British journal of pain
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British journal of pain · Nov 2017
The psychology of chronic post-surgical pain: new frontiers in risk factor identification, prevention and management.
In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. ⋯ Psychological interventions that target known psychological risk factors while enhancing protective psychological factors may reduce new incidence of CPSP. The primary goal of our ACT intervention is to teach patients a mindful way of responding to their postsurgical pain that empowers them to interrupt the negative cycle of pain, distress, behavioural avoidance and escalating opioid use that can limit functioning and quality of life while paradoxically amplifying pain over time. Early clinical outcome data suggest that patients who receive care from TPS physicians reduce their pain and opioid use, yet patients who also receive our ACT intervention have a larger decrease in daily opioid dose while reporting less pain interference and lower depression scores.
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British journal of pain · Feb 2019
Case ReportsRetained catheter during placement of dorsal root ganglion stimulator: a case report.
Dorsal root ganglion (DRG) stimulation is a novel therapeutic option that is being increasingly utilized for patients with neuropathic pain. The potential complications during the placement of this device remain unknown. We describe a potential complication during DRG stimulator placement not previously reported in the literature. ⋯ A fragment of an introducer catheter was retained in the spinal canal and L2-L3 neural foramen. Patient underwent L2-L3 laminectomy for removal of the catheter without any complications. DRG stimulation is an effective option for intractable neuropathic pain, but the safety of the procedure and its long-term complications need to be further investigated.
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British journal of pain · Feb 2019
Attentional, interpretation and memory biases for sensory-pain words in individuals with chronic headache.
Cognitive biases in attention, interpretation and less consistently memory have been observed in individuals with chronic pain and play a critical role in the onset and maintenance of chronic pain. Despite operating in combination cognitive biases are typically explored in isolation. ⋯ The clinical implications of cognitive biases in individuals with chronic pain remain to be fully explored, although one avenue for future research would be specific investigation of the implications of biased interpretations considering the consistency of results found across the literature for this form of bias.
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British journal of pain · Nov 2018
High-frequency spinal cord stimulation causing cardiac paresthesias after lead migration: a case report.
High-frequency (HF) spinal cord stimulation (SCS), a relatively new form of spinal cord stimulation, provides stimulation frequencies of up to 10 kHz and allows for paresthesia-free pain relief, an advantage that distinguishes it from traditional stimulation therapy. Without paresthesias, patients with HF SCS do not experience position-dependent painful stimulation and do not have to experience treatment interruption during sleep. Lead migration is a well-known complication of conventional spinal cord stimulation and usually results in a loss of efficacy along with other unpleasant sensory symptoms. In this case report, we present an incidence of lead migration in HF SCS that resulted in paresthesias, a symptom not expected to occur in this novel therapy. ⋯ While HF SCS has emerged as an effective paresthesia-free means of reducing back and leg pain, we provide the first report of paresthesias occurring with the HF SCS system as a result of cephalad lead migration. As HF SCS is only now being utilized as a treatment modality, we must remain cautious of potential adverse outcomes in patients, in particular above T8.
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British journal of pain · Aug 2018
Ultrasound-guided radiofrequency ablation of genicular nerves of knee for relief of intractable pain from knee osteoarthritis: a case series.
The knee arthroplasty is the best option for patients with advanced osteoarthritis who have failed all other conservative options, but regrettably many patients fail to undergo surgery due to co-morbidities or other reasons. So, new alternative modes are always in demand for these patients. ⋯ Ultrasound-guided RFA of genicular nerves of knee joint is a good alternative option for patients who are having severe pain and disability from knee osteoarthritis and gives a long-lasting pain relief for more than 6 months.