Articles: pain-management-methods.
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Clinical Trial
Percutaneous Peripheral Nerve Stimulation (PNS) for the Treatment of Chronic Low Back Pain Provides Sustained Relief.
The objective of this study was to evaluate the use of percutaneous peripheral nerve stimulation (PNS) for the treatment of chronic low back pain (LBP). Percutaneous PNS offers the potential to provide an effective neuromodulation therapy using a system and fine-wire leads designed specifically for percutaneous use with history of an excellent safety profile. ⋯ This work demonstrates the potential value of percutaneous PNS for the treatment of chronic LBP. Improvements in pain, medication, and patient-centric outcomes, which were sustained long term after the removal of PNS leads, demonstrate the significance of this innovative approach to treat chronic LBP.
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To report a retrospective review of the longer-term results of peripheral neuromodulation in 12 patients with significant chronic sacroiliac joint pain who had previously failed multiple conservative and interventional pain therapies. ⋯ This initial case series has highlighted that SIJ neuromodulation results in the reduction in pain intensity and improved functionality in patients who have already failed conventional medical management and interventional techniques, including RF denervation. These preliminary results merit a prospective randomized trial of peripheral neuromodulation.
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Randomized Controlled Trial
Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients Undergoing Modified Radical Mastectomy.
Simultaneous application of pectoral nerve block and serratus-intercostal plane block (SPB) is one of the most desirable multimodal analgesic strategies, with wide implementation of the enhanced recovery after surgery pathway for modified radical mastectomy (MRM). ⋯ Pectoral nerve block, serratus-intercostal plane block, postoperative analgesia, modified radical mastectomy.
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Comparative Study
A Comparative Study of Opioid Switching to Methadone for Cancer Pain Control in Successful and Unsuccessful Cases.
Background: Methadone may play a role in the control of refractory cancer pain in opioid switching, although some cases fail to switch to methadone. Objective: To evaluate the differences in the clinical aspects in switching to methadone between successful cases (SCs) and unsuccessful cases (UCs). Design: This was a retrospective study of the clinical aspects of cancer patients who experienced opioid switching from other opioids to methadone. Setting/Subjects: Eighty-seven patients who were prescribed oral methadone in our hospital were analyzed. Methadone was initiated from other opioids due to refractory pain in the stop-and-go switching. Among the 87 cases, 7 cases were excluded from further analysis because methadone administration was stopped due to vomiting or self-cessation within six days from switching. Results: Among the 80 cases who had methadone for seven days or more, 70 cases (SCs) were successful in switching to methadone, according to the Japanese definition, although 10 cases (UCs) who experienced the rapid progression of illness failed due to oral difficulty in the course of titration. In comparison of the clinical characteristics between SCs and UCs, the number of days alive from the start of the administration of methadone was significantly greater in the SCs than in the UCs (SCs: 87.1, UCs: 19, p < 0.0001), but no significant differences were observed for any other factors. Conclusion: From this comparative retrospective study of opioid switching to methadone for cancer pain control between SCs and UCs, early switching to methadone may be useful for patients with advanced cancer pain.