The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Tramadol in neuropathic pain after spinal cord injury: a randomized, double-blind, placebo-controlled trial.
To assess the efficacy and safety of tramadol for relieving neuropathic pain after spinal cord injury (SCI). ⋯ Tramadol might be tried for neuropathic pain after SCI after the use of gabapentin/pregabalin, and tricyclic antidepressants have been found to be insufficient. Titration should be slow and individual, to minimize the risk of adverse events.
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Randomized Controlled Trial
Efficacy and tolerability of gastric-retentive gabapentin for the treatment of postherpetic neuralgia: results of a double-blind, randomized, placebo-controlled clinical trial.
To determine the efficacy and safety of a gastric-retentive, extended-release gabapentin (gabapentin ER) taken once or twice daily for treatment of postherpetic neuralgia. ⋯ Gabapentin ER administered twice daily is effective and safe for the treatment of pain associated with postherpetic neuralgia.
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Randomized Controlled Trial
Randomized trial of therapeutic massage for chronic neck pain.
Little is known about the effectiveness of therapeutic massage, one of the most popular complementary medical treatments for neck pain. A randomized controlled trial was conducted to evaluate whether therapeutic massage is more beneficial than a self-care book for patients with chronic neck pain. ⋯ This study suggests that massage is safe and may have clinical benefits for treating chronic neck pain at least in the short term. A larger trial is warranted to confirm these results.
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Randomized Controlled Trial
The effectiveness of clonidine-bupivacaine repeated nerve stimulator-guided injection in piriformis syndrome.
Piriformis syndrome (PS) is often refractory to conventional therapies. Guided injection techniques generally necessitate a computed tomography or fluoroscopic guidance that may not be available in most pain management centers in addition to its relative high cost. The aim of this clinical trial is to investigate whether clonidine-bupivacaine nerve-stimulator guided injections are effective in achieving long-lasting pain relief in PS compared with bupivacaine guided injection. ⋯ Repeated clonidine-guided piriformis injection relieved PS symptoms and reduce analgesic consumption for a 6-month period. It is a cost-effective useful treatment for PS refractory to traditional therapeutic approaches.
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Randomized Controlled Trial
Adjuvant therapy with intrathecal clonidine improves postoperative pain in patients undergoing coronary artery bypass graft.
Alpha2 adrenergic agonists have long been employed as analgesics and to sedate patients undergoing surgical procedures. In addition, their therapeutic response synergizes that elicited by opioids. Although this response is well known, the role of alpha2 agonists, such as clonidine, during various painful surgical procedures remains to be elucidated. The goal of our study was to evaluate the effects of the intrathecal administration of clonidine on postoperative pain control and time to extubation in patients undergoing coronary artery bypass grafting. ⋯ Addition of clonidine to neuraxial opioids improves the quality of analgesia postoperatively and expedites the process of weaning from mechanical ventilation. There were no serious adverse events in the cohort of the patients studied. However, the safety profile of this medication remains to be examined with a larger group of patients.