The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study Clinical Trial
Treatment expectation for pain coping skills training: relationship to osteoarthritis patients' baseline psychosocial characteristics.
This study examined predictors of treatment expectation among osteoarthritis (OA) patients in a multisite clinical trial of pain coping skills training (CST). ⋯ Although many OA patients will approach pain CST with positive expectations, others have lower expectations. This study suggests that a multidimensional assessment of OA patients with chronic pain can identify those who have higher expectations versus lower expectations. The results suggest that patients who are psychologically distressed are less optimistic about engaging in treatment and that these patients, in particular, may benefit from and need pretreatment motivational interviewing to enhance their uptake of pain coping skills.
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Randomized Controlled Trial
Preemptive low-dose epidural ketamine for preventing chronic postthoracotomy pain: a prospective, double-blinded, randomized, clinical trial.
Chronic postthoracotomy pain is the most common long-term complication that occurs after a thoracotomy with a reported incidence of up to 80%. Although thoracic epidural analgesia is a widely used method for managing acute postthoracotomy pain, its effects seems questionable. The objective of this prospective, double-blinded, randomized, controlled trial was to assess the effect of preemptive low-dose epidural ketamine in addition to preemptive thoracic epidural analgesia on the incidence of chronic postthoracotomy pain. ⋯ The addition of preemptive low-dose epidural ketamine (1.2 mg/h) to preemptive thoracic epidural analgesia did not have any beneficial effects in preventing chronic postthoracotomy pain.
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Randomized Controlled Trial
Ondansetron, a 5HT3-antagonist, does not alter dynamic mechanical allodynia or spontaneous ongoing pain in peripheral neuropathy.
The aim of this study was to examine whether the intensity of dynamic mechanical allodynia and spontaneous ongoing pain in patients with neuropathic pain associated with peripheral neuropathy was influenced by an intravenous infusion of the 5HT3-antagonist, ondansetron. ⋯ No influence from 8 mg of ondansetron could be shown on the intensity of brush-evoked or spontaneous ongoing pain in patients with peripheral neuropathy, indicating the lack of involvement of 5HT3-receptors in an earlier proposed spinobulbospinal loop with descending facilitation acting on spinal mechanisms related to dynamic mechanical allodynia.
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Randomized Controlled Trial
Effect of hypnosis on pain and blink reflexes in patients with painful temporomandibular disorders.
This study contrasted the effect of hypnosis on self-reported pain and changes in a nociceptive brainstem reflex, the blink reflex (BR), in 39 women with temporomandibular disorder. ⋯ Hypnosis thus seems to reduce complex temporomandibular disorder pain, most likely because of cortical changes with little, if any, involvement of brainstem reflex pathways.
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Randomized Controlled Trial Comparative Study
Fluoroscopic stellate ganglion block for postmastectomy pain: a comparison of the classic anterior approach and the oblique approach.
Stellate ganglion block is usually performed with the classic anterior paratracheal approach. The anatomy of the stellate ganglion being in close proximity to various critical structures renders a number of complications, which are potentially associated with its blockade. The aim of this study was to assess the analgesic efficacy and safety of a new approach of the stellate ganglion block using an oblique fluoroscopic view. ⋯ The oblique fluoroscopic approach of the stellate ganglion block is as effective as the anterior paratracheal approach but is safer and more satisfactory to the patients.