The Clinical journal of pain
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Randomized Controlled Trial
Alternating-frequency TENS effects on experimental pain in healthy human participants: a randomized placebo-controlled trial.
Transcutaneous electrical nerve stimulation (TENS) is a modality commonly used in pain management. ⋯ The alternating-frequency setting does not result in large hypoalgesic effects such as those previously reported using fixed-frequency TENS.
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Randomized Controlled Trial
Somatosensory sensitivity in patients with persistent idiopathic orofacial pain is associated with pain relief from hypnosis and relaxation.
In a recent study hypnosis has been found to relieve persistent idiopathic orofacial pain. Quantitative sensory testing (QST) is widely used to evaluate somatosensory sensitivity, which has been suggested as a possible predictor of management outcome. The objectives of this study were to examine: (1) possible associations between clinical pain relief and baseline somatosensory sensitivity and (2) the effect of hypnosis management on QST parameters. ⋯ High pain sensitivity at baseline may predict poor pain management outcome. In addition, despite clear clinical pain relief, hypnosis did not significantly or specifically influence somatosensory sensitivity. Future studies should further explore QST measures as possible predictors of different management response in orofacial pain conditions.
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To identify the presence of myofascial trigger points (TrPs) and pressure pain threshold (PPT) levels in the shoulder muscles of both involved and uninvolved sides in patients with unilateral shoulder impingement syndrome (SIS). ⋯ The high number of TrPs in the involved side of patients with SIS suggests the presence of peripheral sensitization. The results reject the presence of central alterations. Finally, the patients with unilateral SIS may present bilateral deficits related to myofascial pain.
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To the best of our knowledge, there have been no reports on the pharmacokinetics and pharmacodynamics during the conversion from continuous intravenous infusion (CII) to transdermal fentanyl administration. The primary objective of the present study was to clarify the pharmacokinetic characteristics during this conversion. A secondary objective was to identify an association between serum albumin and the absorption of fentanyl from the transdermal patch. ⋯ Our study demonstrated that the dose-adjusted serum fentanyl concentrations remained relatively stable, and pain intensity and the number of rescue events remained stable during conversion. Hypoalbuminemia was strongly associated with poor absorption of transdermally administered fentanyl.
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Chronic neuropathic pain (NP) is a well-known phenomenon, whereas acute neuropathic pain is increasingly recognized. Both are potentially difficult for a nonspecialist to diagnose. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and DN4 scales are screening tools developed to identify chronic NP. We aimed to evaluate and compare their performance in 2 different populations: outpatients with chronic pain, and inpatients with acute postoperative pain. ⋯ Although the LANSS performed better than the DN4 in the chronic population, both tools performed less well than published literature, demonstrating the importance of evaluating screening tools in the proposed patient population. There may be potential for using these questionnaires to identify acute NP.