The Clinical journal of pain
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Ziconotide is a nonopioid intrathecal analgesic used to manage moderate to severe chronic pain. Although ziconotide is approved in the United States for intrathecal monotherapy only, it is often used in combination with other intrathecal drugs in clinical practice. ⋯ Although clinical and preclinical studies provide some support for the use of ziconotide in combination with morphine, hydromorphone, clonidine, or baclofen, strong evidence-based data are limited. Controlled, long-term clinical trials are warranted.
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Randomized Controlled Trial Comparative Study
Naprapathic manual therapy or conventional orthopedic care for outpatients on orthopedic waiting lists?: A pragmatic randomized controlled trial.
Traditionally, orthopedic outpatient waiting lists are long, and many referrals are for conditions that do not respond to interventions available at an orthopedic outpatient department. The overall objective of this trial was to investigate whether it is possible to reduce orthopedic waiting lists through integrative medicine. Specific aims were to compare the effects of naprapathic manual therapy to conventional orthopedic care for outpatients with nonurgent musculoskeletal disorders unlikely to benefit from surgery regarding pain, physical function, and perceived recovery. ⋯ The trial suggests that naprapathic manual therapy may be an alternative to consider for orthopedic outpatients with disorders unlikely to benefit from surgery.
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Randomized Controlled Trial
Pregabalin and transcutaneous electrical nerve stimulation for postherpetic neuralgia treatment.
Postherpetic neuralgia (PHN) is responsible for one of the most common types of neuropathic pain, described as a burning pain that shakes, hits, and tightens and includes allodynia and paresthesia. ⋯ These data support the conclusion that Pregabalin gives better results when combined with TENS therapy, which is an analgesic nonpharmacologic procedure. Therefore, a multidisciplinary treatment should be considered for this kind of pain.
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Persistent postsurgical pain (PPSP) after surgery for breast cancer has a prevalence of 20% to 52%. Neuroplastic changes may play a role in the aetiology of this pain. The principal objective of this study was to examine the relationship between acute pain after surgery for breast cancer and the likelihood of subsequently developing PPSP. ⋯ Patients who developed PPSP experienced pain of greater intensity on the fifth postoperative day than those that did not.
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Randomized Controlled Trial Multicenter Study Comparative Study
Efficacy and safety of etodolac-paracetamol fixed dose combination in patients with knee osteoarthritis flare-up: a randomized, double-blind comparative evaluation.
To evaluate the efficacy and safety of etodolac-paracetamol combination in comparison with etodolac alone in patients with knee osteoarthritis (OA) flare-up. ⋯ For the treatment of painful OA flare-ups, the etodolac-paracetamol combination can offer improved clinical outcomes by targeting multiple pain pathways. The results of the current study show that etodolac-paracetamol is more effective in the treatment of OA flare-up than etodolac alone.