European journal of pain : EJP
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Randomized Controlled Trial
Lack of efficacy of alpha-lipoic acid in burning mouth syndrome: a double-blind, randomized, placebo-controlled study.
A systematic review from the Cochrane Collaboration stated that alpha-lipoic acid (ALA) may help in the management of burning mouth syndrome (BMS). Because all of the data on ALA came from a single group, it has been stressed that its effectiveness should be reproduced in other populations. ⋯ The fairly high placebo effect observed is very similar to data obtained from patients affected by atypical facial pain. This study failed to support a role for ALA in the treatment of BMS, and further investigations are needed to identify the cause of BMS in order to develop efficacious therapies.
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The development and refinement of an acute pain service based on the increased availability of clinical evidence would be expected to improve the quality of postoperative pain control. This report reviews the application of postoperative patient-controlled analgesia (PCA) using intravenous morphine in a single institution between 2002 and 2005. More than 5000 patients were evaluated and the results were compared with a similar study performed 10 years ago. ⋯ We conclude that, in our institution over the last decade, PCA has become more popular for postoperative pain management but with no attendant improvement in pain relief or reduction in side effects. Using PCA alone may result in poorer quality postoperative analgesia. Our findings add to the growing body of evidence that postoperative pain management has not substantially improved despite increased adoption of acute pain services.
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Comparative Study
Fibromyalgia pain and its modulation by hypnotic and non-hypnotic suggestion: an fMRI analysis.
The neuropsychological status of pain conditions such as fibromyalgia, commonly categorized as 'psychosomatic' or 'functional' disorders, remains controversial. Activation of brain structures dependent upon subjective alterations of fibromyalgia pain experience could provide an insight into the underlying neuropsychological processes. Suggestion following a hypnotic induction can readily modulate the subjective experience of pain. ⋯ Our results thus provide evidence for the greater efficacy of suggestion following a hypnotic induction. They also indicate direct involvement of a network of areas widely associated with the pain 'neuromatrix' in fibromyalgia pain experience. These findings extend beyond the general proposal of a neural network for pain by providing direct evidence that regions involved in pain experience are actively involved in the generation of fibromyalgia pain.