European journal of pain : EJP
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Randomized Controlled Trial
Driving plasticity in the motor cortex in recurrent low back pain.
The sensory and motor systems can reorganise following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organisation in patients with recurrent low back pain (LBP), which are linked to altered motor coordination. Although changes in motor coordination can be trained and are associated with improved symptoms and function, it remains unclear whether these training-induced changes are related to reorganisation of the motor cortex. ⋯ Changes were not observed following unskilled walking exercise. This is the first observation that motor training can reverse reorganisation of neuronal networks of the motor cortex in people with recurrent pain. The observed relationship between cortical reorganisation and changes in motor coordination following motor training provides unique insight into potential mechanisms that underlie recovery.
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Randomized Controlled Trial
Acupuncture analgesia for temporal summation of experimental pain: a randomised controlled study.
Temporal summation of pain, a phenomenon of the central nervous system (CNS), represents enhanced painful sensation or reduced pain threshold upon repeated stimulation. This pain model has been used to evaluate the analgesic effect of various medications on the CNS. ⋯ EA induces bilateral, segmentally distributed and prolong analgesia on both SPT and TST, indicating a non-centrally specific effect. This effect needs to be verified with heat or mechanical model and in pain patients.
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Randomized Controlled Trial
Effects of pain management on sleep in preterm infants.
This study was conducted to gain better understanding of the prolonged effects of pain and pain management on preterm infants' sleep. ⋯ Pain management with oxycodone markedly altered the structure of the subsequent sleep period. This reduced amount of REM sleep may have consequences for brain development in preterm infants.
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Randomized Controlled Trial
Clarithromycin, a potent inhibitor of CYP3A, greatly increases exposure to oral S-ketamine.
Oral ketamine is used as an adjuvant in the treatment of refractory neuropathic and cancer-related pain. Drug interactions may alter the analgesic or other effects of ketamine. ⋯ Clarithromycin strongly increases plasma concentrations of oral S-ketamine probably by inhibiting its CYP3A-mediated N-demethylation. This increase is reflected as modest changes in behavioral effects of oral S-ketamine.
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Randomized Controlled Trial
Continuous intra-articular infusion of bupivacaine for post-operative pain relief after total hip arthroplasty: a randomized, placebo-controlled, double-blind study.
Instillation of local anesthetics into a surgical site has been gaining popularity in post-operative pain management. ⋯ Continuous intra-articular infusion of 0.5% bupivacaine at 2 mL/h via a PCIP does not provide sustained post-operative pain relief in patients undergoing THA.