Pain physician
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Neuropathic pain occurs for various reasons involving adenosine receptors. One of several drugs used to control neuropathic pain is amitriptyline, a tricyclic antidepressant. Amitriptyline has an antinociceptive effect on the A3 adenosine receptor (A3AR). However, the exact mechanisms underlying A3AR activation remain unclear. ⋯ The release of proinflammatory cytokines via NF-kB expression and subsequent inflammatory responses is significantly associated with the development of neuropathic pain. Our study reveals that AMI effectively suppresses NF-kB-related proinflammatory cytokines, offering a promising avenue for treating pain related to peripheral nerve injuries. These findings provide valuable insights into neuropathic pain management.
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Randomized Controlled Trial
A Placebo-Controlled Randomized Trial Comparing Oral Midazolam, Dexmedetomidine, and Gabapentin on Prophylaxis of Emergence Agitation After Sevoflurane Anesthesia in Adenotonsillectomy.
Sevoflurane causes emergence agitation (EA) in up to 80% of pediatric patients. ⋯ Premedication using oral midazolam, DEX, or gabapentin reduced the incidence of EA, and DEX provided the best sedation and hemodynamics of all.
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Chronic low back pain is a global health burden with significant health care costs. Accurate diagnosis and treatment are often complicated due to its multifactorial nature. The sacroiliac joint has been identified as a major source of lower back pain, especially among the elderly and individuals with a history of lumbar fusion surgery. Conservative treatments frequently fall short in providing relief, leading to the exploration of alternative interventions such as sacroiliac joint radiofrequency ablation (RFA). ⋯ Adipose interference is minimized when a protruding electrode RFA needle is used within a posterior sacral foramen; neural approximation may be enhanced by giving 2% lidocaine prior to ablation. Considerable gaps in knowledge still exist despite advances in our understanding of the effect of tissue on RFA. Thorough research aimed at refining RFA procedures is essential to ensuring the best feasible patient care and sustainable pain relief. For sacroiliac joint RFA, perineural lateral branch ablation is a viable option that needs further clinical research.
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Cancer-related neuropathic pain significantly affects patients' quality of life. Despite existing treatments, pain control remains inadequate for many of these patients. There is a lack of strong evidence for the efficacy of the combination of pregabalin, which is often used to treat neuropathic pain, and opioids for treating cancer-related neuropathic pain. ⋯ Pregabalin combined with opioids reduces cancer-related neuropathic pain but increases dizziness, somnolence, and peripheral edema, thus supporting its use in the clinic for treating cancer-related neuropathic pain. However, further high-quality randomized controlled trials are needed to confirm these findings.