Articles: pain-management-methods.
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Minerva anestesiologica · Jul 2015
Review Meta AnalysisThe evidence of peripheral nerve blocks for cancer-related pain: a systematic review.
The European Association for Palliative Care has initiated a comprehensive program to achieve an over-all review of the evidence of multiple cancer pain management strategies in order to extend the current guideline for treatment of cancer pain. The present systematic review analyzed the existing evidence of analgesic efficacy for peripheral nerve blocks in adult patients with cancer. A search strategy was elaborated with words related to cancer, pain, peripheral nerve and block. ⋯ In general, most cases reported good pain relief and no side effects. The use of peripheral blocks is based upon anecdotal evidence. However, this review only demonstrates the lack of studies, which does not equal a lack of effectiveness.
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Cochrane Db Syst Rev · May 2015
Review Meta AnalysisCognitive-behavioural treatment for subacute and chronic neck pain.
EXPRESSION OF CONCERN - Professor Marco Monticone has acted as the first author of this Cochrane review. Readers should be informed that multiple randomized controlled trials authored by Professor Monticone have been scrutinized because of potential research integrity issues, including irregularities in the data (doi:10.1097/j.pain.0000000000002659). One of the trials suspected of research integrity issues is included in this Cochrane review (doi:10.1007/s00586-012-2287-y). The Cochrane editorial team has concerns about the trustworthiness of the trial data and is applying Cochrane's policy on managing potentially problematic studies (https://www.cochranelibrary.com/cdsr/editorial-policies#problematic-studies). No major differences to the conclusions of this review were found after performing a sensitivity analysis on the main outcomes, whether the potentially problematic trial was included or excluded. Cochrane will take further action as needed on this review once additional investigations into the potentially problematic trial are concluded. In the meantime, a new version of this review topic is underway with a new author team. The new review will supersede this review. ⋯ With regard to chronic neck pain, CBT was found to be statistically significantly more effective for short-term pain reduction only when compared to no treatment, but these effects could not be considered clinically meaningful. When comparing both CBT to other types of interventions and CBT in addition to another intervention to the other intervention alone, no differences were found. For patients with subacute NP, CBT was significantly better than other types of interventions at reducing pain at short-term follow-up, while no difference was found for disability and kinesiophobia. Further research is recommended to investigate the long-term benefits and risks of CBT including for the different subgroups of subjects with NP.
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Cochrane Db Syst Rev · May 2015
Review Meta AnalysisPsychological therapies for sickle cell disease and pain.
Sickle cell disease comprises a group of genetic blood disorders. It occurs when the sickle haemoglobin gene is inherited from both parents. The effects of the condition are: varying degrees of anaemia which, if severe, can reduce mobility; a tendency for small blood capillaries to become blocked causing pain in muscle and bone commonly known as 'crises'; damage to major organs such as the spleen, liver, kidneys, and lungs; and increased vulnerability to severe infections. There are both medical and non-medical complications, and treatment is usually symptomatic and palliative in nature. Psychological interventions for individuals with sickle cell disease might complement current medical treatment, and studies of their efficacy have yielded encouraging results. This is an update of a previously published Cochrane Review. ⋯ Evidence for the efficacy of psychological therapies in sickle cell disease is currently limited. This systematic review has clearly identified the need for well-designed, adequately-powered, multicentre randomised controlled trials assessing the effectiveness of specific interventions in sickle cell disease.
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Complement Ther Clin Pract · May 2015
Review Meta AnalysisAuricular therapy for chronic pain management in adults: A synthesis of evidence.
To evaluate the efficacy and safety of auricular therapy (AT) on chronic pain. ⋯ AT may positively control pain intensity for patients with chronic pain. However, due to the significant heterogeneity and methodological flaws identified in the analyzed trials, the current evidence on AT for chronic pain management is still uncertain. More rigorously designed large-scale randomized controlled trials are required to evaluate the efficacy of AT for patients with chronic pain.
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Cochrane Db Syst Rev · Mar 2015
Review Meta AnalysisEndoscopic or surgical intervention for painful obstructive chronic pancreatitis.
Endoscopy and surgery are the treatment modalities of choice for patients with chronic pancreatitis and dilated pancreatic duct (obstructive chronic pancreatitis). Physicians face, without clear consensus, the choice between endoscopy or surgery for this group of patients. ⋯ For patients with obstructive chronic pancreatitis and dilated pancreatic duct, this review shows that surgery is superior to endoscopy in terms of pain relief. Morbidity and mortality seem not to differ between the two intervention modalities, but the small trials identified do not provide sufficient power to detect the small differences expected in this outcome.Regarding the comparison of surgical intervention versus conservative treatment, this review has shown that surgical intervention in an early stage of chronic pancreatitis is a promising approach in terms of pain relief and pancreatic function. Other trials need to confirm these results because of the methodological limitations and limited number of participants assessed in the present evidence.