The Clinical journal of pain
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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.
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Randomized Controlled Trial
Local pain and spreading hyperalgesia induced by intramuscular injection of nerve growth factor are not reduced by local anesthesia of the muscle.
Injections with local anesthesia for therapeutic and diagnostic purposes are common clinical practice. This double-blind placebo controlled study explores the rational of local anesthetic blocks for the detection of muscle pain as the primary generator in spreading hyperalgesic conditions. ⋯ Muscle pain and spreading hyperalgesia induced by NGF is maintained despite anesthesia of the primary nociceptive locus. This indicates that intramuscular injection of local anesthetics may not be a valid diagnostic method for primary muscle pain.
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Randomized Controlled Trial
Intermediate and long-term effects of a standardized back school for inpatient orthopedic rehabilitation on illness knowledge and self-management behaviors: a randomized controlled trial.
A back school is a mandatory part of the multimodal rehabilitation program for patients with chronic low back pain in Germany. However, no standardized and evaluated back school program has been available for routine use. In this study, we report the evaluation of a new back school that was developed based on theories of health behavior, treatment evidence, practice guidelines, and quality criteria for patient education. ⋯ The superior effectiveness of the back school based on a biopsychosocial approach was demonstrated with regard to illness knowledge and self-management behaviors up to 1 year. Thus, the program may be recommended for dissemination within medical rehabilitation.
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Randomized Controlled Trial
Intravenous regional ketorolac and lidocaine in the treatment of complex regional pain syndrome of the lower extremity: a randomized, double-blinded, crossover study.
Intravenous regional blocks (IVRBs) with ketorolac and lidocaine have been reported to be useful in the treatment of complex regional pain syndrome (CRPS). This is the first controlled prospective study of IVRB with lidocaine and ketorolac for treatment of pain and edema in CRPS of the lower extremity in adults. ⋯ IVRB with ketorolac and lidocaine produced only short-term pain reduction in patients with CRPS involving the lower extremity after 4 serial injections in our study group. Prospective study is warranted, particularly in the pediatric population.
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Randomized Controlled Trial
The effect of auricular acupuncture on fentanyl requirement during hip arthroplasty: a randomized controlled trial.
Although auricular acupuncture (AA) is suggested to be effective in treatment of pain, it has not yet been used for intraoperative analgesia. Therefore, we studied whether the AA reduces intraoperative analgesic requirement during total hip arthroplasty (THA). ⋯ Regarding the modest clinical effect, AA should be further investigated for its clinical usefulness for complementary analgesia during the surgery.