The Clinical journal of pain
-
The primary aim of this study was to determine whether changes in cognitive processes are related to improved functional outcomes across a multidisciplinary pain management program. ⋯ These findings suggest that interventions that specifically target cognitive processes may enhance treatment effects for patients with chronic pain.
-
Randomized Controlled Trial
Enhanced postoperative sensitivity to painful pressure stimulation after intraoperative high dose remifentanil in patients without significant surgical site pain.
This clinical study tested the hypothesis whether intraoperative high versus low dose of intravenous remifentanil resulted in postoperatively increased pain sensitivity to painful cold or pressure stimulation in eye surgery patients without significant postoperative pain. ⋯ After high dose intravenous remifentanil our results show signs of a reduced tolerance to painful pressure but not cold stimuli distant to the surgical field. Although clinically relevant surgical pain was not reported in these patients, the demonstrated induction of hyperalgesia to painful pressure stimuli suggests a general effect in the central nervous system.
-
Randomized Controlled Trial
Combination of topical EMLA with local injection of lidocaine: superior pain relief after Ferguson hemorrhoidectomy.
To determine whether a combination of topical anesthetic (EMLA) and local injection with lidocaine is better than lidocaine alone for pain relief after Ferguson hemorrhoidectomy. ⋯ EMLA is considered a breakthrough in cutaneous analgesia, capable of reducing pain in many cutaneous procedures. Because Ferguson hemorrhoidectomy has been performed for years with ongoing concerns over postoperative pain, we felt that using EMLA could lower postoperative pain intensity and the number of requests for additional medication.
-
Randomized Controlled Trial Multicenter Study
Epidural local anesthetic plus corticosteroid for the treatment of cervical brachial radicular pain: single injection versus continuous infusion.
Efficacy of epidural local anesthetics plus steroids for the treatment of cervicobrachial pain is uncertain. ⋯ Therapy with continuous epidural local anesthetic and methylprednisolone provides better control of chronic cervicobrachial pain compared with Single injection. These results are discussed with respect to the possible mechanism of action of the drugs and may relate to the physiopathologic mechanisms associated with neuronal plasticity that result in chronic pain.