The Clinical journal of pain
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Randomized Controlled Trial
Evaluation of efficacy of the perioperative administration of Venlafaxine or gabapentin on acute and chronic postmastectomy pain.
Postmastectomy pain syndrome is a neuropathic pain syndrome that is known to develop after breast surgery. Preemptive analgesia has been shown to be efficacious in reducing postoperative pain, and may be effective in reducing the incidence of certain types of neuropathic pain. We investigated the analgesic efficacy of Venlafaxine and gabapentin on acute and chronic pain associated with cancer breast surgery. ⋯ Venlafaxine 37.5 mg/d extended release or gabapentin 300 mg/d have equipotent effects (except on the first day in venlafaxine group) in reducing analgesic requirements, although gabapentin is more effective in reducing pain after movement. Venlafaxine significantly reduced the incidence of postmastectomy pain syndromes (chronic pain) 6 months in women having breast cancer surgery. Gabapentin had no effect on chronic pain except decreasing incidence of burning pain.
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Randomized Controlled Trial Clinical Trial
Acute pressure block of the sciatic nerve relieves clinical pain but not cold pressor pain.
Acute pressure applied to the sciatic nerve has been recently reported to offer immediate short-term pain relief in patients with various diseases. This study examined the analgesic effect of this novel method on cold pressor pain compared with clinical pain. ⋯ Our study indicated that cold pressor pain and clinical pain responded differently to acute pressure blockade of the sciatic nerve. Our findings indicate that caution should be exercised when attempting to extrapolate cold pressor pain findings to clinical pain.
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Randomized Controlled Trial Comparative Study
Different activation of opercular and posterior cingulate cortex (PCC) in patients with complex regional pain syndrome (CRPS I) compared with healthy controls during perception of electrically induced pain: a functional MRI study.
Although the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor. ⋯ Stronger PCC activation during painful stimulation may be interpreted as a correlate of motor inhibition during painful stimuli different from controls. Also, the decreased opercular activation in CRPS patients shows less sensory-discriminative processing of painful stimuli.These results show that changed cerebral pain processing in CRPS patients is less sensory-discriminative but more motor inhibition during painful stimuli. These changes are not limited to the diseased side but show generalized alterations of cerebral pain processing in chronic pain patients.
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Randomized Controlled Trial
Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section.
In this study, the preemptive effect of a small dose of ketamine on postoperative wound pain and morphine consumption in patients undergoing elective cesarean section was evaluated. ⋯ Intraoperative low-dose ketamine had no effect on morphine consumption during 2 to 24 hours after surgery. No significant differences were seen in the pain scores of the 2 groups during the study period. The preoperative administration of 0.5 mg/kg ketamine in patients undergoing cesarean section did not elicit a preemptive analgesic effect.
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Randomized Controlled Trial
Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome.
Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. Several methods have been recommended for the inactivation of trigger points (TrPs). We carried out this study to investigate the effectiveness of miniscalpel-needle (MSN) release and acupuncture needling and self neck-stretching exercises on myofascial TrPs of the upper trapezius muscle. ⋯ The effectiveness of MSN release for MPS is superior to that of acupuncture needling treatment or self neck-stretching exercises alone. The MSN release is also safe, without severe side effects in treatment of MPS.