European journal of pain : EJP
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A systematic review and meta-analysis of randomized controlled trials (RCTs) was undertaken to evaluate the effect of intrathecal dexmedetomidine (DEX) on the duration of postoperative analgesia, postoperative pain scores and incidences of adverse effects. ⋯ The analgesic role of intrathecal DEX is promising due to its ability to significantly increase postoperative analgesic duration when compared with placebo. Its usage can be considered for patients undergoing surgeries with significant postoperative pain, particularly those intolerant of systemic analgesia. However, the optimal dose for various surgeries as well as its long-term neurological effects warrants further studies.
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Contactin-associated protein 2-like (caspr2) antibodies have been discovered recently. Since then a multitude of patients with caspr2 antibodies presenting with different neurological symptoms have been reported. ⋯ These cases illustrate the spectrum of symptoms in anti-caspr2 diseases. The pain in such cases can be treated causally.
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Many questions regarding the process by which self-enhancing humour style has an effect on chronic pain individuals' adjustment remain unanswered. The aim of the present study was to analyse the association of self-enhancing humour style with adjustment in a sample of individuals with chronic pain, over and above the role of catastrophizing and pain intensity. Adjustment was assessed using measures of depression, pain interference and flourishing. We also examined the indirect association between self-enhancing humour style and adjustment via pain acceptance. ⋯ Very few studies have investigated the relationship between humour styles and adjustment in chronic pain samples. The results of the current study support the idea that adaptive dispositional traits, such as patient's self- enhancing humour style, play a role in the adaptation of individuals with chronic pain. Given that the association between self-enhancing humour style and adjustment evidenced an indirect association through pain acceptance, training in the use of humour, as individuals with self-enhancing humour style do, might be a useful addition to ACT treatment.
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Although it has been suggested that the different cultural and social environments between countries contribute to variations in pain catastrophizing (PC), an international comparison of PC in patients with chronic pain has not yet been reported. Prior to undertaking this comparison, a cross-cultural assessment of the pain catastrophizing scale (PCS) was undertaken to explore the different factor structures among each translated version of the PCS. ⋯ Although the pain catastrophizing scale has been translated into approximately 20 languages, methodological quality during their translation process has not been systematically assessed. We found that all languages versions showed sufficient internal consistency when assessing whole items, however, there were inconsistent structural models among each translated version, leading to variant subdomain structures for rumination, magnification and helplessness.
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As the development of neuropathic symptoms contributes to pain severity and chronification after surgery, their early prediction is important to allow targeted treatment. ⋯ Development of neuropathies contributes to pain severity and pain chronification after surgery. Here we demonstrate trajectories of quantitative sensory tests (assessed at monthly intervals for 6 months after surgery) that reveal accurate time courses of gain/loss of nerve function following thoracotomy. Independent of the degree of neuropathic signs after surgery, the main predictors for post-surgical neuropathic pain are self-reported neuropathic pain before surgery and sleep quality shortly after surgery.