Pain medicine : the official journal of the American Academy of Pain Medicine
-
Observational Study
Screening for Adult ADHD in Patients with Fibromyalgia Syndrome.
Fibromyalgia syndrome (FMS) is a common chronic pain disorder associated with altered activity of neurotransmitters involved in pain sensitivity such as dopamine, serotonin, and noradrenaline. FMS may significantly impact an individual's functioning due to the presence of chronic pain, fatigue, and cognitive impairment. Dyscognition may be more disabling than the chronic pain but is mostly under-recognized. This study aimed to assess the potential co-occurrence of FMS and adult attention deficit hyperactivity disorder (ADHD), a chronic neurodevelopmental disorder also associated with impaired cognition and dopaminergic function. ⋯ These results indicate that the co-occurrence of adult ADHD in FMS may be highly prevalent and may also significantly impact the morbidity of FMS. Patients with FMS should be assessed for the presence of adult ADHD.
-
To determine symptoms and characteristics of chronic sensory neuropathy in patients treated with oxaliplatin and docetaxel, including patterns of somatosensory abnormalities, pain descriptors, and psychological functioning. ⋯ Both oxaliplatin-induced and docetaxel-induced polyneuropathies represent a significant problem that affects the daily life of the patients. Our results, defining the somatosensory phenotype, can improve the understanding of the pathophysiological mechanisms useful for future studies in the tailored treatment of prevention of chemotherapy-induced peripheral neuropathy and pain.
-
To examine the relationship between the Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference (PI) and PROMIS Physical Function (PF) scales in patients with spinal pain at a university spine center. ⋯ For patients with pain from spinal origin, there is a strong negative correlation between self-reported physical function and pain interference related to physical, social, and mental health. The predictive relationship of function from pain scores supports the PROMIS PI being used as an important adjunct measure of physical function in patients with spinal pain.
-
To evaluate the impact of the Integrated Pain Team (IPT)-an interdisciplinary chronic pain care intervention embedded in primary care at a large Veterans Affairs health care system. Outcomes evaluated included IPT's impact on the perceived effectiveness of chronic pain care; provider self-confidence; and primary care team satisfaction, stress, and burnout. ⋯ Integrating an interdisciplinary chronic pain care intervention into primary care can provide needed support to care teams and may improve chronic pain care. Elements of the IPT model identified as important to its effectiveness include its interdisciplinary biopsychosocial approach and attentive patient follow-up. However, enhancing providers' confidence and self-efficacy in chronic pain care may require educational and support resources beyond the current IPT model.
-
Total knee arthroplasty (TKA) is a commonly performed surgery in the United States, with demand for unilateral and simultaneous bilateral TKAs (BTKAs) expected to increase significantly over the coming decades. This study reports the authors' early experience in a consecutive series of simultaneous BTKAs performed under regional anesthesia and mild sedation. ⋯ This early retrospective case series suggests that it is feasible to effectively manage the postoperative pain associated with BTKA with staged bilateral CFNB and single-injection sciatic nerve blockage in combination with single-injection subarachnoid block as the sole anesthetic technique without negatively influencing early ambulation.