Pain practice : the official journal of World Institute of Pain
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It has been increasingly recognized that many chronic pain conditions are associated with central sensitization (CS). The Central Sensitization Inventory (CSI) is a potentially useful tool for screening patients whose presenting symptoms are suspected of being related to CS, so that additional diagnostic evaluation can be performed and appropriate treatment can be initiated. The original English version is currently not available in Serbian. ⋯ The results of the present study indicate strong psychometric properties, including evidence of convergent and discriminant validity, of the CSI-Serb. These results correspond with those of other translated versions of the CSI that have been psychometrically evaluated and published. Due to the current interest in CS, and its relationship with many chronic pain conditions, it is anticipated that the CSI-Serb will benefit Serbian-speaking clinicians in the evaluation of patients with chronic pain conditions.
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Randomized Controlled Trial
Increased sympathetic outflow induces adaptation to acute experimental pain.
There are interrelationships between the autonomic nervous system and pain. This study aims to explore the effect of different autonomic manipulations on pain perception and modulation. ⋯ Different effects of acute autonomic manipulations on experimental pain were found: an increase in sympathetic tone induced by yohimbine led to reduced pain sensitivity; a decrease in sympathetic tone with no effect on vagal-parasympathetic tone induced by phenylephrine led to reduction in pain adaptation capacity; and a decrease in sympathetic tone and increase in vagal parasympathetic tone by clonidine led to no change in pain adaptation capacity. While increased sympathetic outflow does facilitate pain adaptation, activation of either the sympathetic or parasympathetic limbs of the autonomic nervous system does not affect pain thresholds or CPM. Finally, a correlation exists between nociception and cardiovascular parameters only due to baroreflex activation.
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Intrathecal targeted drug delivery systems historically required physician office visits for dose adjustment to manage fluctuating pain. A wireless device now enables patients to supplement their basal intrathecal infusion with a programmed on-demand bolus dose. We sought to quantify the change in oral breakthrough opioid need associated with the use of an intrathecal bolus in comparison to those treated with the basal infusion alone. ⋯ Utilizing an intrathecal bolus to treat incident pain was a safe way to manage unpredictable breakthrough pain and may represent a cost-saving opportunity by eliminating the need for oral analgesic medications.
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Pregnancy is known to aggravate pre-existing chronic painful conditions. Trigeminal neuralgia (TN), albeit a disease of the elderly, may afflict pregnant females, which can further complicate its management. ⋯ This rare coexistence of TN in pregnancy has not been reported before. Here we present a case of TN in a young woman, whose pain was aggravated when she became pregnant, and she was treated successfully by conventional radiofrequency ablation of the Gasserian ganglion.
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Peripheral nerve stimulation of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. ⋯ Subcutaneous placement of electrodes with our minimally invasive technique and wireless neuromodulation technology was safe and effective. Significant improvements in pain relief ensued, and no further adverse events had been reported at the end of 3 months' follow-up.