Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial
Gabapentin does not reduce preoperative anxiety when given prior to total hip arthroplasty.
Gabapentin is an anti-epileptic drug which is also used for the treatment of postoperative pain and a variety of psychiatric diseases including chronic anxiety disorders. We tested the hypothesis that compared with a placebo control, gabapentin would reduce preoperative anxiety in patients undergoing total hip arthroplasty. ⋯ Administration of gabapentin 600 mg prior to surgery does not reduce preoperative anxiety.
-
Randomized Controlled Trial
A fMRI evaluation of lamotrigine for the treatment of trigeminal neuropathic pain: pilot study.
Using functional magnetic resonance imaging (fMRI) methods, we evaluated the effects of lamotrigine vs placebo in a double-blind 1:1 randomized trial. Six patients with neuropathic pain were recruited for the study. All subjects had baseline pain >4/10 on a visual analog scale (VAS) and allodynia to brush as inclusion criteria for the study. ⋯ Lamotrigine decreased their average pain intensity level from 5.6 to 3.5 on a VAS. All subjects had brush, cold, and heat applied to the affected and mirror-unaffected sides of their face. The results show: 1) in a small cohort, lamotrigine had a significant effect on heat VAS but not on the other stimuli; and 2) contrast analysis of fMRI results for heat stimuli applied to the affected face for lamotrigine vs placebo produced an overall decrease in blood oxygen dependent level signal, suggesting a potential inhibitory effect of the drug on predominantly cortical regions (frontal, parietal, and temporal).
-
Randomized Controlled Trial Multicenter Study
Maintenance of effect of duloxetine in patients with chronic low back pain: a 41-week uncontrolled, dose-blinded study.
To assess the maintenance of the effect of duloxetine in the treatment of chronic low back pain. ⋯ In this study, the analgesic effect of duloxetine in patients with chronic low back pain was not only maintained for 41 weeks, but additional statistically significant improvement in pain and function was observed.
-
Randomized Controlled Trial
Double-blinded, placebo-controlled, prospective randomized trial evaluating the efficacy of paravertebral block with and without continuous paravertebral block analgesia in outpatient breast cancer surgery.
Paravertebral block (PVB) is an effective alternative to general anesthesia for breast cancer surgery. Continuous paravertebral block (CPVB) anesthesia may extend postoperative analgesia at home and improve quality of early postoperative recovery of breast cancer patients. ⋯ The current study does not support the routine use of continuous paravertebral catheter anesthesia in patients undergoing operative treatment for breast cancer.
-
Randomized Controlled Trial Comparative Study
Clinical effectiveness of botulinum toxin A compared to a mixture of steroid and local anesthetics as a treatment for sacroiliac joint pain.
The sacroiliac joint (SIJ) is one of the sources of low back pain and referred pain to the lower limb. Steroid injections have been used to treat SIJ pain, but this frequently necessitates repeated injections. Botulinum toxin (BT) type A has been shown to provide significant reduction of joint pain, and functional improvements. This study investigated the efficacy of BT for reducing SIJ pain and maintaining a clinical effect, compared with steroid injections. ⋯ BT shows clinical usefulness in pain reduction and for functional improvement in patients with SIJ pain. This effect was maintained for 3 months following the injection, by which time the effects of TA had diminished.