Pain medicine : the official journal of the American Academy of Pain Medicine
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The justification for this review is the need for high-quality evidence to assist in the decision-making process when applying percutaneous electrical nerve stimulation (PENS) or transcutaneous electrical nerve stimulation (TENS) in a clinical setting. The main aim was to determine if the use of PENS is more effective and should be recommended when compared to TENS for the reduction of musculoskeletal pain intensity. ⋯ There is low-quality of evidence for more pain intensity reduction with PENS, but the difference was not clinically significant. However, when only studies with low risk of bias are meta-analyzed, there is a moderate quality of evidence that there is no difference when TENS or PENS is applied for pain intensity.
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To provide an estimate of the effectiveness of basivertebral nerve (BVN) radiofrequency ablation (RFA) to treat vertebrogenic low back pain (LBP). ⋯ According to GRADE, there is moderate-quality evidence that BVN RFA effectively reduces pain and disability in most patients with vertebrogenic LBP. Further high-quality studies will likely improve our understanding of the effectiveness of this procedure.
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Meta Analysis
Effectiveness of Repetitive Transcranial Magnetic Stimulation on Managing Fibromyalgia: A Systematic Meta-Analysis.
In fibromyalgia, central sensitization is a key mechanism, and repetitive transcranial magnetic stimulation (rTMS) has been reported to potentially manage symptoms of fibromyalgia. In this meta-analysis, we evaluated the therapeutic effect of rTMS in patients with fibromyalgia according to stimulation locations and follow-up time points. ⋯ High-frequency rTMS had a positive pain-reducing effect immediately and at 1-4 weeks after completion of the rTMS sessions, and the patients' quality of life improved after 5-12 weeks. However, Lt. DLPFC stimulation was not effective in controlling fibromyalgia symptoms.
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The purpose of our study was to perform a systematic review and meta-analysis of randomized, blinded, placebo-controlled studies that, following third-molar extraction, utilized either a combination of acetaminophen (600 mg) with codeine (60 mg) or ibuprofen (400 mg) for pain management. ⋯ Our data indicate that single dose of ibuprofen (400 mg) is an effective pain reducer for post third molar extraction pain.
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To evaluate the efficacy of ultrasound-guided single-shot quadratus lumborum block (QLB) for postoperative analgesia in adults following total hip arthroplasty (THA). ⋯ QLB as part of multimodal analgesia did not result in any significant analgesic benefits in patients undergoing hip arthroplasty in terms of either postoperative opioid consumption or pain scores at rest and on movement. Overall, the level of certainty is low. Further, well-designed trials are required to verify the results.