The Clinical journal of pain
-
Randomized Controlled Trial
Rapid Transition to Virtual Assessment and Treatment in an Interdisciplinary Randomized Clinical Trial for Youth With Chronic Pain: Adaptations and Implications for Future Trials.
COVID-19 abruptly halted in-person clinical care and research requiring a shift to virtual assessment and treatment. This unexpected transition of a 2-arm randomized controlled trial (RCT) examining interdisciplinary graded exposure treatment (GET Living) compared with multidisciplinary pain management for youth with chronic pain provided an opportunity to implement the first remotely delivered exposure treatment and remotely delivered biomechanical assessment for pediatric chronic pain. Here we describe these new approaches and provide lessons learned to inform future efforts in digital health care. ⋯ Overall, our data demonstrate acceptability, feasibility, and equivalent patient engagement to virtual treatment. Novel methods implemented in this RCT can inform trial design and measures of clinical endpoints for future digital health interventions.
-
Randomized Controlled Trial
Combined Programmed Intermittent Bolus Infusion with Continuous Infusion For The Thoracic Paravertebral Block in Patients Undergoing Thoracoscopic Surgery: A Prospective, Randomized, and Double-blinded Study.
Continuous thoracic paravertebral block (TPVB) connected with patient-controlled analgesia (PCA) pump is an effective modality to reduce postoperative pain following thoracic surgery. For the PCA settings, the programmed intermittent bolus infusion (PIBI) and continuous infusion (CI) are commonly practiced. However, the comparative effectiveness between the 2 approaches has been inconsistent. Thus, the aim of this study was to explore the optimal PCA settings to treat postthoracotomy pain by combing PIBI and CI together. ⋯ The combination of PIBI and CI provides superior analgesic modality to either PIBI or CI alone in patients undergoing thoracoscopic surgery. Therefore, it should be advocated to improve the management of postoperative pain, clinical outcomes, and ultimately patient satisfaction.
-
Randomized Controlled Trial
Adductor Canal Blocks with Bupivacaine and Magnesium After Same-day Discharge Total Knee Arthroplasty Improve Post-operative Pain Relief and Decrease Opioid Consumption: A Prospective Randomized Controlled Trial.
Adequate pain management is a critical component of facilitating same-day discharge for total knee arthroplasty (TKA). Adductor canal blocks (ACB) have been shown to be an effective technique for managing pain after TKA. The objective of this study was to investigate the impact of adding magnesium to local anesthetic in ACB on postoperative pain, opioid consumption, nausea, and overall patient satisfaction. ⋯ The addition of magnesium to local anesthetic in ACB decreases pain scores and opioid consumption, without increasing nausea, when compared with ACB with local anesthetic alone.
-
Randomized Controlled Trial
Evaluation of Analgesic Efficacy and Opioid-sparing Effect of Duloxetine After Arthroscopic Rotator Cuff Repair: A Randomized Clinical Trial.
This study aimed to evaluate the analgesic efficacy and opioid-sparing effect of duloxetine in adults having arthroscopic rotator cuff repair, as well as its clinical safety. ⋯ For patients undergoing arthroscopic rotator cuff repairs, duloxetine resulted in a significant reduction in pain within postoperative 2 days, but the reduction was not clinically meaningful. Duloxetine did not decrease the opioid consumption within postoperative 2 days and did not increase the risk of bleeding within postoperative 2 days. The incidence of nausea and vomiting in the duloxetine group was significantly greater than that in the placebo group.
-
Randomized Controlled Trial
Efficacy and Safety of a New Sustained-released Pregabalin Formulation Compared with Immediate-release Pregabalin in Patients with Peripheral Neuropathic Pain: A Randomized Non-inferiority Phase 3 Trial.
This study investigated whether a new sustained-release (SR) pregabalin formulation is noninferior to immediate-release (IR) pregabalin in alleviating peripheral neuropathic pain in Korean patients. ⋯ The results demonstrate that the new once-daily SR pregabalin formulation is noninferior to twice-daily IR pregabalin in reducing peripheral neuropathic pain and is well tolerated in Korean patients with diabetic peripheral neuropathy or postherpetic neuralgia after 12 weeks of treatment.