Pain practice : the official journal of World Institute of Pain
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The reliability of pain assessment in frail and older adults has seldom been assessed. This study aims to assess the test-retest reliability of (1) the number of painful body sites, (2) pain intensity, and (3) pain extent in institutionalized older adults. ⋯ The vertical pain rating scale and the body chart seem reliable to assess pain intensity and number of pain sites, respectively. The wide CI for the ICC found for pain area and the high measurement error compromise its potential clinical relevance.
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Comparative Study Observational Study
Peripheral Nerve Blockade with Combined Standard and Liposomal Bupivacaine in Major Lower Extremity Amputation.
Optimizing perioperative analgesia for patients undergoing major lower-extremity amputation remains a considerable challenge. The utility of liposomal bupivacaine as a component of peripheral nerve blockade for lower-extremity amputation is unknown. ⋯ Peripheral nerve blockade is associated with reduced opioid requirements after lower-extremity amputation compared with general anesthesia alone. However, the incorporation of liposomal bupivacaine is not significantly different to blockade employing only standard bupivacaine.
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Clinical Trial
Long-term inhibition of soleus H-reflex with epidural adhesiolysis and pulsed radiofrequency in lumbosacral neuropathic pain.
Scientific data about neurophysiological changes subsequent to pulsed radiofrequency (PRF) are still lacking. The goal of this study was to evaluate sural nerve conduction and Hoffmann reflex (H-reflex) in soleus muscle following adhesiolysis and PRF in patients with unilateral chronic lumbosacral L5-S1 neuropathic radiating pain. ⋯ Epidural adhesiolysis and PRF of the dorsal root ganglion seem to significantly affect spinal reflexes in patients with lumbosacral neuropathic radiating pain.
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Trigeminal neuralgia (TN) is the most common cause of facial pain, leading to significant disability and impacting a patient's quality of life. Percutaneous procedures like continuous radiofrequency, pulsed radiofrequency (PRF), and combined continuous and pulsed radiofrequency have been studied in past years comparing different voltages in order to find more effective therapies with fewer complications (eg, numbness and masseter muscle weakness). With regard to young patients, there is still insufficient evidence on the most appropriate procedure in this patient population. PRF does not cause thermal damage. The mechanism of action involves delivering an electrical field to targeted nerves or tissues, modulating pain. We propose that bipolar pulsed radiofrequency (2 parallel cannulas) in the trigeminal ganglion produce a denser and larger field resulting in more effective controlled pain. ⋯ Bipolar PRF could be a non-neurodestructive option for young people with TN and deserves further investigation as a treatment option.
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Review Meta Analysis
A Meta-Analysis of Therapeutic Pain Neuroscience Education, Using Dosage and Treatment Format as Moderator Variables.
This meta-analysis aimed to assess the overall effect of therapeutic pain neuroscience education (TPNE) on chronic musculoskeletal pain and to further assess whether such an effect differs by TPNE dosage as well as other treatment format components. Dosage included the number of TPNE sessions provided as well as the amount of time per TPNE session. Structural components included TPNE provided alone as treatment or combined with other pain management modalities, as well as the inclusion of group-based treatment sessions. ⋯ This meta-analysis examined the efficacy of TPNE for patients with chronic pain. It assessed various pain outcome measures following intervention. In addition, this research identified that various moderator variables do not have and do have an impact on the treatment modality of TPNE.