Pain practice : the official journal of World Institute of Pain
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This study was conducted to provide information regarding prevalence of pain, type of provider managing pain, and use of Internet for information regarding pain, among patients coming for presurgical anesthesia consultation at a major academic institution. ⋯ Patients are presenting for surgery with significant pre-operative pain issues. Knowing this information pre-operatively will help healthcare personnel manage postsurgical pain more effectively. Patients are also using the Internet to obtain information regarding pain. As providers, there may be value to directing patients to reliable information online during consultation. As all physicians will eventually be managing chronic pain in their patients, pain education should be given priority in medical school curriculum.
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Diabetic lumbosacral radiculoplexus neuropathy (DLRPN) is a rare painful peripheral neuropathic complication of diabetes mellitus. The clinical features of DLRPN include severe neuropathic pain, weakness, atrophy, and sensory loss in the lower limbs with asymmetrical distribution. Nerve ischemia due to inflammation and microvasculitis has been suggested as the pathophysiological mechanism for DLRPN. ⋯ We measured serum cytokines before and after IVIg; serum tumor necrosis factor α was increased when the patient reported pain and normalized after IVIg in parallel with pain improvement. Our data extend the notion that some types of pain, including peripheral neuropathic pain, may respond to IVIg and give some clue on the mechanism of this therapeutic effect. They are also consistent with the suggested role of the immune system in the pathophysiology of neuropathic pain and offer support to the hypothesis that cytokines may contribute to the pathogenesis of neuropathic pain.
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Comparative Study
Treatment of Neuropathic Pain with the Capsaicin 8% Patch: Is Pretreatment with Lidocaine Necessary?
The capsaicin 8% patch can effectively treat neuropathic pain, but application can cause discomfort or a burning sensation. Until March 2013, it was recommended that patients be pretreated with a topical anesthetic, for example lidocaine, before capsaicin patch application. However, speculation existed over the need for pretreatment and its effectiveness in alleviating treatment-associated discomfort. ⋯ The same proportion of pretreated and non-pretreated patients reported willingness to receive retreatment with the capsaicin patch. This analysis shows that the capsaicin 8% patch is generally tolerable, and the small discomfort associated with patch application is short-lived. Lidocaine pretreatment does not have a significant effect on tolerability, efficacy, or patient willingness to receive retreatment.
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Randomized Controlled Trial
A Randomized Controlled Study to Compare the 2% Lignocaine and Aqueous Lubricating Gels for Female Urethral Catheterization.
The 2% lignocaine gel has long been used for male urethral catheterization, but aqueous gel as lubricant has been used for females. However, studies report that females experience pain during urethral catheterization. We compared the effectiveness of 2% lignocaine gel (intervention) and aqueous gel (control) for female urethral catheterization in reducing procedural pain. ⋯ The 2% lignocaine gel significantly reduces the procedural pain of female urethral catheterization as compared with aqueous gel. This study provides evidence for the hospital to change the current practice in the hope of reducing procedural pain for female patients during urethral catheterization.