Journal of pain research
-
Journal of pain research · Jan 2013
Ultrasound-guided transversus abdominis plane injection with computed tomography correlation: a cadaveric study.
Ultrasound-guided transversus abdominis plane (TAP) injections are increasingly being used as an alternative to traditional perioperative analgesia in the abdominal region. With the use of a "blind" TAP block technique, these procedures have had variable success in cadaver and in vivo studies. For more accurate injection with the intended medication, ultrasound guidance allows visualization of the correct layer of the abdominal wall planes in which the thoracolumbar nerves reside. ⋯ This study helps further the understanding of injectate spread following ultrasound-guided TAP injections. Specifically, it suggests that 15 mL provides additional cranial-caudal spread and may be an optimal volume of anesthesia.
-
Journal of pain research · Jan 2013
Persistent pain after total knee or hip arthroplasty: differential study of prevalence, nature, and impact.
This study compares the incidence, nature, and impact of persistent post-surgical pain after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and investigates differences between these procedures, with the focus on potential presurgical and post-surgical issues that could be related to the distinct persistent post-surgical pain outcomes between these two groups. A consecutive sample of 92 patients was assessed prospectively 24 hours before, 48 hours, and 4-6 months after surgery. The data show that TKA patients had a higher likelihood of developing persistent post-surgical pain, of reporting higher pain levels, and of using more neuropathic descriptors when classifying their pain. ⋯ Heightened acute post-surgical pain experience among TKA patients could also be related to distinct outcomes for persistent post-surgical pain. Future prospective studies should therefore collect TKA and THA samples wherein patients are homogeneous for demographic and presurgical clinical issues. Overall, these findings contribute to a small but growing body of literature documenting persistent post-surgical pain after major arthroplasty, conducted in different countries and across different health care settings.
-
Journal of pain research · Jan 2013
A comparison between acute pressure block of the sciatic nerve and acupressure: methodology, analgesia, and mechanism involved.
Acupressure is an alternative medicine methodology that originated in ancient China. Treatment effects are achieved by stimulating acupuncture points using acute pressure. Acute pressure block of the sciatic nerve is a newly reported analgesic method based on a current neuroscience concept: stimulation of the peripheral nerves increases the pain threshold. ⋯ The acute effect attained with acupressure presents a scope that is very different from that of the chronic effect attained after long-term treatment. This acute effect appears to have some similarities to that achieved with acute pressure block of the sciatic nerve, both in methodology and mechanism. More evidence is needed to determine whether there is a relationship between the two methods.
-
Journal of pain research · Jan 2013
The effect of transdermal opioid use on breakthrough opioid and sedative prescribing for rural patients with chronic pain in Northwest Tasmania: a longitudinal study.
The aim of the study reported here was to determine the frequency of prescribing of immediate-release (IR) opioids, and benzodiazepines, with both oral sustained-release (SR) and transdermal (TD) opioid maintenance treatment, in a rural population with chronic noncancer pain (CNCP). ⋯ There was a nonsignificant trend toward reduced prescribing of IR opioids with TD opioid-maintained, compared with oral SR opioid-maintained, CNCP rural patients. Benzodiazepine prescribing was similar for both groups. The rationale for use and the provision of breakthrough opioid analgesia for CNCP patients are complex, both for patients and their prescribers, while the regular use of benzodiazepines compounds the sedation from the subjects' maintenance opioid. The prolonged analgesic affect of TD opioids may benefit rural and remote CNCP populations and reduce the risk of diversion associated with oral opioids.
-
Journal of pain research · Jan 2013
Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases.
Sacroiliac joint pain is a common cause of chronic low back pain. Different techniques for radiofrequency denervation of the sacroiliac joint have been used to treat this condition. However, results have been inconsistent because the variable sensory supply to the sacroiliac joint is difficult to disrupt completely using conventional radiofrequency. Cooled radiofrequency is a novel technique that uses internally cooled radiofrequency probes to enlarge lesion size, thereby increasing the chance of completely denervating the sacroiliac joint. The objective of this study was to evaluate the efficacy of cooled radiofrequency denervation using the SInergy™ cooled radiofrequency system for sacroiliac joint pain. ⋯ Cooled radiofrequency denervation showed long-term efficacy for up to two years in the treatment of sacroiliac joint pain.