Pain physician
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Review Meta Analysis
The impact of genetic variation on sensitivity to opioid analgesics in patients with postoperative pain: a systematic review and meta-analysis.
Individual response to opioid analgesics varies among patients. ⋯ The results indicate that among the genetic SNPs we studied which include those affecting analgesic drug metabolism, transport of analgesic agents across the blood-brain barrier, and their activity at target receptors and ion channels and in the modulation of neurotransmitter pathways, the A118G allele variant of OPRM1 has the most potent influence on pain management of postoperative patients. Opioid receptor gene information may provide valuable information for clinicians to properly manage the analgesic use of opioids individually for better pain management.
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Randomized Controlled Trial
Effects of stellate ganglion block on sedation as assessed by bispectral index in normal healthy volunteers.
The sympathetic nervous system plays an important role in the arousal response. Recently, the stellate ganglion block (SGB) was found to effectively treat anxiety and night awakening in humans and decrease electroencephalogram (EEG) indices of arousal responses in rat. But, the role of the sympathetic block in human arousal responses has not yet been studied. ⋯ This study showed that SGB has a sedative effect in normal healthy volunteers, as evidenced by decreased OAA/S scores and BIS values.
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Randomized Controlled Trial Multicenter Study
Pressure pain and isometric strength of neck flexors are related in chronic tension-type headache.
In patients with chronic tension-type headache (CTTH) changes in pressure pain in the cervical region are associated with peripheral or central sensitization. It is hypothesized that an increase of isometric strength of neck flexors would lead to a decrease of pressure pain in CTTH, as an expression of reduced peripheral or central sensitization ⋯ Decrease in PPS correlates with increases in isometric strength of neck flexors in patients with CTTH in short- and long-term.
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The pathological entities commonly associated with lumbosacral pain are the intervertebral discs, facet joints or surrounding muscle. However, in the absence of diagnostic confirmation of the aforementioned structures, the diagnosis may become confusing and intractable. Sacroiliac fascial lipocele (SFL), namely, pannicular hernia, could be a neglected cause. ⋯ It is important to distinguish SFL some cases with lumbosacral back pain. Detailed physical examination, superficial ultrasonography and diagnostic nerve block are extremely valuable for acquiring a precise diagnosis. Overall, when considering the clinical outcome of such cases and the foregoing benefits, percutaneous endoscopic treatment could be an efficacious alternative treatment for SFL-related lumboscral back pain.