Articles: neuralgia.
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Randomized Controlled Trial Comparative Study
Comparison of epidural analgesia and intercostal nerve cryoanalgesia for post-thoracotomy pain control.
Epidural analgesia is regarded as the gold method for controlling post-thoracotomy pain. Intercostal nerve cryoanalgesia can also produce satisfactory analgesic effects, but is suspected to increase the incidence of chronic pain. However, randomized controlled trials comparing these two methods for post-thoracotomy acute pain analgesic effects and chronic pain incidents have not been conducted previously. ⋯ Both thoracic epidural analgesia and intercostal nerve cryoanalgesia showed satisfactory analgesia for post-thoracotomy acute pain. The incidence of post-thoracotomy chronic pain is high. Cryoanalgesia may be a factor that increases the incidence of neuropathic pain.
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Randomized Controlled Trial Multicenter Study
Vaccination against Herpes Zoster and Postherpetic Neuralgia.
Herpes zoster (HZ) and postherpetic neuralgia (PHN) cause significant morbidity in older adults. The incidence and severity of HZ and PHN increase with age in association with an age-related decline in varicella-zoster virus (VZV)-specific cell-mediated immunity (VZV-CMI). VZV vaccines can boost VZV-CMI. Therefore, we tested the hypothesis that VZV vaccination would protect older adults against HZ and PHN. ⋯ The Shingles Prevention Study demonstrated that HZ vaccine significantly reduced the morbidity due to HZ and PHN in older adults.
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Randomized Controlled Trial Clinical Trial
Ibuprofen versus acetaminophen for the relief of perineal pain after childbirth: a randomized controlled trial.
To evaluate efficacy of ibuprofen compared with acetaminophen for relief of perineal pain after childbirth, side effects of ibuprofen compared with acetaminophen and patient satisfaction in treatment between the 2 groups. ⋯ Ibuprofen was consistently better than acetaminophen at 1 hour after treatment for relief of perineal pain after childbirth without any side effects. After 2 hours, ibuprofen and acetaminophen had similar analgesic properties.
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Randomized Controlled Trial Multicenter Study
Pregabalin for relief of neuropathic pain associated with diabetic neuropathy: a randomized, double-blind study.
Seven published, randomized, placebo-controlled clinical trials with pregabalin have shown robust efficacy for relief of neuropathic pain from DPN and PHN. An investigation of the efficacy and safety of twice daily pregabalin enrolled 395 adults with painful DPN for > or = 1 year in a 12-week, double-blind, placebo-controlled trial. Patients were randomized to placebo, 150, 300, or 600 mg/day pregabalin (n = 96, 99, 99, and 101). ⋯ Pregabalin 600 mg/day was significantly superior to placebo in improving pain-related sleep-interference scores (p = 0.003), PGIC (p = 0.021), and CGIC (p = 0.009). (Neither pregabalin 150 nor 300 mg/day separated from placebo on these measures, largely because of an atypically large placebo response in one country representing 42% of patients.) All pregabalin dosages were superior to placebo in improving EQ-5D utility scores (all p > or = 0.0263 vs placebo). Pregabalin was well tolerated at all dosages; adverse events were generally mild to moderate. Number needed to harm (discontinuation because of adverse events) was 10.3 for pregabalin 600 mg/day.
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Randomized Controlled Trial
Mirtazapine decreases the pain feeling in healthy participants.
The treatment of neuropathic pain is mainly based on antiepileptics, tricyclic antidepressants, and opiates. These drugs have important side effects disturbing the patient's quality of life. Mirtazapine (MTZ) is a new and well-tolerated tricyclic antidepressants with both monoaminergic and opioid properties that might favorably influence pain. The aim of this study was to assess whether MTZ can reduce the pain induced by a standardized stimulus presented to healthy human participants. The nociceptive flexion reflex (NFR) to an electric stimulus was chosen to determine the pain threshold. ⋯ MTZ increases the pain tolerance in healthy participants. The potential benefit of this effect on pain should be investigated more thoroughly in chronic neuropathic pain patients. The NFR might serve as an additional tool for the monitoring of these patients.