Articles: chronic.
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Anesthesia and analgesia · Dec 2024
Randomized Controlled Trial Multicenter StudySmallest Clinically Meaningful Improvement in Amputation-Related Pain and Brief Pain Inventory Scores as Defined by Patient Reports of Global Improvement After Cryoneurolysis: a Retrospective Analysis of a Randomized, Controlled Clinical Trial.
The smallest meaningful improvement in pain scores (minimal clinically important difference [MCID]) after an analgesic intervention is essential information when both interpreting published data and designing a clinical trial. However, limited information is available for patients with chronic pain conditions, and what is published is derived from studies involving pharmacologic and psychological interventions. We here calculate these values based on data collected from 144 participants of a previously published multicenter clinical trial investigating the effects of a single treatment with percutaneous cryoneurolysis. ⋯ Amputees with phantom limb pain treated with percutaneous cryoneurolysis rate analgesic improvements as clinically meaningful similar to pharmacologic treatments, although their MCID for the Brief Pain Inventory was somewhat larger than previously published values. This information on patient-defined clinically meaningful improvements will facilitate interpretation of available studies and guide future trial design.
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Randomized Controlled Trial
Effects of Clinic-Based and Telerehabilitation-Based Motor Control Exercises in Individuals with Chronic Low Back Pain - A Randomized Controlled Trial with 3-Month Follow-Up.
To evaluate the effectiveness of clinic-based and telerehabilitation-based motor control exercises in individuals with chronic low-back pain 3 months posttreatment. ⋯ Telerehabilitation-based motor control exercises proved as effective as clinic-based methods in treating chronic low-back pain, offering a viable alternative tailored to individual needs and circumstances.
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Randomized Controlled Trial Comparative Study
Comparison of Intercostal Nerve Block and Serratus Anterior Plane Block for Perioperative Pain Management and Impact on Chronic Pain in Thoracoscopic Surgery: A Randomized Controlled Trial.
The intent of this study was to compare the analgesic efficacy of intercostal nerve block (ICNB) under direct thoracoscopic visualization and serratus anterior plane block (SAPB) with ultrasound guidance during thoracoscopic surgery's perioperative period. Furthermore, it examined their impact on chronic pain and identifies potential risk factors associated with its development. ⋯ ICNB and SAPB demonstrated comparable analgesic effects, with similar rates of chronic pain occurrence. Chronic pain independent risk factors included resting VAS score at 12 hours, chest tube duration, and surgical duration.
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Randomized Controlled Trial Multicenter Study
European randomized controlled trial evaluating differential target multiplexed spinal cord stimulation and conventional medical management in subjects with persistent back pain ineligible for spine surgery: 24-month results.
Differential target multiplexed spinal cord stimulation (DTM SCS) was shown to be superior to conventional SCS for treating chronic low back pain (CLBP) in subjects with persistent spinal pain syndrome with previous spinal surgery (PSPS-T2) or ineligible for it (PSPS-T1). This study reports 24-month efficacy and safety of DTM SCS vs. conventional medical management (CMM) in PSPS-T1 subjects across four European countries. ⋯ This randomized controlled trial shows that Differential Target Multiplexed SCS (DTM SCS) is an effective and safe long-term treatment for PSPS type 1 patients suffering from axial low back pain with or without leg pain and who are ineligible for spinal surgery. Currently, CMM treatments are their only option and provide limited benefits. Besides superior pain relief, DTM SCS provides significant improvements in functional disability, quality of life, high levels of satisfaction and perceived impression of change.
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Randomized Controlled Trial
A randomised controlled trial of the effect of intra-articular lidocaine on pain scores in inflammatory arthritis.
Chronic pain in inflammatory arthritis (IA) reflects a complex interplay between active disease in a peripheral joint and central pronociceptive mechanisms. Because intra-articular lidocaine may be used to abolish joint-specific peripheral input to the central nervous system, we aimed to validate its use as a clinical tool to identify those patients with IA whose pain likely incorporates centrally mediated mechanisms. We began by investigating whether there was a placebo response of intra-articular injection in patients with IA 1:1 randomised to receive intra-articular lidocaine or control (0.9% saline). ⋯ Firstly, the placebo effect of intra-articular injection was low: compared to baseline, the mean pain NRS score 5-minutes postinjection was reduced by 3.5 points in the lidocaine group vs 1.2 points in the control group. Secondly, postlidocaine NRS scores were significantly higher in those with a high (>18) baseline painDETECT score, fibromyalgia, and low-pressure pain threshold at the trapezius ( P = 0.002, P = 0.001, P = 0.005, respectively). Persistent high pain after intra-articular lidocaine injection could be used as an indicator of pronociceptive mechanisms that are centrally mediated, informing centrally targeted analgesic strategies.