Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial
Efficacy of Continuous Intrathecal Infusion Trialing with a Mixture of Fentanyl and Bupivacaine in Chronic Low Back Pain Patients.
Intrathecal trialing is used as a screening prognostic measure prior to intrathecal drug delivery system implant. The purpose of this study was to determine the efficacy of a continuous intrathecal infusion of an admixture of bupivacaine and fentanyl in patients with chronic low back pain. Patients with refractory chronic low back pain in the setting of previous lumbar spine surgery and/or chronic vertebral compression fracture(s) were enrolled in a randomized double blind cross-over study comparing saline infusion to infusion of a solution containing bupivacaine combined with low-dose fentanyl over a 14-18 hour period. ⋯ At 12 months following implant, primary and secondary outcome measures continued to be significantly reduced from baseline. Continuous intrathecal delivery of a combination of zlow-dose fentanyl with bupivacaine is superior to saline in screening intrathecal trialing for back pain reduction. With longer term delivery, a sustained reduction of chronic low back pain was also observed.
-
Randomized Controlled Trial
Randomized Controlled Study to Evaluate the Efficacy and Safety of Soticlestat as Adjunctive Therapy in Adults with Complex Regional Pain Syndrome.
The objective was to investigate the efficacy and safety of soticlestat as adjunctive therapy in participants with complex regional pain syndrome (CRPS). ⋯ Adjunctive soticlestat treatment did not significantly reduce pain intensity in participants with chronic CRPS.
-
Randomized Controlled Trial
Ultrasound-guided Genicular Nerve Radiofrequency Treatment-Three- versus Five-Nerve Protocol: Prospective Randomized Comparative Trial.
Genicular nerve radiofrequency procedures increasingly are being performed to treat chronic pain due to knee osteoarthritis. Targeting additional sensory nerves and improving target identification by using ultrasound guidance could improve treatment success. The aim of this study was to compare the effectiveness of targeting only the traditional genicular nerves versus targeting the traditional genicular nerves plus 2 additional sensory nerves in ultrasound-guided genicular nerve radiofrequency procedures in patients with chronic knee osteoarthritis. ⋯ The ultrasound-guided 5-nerve-targeted technique is a safe method and a more effective therapeutic procedure than the traditional 3-nerve-targeted technique for chronic knee osteoarthritis.
-
Randomized Controlled Trial
Transcranial direct current stimulation to reduce chronic pelvic pain in endometriosis: Phase II Randomized Controlled Clinical Trial.
It is known that various chronic pain conditions lead to maladaptive changes in the central nervous system. Endometriosis is frequently associated with chronic pelvic pain (CPP). Its sufficient treatment remains a clinical challenge. Transcranial direct current stimulation (tDCS) has been shown to be a powerful method to reduce chronic pain. Therefore, this study aimed to investigate pain reduction via anodal tDCS in patients with endometriosis and CPP. ⋯ The present study provides evidence that tDCS is an effective therapy for pain reduction in endometriosis-associated CPP. The results support the notion that CPP is developed and maintained in the central nervous system, making a multimodal pain therapy necessary.
-
Randomized Controlled Trial
A 4-Week Morning Light Treatment with Stable Sleep Timing for Individuals with Fibromyalgia: A Randomized Controlled Trial.
Fibromyalgia is characterized by chronic widespread pain, mood, and sleep disturbance. Pharmacological treatments have modest efficacy and are associated with negative side effects, and alternative approaches are needed. Morning bright light treatment may assist in the management of fibromyalgia as it can reduce depressive symptoms, improve sleep, and advance circadian timing. ⋯ Findings indicate that the effects of a morning bright light treatment did not exceed those of a comparison dim light treatment; yet the changes on average in both conditions revealed clinically meaningful improvements. Future research is warranted to identify what elements of this trial may have contributed to the observed effects.