Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Combined Intrathecal Morphine and Dexmedetomidine for Postoperative Analgesia in Patients Undergoing Major Abdominal Cancer Surgery.
To compare the analgesic effect of combined intrathecal morphine and dexmedetomidine with either drug alone for postoperative analgesia in patients undergoing major abdominal cancer surgery. ⋯ Our results do not support improved analgesia with the combination of intrathecal morphine and dexmedetomidine, despite the absence of significant adverse effects.
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OBJECTIVE : Pain catastrophizing is an important predictor of functioning and disability among individuals with chronic pain, and modification of catastrophic interpretations of pain is a proposed treatment mechanism of pain rehabilitation. The purpose of the current study is to examine the relationship between changes in catastrophic thinking and treatment outcomes for a large sample of patients with chronic pain. METHODS : 648 adult patients with chronic pain completed a 3-week intensive outpatient comprehensive pain rehabilitation program. ⋯ RESULTS : Consistent with prior research, pain catastrophizing was associated with several negative pain-related outcomes. Results of a within-subjects mediational analysis indicated that pain catastrophizing not only improved during the treatment program, but also accounted for a significant portion of the variance in the reduction of pain severity, pain interference, and depression at the end of treatment. CONCLUSIONS : This study adds further support to the position that pain catastrophizing has a detrimental role in adaptation to chronic pain, and that this construct can be successfully modified in treatment to improve patient outcomes.
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Pain has been shown to be associated with poor sleep quality. The aim of this study was to better understand the role that pain intensity and pain extent (number of painful areas) may play in the sleep quality of young people with acute and chronic pain. ⋯ Sleep quality in young people could be improved by teaching them strategies to better manage pain intensity and pain extent. Clinical trials to evaluate the efficacy of (and best timing for) pain interventions to improve sleep quality are warranted.
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Ultrasound-guided cervical nerve root block (US-CRB) is considered a safe and effective method for the treatment of radicular pain. However, previous studies on the spreading pattern of injected solution in US-CRB have reported conflicting results. The aim of this study was to investigate the spreading pattern in relation to injection volume. ⋯ The spreading pattern of injected solution in US-CRB could be partially affected by the injectant volume. However, further studies are needed to assess the importance of other factors, such as needle position and physiological effects.