The Clinical journal of pain
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Review
Review of the Evidence on the Efficacy of Dexamethasone on Postoperative Analgesic Consumption.
The effect of dexamethasone on analgesic consumption has not been adequately studied. The aim of this review was to investigate recent literature regarding the possible effect of dexamethasone on postoperative analgesic consumption. ⋯ Dexamethasone administered at a dose of 8 mg before surgical incision may be beneficial in laparoscopic cholecystectomies, thyroid, laparoscopic gynecologic and breast surgery, and tonsillectomies in children. Dexamethasone's potential impact on reducing postoperative analgesic requirements should be investigated in more detail in a systematic manner, to support its use in other kinds of operations.
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Meta Analysis
Gray Matter Abnormalities Associated with Chronic Back Pain: A Meta-analysis of Voxel-based Morphometric Studies.
Studies employing voxel-based morphometry have reported inconsistent findings on the association of gray matter (GM) abnormalities with chronic back pain (CBP). We, therefore, performed a meta-analysis of available studies to identify the most consistent GM regions associated with CBP. ⋯ The present study demonstrates a pattern of GM alterations in CBP. These data further advance our understanding of the pathophysiology of CBP.
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Randomized Controlled Trial
Happy Despite Pain: A Randomized Controlled Trial of an 8-week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients with Chronic Pain.
There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. ⋯ The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.
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Comparative Study
Emergency Department Pain Management in Children with Appendicitis in a Bi-Ethnic Population.
Our goal was to examine factors associated with the administration of emergency department analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children's hospital in Israel, and to examine ethnic differences. ⋯ Low rates of analgesia and opioid administration were found with no ethnic differences.
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Pediatric chronic pain is a major health issue that can lead to significant interference in daily functioning. Mindfulness-based interventions (MBI's), which emphasize acceptance rather than control of pain, have gained increasing attention as a viable treatment option among adults with chronic pain. The effectiveness of MBIs for chronic pain in pediatric populations remains largely unknown. This prospective pre-post interventional study was conducted to examine the feasibility, acceptability, and initial effectiveness of an 8-week group MBI adapted for adolescents (MBI-A) with chronic pain. ⋯ The MBI-A is a feasible, well-received intervention for adolescents with chronic pain conditions. Findings support the need for further investigation of the efficacy of MBI-A through randomized-controlled trials.