official journal of World Institute of Pain
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The assessment of painful areas through printed body charts is a simple way for clinicians to identify patients with widespread pain in primary care. However, there is a lack in the literature about a simple and automated method designed to analyze pain drawings in body charts in clinical practice. ⋯ PainMAP software is reliable and valid for quantification of the number of pain sites and the pain area in patients with low back pain.
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Case Reports
Case Report: Treatment of Refractory Post-Surgical Neuralgia with Erector Spinae Plane Block.
Peripheral nerve blocks (PNBs) are used for a wide spectrum of headache and facial pain disorders. The objective of this case report is to highlight the erector spinae plane (ESP) block, which has recently been reported to successfully treat headache. ⋯ PNBs, ESP block in our case, can be a useful modality in managing chronic neuralgiform pain for treatment-refractory patients. It can provide improvement in quality of life and spare the patient from medication side effects. In an inpatient setting, it can decrease length of stay that would otherwise be extended due to a trial of multiple medications until the pain was controlled. PNBs are used for a wide spectrum of headache and facial pain disorders. This case report highlights successful management of chronic neuralgiform pain with the ESP block, which has recently been reported to successfully treat headache. ESP block provided relief to the patient's neuralgiform pain that was refractory to multiple medications, resulting in decreased length of stay, fewer medication side effects, and improved quality of life. It also provided a window for initiation of long-term pain medications.
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Adolescents with chronic musculoskeletal pain face different impairments in daily life. After an inpatient pain rehabilitation program, adolescents function better on several domains. The aim of this study was to explore the long-term work participation of adults who followed inpatient pain rehabilitation during adolescence because of chronic musculoskeletal pain and to identify potential facilitators and barriers regarding work in later life. ⋯ Ten out of 14 participants are currently working, most of them despite experiencing pain. Several factors based on the 4 systems of the Sherbrooke model contribute as facilitators or barriers regarding current work participation. Pain rehabilitation is mostly regarded as a facilitator for work participation later on in life.
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Review Meta Analysis
Analgesic Efficacy and Safety of Local Infiltration of Tramadol in Pediatric Tonsillectomy Pain: A Systematic Review and Meta-Analysis.
The aim of this systematic review and meta-analysis was to appraise clinical evidence of the impact of peritonsillar infiltration of tramadol, on postoperative pain control and the occurrence of adverse effects in children undergoing tonsillectomy. ⋯ In children undergoing tonsillectomy, peritonsillar infiltration of tramadol is associated with a postoperative analgesic benefit when compared to placebo, with negligible adverse events. Yet, no definite conclusion can be drawn due to the low quality, considerable heterogeneity, and paucity of the available data.
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To assess the supraspinal working mechanisms of the burst spinal cord stimulation (SCS) mode, we used functional magnetic resonance imaging (fMRI) in chronic neuropathic rats. We hypothesized that active recharge burst SCS would induce a more profound blood oxygenation level-dependent (BOLD) signal increase in areas associated with cognitive-emotional aspects of pain, as compared to tonic SCS. ⋯ In conclusion, active recharge burst and tonic SCS have different effects on the intensity and localization of SCS-induced activation responses in the brain. This work demonstrates that active recharge burst is another waveform that can engage brain areas associated with cognitive-emotional aspects of pain as well as areas associated with location and intensity of pain. Previous studies showing similar engagement used only passive recharge burst.