Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial
Modulation of mRNA expression of IL-6andmTORC1 and efficacy and feasibility of an integrated approach encompassing cognitive behavioral therapy along with Pregabalin for management of neuropathic pain in Postherpetic Neuralgia: A Pilot Study.
This study was designed to explore the efficacy and feasibility of cognitive behavioral therapy (CBT) along with pregabalin and compare it with pregabalin monotherapy for the management of neuropathic pain in post-herpetic neuralgia (PHN) patients and to explore the modulation of messenger RNA (mRNA) expression of interleukin (IL)-6 and mammalian target of rapamycin-1 (mTORC1) genes in these patients. ⋯ A significant downregulation of mRNA expression of IL-6 was observed; however, no significant correlation was observed between NRS pain score and ΔCt values of mRNA expression of both mTORC1 gene and IL-6 gene at baseline and at the end of 12th week. In addition, we note a significant decrease in pain intensity, depressive symptoms, and pain-related catastrophizing while improving QOL was observed with the use of CBT as a clinical adjunct along with pregabalin in PHN patients.
-
Meta Analysis
Effects of abdominal binders on postoperative pain and functional recovery: a systematic review and meta-analysis.
This study aimed to assess the effectiveness of abdominal binders (ABs) on postoperative pain and functional recovery in patients receiving abdominal surgery. ⋯ ABs probably improve postoperative pain and physical function, especially on the fourth day or more following abdominal surgery, but they have no effects on pulmonary function.
-
Randomized Controlled Trial
Ultrasound Versus Fluoroscopy for Stellate Ganglion Block: A Cadaveric Study.
Post-Traumatic Stress Disorder (PTSD) is a common psychiatric disorder. Recent investigations have demonstrated effectiveness of Stellate Ganglion Blocks (SGB) for reducing symptoms associated with PTSD. Both fluoroscopic guided and ultrasound guided SGB have been described and are regularly used in clinical practice. This study sought to evaluate differences in block performance when comparing fluoroscopic versus ultrasound guided SGB. ⋯ While there appeared to be a trend favoring ultrasound guidance, no statistical significance was achieved. This was likely due to this being a limited pilot study. Numerous limitations exist in cadaveric studies, and future investigations should be completed to further study this comparison. That said, the use of the SGB may provide significant relief for patients suffering with PTSD.
-
To examine the impact of educational materials for chronic overlapping pain conditions (COPCs), the feasibility of delivering materials online, and to explore its impact on self-reported self-management applications at 3-month follow-up. ⋯ The educational materials facilitated teaching of key pain concepts in self-management programs, which translated easily into an electronic format. Education alone may not elicit self-management engagement or symptom reduction in this population; however, conclusions are limited by the study's uncontrolled design. Education is likely an important and meaningful first step in comprehensive COPC self-management.
-
About one-third of patients with multiple sclerosis (MS) suffers from chronic and excruciating central neuropathic pain (CNP). The mechanism underlying CNP in MS is not clear, since previous studies are scarce and their results are inconsistent. Our aim was to determine whether CNP in MS is associated with impairment of the spinothalamic-thalamocortical pathways (STTCs) and/or increased excitability of the pain system. ⋯ CNP in MS is characterized by a specific impairment of STTC function, the innocuous thermal pathways, and by pain hyperexcitability. Whereas CNP presence is associated with STTC impairment, its severity and extent are associated with pain hyperexcitability. Interventions that reduce excitability level may therefore mitigate CNP severity.