Journal of pain research
-
Journal of pain research · Jan 2017
Retention of finger blood flow against postural change as an indicator of successful sympathetic block in the upper limb.
Sympathetic block in the upper limb has diagnostic, therapeutic and prognostic utility for disorders in the upper extremity that are associated with sympathetic disturbances. Increased skin temperature and decreased sweating are used to identify the adequacy of sympathetic block in the upper limb after stellate ganglion block (SGB). Baroreflexes elicited by postural change induce a reduction in peripheral blood flow by causing sympathetic vasoconstriction. We hypothesized that sympathetic block in the upper limb reduces the decrease in finger blood flow caused by baroreflexes stimulated by postural change from the supine to long sitting position. This study evaluated if sympathetic block of the upper limb affects the change in finger blood flow resulting from postural change. If change in finger blood flow would be kept against postural changes, it has a potential to be a new indicator of sympathetic blockade in the upper limb. ⋯ Our study shows that with sympathetic block in the upper limb, the ratio of finger blood flow significantly increases despite baroreflexes stimulated by postural change from the supine to long sitting position. Retention of finger blood flow against postural changes may be an indicator of sympathetic block in the upper limb after SGB or brachial plexus block.
-
Journal of pain research · Jan 2017
ReviewOpioid analgesics-related pharmacokinetic drug interactions: from the perspectives of evidence based on randomized controlled trials and clinical risk management.
Multimorbidity results in complex polypharmacy which may bear a risk of drug interactions. A better understanding of opioid analgesics combination therapy used for pain management could help warrant medication safety, efficacy, and economic relevance. Until now there has been no review summarizing the opioid analgesics-related pharmacokinetic drug interactions from the perspective of evidence based on randomized controlled trials (RCTs). ⋯ Effective and safe combination therapy of opioids can be achieved by promoting the awareness of potential changes in therapeutic efficacy and toxicities, prescribing alternatives or changing administration strategy, tailoring dose, reviewing the appropriateness of orders, and paying attention to medication monitoring.
-
Journal of pain research · Jan 2017
Pregnancy suppresses neuropathic pain induced by chronic constriction injury in rats through the inhibition of TNF-α.
Pregnancy-induced analgesia develops during late pregnancy, but it is unclear whether this analgesia is effective against neuropathic pain. The detailed molecular mechanisms underlying pregnancy-induced analgesia have not been investigated. We examined the antinociceptive effect of pregnancy-induced analgesia in a neuropathic pain model and the expression of tumor necrosis factor (TNF)-α, glial fibrillary acidic protein (GFAP), Iba-1, and c-Fos in the spinal dorsal horn just before parturition. ⋯ Our findings indicate that pregnancy-induced analgesia suppresses neuropathic pain through reducing spinal levels of TNF-α, GFAP, Iba-1, and c-Fos in a rat model of CCI.
-
Journal of pain research · Jan 2017
Factors associated with prescription opioid misuse in a cross-sectional cohort of patients with chronic non-cancer pain.
To examine demographic features, psychosocial characteristics, pain-specific behavioral factors, substance abuse history, sleep, and indicators of overall physical function as predictors of opioid misuse in patients presenting for new patient evaluation at a tertiary pain clinic. ⋯ These findings indicate the importance of considering substance use history, current opioid prescriptions, and sleep in universal screening of patients with chronic non-cancer pain for opioid misuse. Future work should target longitudinal studies to verify the causal relationships between these variables and subsequent opioid misuse.
-
Journal of pain research · Jan 2017
Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials.
Plantar heel pain can be managed with dry needling of myofascial trigger points (MTrPs); however, whether MTrP needling is effective remains controversial. Thus, we conducted this meta-analysis to evaluate the effect of MTrP needling in patients with plantar heel pain. ⋯ MTrP needling effectively reduced the heel pain due to plantar fasciitis. However, considering the potential limitations in this study, more large-scale, adequately powered, good-quality placebo-controlled trials are needed to provide more trustworthy evidence in this area.