The Clinical journal of pain
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Although pain is always intense and unpleasant, the capacity to experience this sensation is, under normal circumstances, fundamental to the preservation of bodily integrity. Clinically, however, after injury to peripheral tissue or directly to the nervous system, spontaneous and evoked pain manifest that serve no physiologic function, are crippling to patients, and are difficult to treat. ⋯ This spinal neuronal plasticity is shown to be a key contributor to pathologic pain hypersensitivity. The potential for the molecular mechanisms responsible for the spinal plasticity in revealing new targets for future treatment is also discussed.
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Randomized Controlled Trial Clinical Trial
Evaluating skin anesthesia after administration of a local anesthetic system consisting of an S-Caine patch and a controlled heat-aided drug delivery (CHADD) patch in volunteers.
The objective of this study was to evaluate the depth and duration of skin anesthesia after the administration of a local anesthetic system consisting of an S-Caine (Zars, Salt Lake City, UT) patch coupled with a controlled heat-aided drug delivery (CHADD; Zars) patch. ⋯ The local anesthetic system consisting of a combination of S-Caine and CHADD patches provided a statistically significant dermal anesthesia effect compared with placebo in this volunteer study. If confirmed in other studies, this system has promise as a noninvasive method of producing dermal anesthesia for minor surgical procedures or intravenous insertion.
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Research on the pathophysiology of chronic pain has begun to challenge the traditional diagnostic and treatment paradigms for the patient with neuropathic pain. The heterogeneous nature of neuropathic pain indicates that more than one anatomic lesion is most likely responsible for the clinical presentation of a particular syndrome. Numerous pharmacologic agents that have shown improved efficacy in the treatment of neuropathic pain have been developed over the past decade. For the practicing clinician, an important concern is whether the current paradigm for classification of neuropathic pain syndromes is comprehensive enough to address this rapidly expanding body of knowledge.
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The objective of this study was to investigate the hypothalamic-pituitary-gonadal response to intrathecal opioids. ⋯ Hypogonadotrophic hypogonadism is a common complication of intrathecal opioid therapy in both men and women.
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Randomized Controlled Trial Clinical Trial
Effect of acupuncture upon experimentally induced ischemic pain: a sham-controlled single-blind study.
To investigate the hypoalgesic effect of true and sham acupuncture upon experimentally induced ischemic pain. ⋯ The results of the study provide no convincing evidence for a superior hypoalgesic effect of acupuncture compared with "sham" procedures on this model of experimental pain.