The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Vibration pain provocation can improve the specificity of MRI in the diagnosis of symptomatic lumbar disc rupture.
The purpose of this study was to determine if vibration pain provocation could be combined with magnetic resonance imaging (MRI) to increase its specificity in identifying symptomatic disc disruption identified by discography. ⋯ A small hand-held vibrator could produce pain provocation results similar to those obtained by discography. Results of this noninvasive pain provocation method can improve the specificity and accuracy of MRI in identifying symptomatic disc lesions.
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Randomized Controlled Trial Clinical Trial
Analysis of peak magnitude and duration of analgesia produced by local anesthetics injected into sympathetic ganglia of complex regional pain syndrome patients.
Pain-relieving effects of lidocaine/bupivicaine local anesthetic (LA) and saline (S) block of sympathetic ganglia (stellate block, 4 patients; lumbar sympathetic block, 3 patients) were compared in 7 complex regional pain syndrome (CRPS) patients on a double-blind crossover basis to evaluate the diagnostic and therapeutic value of local anesthetic sympathetic blocks. ⋯ The combination of these results provides evidence that duration of pain relief is affected by injection of local anesthetics into sympathetic ganglia. These results indicate that both magnitude and duration of pain reduction should be closely monitored to provide optimal efficacy in procedures that use local anesthetics to treat CRPS.
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Randomized Controlled Trial Comparative Study Clinical Trial
Symptoms of spinal stenosis do not improve after epidural steroid injection.
This study was carried out to evaluate the therapeutic effect of epidural steroid injection on pseudoclaudication in patients with lumbar degenerative spinal canal stenosis. ⋯ The results suggest that epidural steroid injection has no beneficial effect on the pseudoclaudication associated with spinal canal stenosis as compared with epidural block with a local anesthetic alone.
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Randomized Controlled Trial Clinical Trial
A comparison a amitriptyline and maprotiline in the treatment of painful polyneuropathy in diabetics and nondiabetics.
To compare amitriptyline and maprotiline in the treatment of painful polyneuropathy in diabetics and nondiabetics. ⋯ From the present results and the literature, it is concluded that tricyclic antidepressants with a pharmacologic profile similar to amitriptyline are the most effective drugs in the treatment of polyneuropathy pain in both diabetic and nondiabetic patients.
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Randomized Controlled Trial Clinical Trial
Iontophoretic administration of 2% lidocaine HCl and 1:100,000 epinephrine in humans.
The primary objective was to evaluate the clinical safety and effectiveness of the iontophoretic administration of lidocaine HCl 2% and epinephrine 1:100,000 to induce local dermal anesthesia before intravenous (i.v.) cannulation. ⋯ Iontophoresis of lidocaine 2% with 1:100,000 epinephrine for short delivery times does not lead to delivery of clinically important systemic levels of lidocaine in healthy adults. Iontophoresis of lidocaine 2% with 1:100,000 epinephrine provides adequate skin anesthesia for placement of peripheral small-gauge i.v. catheters.