The Clinical journal of pain
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Sickle cell disease-related pain is difficult to treat adequately. Pain secondary to vasoocclusive episodes (VOE) may be unresponsive to high-dose intravenous opiates. Alternative treatment options for VOE are needed. We sought to review our experience with low-dose ketamine for children hospitalized with VOE. ⋯ Further research into ketamine for vasoocclusive pain is warranted.
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Pain is identified as the third largest health problem in the world, impacting sleep, physical functioning, and psychologic functioning. Pain has been viewed as a multidimensional experience influenced by biology, psychology, cultural conditioning, expectancies, and social contingencies. The aims of this study were to examine the psychometric properties and the differential item functioning (DIF) of the short-form McGill Pain Questionnaire (SF-MPQ) to test the cultural differences in verbally based pain expression. ⋯ Test bias was relatively small (0.74) given the entire scale of the SF-MPQ (0 to 45), indicating that this measure seems to be used equivalently across these 2 groups. This study shows 1 method in evaluating the cross-cultural validity of pain assessment instruments, and contributes to the understanding of cross-cultural variability in item reporting on the SF-MPQ.
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To investigate the changes in surface and intramuscular electromyographic (EMG) activity at latent trigger points (TrPs) in the extensor carpi radialis brevis muscle after injection of either glutamate or isotonic saline into latent TrPs in the infraspinatus muscle. ⋯ Our results show that an increased nociceptive activity at latent TrPs in the infraspinatus muscle may increase motor activity and sensitivity of a TrP in distant muscles at a same segmental level.
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To determine the correlation between magnetic resonance imaging (MRI) pathology and the response to diagnostic facet medial branch block (MBB) and L5 dorsal ramus medial branch block and radiofrequency (RF) denervation of lumbar facet joints. ⋯ Whereas some relationships were noted between MRI findings and the response to lumbar facet joint interventions, many of these correlations tended to be weak. However, this study does suggest the possibility that patients with spinal stenosis, often considered an exclusion criterion for facet interventions, may respond to RF denervation of facet joints. Prospective studies are needed to confirm these observations.
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To compare a central analgesic mechanism known as diffuse noxious inhibitory controls (DNIC) using somatic test stimuli and somatic conditioning stimuli, (CS) in irritable bowel syndrome (IBS) patients and healthy controls. ⋯ These data demonstrate deficient DNIC in IBS. This is the first study to adequately control for alternative explanations of pain reduction during counterirritation. Only by controlling for nonspecific effects can evidence of deficient DNIC be attributed to dysregulation in endogenous analgesic mechanisms.