Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Randomized Controlled Trial
Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-Blind Controlled Trial.
Multimodal cocktail periarticular injections comprising corticosteroids are the most suggested therapy for postoperative discomfort and swelling following total knee arthroplasty (TKA). Nevertheless, previous findings cannot be applied to instances of unilateral total knee arthroplasty on bilateral knees. This randomized, prospective, double-blind, controlled clinical study examines the efficacy as well as safety of periarticular multimodal cocktail injection along or sans corticosteroids in certain situations. ⋯ Multimodal periarticular injection without corticosteroid will alleviate postoperative swelling and pain. More studies are needed for the use of betamethasone as a corticosteroid in periarticular multimodal cocktail injections. This Chinese Clinical Trial Registry is registered with ChiCTR-OPC-17013503, dated 2017-11-23, available from http://www.chictr.org.cn/showproj.aspxproj=23146.
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Brachial plexus block is frequently recommended for upper limb surgeries. Many drugs have been used as adjuvants to prolong the duration of the block. This study aimed to assess the effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block duration time, pain score, and hemodynamic variations in the supraclavicular block in upper extremity orthopedic surgery. ⋯ Dexmedetomidine plus bupivacaine reduced the onset time of sense and motor blocks and increased numbness and immobility duration. Also, dexmedetomidine reduced postoperative pain significantly with the use of bupivacaine for supraclavicular blocks. Trial Registration. IRCT, IRCT20160430027677N15. Registered 05/28/2019, https://www.irct.ir/trial/39463.
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Randomized Controlled Trial
Effects of the Multidimensional Treatment on Pain, Disability, and Sitting Posture in Patients with Low Back Pain: A Randomized Controlled Trial.
The purpose of this study was to investigate the effects of multidimensional approach model on the pain, disability, and sitting posture in patients with nonspecific low back pain (LBP). Sixty LBP patients were recruited and were randomly divided into two groups: multidimensional treatment (MT) group (n = 30) and unimodal treatment (UT) group (n = 30). All participants underwent 48 sessions of treatment (40 min/session, two sessions per day, 2 days per week) for 12 weeks. ⋯ In the MT group, the pain relief effect persisted 3 months after the end of training. Thoracolumbar kyphosis and lumbar lordosis in the MT group were significantly improved compared to the UT group (p < 0.05). Thus, MT combined with core stability exercise may be used to improve the pain, disability, and sitting posture in patients with LBP.
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Review
Patient Preferences and Values in Decision Making for Migraines: A Systematic Literature Review.
To comprehensively summarize the evidence on the preferences and values of migraine patients. ⋯ Efficacy is the primary consideration in the treatment of migraine. Specifically, the most important embodiment of patient preferences and values is the reduced frequency of attacks with preventive treatment as well as prompt analgesia with acute symptomatic treatment.
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The prevalence of various temporomandibular disorders (TMD) and the severity of attrition in patients with either bilateral or unilateral deep bite and/or posterior crossbite has not been established, nor has the effect of one year of orthodontic treatment on TMD. ⋯ Deep bite may be related to dental wear but not to pain from TMD and/or disc displacement. Only crossbite that presents simultaneously on the anterior and the posterior dentition (mixed X-bite) may have some effect on the level of pain in TMD, but not on in the prevalence of disc displacement. Confirmation of these conclusions by well-designed studies on larger patient groups is warranted. There was a clinically significant improvement in TMD findings after one year of treatment.