Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Gabapentin does not reduce preoperative anxiety when given prior to total hip arthroplasty.
Gabapentin is an anti-epileptic drug which is also used for the treatment of postoperative pain and a variety of psychiatric diseases including chronic anxiety disorders. We tested the hypothesis that compared with a placebo control, gabapentin would reduce preoperative anxiety in patients undergoing total hip arthroplasty. ⋯ Administration of gabapentin 600 mg prior to surgery does not reduce preoperative anxiety.
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Randomized Controlled Trial
A fMRI evaluation of lamotrigine for the treatment of trigeminal neuropathic pain: pilot study.
Using functional magnetic resonance imaging (fMRI) methods, we evaluated the effects of lamotrigine vs placebo in a double-blind 1:1 randomized trial. Six patients with neuropathic pain were recruited for the study. All subjects had baseline pain >4/10 on a visual analog scale (VAS) and allodynia to brush as inclusion criteria for the study. ⋯ Lamotrigine decreased their average pain intensity level from 5.6 to 3.5 on a VAS. All subjects had brush, cold, and heat applied to the affected and mirror-unaffected sides of their face. The results show: 1) in a small cohort, lamotrigine had a significant effect on heat VAS but not on the other stimuli; and 2) contrast analysis of fMRI results for heat stimuli applied to the affected face for lamotrigine vs placebo produced an overall decrease in blood oxygen dependent level signal, suggesting a potential inhibitory effect of the drug on predominantly cortical regions (frontal, parietal, and temporal).
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To evaluate the efficacy of a novel variant of electroencephalograph biofeedback, the Low Energy Neurofeedback System (LENS), that utilizes minute pulses of electromagnetic stimulation to change brainwave activity for the amelioration of fibromyalgia (FM) symptoms. ⋯ LENS cannot be recommended as a single modality treatment for FM. However, further study is warranted to investigate the potential of LENS to interact synergistically with other pharmacologic and nonpharmacologic therapies for improving symptoms in FM.