Articles: neuropathic-pain.
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J. Korean Med. Sci. · Jul 2020
Anti-Allodynic Effects of Polydeoxyribonucleotide in an Animal Model of Neuropathic Pain and Complex Regional Pain Syndrome.
Spinal nerve ligation (SNL) model is one of the representative models of the neuropathic pain model. Neuropathic pain in a chronic post-ischemic pain (CPIP) mimics the symptoms of complex regional pain syndrome (CRPS). The administration of polydeoxyribonucleotide (PDRN), which has regenerative and anti-inflammatory effects, has been studied and is used in clinical practice treating various diseases. However, the analgesic effect of PDRN in a neuropathic pain or CRPS model remains unknown. ⋯ SC administration of PDRN results in the attenuation of allodynia and activation of astrocytes in neuropathic pain or CRPS models. We propose that PDRN can have significant potential advantages in neuropathic pain treatment.
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Case Reports
Utilization of Erector Spinae Plane Block in the Chronic Pain Clinic for Two Patients With Post-Thoracotomy Pain.
The erector spinae plane (ESP) block is a regional block that has become more commonly utilized in the setting of acute pain and post-operative analgesia. This block has been successfully utilized for pain management after a variety of surgical procedures for immediate post-operative pain management. ⋯ We describe the use of this block at our pain clinic for the treatment of two patients with refractory neuropathic pain after thoracotomy as well as video-assisted thoracic surgery (VATS). Our cases further demonstrate the utility of this block for long-term pain control of neuropathic pain conditions, especially post-thoracotomy pain.
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Evaluating the effectiveness of stellate ganglion blockades (SGBs) proves challenging, since the criteria defining a successful blockade are controversial. This may be one reason for the scarcity of studies on this topic, thus forcing clinical guidelines to remain conservative in recommending SGBs. Moreover, factors to predict which patients will benefit from blockade series are not yet available. ⋯ Data indicate that us-SGBs are safe and effective in reducing sympathetically maintained pain in patients with CRPS and neuropathic pain syndromes. Pain reduction after the first blockade may predict total pain reduction after a blockade series. Other clinical measures seem unsuitable to predict effectiveness.
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This review surveys current pharmacotherapies available for the treatment of diabetic peripheral neuropathy (DPN), emphasising their mechanisms of action. ⋯ Diabetic neuropathy is a highly prevalent, disabling condition, the management of which is associated with significant costs. Evidence supports the use of specific anticonvulsants and antidepressants for pain management in patients with diabetic peripheral neuropathy. All current guidelines advise a personalised approach with a low-dose start that is tailored to the maximum response having the least side effects or adverse events.