Articles: pain-clinics.
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Randomized Controlled Trial
Bilateral Greater Occipital Nerve Block; Distal Versus Proximal Approach for Postdural Puncture Headache: A Randomized Clinical Trial.
One of the common neuraxial anesthesia complications is postdural puncture headache (PDPH). Greater occipital nerve block (GONB) is a simple and safe maneuver with a faster onset than other treatment modalities. ⋯ Postdural puncture headache, distal, proximal, greater occipital nerve, block, ultrasound, pain-relieving, neuraxial anesthesia.
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There are numerous, well-established racial disparities in the management of pain. The degree to which these are evident at the stage of conducting clinical trials is unknown. To address this knowledge gap, we examined race-based reporting, participation of Black individuals, and the factors associated with reporting and participation in pain clinical trials in the United States. ⋯ Our results indicate that representation of Black participants in pain clinical trials generally aligns with national demographics in the United States. Increased representation corresponds with health conditions more prevalent among Black individuals (eg, cardiovascular disease) and with a diverse study team composition. Despite these encouraging results, less than half of pain trials reported race, which introduces potential publication bias and limits external validity.
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The International Classification of Diseases ( ICD ) is applied worldwide for public health data collection among other use cases. However, the current version of the ICD ( ICD-10 ), to which the reimbursement system is linked in many countries, does not represent chronic pain properly. This study aims to compare the ICD-10 with the ICD-11 in hospitalized patients in terms of specificity, clinical utility, and reimbursement for pain management. ⋯ The simulated reimbursement fee remained the same when adding 397 pain-related codings, even if the cost of pain management, such as cost of labor, existed. Compared with the ICD-10 version, the ICD-11 is more specific and makes pain diagnoses more visible. Thus, shifting from ICD-10 to ICD-11 has the potential to improve both the quality of care and the reimbursement for pain management.
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Observational Study
Infrared Thermography: Clinical Value for Diagnosing Persistent Somatoform Pain Disorders?
Patients with persistent somatoform pain disorder (PSPD) are not uncommon. Still, the disease diagnosis relies primarily on structured interviews, with no objective indicators yet available to aid in the diagnosis. This has led to low diagnostic rates and overconsumption of health care resources for the disorder. Although there is a large body of research to improve the diagnosis of the condition, there are currently no objective indicators available for diagnosis. ⋯ Persistent somatoform pain disorder, PSPD, thermal imaging, infrared thermography, IRT, image texture characteristics, psychometric variables, image analysis.
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Both computed tomography-guided extracranial nongasserian ganglion radiofrequency thermocoagulation (RFT) and percutaneous balloon compression (PBC) have significant clinical efficacy in the treatment of trigeminal neuralgia, but a comparison of the efficacy of the 2 methods for pain in primary multibranch trigeminal neuralgia (TN) has not been studied clinically. ⋯ Radiofrequency thermocoagulation, percutaneous balloon compression, trigeminal neuralgia, extracranial nongasserian ganglion, multibranch pain.