Pain practice : the official journal of World Institute of Pain
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Randomized Controlled Trial Clinical Trial
The relation between the duty cycle and anesthetic effect in lidocaine iontophoresis using alternating current.
We assessed the effect of the duty cycle on the anesthetic effect during lidocaine alternating current (AC) iontophoresis. A solution of 2% lidocaine was delivered to the medial antecubital skin for 20 minutes using AC iontophoresis with a duty cycle of 60%, 70%, or 80%. ⋯ TT were significantly elevated at 0 minutes in the group treated with a 60% duty cycle. The anesthetic effect was significantly enhanced in a duty cycle-dependent manner.
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Randomized Controlled Trial Comparative Study
A comparative subjective assessment study of PENNSAID® and Voltaren Gel®, two topical formulations of diclofenac sodium.
Osteoarthritis (OA) is a chronic degenerative joint disease that is debilitating for many individuals. While oral nonsteroidal anti-inflammatory drugs (NSAIDs) remain a common and effective treatment approach to managing OA, concerns over cardiovascular and gastrointestinal adverse events can potentially limit their use. Various formulations of topical NSAIDs have been shown to provide effective localized treatment with minimal adverse events. ⋯ Overall, each drug's application was well tolerated and no adverse events were reported. Results of the patient preference survey demonstrated that topical diclofenac solution with DMSO had a number of characteristics that were rated significantly better than for diclofenac sodium gel. Mean subjective responses to topical diclofenac solution with DMSO were also more favorable for most items in the questionnaire, and more subjects preferred or highly preferred topical diclofenac solution with DMSO over diclofenac sodium gel.
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This study's objective was to systematically review the literature to assess analgesic outcomes of intravenous (IV) acetaminophen for acute postoperative pain in adults. ⋯ In aggregate, these data indicate that IV acetaminophen is an effective analgesic across a variety of surgical procedures.
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Meralgia paresthetica (MP) is a neurological disorder of the nervus cutaneous femoris lateralis (lateral femoral cutaneous nerve) (LFCN) characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. Medical history and neurological examination are essential in making the diagnosis. However, red flags such as tumor and lumbar disc herniations must be ruled out. ⋯ Anatomical variants of the LFCN occur in a quarter of patients and may be the reason for negative response to diagnostic blocks. For interventional treatment of MP, such as local injection with anesthetics and corticosteroids or pulsed radiofrequency treatment of the LFCN, the evidence is limited. In particular, pulsed radiofrequency treatment of the LFCN should only take place in a study context.
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Chronic pain affects a substantial part of the population, and conveys a huge economic cost to society. Owing to its prevalence and adverse impact, it is of particular interest to clinicians, patients, and the pharmaceutical industry. Conversely, the effects of pain on sleep, sleep on pain, and opioid analgesics on sleep represent a large gap in our understanding, even though pain and sleep are closely linked, inter-related conditions. ⋯ The effects of opioids vary according to their formulation and duration of action, and have diverse effects on sleep processes. Despite the prevalence of this problem, there is a surprising paucity of data on the effects of opioids on sleep. This review attempts to summarize the links between pain and sleep, and to look at the studies with opioid analgesics, particularly those with extended-release formulations, that have investigated the effects of opioid analgesics on sleep.