Pain physician
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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.
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Recent research underscores the potential of intradiscal biologics, such as mesenchymal stem cells (MSCs), platelet-rich plasma (PRP), and alpha-2-macroglobulin, in promoting chondrogenesis within lumbar intervertebral discs as a treatment for discogenic low back pain. Studies indicate significant improvements in pain relief, physical function, and overall quality of life following these interventions. ⋯ This systematic review and single-arm meta-analysis suggest that intradiscal injections of MSCs and PRP may be effective in managing discogenic low back pain, supported by Level III evidence.
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Hip osteoarthritis is a joint disease that causes worsening pain and inhibits activities of daily living. Due to poor pain control and the function of usual clinical treatment, joint infiltration with orthobiologics is a therapeutic alternative. Among these, bone marrow aspirate (BMA) represents a cellular therapy with promising clinical results. ⋯ In this meta-analysis, joint infiltration with BMA or BMC was associated with an improvement in pain and quality of life in patients with hip osteoarthritis. Further randomized studies are needed to improve the quality of evidence.
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Meta Analysis
Regional Analgesia Techniques Following Thoracic Surgery: A Systematic Review and Network Meta-analysis.
Regional analgesia techniques have become the basis of multimodal analgesia for acute and chronic pain. They are widely used in thoracic surgery, but the best treatment is still uncertain. ⋯ The cTEA and cSAPB techniques are more likely to reduce the cumulative opioid consumption within 24 hours. The cTEA, cSAPB, ESPB techniques were more likely to improve pain at postoperative 6, 12, and 24 hours. Therefore, cTEA, cSAPB, and ESPB are the first choices for pain relief post thoracic surgery, whereas wound infiltration, intercostal block, continuous wound infiltration, and continuous intercostal block were less likely to be effective. We need more high-quality randomized controlled trials with larger sample sizes to validate our results and to determine the ideal regional analgesia technique and the optimal drug formula.
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Meta Analysis
Mindfulness Meditation for Fibromyalgia Syndrome: A Systematic Review and Meta-analysis.
The effectiveness of mindfulness meditation (MM) for the treatment of fibromyalgia syndrome (FMS) is unknown and needs to be updated. ⋯ Very low to moderate evidence shows that MM improves quality of life, relieves stress, and relieves insomnia and depression in patients with FMS in the short-term. Notably, the improvement in depression and stress levels continued into the medium-term period. Furthermore, quality of life improvement was discernible at long-term follow-up. This suggests that MM can be used as an adjunct therapy for FMS.International Prospective Register of Systematic Reviews (PROSPERO) Registration Number: CRD42023442356.