The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Safety and Efficacy of Needle-Free Powder Lidocaine Delivery System in Adult Patients Undergoing Venipuncture or Peripheral Venous Cannulation: Randomized, Double-blind, Placebo-controlled Trial.
The purpose of this study was to evaluate the efficacy, safety, and tolerability of a needle-free powder lidocaine delivery system compared with sham placebo in adults. ⋯ This clinical trial demonstrated that use of a needle-free powder lidocaine delivery system resulted in a significant reduction of pain during venipuncture and peripheral intravenous cannulation in adults. Both the predefined primary endpoint and all 3 secondary endpoints were met. The needle-free powder lidocaine delivery system may be an option for analgesia during venous access procedures in adults.
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Multicenter Study
Chronic Pain and Heart Rate Variability in a Cross-Sectional Occupational Sample: Evidence for Impaired Vagal Control.
The vagus nerve influences the modulation of pain. Chronic pain is associated with disturbance of the descendent inhibitory pathway (DIP). Heart rate variability (HRV) is a proxy measure for vagal activity and may reflect dysfunction of the DIP. We aimed to investigate the association of HRV and pain in individuals with and without chronic pain. ⋯ Our results suggest that the DIP indexed by vagal activity operationalized as RMSSD is disturbed in persons with chronic pain. Furthermore, the correlations between RMSSD and pain are different between those without and those with chronic pain. The findings are discussed, emphasizing changes in brain activity and the comorbid dysregulation of emotion in patients with chronic pain, to provide implications for the treatment of chronic pain.
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Multicenter Study Observational Study
Pain-related Sleep Disturbance - A Prospective Study with Repeated Measures.
Pain has been found to be associated with poor sleep quality, awakenings, and shorter sleep time. There is a need to understand the relationship of pain and sleep over time to adequately manage the pain disorder and its consequences. The objectives of this study were to establish the prevalence of sleep disturbance in patients with acute or persistent low back pain (LBP), to investigate the correlation between pain and sleep disturbance and to explore the influence of pain on sleep disturbance. ⋯ This study used repeated measures of both pain and sleep disturbance. The results were in line with previous research, confirming that sleep disturbance was found in the majority of patients with LBP. Pain and sleep measures were significantly correlated, and there was an increased risk of reporting sleep disturbance after experiencing LBP.
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Randomized Controlled Trial Comparative Study
Sympathetic Dysfunction in Patients with Chronic Low Back Pain and Failed Back Surgery Syndrome.
Chronic low back pain (CLBP) is defined as pain that persists longer than 12 weeks and is often attributed to degenerative or traumatic conditions of the spine. Failed back surgery syndrome is a condition in which chronic pain persists after spinal surgery. Electrodiagnostic studies can be used to confirm the diagnosis of lumbosacral radiculopathy, but other diagnostic methods are often needed to assess sympathetic nervous system dysfunction. ⋯ It was concluded that the sympathetic nervous system is affected in CLBP and FBSS patients with abnormalities in SSR and that the dysfunction of sympathetic nervous system may contribute to the intensity and chronicity of pain in these groups of patients. Moreover, a strong association was found between SSR and functional disabilities in these patients.
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Randomized Controlled Trial
Triggering Descending Pain Inhibition by Observing Ourselves or a Loved-one in Pain.
Recent studies demonstrate that empathy-evoked brain responses include the activation of brainstem structures responsible for triggering descending pain inhibition. Unfortunately, direct evidence linking empathy for pain and descending inhibitory controls (conditioned pain modulation) is lacking. This study, therefore, aimed to determine if the observation of ourselves or a loved-one in pain could activate descending pain inhibition without exposure to a noxious stimulation; which is otherwise required. ⋯ This study showed that observing someone in pain triggers descending pain inhibition. Results also demonstrate how empathy and gender are affecting pain modulation mechanisms.