The journal of pain : official journal of the American Pain Society
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Review Meta Analysis
Efficacy and safety of transdermal buprenorphine for acute postoperative pain: A systematic review and meta-analysis.
Transdermal buprenorphine (TBUP) may have some advantages for the management of acute postoperative pain. The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of TBUP compared to other analgesics or placebo for acute postoperative pain. A systematic search was conducted using Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) until December 26, 2022. ⋯ PERSPECTIVE: This systematic review and meta-analysis compared the use of TBUP to other analgesics for postoperative pain. The results showed that there is insufficient evidence to recommend the use of TBUP in this setting. The findings will help clinicians select the most appropriate opioid regimens for postoperative pain.
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Research exploring the specific manifestations of chronic pain (CP) public stigma is scarce. One potential factor influencing public stigma manifestations may be the CP type, that is, the presence (secondary CP) or absence (primary CP) of a clearly identifiable pathophysiology. Furthermore, patient gender may play a key role, whereby pain-related gender stereotypes may evoke distinct gender role expectations towards men and women experiencing CP. ⋯ The study contributes to the literature on CP stigma, as well as the psychometric examination of items assessing stigmatizing manifestations. PERSPECTIVE: This study examined the role of contextual factors chronic pain type and patient gender into cognitive, affective, and behavioral stigmatizing manifestations coming from the general population towards individuals with chronic pain through an experimental vignette study. The study contributes to the chronic pain stigma literature, as well as the psychometric examination of items assessing stigmatizing manifestations.
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This systematic review and meta-analysis investigated the effects of non-pharmacological manipulations on experimentally induced secondary hypersensitivity in pain-free humans. We investigated the magnitude (change/difference in follow-up ratings from pre-manipulation ratings) of secondary hypersensitivity (primary outcome), and surface area of secondary hypersensitivity (secondary outcome), in 27 studies representing 847 participants. Risk of bias assessment concluded most studies (23 of 27) had an unclear or high risk of performance and detection bias. ⋯ We discuss opportunities to improve methodological rigor including manipulation checks, structured blinding strategies, control conditions or time points, and public sharing of raw data. PERSPECTIVE: We described the effects of several non-pharmacological manipulations on experimentally induced secondary hypersensitivity in humans. By shedding light on the potential for non-pharmacological therapies to influence secondary hypersensitivity, it provides a foundation for the development and testing of targeted therapies for secondary hypersensitivity.
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Self-reported pain intensity, frequently used as an outcome in randomized clinical trials (RCTs) of chronic pain, is often highly variable and could be associated with multiple baseline factors. Thus, the assay sensitivity of pain trials (ie, the ability of the trial to detect a true treatment effect) could be improved by including prespecified baseline factors in the primary statistical model. The objective of this focus article was to characterize the baseline factors included in statistical analyses of chronic pain RCTs. ⋯ Prespecified adjustments for baseline covariates that could increase precision and assay sensitivity should be considered in future clinical trials of chronic pain treatments. PERSPECTIVE: This review demonstrates inconsistent inclusion and potential underutilization of covariate adjustment in analyses of chronic pain RCTs. This article highlights areas for possible improvement in design and reporting related to covariate adjustment to improve efficiency in future RCTs.
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Review Observational Study
Pain-related beliefs, coping, and function: An observational study on the moderating influence of country of origin.
Chronic pain is a multidimensional experience and pain treatments targeting psychosocial factors reduce pain and improve function. These treatments often overlook the sociocultural factors that influence pain and the psychological factors associated with function in people with chronic pain. Although preliminary findings suggest that cultural background may influence pain and function via their effects on beliefs and coping, no previous study has directly tested if the country of origin moderates the associations between these psychological factors and pain and function. ⋯ Some modifications may be needed when adapting multidisciplinary treatments from one country to another. PERSPECTIVE: This article examines the similarities and differences in beliefs and coping endorsed by adults with chronic pain from 2 countries, and the potential moderation effects of country on the associations between these variables and pain and function. The findings suggest that some modifications may be needed when culturally customizing psychological pain treatments.